Here & Now

COVID-19 Preparedness in UW-Hospital and Clinics

Frederica Freyberg:

While work is ongoing in Washington to help prevent medical supply shortages, doctors on the front line of the coronavirus outbreak are living it including Dr. Nasia Safdar, medical director of Infection Control at UW Hospital and Clinics in Madison. She’s also a professor of infectious disease and joins us now. Thanks very much for being here.

Nasia Safdar:

Thank you.

Frederica Freyberg:

We know your hospital treated the first and to date only person with coronavirus who has now recovered. But increasing number of tests are being done right now. What is your expectation as to the progression or how this develops?

Nasia Safdar:

I think we’re seeing global spread of the virus. Every day there is increasing number of cases being reported. I think it seems inevitable it will arrive here as well.

Frederica Freyberg:

Your hospital has instituted its preparedness plan including a hotline number which we want to just put up on the screen that is 608-720-5300. Who should use that hotline? What is it for?

Nasia Safdar:

Generally it’s for the public, UW health patients, those that might have questions about whether their symptoms need to be evaluated or if they have particular concerns about travel and symptoms.

Frederica Freyberg:

And how does that work? If someone feels they need to be seen, the expectation is not that they would just walk into the emergency room. Is that right?

Nasia Safdar:

Yes, I think an important aspect of containment is we want to be able provide the best care possible in all settings. We recommend that people call for two reasons. One is to evaluate whether one really needs to be seen, or are the symptoms mild that they would recover on their own. The other is to prepare the health system and healthcare workers and so on to receive them and provide the safest care possible.

Frederica Freyberg:

And yet, you must have had through your hospital and emergency room some of these people coming in suspecting that they had this virus.

Nasia Safdar:

Yes, that’s correct.

Frederica Freyberg:

And what do you do? How does that protocol work in terms of being prepared for that?

Nasia Safdar:

I think the protocol works is that we first screen to see what the risk is of COVID-19. Since we haven’t had any additional cases in Wisconsin thus far, we’re still focusing on travel and exposure to known cases to the extent the patient may be aware of. And then if there is such a risk, then what we do is we place them in these private rooms that are negative pressure rooms as recommended by the CDC. The healthcare workers will gown and glove and put on a respirator and then go in to assess them. Even though we’re of course focusing on diagnostic testing for COVID-19, there are other viruses that also need to be evaluated and tested for.

Frederica Freyberg:

Your plan also includes conserving personal protective equipment like masks, gloves, hand sanitizer. What’s the status of the stocks in your hospital of these things and what are you doing to conserve?

Nasia Safdar:

I think from the preparedness standpoint you just have to prepare a progressive escalation plan. So what do you do if there are a few patients? What do you do if there’s a few more than that and then if there’s a true surge? The way we conserve personal protective equipment is that ordinarily if there is no prospect of an eminent shortage or anything like that you would use a mask, which is a respirator in this case for healthcare workers. You would use it for one encounter and then you would dispose of it. But the CDC has guidance about how to extend the life of these respirators by reusing them for the same patient in multiple encounters. So those are things we have instituted. We think it’s really important only essential people enter the room of somebody who’s being evaluated and tested to preserve pp for the same reason so that’s being instituted as well. Then keeping a really close eye on inventory and auditing it to make sure usage is going as planned.

Frederica Freyberg:

Do you have any shortages of things like IV bags and even medicines?

Nasia Safdar:

At the moment that doesn’t seem to be the case. I think as things progress and escalate, we’ll just keep a really close eye on those things as well.

Frederica Freyberg:

In terms of escalation and progression, what concerns do you have about staff shortages in the event of a widespread outbreak?

Nasia Safdar:

I think what we’ve learned from other places that have experienced it is staff shortages are likely to occur if there are a number of cases in the health system and to be able to plan for that. It means being flexible and creative in thinking how best can the workforce be put to use. So for example, if a healthcare worker has to be out of work because for whatever reason they were exposed to somebody with COVID-19, they might feel well. Then in that case can telemedicine be used as a way to still allow them to participate in patient care. Individuals may be thinking about being flexible with the work they normally do and being able to do different work because as MD-trained physicians, we can be flexible in work. As can other members of the workforce.

Frederica Freyberg:

All right doctor. Thank you very much for your information.

Nasia Safdar:

Thank you.