Health & Safety Q & A about Masks for Employees & Visitors in Clinics

At a recent SHARE Rep meeting, questions about health and safety came up that would likely be of interest to many SHARE members.

Dr. Kimi Kobayashi

We asked Dr. Kimi Kobayashi, UMass Memorial’s Chief Quality Officer to answer these questions:

Q. Clinic staff wonder why they get the yellow surgical masks. They are concerned that because they rip easily that they aren’t effective barriers for COVID protection. They would rather have the blue masks. Are the yellow surgical masks safe? Why can’t the clinics get blue masks?

A. We have received many questions about the yellow masks. Interestingly they are actually more sophisticated than the blue masks. That’s because they are the hypoallergenic masks which is the reason why some folks feel that they are “thinner.” In terms of filtration ability which really reflects the ability to protect caregivers, it performs the same as the blue masks. All of that being said, I think folks will start to see less of the yellow masks because our inventory of them is set to expire either this week or next.

Q. Another mask question in clinics: They say they are only allowed to order the Gerson N95, which doesn’t fit many people, is cheaply made and the elastic headband breaks easily. Are there better N95s available in ambulatory areas? Are the Gerson N95s effective?

A. The clinical staff should be wearing the N95 mask that they were fit tested to. If that is the Gerson then it should be ok. Do you know if these are folks that are looking for the mask they were fit-tested to? If so, they could go get repeat fit-testing to see if they might fit to a different mask. The clinic should be able to order the specific mask that a caregiver is fit tested to.

Q. Is there any thought to limiting visitors to ambulatory clinics? I hear frustration from clinic staff who find out they’ve been exposed to COVID from a patient’s family or companion during appointments.

A. We have consistently and continuously evaluated our visitor policies. We actually just had a call today about the ambulatory visitor policy. We review DPH guidance which currently requires us to allow visitors and we also benchmark with other peer institutions in the state and we are right in line with other organizations.

How Does the Hospital Know that Caregivers Are Not Getting COVID at Work?

Dr. Robert Klugman, Associate Vice President and Medical Director Employee and Occupational Health Services

Because SHARE members have been asking, we put that question to Dr. Robert Klugman. Among other things, Dr. Klugman serves as UMass Memorial’s Medical Director of Employee Health. Specifically, we wanted to understand: How does UMass Memorial know that the employees who’ve recently gotten COVID have done so in the community? How do we know most of them didn’t contract the disease while working in our hospital?

Here’s what Dr. Klugman had to say about Covid-19 infections in healthcare workers in our hospital:

• Presently, Omicron makes up essentially all the infections we are seeing.

• It is highly contagious, and requires far fewer virus particles to be transmitted than Delta and others, regardless of vaccination status.

• We track all healthcare workers who contract Covid-19 and have analyzed transmission patterns for many months, both in terms of patient-caregiver as well as caregiver-caregiver.

• We have had a huge upswing of cases since late December with the advent of Omicron.

• Despite literally hundreds of infections, we have seen only rare patient-caregiver and caregiver-caregiver infections. This includes our ED’s, where Covid is prevalent, as well as Covid units. This is, in part, due to masking, distancing, PPE.

• We track healthcare workers who test positive and report that they having eaten with, sat with, spent time with other healthcare workers without consistent masking and distancing, and have had very very few of those potentially exposed  test positive from these exposures.

• We have had countless reports of ill family members, friends and other outside contacts as the source of a HCW infection and in many cases, staff have not been on site or work remotely when become positive.

Process Changes in COVID Patient Care

SHARE has received some questions from members about a recent change regarding patients with (or under investigation for) COVID-19. Hospital leaders have assured SHARE that the new procedures are based on safe, common practices.  

“A recent study comparing MGH and BWH showed that even though 22% of COVID-19 patients were cared in negative pressure rooms at MGH (compared to 96% at BWH), the rate of HCW infection was the same. Most patients at MGH were cared in a standard room without a HEPA filter.
”

— UMass Memorial

WHAT CHANGED? 

Before, the hospital required these patients to be roomed in isolated and negative-pressure rooms, and that caregivers be in the room for a more limited amount of time. However, those guidelines have changed. Over the course of the pandemic, researchers have come to understand that COVID-positive patients actually pose low risk of transmitting the disease in well-ventilated spaces, including standard hospital rooms. Therefore, patients may now be roomed in positive-pressure rooms, and staff may remain in the room with these patients for up to 2.5 hours. 

WHAT IS UMASS MEMORIAL DOING TO MAKE SURE PATIENTS ARE IN THE APPROPRIATE ROOMS?  

Bed Control is up-to-date with the latest guidelines. The Infection Control team reviews patients daily to monitor for appropriate room placement and can work with them to make changes if necessary. 

DO OTHER HOSPITALS FOLLOW SIMILAR GUIDELINES FOR COVID PATIENTS? 

According to UMass Memorial, hospitals in the Boston area and around the country have cared for large numbers of COVID-19 positive patients in standard rooms without evidence that COVID–19 transmission is higher.  

WHAT SHOULD I DO IF I HAVE QUESTIONS OR CONCERNS ABOUT THE PROCEDURES I’M ASKED TO USE IN CARING FOR COVID PATIENTS? 

Talk with the nurse manager or nursing supervisor in your area.