SLIDE 29 Responses were provided based on information known on 6/2/2020 and may become out of date. Guidance is being updated rapidly, so users should look to CDC and NE DHHS guidance for updates. NETEC – NICS/Nebraska DHHS HAI-AR/Nebraska ICAP Small and Critical Access Hospitals-Outpatient Region VII Webinar on COVID-19 6/2/2020
- 1. We want to use a MDI spacer for multiple patients in our respiratory disease clinic. How do we
disinfect the spacer to use it for different patients? Nebraska Medicine has a process that includes taking the canister portion out and cleaning that part of the spacer. Check the manufacturer’s instructions for the MDI portion of the equipment to see if they say it is something that can be reprocessed. You will know that it can’t be reprocessed if it has a “2” with an “X” through it - . This means the device cannot be used for more than one patient. You can’t try to reuse it. If it does have some disinfection guidance you need to follow those manufacturer’s direction. The canister of drug could be removed and disinfected and reused but the plastic component would be difficult to clean. You are bound to follow the manufacturer’s rules.
- 2. Some employers are requiring a negative test after infection prior to return to work. But they
have been finding the test may be positive for several weeks even though the staff member is asymptomatic and meets clinical criteria to return to work. What is the recommendation in these cases? For people like that, you can’t dictate employer policy; but that is the problem using a test-out (test based) strategy, because there are people who are shedding viruses for a long period of
- time. That is why the CDC made that very clear statement. Nebraska Medicine is allowing
healthcare workers to return to work; we use universal masking and no test to return to work policy is in place. Dr. VanSchooneveld’s personal opinion is -- The one question might be immune-compromised workers, but in general, for workers who are better and meet the CDC criteria, they can return to work at Nebraska Medicine.
- 3. Our lab is being told that VTM is still on short supply. Is this true throughout the state?
- Dr. VanSchooneveld said that he has heard that viral transport material is in short supply.
Nebraska Medicine has been manufacturing some of their own. There have been shortages of all Testing supplies.
- 4. Why is there so little info on presence of immunity or duration of protective effects? Can
you summarize any current practices for postpositive staff returning to work in your system? The reason for there is so little information on immunity is that this virus has only been around since December 2019. We only have 6 months of experience to study it. Animal studies are going on, which will help us understand this. That is why we don’t know the duration of
- immunity. Current practice for post-positive depends on the decision a facility makes on what
criteria is being used, whether test-based or symptom-based and do they meet your criteria. Make sure your people follow your safety practices. Our experience is that the most problematic are staff members who have mild symptoms and continue to work anyway, not doing anything about it and exposing other people.
