Doctors and nurses are increasingly worried they will become the spreaders of the coronavirus rather than the healers, as hospitals themselves become a hot spot for the pandemic. That fear is already a reality in Italy, the global epicenter of the pandemic, where researchers have found hospitals overloaded by coronavirus patients have become transmission points. Public health officials, like those at the World Health Organization, have increasingly warned that health care workers themselves could be vectors for the disease — accelerating its spread and undermining the ability of countries’ health systems to combat it. U.S. hospital staff worry a similar scenario could play out here, according to 10 health care workers who responded to a POLITICO survey and others who spoke on the condition of anonymity for fear of losing their jobs. In an open call for hospital workers to tell us what they're seeing, dozens of others cited concerns about equipment and testing shortages, as well as sickness among hospital staff. Essential gear protecting providers is woefully inadequate and could remain so in some areas for weeks, despite assurances from federal officials that more specialized masks and surgical gowns are on their way. And because of a widespread lack of testing, frontline workers said they are treating patients without knowing if they’re infected — and that the coronavirus could spread not just to doctors and nurses, but security and cleaning staff as well. Several American health workers have already died after contracting the virus. In a suburb of Washington, D.C., one major health system isn’t sending sick staff home, even when their symptoms indicate a possible coronavirus infection, according to a nurse who said she took vacation time to self-quarantine after getting symptoms, including a low-grade fever. She’s still waiting for test results she had to drive to another Virginia county to get. In hard-hit New York City, a critical care nurse reported that a sick hospital clinician has exposed a long-term patient to the coronavirus. POLITICO is withholding the names of most facilities in this story on the request of workers who feared retribution for speaking out. The outbreak in Italy could hold important lessons for the worst that could come to America. Physicians handling the brunt of that country's outbreak, to reduce transmission in hospitals, are encouraging mobile clinics and even moving ventilators into patients' homes. "We are learning that hospitals might be the main COVID-19 carriers." "We are learning that hospitals might be the main COVID-19 carriers, as they are rapidly populated by infected patients, facilitating transmission to uninfected patient," Italian doctors wrote in the New England Journal of Medicine recently. In Washington state, an early epicenter of the country’s outbreak, the virus had been “blossoming” undetected in some hospitals for weeks, according to a physician with CHI Franciscan’s network of hospitals there. Early in the outbreak, one patient with an unrecognizable cough had already infected some frontline staff by the time the person’s COVID-19 test came back positive, the physician said. And this wasn’t an isolated case. The physician reported that over the weekend clinicians — unprotected at the time due to the protective mask shortage — came into contact with patients whose tests came back positive. “I don’t think the problems are any different in our system than elsewhere. It's just that we haven't gotten the surge completely yet," said the physician, who credited the health system for shutting down elective surgeries over 10 days ago, before there was mounting pressure on hospitals to do so. A spokesperson for the hospital system said all staff members are being screened before entering a facility and health care workers who are "coughing, have a fever, or feel ill" are asked to stay home. “These are not normal times, and we are doing everything we can to keep our staff and patients safe, while also conserving masks under the latest local CDC guidelines," said Carly Evans, the spokesperson. Evans said the system’s hospitals are sharing resources and “working very hard to find more resources as soon as possible." In Connecticut, a nurse at a community hospital said her facility is giving providers just one specialized mask to treat coronavirus patients; they put a face shield in front of the mask to protect it and reuse both. Those who aren’t treating coronavirus patients or suspected cases don’t use the masks, but there’s still fear that the infection could spread. “Am I going to bring this home to my kids? Am I going to bring this home to my husband?” “Am I going to bring this home to my kids? Am I going to bring this home to my husband?” said the nurse, whose spouse is a first responder. Many hospitals are urging patients who aren’t very sick to stay at home, and some are conducting tests in isolation tents or screening patients in their cars. The Trump administration has urged hospitals to postpone nonessential elective procedures, such as cataract surgery and colonoscopies. There's been resistance among some hospitals which depend on the lucrative procedures, though, and some health workers expressed concern to POLITICO that those could further spread the virus throughout hospitals. Federal officials say they’re prioritizing measures to keep health care workers safe. President Donald Trump said this week that FEMA is distributing 8 million special medical masks and 14 million surgical masks to areas around the country, particularly where they're needed most. FEMA has received 6.5 million more in donations. Surgeon General Jerome Adams, the nation's top doctor, said he's heard concerns around the country about protecting health workers. “I want health care workers of America to know, we are fighting for you each and every day to make sure you get what you need from the stockpile, to make sure you get what you need from manufacturers across America," Adams said during a Fox News virtual town hall on Tuesday. For weeks, however, state officials and hospitals have urged the federal government to provide more protective equipment. Some frontline health workers made pleas on social media. Others crafted their own surgical masks and have taken to recycling whatever gear they can. “Hospitals are in a tough position," said an emergency physician based near Oakland, Calif. "Because all the leadership would prefer to have more equipment available and the sudden surge of demand has put all these hospitals in this untenable position of trying to procure something that needs massive manufacturing.” In some parts of America, the risk of infection isn’t confined to hospitals directly treating coronavirus patients. It appears to be spreading through facilities connected to health systems. One Indiana nurse who works at a drug and alcohol rehabilitation clinic next to a hospital said she had virus symptoms and went through multiple phone screenings while her supervisors debated how to handle the situation. One supervisor said she should get tested, but another manager reversed that decision. She said she was cleared to return to work as soon as she recovered from her low-grade fever, even though she hadn't completed the typical 14 days of quarantine for people who've been ill or directly exposed to the virus, and she was still coughing. She still doesn't know if she had the virus, and she and her colleagues don’t typically wear protective masks since they work outside the hospital. Source
