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COVID-19: Occupational Health, 7/30 · The SHEA Podcast

• 0:08
  SPEAKER_01: Welcome to the Rapid Response Podcast brought to you by the Society for Healthcare Epidemiology of America, today, promoting the prevention of healthcare-associated infections and antibiotic resistance, and seeking to advance the field of healthcare epidemiology and antibiotic stewardship.
• 0:24
  SPEAKER_01: I'm Dr.
• 0:25
  SPEAKER_01: Sandy Crettis, a specific professor of epidemiology at the University of Florida, and a health service moderator.
• 0:39
  SPEAKER_01: As we go to this healthcare together, the 24th episode of this podcast.
• 0:46
  SPEAKER_01: COVID-19 update is what we know.
• 0:54
  SPEAKER_01: And the 5th Professor of Education at Washington University and the COVID.
• 0:58
  SPEAKER_01: And the 15th hospital at the healthcare at Park Code Hospital.
• 1:03
  SPEAKER_01: And the leader for occupational health for COVID-19 at Warkent University.
• 1:07
  SPEAKER_01: Thank you for joining us today.
• 1:09
  SPEAKER_01: Before we begin our discussion, I'll get started with a new update of the week.
• 1:20
  SPEAKER_01: And 655,000 data.
• 1:23
  SPEAKER_01: There have been 4.3 million cases in the US and nearly 150,000 data.
• 1:29
  SPEAKER_01: And conservative focus is a writing number of data and calls code data.
• 1:34
  SPEAKER_01: There were some hundred interesting factors.
• 2:10
  SPEAKER_01: Researchers will also look for addresses whether the data data for that code type effects.
• 2:16
  SPEAKER_01: And whether one type effective code ID researchers look for the result of the AD research, have the vaccinated with add or whatever microcontroller.
• 2:32
  SPEAKER_01: And then how does it work?
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  SPEAKER_01: And the extracurricular both the low dose and high dose groups have lower levels of hard code to R and the control group in BIL and the MIDI level.
• 3:11
  SPEAKER_01: Which is not typically associated with vaccinated associated respiratory data.
• 3:18
  SPEAKER_01: Which has been associated with results of the dose dependent increase at age one, four weeks after vaccination, but low detectable levels of age two.
• 3:29
  SPEAKER_01: I now want to move into a discussion with Dr.
• 3:31
  SPEAKER_01: Kwan.
• 3:32
  SPEAKER_01: So one of the most concerning things that happened at the start of the COVID pandemic was potential lack of access to appropriate PPE.
• 3:40
  SPEAKER_01: And there's also a lot of confusion about what was the appropriate PPE for certain tasks within the healthcare system.
• 3:47
  SPEAKER_01: So how did occupational health make sure that credible information was getting out to our healthcare workers?
• 3:53
  SPEAKER_00: So this is an extremely important question.
• 3:56
  SPEAKER_00: To really keep healthcare professionals and patients safe, we at Occupational Health had to adapt our practices and policies in real time in response to emerging evidence, limited supplies, and evolving policies by public health and professional organizations.
• 4:11
  SPEAKER_00: So in the face of these unprecedented obstacles and PPE shortage, we were challenged with making swift adjustments.
• 4:17
  SPEAKER_00: We had to get very creative in an effort to mitigate risk and maximize safety for patients and healthcare workers.
• 4:23
  SPEAKER_00: Let me give you some examples.
• 4:25
  SPEAKER_00: So we and many peer institutions had to optimize PPE use with extended use and reuse policy.
• 4:32
  SPEAKER_00: And here at Washington University and BJC, we started to reprocess N95 respirators for reuse, and we even had our medical students volunteer to work and make space shields that could be used for healthcare professionals.
• 4:45
  SPEAKER_00: And to answer your second question, a key part of making sure that we got credible information to healthcare professionals was through open communication.
• 4:53
  SPEAKER_00: We partnered with communications teams and used COVID-19 specific newsletters, video interviews, town halls, websites, and social media to provide real-time updates on our occupational health policies, PPE use policies, and strategies.
• 5:08
  SPEAKER_00: In addition, Dr.
• 5:09
  SPEAKER_00: Babcock and I went to the COVID-19 wards, emergency rooms, ICUs, and we just talked to people.
• 5:15
  SPEAKER_00: We asked them what works, what doesn't work, and we tried to answer any questions they may have, and we tried to make sure that they had what they needed.
• 5:23
  SPEAKER_00: That one-on-one interaction was really essential to informing us what is going on and also to offer credible information to healthcare providers.
• 5:31
  SPEAKER_01: Those partnerships, you know, both for the PPE and then also for your communications, sound really critical and really important.
• 5:39
  SPEAKER_01: And how has occupational health taken a more active role as a result of COVID-19?
• 5:44
  SPEAKER_00: With the goal of providing healthcare professionals with what they need, we have definitely taken a bigger spotlight in the setting of the pandemic.
• 5:51
  SPEAKER_00: The biggest thing I've noticed is that more people than ever are interested in occupational health, and I've never felt so popular in my life.
• 5:59
  SPEAKER_00: Given the impact of COVID-19 on healthcare professionals, both university and hospital leaders are very interested in supporting AU health policies and procedures because they directly impact the ability to keep our workforce healthy and take care of patients.
• 6:14
  SPEAKER_00: And for us, we saw this as a great opportunity.
• 6:17
  SPEAKER_00: We were fortunate to have resources provided to us to build our AU health systems.
• 6:22
  SPEAKER_00: For example, my position within occupational health did not exist pre-COVID, and Dr.
• 6:27
  SPEAKER_00: Hilary Babcock, our medical director for occupational health at BJH, Barnes Jewish Hospital, and my mentor was the sole ID provider doing this work in any official capacity.
• 6:37
  SPEAKER_00: After COVID-19, I was brought on board to help support our nearly 50,000 employees across the BJC Health System and Washington University.
• 6:46
  SPEAKER_00: I've also noticed that occupational health is really being brought to the table often for important policies all throughout the healthcare system.
• 6:54
  SPEAKER_00: For example, occupational health and infection prevention are central players at our incident command centers, and we are involved in many of the decisions involving COVID-19, ranging from screening policing, testing policies, and PPE policies as well.
• 7:08
  SPEAKER_00: People are really attuned to the AUC health and infection prevention perspective right now, and we are very thankful for that.
• 7:15
  SPEAKER_01: Yeah, I think that's really important.
• 7:17
  SPEAKER_01: You know, the fact that AUC Health has been around, but I don't think that it's always been appreciated what the need is and what AUHELP does for our healthcare workers.
• 7:26
  SPEAKER_01: So I really am happy that you've been able to sort of come more to the forefront and be more visible during the COVID-19 pandemic.
• 7:34
  SPEAKER_01: Are you seeing a majority of your healthcare workers when they're getting COVID-19, do you see that they're getting it within the healthcare setting or are they getting it within the community, or is it a mix of these things?
• 7:45
  SPEAKER_00: So that is a really important question.
• 7:47
  SPEAKER_00: We as healthcare professionals, we're in a unique position in that we can be exposed to COVID-19 both in the workplace and in the community.
• 7:56
  SPEAKER_00: In our workplace, we have policies in place to try to screen healthcare workers prior to coming to work for symptoms and a fever.
• 8:03
  SPEAKER_00: We have physical distancing measures and bidirectional masking, meaning both the patient and the healthcare professional are wearing masks.
• 8:11
  SPEAKER_00: These measures are designed to protect us from being exposed at work, and when properly adhered to, they're working.
• 8:16
  SPEAKER_00: Although in the workplace we have these policies, policies such as masking are not uniformly required in the community, depending on where you live.
• 8:24
  SPEAKER_00: And what we're seeing is that COVID-19 in the community is spilling over into the workplace.
• 8:30
  SPEAKER_00: We need to remember that healthcare workers, we're people, we're in the community.
• 8:34
  SPEAKER_00: We go to the grocery store, we live with kids, significant others, houseways, and these people have context as well.
• 8:40
  SPEAKER_00: Thus, exposures in the community are definitely happening.
• 8:43
  SPEAKER_00: And what we're seeing locally and nationally is that healthcare professionals are getting COVID from these interactions.
• 8:49
  SPEAKER_00: Both through internal data and through discussions with colleagues, COVID-19 rates seem to be tracking with healthcare professional rates, and this hints that exposures are happening in the community.
• 9:00
  SPEAKER_00: We're also seeing situations arise where healthcare professionals are getting COVID-19 from each other, either outside the workplace at social interactions or through social interactions at work.
• 9:11
  SPEAKER_00: We as healthcare providers, we want to collaborate, we want to talk to each other because that's how we ensure the best care for our patients.
• 9:18
  SPEAKER_00: And for some of us, we've been working together for years.
• 9:20
  SPEAKER_00: This can sometimes lead to us letting our guards down and not adhering to masking as well as we should.
• 9:25
  SPEAKER_00: And in these settings, myself and multiple colleagues have seen healthcare professional to healthcare professional transmission of COVID-19.
• 9:32
  SPEAKER_00: And it really saddens us every time that we find out that one of our fellow healthcare professionals get COVID.
• 9:38
  SPEAKER_00: And I want to say that it's not okay that we're getting sick from each other.
• 9:41
  SPEAKER_00: Now more than ever, we really need to make sure that we have these measures at work to protect ourselves and each other, and that our healthcare systems work to support those measures.
• 9:51
  SPEAKER_01: I imagine that that can really add to the challenge too if you have healthcare professionals that are getting COVID-19, you know, outside the healthcare setting, and then you potentially have to put them off of work and worry about shortages as well, especially in places where you know we have been seeing increase in cases.
• 10:08
  SPEAKER_01: That's definitely a concern.
• 10:10
  SPEAKER_01: Kind of switching gears a little bit.
• 10:12
  SPEAKER_01: I mean, everyone's hyper-focused on COVID-19, obviously, but what are some of the other things that you're seeing in occupational health that have changed besides COVID-19?
• 10:22
  SPEAKER_00: As noted, there is a lot of attention being paid to occupational health in recent times.
• 10:27
  SPEAKER_00: And for us, COVID-19 has really provided an impetus to improve our systems that support our work.
• 10:33
  SPEAKER_00: For instance, we realized that our technologies for tracking data needed to be upgraded, so we quickly shifted to a system that could more easily manage our data.
• 10:42
  SPEAKER_00: And this is a good thing because this benefit will extend even beyond the pandemic and we'll be able to use them for overall awk health purposes.
• 10:50
  SPEAKER_00: We've also been able to see how nimble our healthcare system can be when it comes to taking care of healthcare professional needs.
• 10:56
  SPEAKER_00: For instance, we have partners from the university and hospital collaborate to swiftly work together to create a support system for healthcare workers, an example being providing alternate housing options for healthcare professionals to quarantine outside of the regular home.
• 11:11
  SPEAKER_00: Even the cafeteria, they started stocking groceries like milk and eggs so that healthcare professionals could pick up essential items on the way home.
• 11:18
  SPEAKER_00: And it was really amazing to watch everyone come together to focus on the healthcare professional as a whole and think about them, not just here in the workplace, but what happened outside the workplace.
• 11:28
  SPEAKER_01: Yeah, those are really neat initiatives.
• 11:30
  SPEAKER_01: I never would have thought of the idea of just being able to, you know, go pick up your essentials on the way home, but that could make for such a difference in a quality of life when you're tired and just trying to get home and get what you need.
• 11:42
  SPEAKER_01: So, what are you doing in terms of influenza and COVID planning from the occupational health point of view?
• 11:48
  SPEAKER_01: Because we know that we are getting through summer and headed toward that influenza season in fall.
• 11:54
  SPEAKER_00: This is definitely on the forefront of our minds right now.
• 11:57
  SPEAKER_00: Getting the influenza vaccine is going to be more important than ever, especially because the flu-like symptoms that occur with influenza can look exactly like COVID-19.
• 12:07
  SPEAKER_00: And many of the same resources necessary to test for flu, such as the swabs, are the same that we need for COVID-19.
• 12:14
  SPEAKER_00: So, from a testing standpoint, we're cognizant that the resources that are needed to test the flu, including people resources and the testing resources, are the same as for COVID-19.
• 12:25
  SPEAKER_00: Thus, we're creating strategies to test healthcare professionals for both flu and COVID-19 concurrently, so that the tests can be run on the same exact swab.
• 12:33
  SPEAKER_00: And if one's negative, we can also see if the other one is positive and causing the healthcare professional to fall ill.
• 12:39
  SPEAKER_00: We will also continue to implement basic infection prevention measures such as good hand hygiene and in this setting masking.
• 12:46
  SPEAKER_00: We also have pre-work screening measures to help avoid people coming to work sick called presenteism.
• 12:52
  SPEAKER_00: And this should also work for flu like symptoms as well, since many of the questions we ask for pre-work screening are the same as what we would ask for flu.
• 12:59
  SPEAKER_00: And of course, vaccination, it's a high priority topic.
• 13:03
  SPEAKER_00: Traditionally, we actually have vaccine walk-up kiosks, wherein healthcare professionals will come to a common space, wait in line, and they would all get their vaccine in a very efficient manner.
• 13:15
  SPEAKER_00: This is not possible in the setting of COVID-19 where we need to socially distance.
• 13:19
  SPEAKER_00: So our team has been really thinking of creative ways to provide vaccination.
• 13:23
  SPEAKER_00: I'll give an example.
• 13:24
  SPEAKER_00: Some of the ideas we have is the use of a large space on campus, such as a campus gym or conference centers to provide vaccination, having healthcare professionals pre-schedule vaccines to avoid waste, and even alternate vaccination plans.
• 13:39
  SPEAKER_00: And by that I mean instead of the local AlcHel providing vaccinations, we can provide healthcare professionals with vouchers to obtain vaccination at pharmacies or other places at their convenience.
• 13:50
  SPEAKER_00: Then they would bring in a record of the vaccination to us for documentation.
• 13:54
  SPEAKER_00: Another idea is training individuals within a clinic, division, or department to administer the flu shots, providing them with the flu shots and having them administer to the personnel within their space.
• 14:04
  SPEAKER_00: Then they would give us that information for documentation.
• 14:08
  SPEAKER_00: In speaking to other colleagues, they're also considering drive-through vaccination as well.
• 14:12
  SPEAKER_00: And I also want to add that we are also thinking about the culture surrounding vaccination.
• 14:18
  SPEAKER_00: The WHO has listed vaccine hesitancy as one of the top 10 threats to global health, and taking a vaccine, as we know, is a great benefit to us as individuals, but also has a communal benefit of protecting those who cannot be vaccinated, such as young infants or certain immigrant compromised individuals.
• 14:35
  SPEAKER_00: However, with our current social and political climate, this benefit alone may not be enough to overcome the challenges of vaccine hesitancy, but we really need to continue to work towards ways to help people make the decision to get the flu vaccine, especially in the setting of a likely surge of COVID-19 in the fall.
• 14:54
  SPEAKER_00: This may mean partnering with social services, health coaches, and local community programs and organizations, but we really need to have this at the forefront of our minds.
• 15:03
  SPEAKER_01: Yeah, I love those creative ideas.
• 15:05
  SPEAKER_01: I think that you know, making it so that it's as easy as possible for anyone to get vaccinated, taking away those barriers, and then you know, really focusing on changing some of those health behaviors and ideas against vaccination are really critical.
• 15:20
  SPEAKER_01: I can see how having that plan in place now is going to be great for you when the COVID vaccine eventually gets approved and distributed.
• 15:28
  SPEAKER_00: Absolutely.
• 15:29
  SPEAKER_01: How are you ensuring that other occupational health issues are staying on the front of the mind during the pandemic?
• 15:35
  SPEAKER_01: Because you know, we mentioned that health is always there, you're always busy doing things, but you know, how are you keeping some of those other activities front and center while still dealing with COVID-19?
• 15:46
  SPEAKER_00: That's a good point.
• 15:47
  SPEAKER_00: Just because there's pandemic issues such as needle sick injuries, blood-borne pathogen exposures, and other illnesses don't stop.
• 15:56
  SPEAKER_00: We really still need to continue to run our regular AU health programs, including the flu vaccination program as noted.
• 16:02
  SPEAKER_00: To ensure that we are continue to care for other important auc health issues, we need to create systems to support our local programs.
• 16:09
  SPEAKER_00: Our university and hospital systems did just that.
• 16:12
  SPEAKER_00: An example of that is through redirecting of some of the COVID-19 work.
• 16:16
  SPEAKER_00: Here's what we did.
• 16:17
  SPEAKER_00: We developed a COVID-19 employee call center.
• 16:20
  SPEAKER_00: Traditionally, healthcare professionals contact us at AUCHealth directly if they have a concern surrounding a workplace exposure or some sort of other AUCHealth issue.
• 16:30
  SPEAKER_00: But with the volume of calls that we're getting from COVID-19, which on some days are greater than 200 a day, remember we serve greater than 50,000 employees, that's not sustainable for our team.
• 16:41
  SPEAKER_00: So we created a call center.
• 16:43
  SPEAKER_00: This call center is staffed by trained, skilled clinical staff who take the initial intake call from healthcare professionals regarding their COVID-19 exposure or concern for signs and symptoms to COVID.
• 16:54
  SPEAKER_00: Then they use an algorithm and AUCHealth physician support, if needed, to provide recommendations to the healthcare professionals, which may include quarantine, working while masked, or testing.
• 17:05
  SPEAKER_00: For those who require testing, we then utilize a testing center designed for quick in-and-out testing for healthcare professionals.
• 17:12
  SPEAKER_00: These programs help unburden the Auck Health teams and support the work that AuckHealth is doing outside of COVID-19 as well.
• 17:19
  SPEAKER_01: It's really incredible to hear, you know, everything that you're doing.
• 17:22
  SPEAKER_01: And I also have to say it's really nice to hear all your enthusiasm for what you're doing and achieving.
• 17:28
  SPEAKER_01: So what do you find most rewarding about occupational health?
• 17:31
  SPEAKER_00: It's definitely the people.
• 17:33
  SPEAKER_00: Everyday healthcare professionals, they're going to work, putting themselves on the front line to take care of patients.
• 17:39
  SPEAKER_00: And these individuals are putting the good of the patient and the community above their own needs and sometimes even their family's needs.
• 17:46
  SPEAKER_00: Within this role in occupational health, I'm able to take care of my fellow healthcare professionals at a really vulnerable time in their lives.
• 17:54
  SPEAKER_00: You know, there's a lot of talk about how we as healthcare professionals are heroes, but we also need to remember that we're people.
• 18:01
  SPEAKER_00: I agree, healthcare professionals are heroes, but just like everyone else, we're trying to balance this new reality as people who just happen to be healthcare professionals in the face of a pandemic that has disrupted our lives and all of our plans.
• 18:13
  SPEAKER_00: Getting exposed to COVID-19 or actually getting COVID-19 is really scary.
• 18:18
  SPEAKER_00: And we need to take care of healthcare professionals both from a physical and mental health standpoint.
• 18:23
  SPEAKER_00: For me, being able to listen, take care of, and advocate for resources for my colleagues is very special, and I'm honored to be a part of that.
• 18:31
  SPEAKER_00: And I know our whole occupational health team is honored too.
• 18:34
  SPEAKER_00: It really motivates me to work hard and be better at my profession every day.
• 18:38
  SPEAKER_01: I think that's wonderful.
• 18:40
  SPEAKER_01: And I just want to thank you so much for joining us, and thank you for working so hard to protect our healthcare workers.
• 18:47
  SPEAKER_00: Thank you for the opportunity to share experiences with the Shea community and uh stay healthy, everyone.
• 18:51
  SPEAKER_01: Thank you very much to our speaker for sharing your perspectives and experiences.
• 18:55
  SPEAKER_01: And a severe thank you for today to all healthcare personnel for all that you're doing to respond to COVID-19.
• 19:02
  SPEAKER_01: This podcast can be accessed under the online education center learning facilities under the Rapid Response Program.
• 19:09
  SPEAKER_01: You'll also find additional resources such as the recorded webinars, Healthcare Facility Outbreak Preparedness, and K COVID-19 at all.
• 19:19
  SPEAKER_01: Additional resources available on Learning Activity program in this pandemic include today's ADC outbreak response training program, ORTP, and the Prevention Course at HAI Knowledge and Control Prevention Check.
• 19:33
  SPEAKER_01: This concludes this episode of the Rapid Response Podcast.
• 19:37
  SPEAKER_01: Thank you for tuning in.