Healthcare workers on the frontlines of the coronavirus outbreak are urging hospitals to work with them to reduce the risk of infections among employees as a way to ensure there are enough staffer to care for patients.
A total of 14 people in the U.S. have died from COVID-19 as of Friday, according to reports. The Centers for Disease Control and Prevention reports more than 200 coronavirus cases have been reported across 19 states.
As the outbreak continues to spread, the risk of infection among healthcare workers rises.
In California, at least 50 healthcare workers were sent home after coming into contact with infected patients.
In Washington state, more than 20 healthcare workers have reportedly been put under observation after interacting with a patient who died before testing positive for COVID-19.
Such cases have prompted leaders of some of the country's leading healthcare labor unions on Friday to call for hospitals and federal health officials to develop better approaches to prevent exposure to healthcare workers.
"There's a lot that can be done that's not necessarily being done," said Sean Wherley, a spokesman for the Services Employees International Union-United Workers West. "Some hospitals are better when they have setup operations where they have involved workers upfront."
In addition to making sure facilities have adequate supplies of personal protective equipment, the group is calling for hospitals to develop quicker methods to assess and isolate patients suspected of having COVID-19, as well as providing more training on proper safety protocol for both clinical and non-clinical staff.
But hospitals have shown lapses in their ability to conduct consistent infection control practices.
According to a survey released by nurse union organization National Nurses United, 44% of nurses said their employer provided them with information to identify potential coronavirus cases. Only 19% of the 6,500 nurses across 48 states surveyed knew if their employer had policies to address if workers were potentially exposed to the virus.
Only 29% of nurses surveyed reported their employer had a plan in place to isolate patients suspected of having coronavirus, while 58% reported their employer had instituted travel history screening for all patients with symptoms to assess their level of risk of virus exposure.
Wherley said worker buy-in to develop better safety approaches was critical to avoid staffing difficiences.
In China, more than a thousand healthcare workers were infected with COVID-19 and six of them died.
But some experts say CDC guidelines that recommend a quarantine of 14 days for healthcare personnel at medium or high risk of exposure to COVID-19 will soon affect staffing levels as more cases occur.
"I think there's no question that that policy needs to be re-examined," said Dr. Jennifer Hanrahan, chief of the division of infectious diseases at the University of Toledo Medical Center. "You make changes as this evolves."
Dr. Amesh Adalja, senior scholar at the Johns Hopkins Center for Health Security, this week co-wrote an editorial calling for health officials to put an end to quarantines for healthcare workers, arguing the policy would "cripple" many hospitals trying to handle a surge in coronavirus patients.
"It's going to be very challenging to take care of every patient without any kind of breach," Adalja said.
Like Hanrahan, Adalja felt isolation policies should change as more is learned about the coronavirus incubation period and how it is transmitted.
In the U.S., nearly 1.7 million patients acquire an infection in a healthcare setting, resulting in more than 98,000 deaths annually, according to the CDC. While evidence shows healthcare providers have improved in reducing infections, a 2018 report conducted by the Leapfrog Group found the percentage of hospitals achieving zero infections has declined since 2015.
Wherley agreed it was important to maintain appropriate staffing levels. He said more hospitals may have to take stricter infection control efforts such as imposing visitor restrictions and conducting coronavirus screenings outside of their entrances to limit the risk of transmission. Scripps Health in San Diego this week instituted the latter.
Nancy Foster, vice president of quality and patient safety policy for the American Hospital Association, said it is important for hospital leadership to heed suggestions of frontline staff about their needs for resources. But she said employees must be mindful of the regulations hospitals must follow.
"As with all things during a crisis, it will be a challenge, but it is a challenge that we're prepared to take on," Foster said.