WSNA is contin­uing our advocacy at the highest state level. We shared your stories and concerns over PPE and other mixed messages on Saturday in two confer­ence calls with officials from the Washington State Depart­ment of Health (DOH). Both Secre­tary of Health John Wiesman and State Health Officer Kathy Lofy spent an hour on the phone with WSNA, as well as UFCW 21 and SEIU 1199NW. We empha­sized that some hospi­tals appear to not be following any standard proto­cols (CDC or WHO).

Secre­tary Wiesman said that Washington state has now received its first full shipment of PPE from the National Strategic Reserves. DOH is working to distribute those supplies quickly.

Staff from the Governor’s Office partic­i­pated on this call, as did the Washington State Medical Associ­a­tion and Washington State Hospital Associ­a­tion (WSHA).

WSNA has been diligently cataloging the infor­ma­tion you’ve shared with us, and on Sunday morning we sent the Governor’s Office, DOH and WSHA a document detailing some of the concerns reported by our members across the state. We will continue to demand that state leaders ensure all hospi­tals are keeping nurses and other health care providers safe.

WSNA believes that N‑95 respi­ra­tors are the gold standard and are the neces­sary and minimum protec­tion for our nurses and health care workers caring for suspected and confirmed COVID-19 patients. The science of this disease is evolving. Many infec­tious disease experts are now reporting that due to the droplet trans­mis­sion of COVID-19, surgical masks can be used.


Answering your questions #

This crisis is devel­oping very quickly, and we want to ensure you have clear, correct answers to your questions. Here are some of the top questions we are hearing and answers that include links to source infor­ma­tion.

This article from The Seattle Times has very clear infor­ma­tion on COVID-19 trans­mis­sion and symptoms – WSNA will be sharing this on social media.


How is COVID-19 transmitted? #

  • Between people who are in close contact with one another (within about 6 feet).
  • Through respi­ra­tory droplets produced when an infected person coughs or sneezes.
  • It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Source: Centers for Disease Control & Prevention


Will more testing be available? #

    As of March 6, 2020, the Washington State Depart­ment of Health reported that they would soon be able to run 200 tests per day. Those tests were being distrib­uted in the order of public health impor­tance with those living within an outbreak (e.g., Kirkland nursing care home) and health care workers being top priority.

    The Univer­sity of Washington is also expected to be able to run 1000 – 1,500 tests per day begin­ning the week of March 9, 2020.

    Source: Washington State Depart­ment of Health; Washington State Epidemi­ol­o­gist for Commu­ni­cable Disease Scott Lindquist, MD, Nursing Union TeleTown­hall, March 6, 2020.


    What PPE is needed when treating a COVID-19 suspected or positive patient? #

      Current CDC guidance for COVID 19 PPE is an N‑95 respi­rator, gown, gloves, and eye protec­tion. This is based on the original assump­tion that COVID 19 is an airborne disease process. Many infec­tious disease experts are now reporting that studies show COVID 19 is spread via droplet trans­mis­sion; there­fore, surgical masks can be used. As previ­ously mentioned, WSNA believes that N9‑5 respi­ra­tors are the gold standard and are the neces­sary and minimum protec­tion for our nurses and health care workers.

      Source: Centers for Disease Control & Prevention


      Are exposed providers supposed to rely on their employer to tell them when a patient they’ve treated tests positive?
      #

      Yes. DOH, Public Health – Seattle & King County, and other local public health officials have told us it is the oblig­a­tion of hospi­tals to tell their employees when they have been exposed to COVID-19.

      Source: Meetings with DOH, PHSKC, other LHJs via confer­ence call.


      If exposed to a COVID-19 positive patient, what are the different risk levels and what actions should be taken at each level? #

        On March 7, 2020, the CDC updated its guidance regarding exposure risk categories and recom­men­da­tions (including work restrictions).

        This updated guidance lets hospi­tals allow asymp­to­matic health care providers who have been exposed to a COVID-19 patient to continue working after options to improve staffing have been exhausted and in consul­ta­tion with their occupa­tional health program. CDC goes on to say that these health care providers should still report temper­a­ture and absence of symptoms each day prior to starting work. CDC says “[i]f HCP develop even mild symptoms consis­tent with COVID-19, they must cease patient care activ­i­ties, don a facemask (if not already wearing), and notify their super­visor or occupa­tional health services prior to leaving work.”

        Source: Centers for Disease Control and Preven­tion


        If I am on quarantine at home, what precautions should I take to protect my family? #

          Take the same steps as if you have influenza or seasonal flu. 

          • Call your health care provider before going in
          • Stay home except to get medical care (if needed, call provider first)
          • Separate yourself from other people and animals in your home
          • Cover coughs and sneezes with a tissue, discard in trash, wash hands
          • Wear a mask if going in car with others and in health care provider’s office
          • Ensure high-touch” surfaces are cleaned daily

          Source: Centers for Disease Control and Preven­tion


          Is there a recommendation to limit visitors during the COVID-19 outbreak? #

            Yes. According to DOH, visitors should be limited especially when a patient has tested positive for COVID-19.

            Source: Washington State Epidemi­ol­o­gist for Commu­ni­cable Disease Scott Lindquist, MD, Nursing Union TeleTown­hall, March 6, 2020


            Which countries are currently on the list for automatic quarantine if you have visited there? #

              As of March 8, 2020, the following countries are listed as Level 3, and non-essen­tial travel to these countries should be avoided. Travelers from these countries should stay home for 14-days and practice social distancing upon arrival in the U.S.

              • China (does not include Hong Kong, Macau, or Taiwan)
              • Iran
              • Italy
              • South Korea

              As of March 8, 2020, the following countries are listed as Level 2, experi­encing sustained commu­nity trans­mis­sion. Older adults and those with chronic medical condi­tions should consider postponing nonessen­tial travel:

              • Japan

              As of March 8, 2020, the following countries are listed as Level 1, risk of limited commu­nity trans­mis­sion. Travelers to these countries should practice normal precau­tions against illness and pay close atten­tion to their health for 14-days after returning to the U.S.:

              • Hong Kong

              Source: Centers for Disease Control and Prevention


              Please contact your Nurse Repre­sen­ta­tive with any questions or concerns.