Covid-19 response

Can you give me more detail about reducing some of our restrictions to take on more cases?

  • 1.  Can you give me more detail about reducing some of our restrictions to take on more cases?

    Posted 15 days ago
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    Member Question:

    We have put a lot of restrictions in place in terms of staff and we were considering using phase 1 as a signal that we may be able to modify, while not eliminate, these restrictions. However, it is hard to know how to best do this. For example, we have an open, shared, doctors office with cubicles that normally could have 14 sharing it, though rarely more than 8 in the office at the same time. To decrease these numbers, we have separated ambulatory and hospital staff and are not allowing ambulatory doctors into the building. This is very hard from a cultural standpoint and if there is a safe way we can allow people back in but still limit the number of people at a given time and with appropriate distancing that would be great. Within the hospital, we are wearing masks when within 6' but I wonder about just requiring it at all times given the shared keyboards, etc. We have also restricted hospital doctors from coming back into the building if they go out on the road, which from what I'm reading may not really be necessary at all (they are distancing from staff and wearing masks). We want to be compliant and keep people safe and having some sort of official guideline to lean on is really helpful.


    Answer:

    Caroline Yancey, DVM, MPH. Director, International Programs. Lecturer, Master of Public Health Program. College of Veterinary Medicine Cornell University



    The Reopening NY document does provide some specific guidance, which may help. For example:

    • For any work occurring indoors, restrict workforce presence to no more than 50% max occupancy for a particular area as set by the certificate of occupancy
    • Modify the use and/or restrict the number of work areas and employee seating areas to maintain 6 ft. distance and avoid multiple crews and/or teams working in one area. If not feasible, provide and require face coverings or enact physical barriers
    • Create additional space for employees by limiting in-person presence to only personnel necessary for the current task(s), adjusting workplace hours, staggering arrival/departure times, creating A/B teams, and/or scheduling only one team in an area at a time.

     

    Enclosed rooms with several people is considered a higher risk environment, so a suggested approach for the doctor's office room with 14 cubicles would be to have A and B teams alternate use. For example, the hospital staff get access in AM and the ambulatory team gets access in the PM (or alternate days). If they share any equipment (computers, printers), each team should have to clean/disinfect prior to leaving. Of course, if this means the hospital staff congregate somewhere else in the hospital, that isn't a viable solution. But the goal would be to depopulate areas by 50%. Maybe set ambulatory up in a separate area of the hospital.

     

    An additional benefit of continuing to separate ambulatory from hospital team – if someone got exposed to a COVID case and had to quarantine until testing performed, the fewer "close contacts" that employee had, the less the impact on the hospital staffing. If they are all back interacting, in theory, the health department could recommend quarantining everyone that had contact with that employee. So having the A/B teams ("cohorting") even within the hospital (ie: with no close contact) is a recommended best practice (and recommended in the Reopening NY guidelines and the OVMA document).

     

    Regarding masks, the CDC guidance for veterinarians:

    • Everyone who enters the clinic, including employees and visitors, should wear a cloth face covering over their nose and mouth to contain respiratory secretions, unless engaged in an activity that requires a different form of PPE (meaning a respirator).

    Many business are requiring masks except when staff are in their office alone.

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