March 24, 2020

Hospital workers express worry about lack of testing, protective gear

Airman 1st Class Elora J. Martinez/U.S. Air Force

Senior Airman Alexis Lopez, dental assistant with the 319th Medical Group, demonstrates proper sanitary procedure by putting on a face mask at the medical treatment facility at Grand Forks Air Force Base, N.D., Sept. 7, 2017.

Frontline clinicians in Albuquerque — the hospital workers most likely to come into direct contact with contagious patients — face rationing of personal protective equipment, or PPE, and are not being tested for COVID-19 unless they start to show symptoms, hospital officials and state officials have confirmed. 

So far, nine patients have been hospitalized in New Mexico, including one Arizona resident, the governor said Monday. 

But hospitals are preparing for many more. Presbyterian hospitals in Albuquerque and elsewhere in the state are setting up outdoor triage and intake tents, for example.

Some hospital workers are concerned they could infect patients and peers before they develop COVID symptoms, or take the disease home to loved ones. 

“We expect to catch it, especially in the [Emergency Department],” one Albuquerque emergency room nurse told New Mexico In Depth, which is withholding that person’s name because of a fear of employer retribution. “Health care workers have rights to PPE and that right is being violated. We are being given equipment but [are] asked to reuse it in an unsafe manner. I get it but we should have been prepared as an organization, as a state, as a nation.”

New Mexico In Depth has heard similar concerns from other Albuquerque health care workers, who’ve indicated the concerns are widespread among their colleagues.

Despite reports that people might spread COVID-19 before they show symptoms, New Mexico hospital emergency department and Intensive Care Unit (ICU) workers will not be tested until they become symptomatic, state and hospital officials acknowledged Monday. 

State and federal COVID-19 response guidelines do not require that asymptomatic clinicians be tested. Tests have been in short supply statewide and nationwide.

“We are trying to avoid shortages, that’s why we’re limiting testing currently to those with symptoms,” said Department of Health spokesman David Morgan, referring to test kits and protective gear.

Once ICU and ER workers show symptoms of COVID-19, their tests will be prioritized by the state health lab and TriCore Reference Labs, Jodi McGinnis Porter of the New Mexico Human Services Department wrote in an email.

Symptomatic hospital workers in New Mexico will be “isolated and excluded from work,” McGinnis Porter wrote.

The CDC website on COVID-19 transmission states: “Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.”

Presbyterian staff could be tested if they are asymptomatic but have a high risk of exposure according to CDC guidelines, said Jeff Salvon-Harman, M.D., chief patient safety officer and medical director for infection control at Presbyterian Healthcare Services. Those guidelines for issuing personal protective gear, and when to restrict medical providers from work after exposure to a COVID-19 patient, rely on a number of factors characterized from low to high exposure risk. 

The hospital will “assess” staff for exposure risk before they return to work after being exposed to COVID-19 patients, Salvon-Harman said, citing state health department policy and U.S. Centers for Disease Control and Prevention (CDC) guidelines. “COVID-19 testing depends on the exposure risk of the staff member and follows CDC and NMDOH guidelines.”

Officials at Lovelace Health System did not respond to a question about testing asymptomatic clinicians. 

Nurses have been told to store and reuse masks, Albuquerque-area hospital workers have told New Mexico In Depth.

Presbyterian Hospital, UNM Hospital and the VA Medical Center are all carefully allocating personal protective gear like gowns, gloves, hooded protective suits, face shields and N95 respirators to clinical staff who come into direct contact with patients, according to hospital workers and officials contacted by New Mexico In Depth.

“Even though we are not concerned about running out of supplies right now, we are being cautious and judicious with these items to ensure we continue to have supplies for our staff treating suspected or confirmed COVID-19 patients,” UNM Hospital spokesman Mark Rudi wrote in an email.

This article first appeared on New Mexico In Depth and is republished here under a Creative Commons license.