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  • Writer's pictureHelene Paxton

Where are we..My two cents

WHERE ARE WE? My two cents…. Dealing with COVID-19 Pandemic has taught us all that we were not prepared for this occurrence. We were somewhat prepared for EBOLA, but in reality most did not believe it would really be a factor in the US and in fact when we were faced with a few cases some imported and some contracted while caring for those patients, no one continued to really think about it. We have come to accept the death of people with Flu in numbers that are unacceptable even in the presence and use of vaccine. Why have we been so complacent in our emergency Preparedness despite monies given to each State for these activities of preparedness? Why has the CDC been so slow to respond? Is it leadership? Is it money? Is it lack of focus? Most Infection Preventionists look to the CDC for the ultimate guidance for our processes. As a nation we have faced many infectious challenges, but rarely of this intensity except for !916-1918 flu pandemic and HIV not called a pandemic, due to its select population of infected individuals at the start, but now an accepted part of our society. In the 80’s we had similar struggles of no effective drugs, no vaccine, no real knowledge as to the origin or means of transmission of the virus. In the 80’s we had demonstrations to support those with HIV and AIDS. Where are the demonstrations for better health care and preparedness today?

As we continue in the health care arena, we must reconsider how we manage our patients as well as our devices. Do we need to mask all patients as they enter our Emergency rooms, do we need to test all patient for the presence of antibodies? Will we vaccinate all incoming patients for COVID-19 as done for Flu and pneumonia? Will we all need to wear masks in our work and play. Do the masks really work?

What about our personal electronic equipment, our stethoscopes, bed-side monitoring devices, our eye glasses, how will we assure that they are free of virus or bacteria? This issue is not new and certainly has been associated with a stream of hospital and facility health care related infections for many years. Why have our nursing homes been the target of COVID-19? Should we be surprised? Is this due to poor training, staff shortages, overcrowding, poor facility design, lack of equipment, poor supervision?

Lack of handwashing compliance has been with us for many years, perhaps now this is changing due to the spread of COVID-19. Yet, we do not have robust protocols for how to handle and disinfect our devices and tools as we practice our medical specialties and care for our patients.

The data suggests that we all touch our faces at least twenty times per hour, we touch inanimate objects, we touch our faces, sometimes we wash our hands. Hand washing becomes an impossible task no matter how robust our willingness to be compliant. Why are we not using better tools for protection? Hand sanitizers with long lasting disinfectant capabilities would be a great start…they are available but more expensive. Why are these not in widespread use in our healthcare facilities? Does increased cost have to be the limiting factor? Safety of our staff and patients should be paramount!

Use of bedside equipment and the disinfection thereof, has traditionally been with wipes, and more wipes. Issues with wipes are confusing…What do we use, when do we use, for how long, and does it make a difference? Our patients are using wipes too, with 99.9% (3-log kill), do they really make a difference in their homes? Are we just spreading more bacteria and viruses? Are we damaging electronic equipment and giving ourselves a false sense of security?

What alternatives can we use in the healthcare arena as well as other venues? Several companies manufacture UVC cabinets for use with smaller electronic devices, stethoscopes, point of care equipment, digital readers and unopened packages with medical supplies left in isolation rooms. Many have 30 second or less kill for C. diff and other pathogens. What if we had these in every clinical unit, and entry points in our hospitals, clinics, nursing homes, schools, and daycare centers along with easy to use hand sanitizers? These UVC units can also be used to rapidly disinfect masks when there is a shortage. The use of these cabinets with save time and money and assure disinfection that the wipes cannot provide. The UVC devices are robust and are certified to deliver the disinfection needed for our point of care needs as well as other venues. They do not damage electronics. Protocols for handling devices need to be considered in each venue to protect our patients, the elderly, kids, and ourselves.

For more information Contact:

Helene Paxton, MS, MT(ASCP), PhD, CIC

BioGuidance, LLC

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The Ongoing Crisis of COV-19:  An Exhausting Proposition for All

 

              This has been an exhausting week both physically and mentally due to pressures from all sides and most of all from the media.  Those of us that teach are having to reinvent our courses and reinvent ourselves to meet the needs of our students.  The students are a very diversified group with many different capabilities and very different access to technology.  Although it sounds great to have a plan to put all our courses on-line…it’s not so simple.  I have the privilege of tutoring students from many different countries and states and the common denominator is confusion!  Most want to do what’s right but don’t know how to or are getting conflicting messages from their instructors.  Most are worried about their grades and completing their assignments.  Many are still working which adds to the burden. 

              I find it interesting that people want this to be over and yet are fearful that if they go back to work, they will be at risk.  The Ford Company wants to go back to work, but employees are afraid.  Has the media made us so fearful that rational thinking is not possible?  Does the whole country have to be on lock-down just because parts of the country have a high number of cases or are considered an epi-center?  We understand the fear associated with this unknown entity, yet are we applying our best resources to this issue?  Have we tapped into the experts that understand the ecology of the viruses? David Quammen in his recent book called “Spillover”:…..Discusses the possibilities of such a Pandemic and reviews  SARS-1 and HIV, Nipah and others.  Were we not already forewarned many times of this pandemic possibility?

  What modeling has been done to predict where the virus may go?  Are all States and counties there in, in the same predicament?  Can we not narrow down our recommendations to allow parts of the country to go back to work? For Once I agree with our President, we need to get this country back at work.  We need to maintain safe distancing, lower risks where possible, maintain cleanliness and good eating habits, but lets go back to work where the virus is not.

 

Dr. Helene Paxton

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