UMMC leaders, infectious disease experts answer COVID-19 questions

Published on Thursday, March 5, 2020

By: Ruth Cummins

Editor's Note: This article was updated on March 13 to reflect new information.

As questions arise from University of Mississippi Medical Center employees concerning the spread of COVID-19 in U.S. communities, answers will be provided by operational leadership and the Medical Center’s Infection Prevention and Division of Infectious Diseases.

Early the evening of Wednesday, March 11, the Mississippi State Department of Health (MSDH) reported the state’s first presumptive positive case of COVID-19. Final verification will come from the Centers for Disease Control and Prevention (CDC).  The individual is a Forrest County man under age 65 who recently traveled to Florida. The patient voluntarily isolated himself at home to prevent further transmission to others and was not hospitalized, and MSDH is investigating to limit spread of the virus from this case.

Two more cases were identified March 13: a Forrest County woman over 65 who recently traveled to North Carolina and is hospitalized; and a Forrest County man who recently traveled to Florida, and who is home self-isolating and didn’t require hospitalization.

Earlier Wednesday, the World Health Organization declared COVID-19 a global pandemic.

With the disease’s changing landscape, some answers will change – and more questions will emerge and be answered.  Keep up with developments by accessing this Q and A and other employee information about COVID-19 on the Intranet.

Dr. Jonathan Wilson, UMMC chief administrative officer, is the operational leader of our preparations and response to this potential public health emergency.  He will have broad authority to take steps to protect our staff and preserve our ability to deliver care to all the patients who need us during this period.  He will be working closely with the MSDH, which is the lead agency for response to the virus.

A patient or visitor at any UMMC location statewide suspected of having the novel coronavirus should be reported to Mississippi MED-COM by calling 601-984-4367. This phone line is monitored all day, every day.

Additionally, the following steps should be taken:

• Put a mask on the patient
• Place them in a private room (negative pressure room if available)
• Initiate airborne and contact precautions     

“We are in a calm before the storm,” Dr. LouAnn Woodward, vice chancellor for health affairs and dean of the School of Medicine, said March 4 in a campus memo. “I hope that there will be no storm, but now is the time to prepare at all UMMC locations for whatever may come our way.

“It is in times like these that we stand and deliver for our patients, for the people of Mississippi, and for each other.  And I know that we will.”

Among employees’ frequently asked questions:

Q: Is UMMC the hospital that will be treating patients confirmed to have COVID-19?

A: Most acute care hospitals in Mississippi have the facilities necessary to screen, isolate and care for COVID-19 patients. When the need arises, the Medical Center has a highly skilled medical team trained to respond. Unlike in the Ebola crisis of a few years ago, COVID-19 patients do not receive added benefit from a higher level of care offered by medical centers that are tertiary, meaning those that treat more severe conditions that require specialized knowledge and more intensive health monitoring.

Q: What is the Medical Center doing to prepare employees for COVID-19 patients?

A: Even though your job here may seem like business as usual, our overall operations very quickly can change and become a very challenging environment. Employees in patient care areas have been assigned a HealthStream module on COVID-19, and managers have been prepared to answer questions posed by their team and to give additional information as it becomes available. A number of campus memos have been disseminated to all employees with details that include employee protocols, identification of and care for suspected COVID-19 patients, use and protection of PPE, and employee travel restrictions. Information for employees is updated frequently on the Intranet under “Coronavirus Updates,” and campus memos on COVID-19 also can be found there.

Q: How will front-line employees protect themselves from COVID-19 infection?

A: Employees caring for suspected or confirmed case should wear appropriate personal protective equipment such as gowns, gloves, a fit-tested N95 mask and a face shield. Glasses are not considered adequate for eye protection. Performing hand hygiene with soap and water or alcohol-based hand sanitizer is essential before and after entering a patient’s room.

Q: Many UMMC employees not currently in a patient-care role previously served as nurses, physicians or in some other clinical position. If needed, could they be deployed for bedside care?

A: Although it would be a possibility, there are no current plans to do that.

Q: There’s an international shortage of facemasks, and members of the public who believe they should wear them are contributing to the shortage. Does UMMC have enough personal protective equipment (PPE) for caregivers and patients?

A: Please review this campus memo for details on PPE. Currently, supplies of PPE are adequate to respond to the anticipated increased usage in case of a COVID-19 outbreak locally. However, in view of the national shortage, it’s important for us to begin conserving our supplies of items like N-95 masks, surgical masks, disposable isolation gowns, disposable visors and related equipment.  Please help us by taking these immediate steps:

• Store PPE in a secure place and use it only when clinically indicated.
• Do not allow employees to take PPE home for personal use. Taking UMMC property without authorization is a violation of UMMC policy and will result in disciplinary action up to and including termination and criminal prosecution (for more information, consult page 49 of the Faculty and Staff Handbook).
• Do not provide masks and other hospital PPE to patients and their families to take home.
• When rounding with teams, take appropriate steps to conserve PPE without compromising team communication.

Longstanding UMMC policy prohibits Medical Center faculty, staff and students from taking UMMC property or the property of another person without authorization. Faculty, staff and students must comply with requests by UMMC Campus Police to open all packages, purses, luggage, briefcases and/or any other form of container in their possession while at or upon leaving the Medical Center.

Q: Do we have enough vents for the most severely ill patients whose breathing is compromised?

A: That would depend on how many patients we receive who might need that support. If we need more, other hospitals will, too. Then it could be an issue. 

Q: Should non-clinical employees wear a facemask or PPE?

A: The U.S. Centers for Disease Control and Prevention does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. The appropriate use of facemasks is limited to patients who have respiratory symptoms and to health workers and other people who are taking care of someone infected with COVID-19 in close settings, such as a hospital, health care facility or at home.

We need to preserve PPE for health care workers taking care of COVID-19 patients.

Q: What if my front-line coworker doesn’t want to take care of patients who have COVID-19?

A: Health care workers are committed to providing care to our patients, irrespective of the disease type or severity. If you want to be excluded from taking care of COVID-19 patients, this discussion needs to occur early on with your supervisors.

Q: Do we have relationships with agencies that can provide temporary front-line staffing?

A: We do, but we cannot depend on them. Other hospitals will have those same needs.

Q: Who is being screened for COVID-19?

A: As COVID-19 spreads through communities, guidelines from the U.S. Centers for Disease Control and Prevention on who should be screened are changing.

Screenings will take place on someone experiencing fever and signs/symptoms of lower respiratory illness (cough, shortness of breath), and, in the last 14 days before symptoms appeared, had either a history of travel from any of five geographical areas outside the United States: China, Japan, South Korea, Italy and Iran; or close contact with a laboratory-confirmed COVID-19 patient.

In addition, given the increased evidence of community spread within the United States, CDC updated its guidelines to say a physician's suspicion for COVID-19 is sufficient indication for testing for what appears to be a milder case not requiring hospitalization. They will base this on the local outbreak situation, and evaluation of those with severe respiratory illness of unclear origin.

UMMC Infection Prevention has prepared a flow chart for employees to follow when screening and isolating patients.

Q: Are we doing testing for COVID-19 in our own labs?

A: Testing is done by the MSDH. Any Mississippi hospital or clinic with a patient suspected of having COVID-19 is collecting specimens and sending them to MSDH for testing. The Medical Center may be doing testing in-house in the future, however.

Q: What should I do if I think I might have been infected, whether it’s at work or in the community?

A: If you work in a patient care area, immediately isolate yourself from patients and other health care workers.  Any employee who believes they may be ill should alert their supervisor of symptoms, and based on your symptoms, you might be relocated to a non-patient care area or advised to go home to avoid risk for exposure to other staff. Be cognizant of the flow chart prepared by Infection Prevention on how to identify, isolate and call for assistance.

The CDC advises people consider these sets of symptoms in evaluating what illness they might have. Itchy eyes, stuffy nose and sneezing are symptoms of a cold or allergies. Fever, fatigue, body aches, cough and worsening symptoms can be the flu or COVID-19. Adding shortness of breath, a travel history and exposure to someone with COVID-19 could mean you have COVID-19.

However, symptoms and risks vary from person to person, so always check with your doctor.

If you’re at home and feel ill, stay home. Check with your provider, report your symptoms and ask about a safe time to return to work. Feel free to call Student and Employee Health for advice as well. 

Q: Will COVID-19 patients be scattered throughout the hospital? All on one floor? Wil they also be in quarantine rooms?

A: Because the situation is rapidly evolving, we anticipate making changes as needed. If only a few cases are admitted, we will try to limit them to a floor. However, if we have widespread transmission- associated cases, patients will be admitted to airborne isolation rooms, or negative pressure rooms. If isolation rooms are not available, they might be temporarily placed in a regular room with HEPA filters and moved into a negative pressure room as soon as one becomes available. The Medical Center does have the capacity to convert some regular patient rooms into negative pressure rooms.

Q: Will the “Ebola” rooms that were prepared at the old University Rehabilitation Center be used in caring for COVID-19 patients?

A: They will not, because the two diseases are totally different, and treated in totally different ways. There are only two patient rooms that were intended for Ebola use at URC, and it would not be feasible to staff them separately from the main hospitals.

Q: If I have chronic health conditions that affect my immune system, will I be expected to care for someone with COVID-19?

A: There are no specific employee limitations established for care of COVID-19 patients at this time.

Q: If I’m not a front-line caregiver but my job takes me onto hospital floors and clinic areas, should I be concerned if those areas are taking care of suspected or confirmed COVID-19 patients?

A: Direct or close contact with a COVID-19 patient is the common mode of transmission of infection. That being said, following regular prevention measures such as hand hygiene while entering and exiting patient care areas, and staying away from those who are sick, will help you protect yourself. 

Q: If we find ourselves taking care of a large number of COVID-19 patients, will employees still get to take vacation?

A: This is a rapidly evolving situation, and currently there are no limitations on employees. This is subject to change if we see widespread transmission.

Q: If I’m a member of the U.S. military and coming back from an overseas deployment, especially in a country with a COVID-19 outbreak, can I come back to work?

A: The military will screen all service members upon returning from deployments outside this country before they are released from orders to return to work.

Q: If I’m a researcher and have foreign travel scheduled, will the Medical Center allow it in light of COVID-19?

A: All UMMC-related international travel has been canceled, as has all UMMC-related, non-essential, out-of-state travel. The Medical Center strongly discourages personal international travel, and urges extreme caution and judgment for any personal domestic travel, including driving when possible instead of flying. For more information, read the campus memo on COVID-19 Protocols for Travel and Events.

Q: What do I do if a family member in my household gets sick with COVID-19?

A: Close contact with a family member with COVID-19 exposes you, and puts you at risk for developing and transmitting the infection. Faculty and staff may be eligible to work from home, as determined on a case-by-case basis. Use of Personal Leave will be allowed during the self-monitoring period as approved by Human Resources. (Medical Leave may be used for diagnosed illness after the required initial 8 hours of Personal Leave.) After the self-monitoring period, faculty, staff and students will be eligible to return to campus with the approval of Student/Employee Health and upon provision of the documentation of signs and symptoms from the self-monitoring period. For details, see the campus memo on Employee Protocols.