Called to work in COVID-19 clinic

I've been called to work inthe COVID19 clinic for a month. I don't wish to bring anything home and infect my family. Is it worth it to camp outside my house? Or rent an air bnb?

Or strip naked before coming inside and showering?

Recommendations is to gown up and perform hand hygiene before leaving work.

Comments

  • Recommendations is to gown up and perform hand hygiene before leaving work.

    Try doing this.

  • I reckon shower and change clothes before going home. Leave shoes at work and wear different pair home. Yup definitely hand hygiene.

    • Hospitals recommend against this. Chance of contamination. Best to go home, and strip and clean before entering. All that is in vain if you're already infected unfortunately.

      • The best time to decontaminate is between finishing the task/job/worksite and before entering the vehicle/uber/taxi/public transport to go home.

        firedragon is leaving the contaminated site clean which is safer for anyone that they come in contact with for the rest of the day.

        • They shouldn't be coming into contact with anybody. Staff should be immediately be going home to change and shower.

          If they must use public transport then change at both ends.

      • This is absolutely false. Hospitals encourage you to shower and change at work.

      • What zeggie has said is correct and I don't know why this was negged. Hospital staff are being advised to do just this.

        • I still don't get why showering at work is not recommended from a theoretical point of view. Zeggie says above "chance of contamination", does that mean contaminating the shower area?

          Let's imagine from a contact precaution point of view. If I were to work in the clinic, and use my stethoscope on an infectious patient and then coincidentally wrap the stethoscope around my neck, before wiping down my stethscope, then my neck and impervious gown would be "dirty". My regular hand hygiene would have cleaned my hand, but not my neck.

          Removing the gown would solve half the problem, but say I finish work, changed my clothes and did not shower. I touch my neck with my hand and followed up by holding onto the steering wheel / pressing "stop" on the bus, then these areas could potentially carry whatever organism. This is with the presumption that organisms can survive on surfaces for hours if not longer etc

          When exposed to body fluids, AFAIK the recommendation is to wash the area ASAP with soapy water etc (correct me if I'm wrong). So i would think there is no risk of showering after work. Having said that showering facilities aren't readily available for all clinical areas

          • @k15866:

            chance of contamination", does that mean contaminating the shower area?

            It is probably this. You also mention in your post that most facilities don't have great showering areas which is also true.

            I think the idea is that trying to decontaminate at home by putting your clothes in a plastic bag there and then showering you are less likely to contaminate a public place.

            I don't think this method is without flaws by a long stretch. Maybe they'll invest in a more stringent procedure if staff are continually sparking community transmission, but this is the method for now.

    • This is what the CDC advises. Don't listen to zeggie.

      • What authority does the CDC have in Australia?

        • All of our hospitals rely on this. The CDC is a very valuable source of information, and our health departments in conjunction with our own experts use a variety of sources.

          • @meowsers: we aren't in america

              • @whooah1979: That is not my point. CDC has no authority in Australia

                • @hmac: I never said it has authority, I am intimating that the CDC guidelines, practices and clinical protocols are used in Australia more often than not.

                • @hmac: https://www1.health.gov.au/internet/main/publishing.nsf/Content/7A8654A8CB144F5FCA2584F8001F91E2/$File/interim-COVID-19-SoNG-v2.4.pdf

                  "It has been adapted from CDNA National Guidelines for Public Health Units MERS-CoV, utilising current CDC and WHO guidance".

                  As much as you don't want to admit it. The CDC plays a very large role in this as the world's leading authority on this sort of stuff, in conjunction with WHO.

            • @hmac: We aren't in America, but CDC guidance is used literally verbatim many times.

              https://www.dhhs.vic.gov.au/sites/default/files/documents/20...

              Check out the bottom of this flyer. I would suggest you learn more before you comment.

              CDC guidelines are literally on the DHHS website as recommended resources.

              • -14 votes

                @meowsers: Congratulations. You can use google. You found documents related to COVID-19 that contain the term 'CDC'

                None of the documents you provided refer to OP's specific question. Not one.

                Amusingly, the document you linked here only mentions CDC as being 1 of 28 sources referenced in the bibliography. Hardly an "authority" or "very large role".

                Were you actually in this line of work, you would have known the actual policy is made at the hospital level :)

                • @zeggie:

                  Amusingly, the document you linked here only mentions CDC as being 1 of 28 sources referenced in the bibliography. Hardly an "authority" or "very large role".

                  meowsers said

                  The CDC is a very valuable source of information, and our health departments in conjunction with our own experts use a variety of sources.

                  Your suggestion that being 1 of the 28 sources diminishes their large role or authority on matters pertaining to this pandemic is laughable. This isn't some simple quantity > quality

                  • @Blitzfx: Pertaining to pandemic? That's not the topic. This topic is specifically pertaining to policy regarding PPE and uniforms and going home safely. Read OP's post again.

                    …Which again is hospital policy. Not CDC. Not health departments. Not government. Note my very first post stated hospitals?

                    I'm calling out everything because it's clear they are not involved professionally and are relying on Google for documents to suit their narrative.

                • @zeggie: Policy is certainly implemented at a hospital level, but ultimately made at a Federal and state level.

            • @hmac:

              we aren't in america

              CDC has branches all over the world, not just America. Even in China.

            • @hmac: This week, the TGA rules have been relaxed to allow anyone to produce and sell the product, as long as it's made according to recipes provided by either the World Health Organisation or the US Food and Drug Administration.

              Lol well the TGA seems to think otherwise.

        • Soo… they don't know what they're talking about due to our locality?

    • If you breathe in the virus, which can be "hanging" in the air for a while, chances are you get infected. So clothes should be your secondary worry.
      Operation mask are for the wearer not to expel contaminants, for example the doctor not to pass on viruses of infection to the patient being operated. They do not work ( my opinion ) that well the other way round.

      If you can, sleep and live in a separate room, and eat in a different place. Put your cuttlery and dishes in boiling water after use.

      In other words, behave like you are infected.

      (P.S. No doctor here, just trying to remember my biology classes )

      • This is only partially true at best.

        Surgical masks are there as a barrier to prevent the wearer from body fluids, secretions, etc. of other people just as much to protect others from the wearer.

        As others have mentioned, ideally you you stay away from your family while working in the COVID clinic. Failing that, showering at work before returning home & then changing & showering ASAP would be next best.

        I'm a GP Registrar & I wear scrubs at work, then change into street clothes before leaving for home. Once home I leave my shoes outside, undress in the laundry & then have a shower before acknowledging my wife & kids.

        I'm not quite as front line as a COVID clinic, but we have no idea what's coming through our door most of the time, so they're the precautions I'm taking.

  • it dosent fall off your clothes like a powder. take your shoes off before u go in the house and walk straight to the shower. or better yet, set up one of those camp showers in the back yard with a hose. but they would definitely tell u what the actual going home protocol is when u start working. first thing they will tell u is dont ask for advice on the internet.

  • +12 votes

    I perform hand hygiene, disinfect my forearm and elbow, watch, phone, water bottle, wallet as I leave work.
    Hand hygiene again if I have to press elevator buttons, keypads or use door handles on the way out.
    Disinfect car keys, door knobs (inside and outside), put my bag away in a corner when I get home and go straight to the shower.
    Personally I believe that's about as careful as I can be but this won't protect my family at all if I get infected.

    So yes, living separately from your family would be your best bet.

    • Can I ask please what you are using to disinfect your watch, wallet and car keys?

      • Commercial disinfectant spray at work, hand sanitizer at home.
        But I’ve managed to pick up some denat alcohol a few days ago so will start doing my own mixture to disinfect items.

  • +21 votes

    My wife is a nurse. She enters the house through the laundry leaving her shoes outside, undresses in the laundry and puts her outer clothes straight into the washing machine, then goes for a shower.

  • Sleep in a tent, good adventure anyway

  • Thank you for your work OP

  • Thanks all. I'll try to make an outdoor shower with hot water, just to scare you the neighbours.

  • I take off my clothes the moment I get into the house and take it into the laundry. Then shower.
    There's an intensivist on twitter who lives in a tent in his garage now

    • My colleagues have said they showered at the gym (before they closed), some have rented an apartment to isolate themselves.

      I'll probably, shoes off and outside, buy cheap clothes to wear, strip outside before coming inside.

      I will definitely be in contact with the virus.

      People are filling in, as some frontline healthcare workers are more vulnerable (pregnant, diabetes, heart disease, underlying respiratory illness).

  • My office ended up being within the COVID-19 clinic some weeks ago until I moved out. I ended up taking my scrubs off at the change rooms, showering, changing into new clothes and washing the scrubs at home. Wearing a gown and mask ended up being compulsory.

  • Try contacting a local hostel to see if they are able to offer Isolation stays and see if work is able to reimburse you or if you are able to write it off as an expense.

    Or you can try to AirBnb it. Personally, I wouldn't try to bring anything home especially if you have elderly or immunocompromised family.

  • By now you would have completed loads of mandatory training for this
    e.g donning and doffing. You can make an informed choice, why ask on here?

    10% of infected health staff in Spain have died. Take some care. Don't stuff up.

  • do u get told what PPE u HAVE to wear to follow some guidelines and be uniform? because u will be given N95 masks to wear like all the other front line workers. but if u had say… a P100 full face mask, like the ones i have (3m 6800, with 6038/6035 filters) which i find are actually alot more comfortable and i could wear even longer than a regular n95 mask (part of my regular job). would u be able to wear that? cos if u can, they are basically full proof. 99.99% protection over the n95 (95%). the only way u could be infected is if u take your mask off and touch your face. i dont know why i dont see more people wearing them while watching the news.

    • My wife works in a hospital. They skimp on masks etc., only wearing protection once a patient is proven positive. Heck sometimes the referrals don't even say query MERS when they should. For some reason she doesn't want to look odd wearing a larger mask. I'd love it if she wore your kit!

  • Maybe you should have not paid for your tennants rent - you could have stayed there.

  •  

    And leave your pen at work

  • Just keep in mind if you get infected (either at work or from taking off PPE at home) then there'll be a long period of time your body will be shedding the virus all over the house and can (will) infect your household members.

    No amount of care with your PPE or washing yourself will matter if you're infected.

    The only guaranteed method is isolation.

  • I've seen people using their garages as the transit zone. Stripping off in there, bagging up clothes for the wash and cleaning up themselves and their belongings.

    Main principal has to be avoiding bringing anything that has been exposed to the working environment into your home.

    Ideally get changed at work, leave shoes etc there. Clean the car regularly too as a potential source of transmission

    • Hospitals are recommending their staff do not change at work as there's a high chance of contamination in their facilities.

      • Good point. You can't guarantee the changing rooms are clean etc.

        Maybe stick with a changing zone at home then

  • Protocol at my work is to have a disinfection spray, wipes and plastic bags in the car and one at home. Have the house keys seperate to car keys and leave it in the plastic bag inside the car.

    Touch only what is necessary when leaving - office door, car door, car keys, gear shift, seat, belt, wheel.

    Upon leaving the car spray all surfaces touched and wipe down, use wipe to close door.

    Invert the bag and use as a glove. Enter the house and go straight for the shower. Leave the housekey in the sink, remove all clothing and place into the bag. Shower.

    After shower, take the bag of dirty clothes/scrubs and place into the laundry machine. You should keep the spray and wipes for home on top of the laundry. Wipe all surfaces you've come in contact with and work backwards. Spray the keys, spray and wipe the laundry machine handle, doors and shower handle/faucets.

    You are now clean.

    • Exactly this.

      OP will get to enjoy a nice long training seminar going into all this in detail.

    • Enter the house and go straight for the shower. Leave the housekey in the sink, remove all clothing and place into the bag. Shower.

      This part doesn't make sense.

      Contaminated material are on PPE and sometime on work uniforms. Proper decontaminating procedures must be to bag and seal all PPE onsite while work uniforms should be changed before entering the vehicle.

      • PPE doesn't leave. Uniform does.

      • Sorry, I should elaborate, I'm not regularly in the hospitals.

        This is additional personal protocol - what to do from the moment you step out of work, after completing all required hospital/regular workplace protocol.

        The above personal protocol can be exercised even if one takes a trip to the supermarket. It is to minimise the aerosols/splatter accumulated from sources outside the home from ending up in the home.

        It has less to do with bringing germs out of work and more to do with minimising the germs you bring home.

    • https://www.anzics.com.au/wp-content/uploads/2020/03/ANZICS-...

      These are the ANZICS guidelines and are being adopted by most (if not all hospitals).

      Read page 21 (some numbering differences on PDF) Ignore what your hospital tells you as they are placing you at risk. Don't wear your scrubs home. Utterly stupid. Take a shower at work. Change into fresh clothes at work. IF it's good enough in ICU, it's good enough to listen to .

      "
      We recommend that hospitals have the following available for all staff in intensive care:
      ● Clean scrubs available to change into before each shift
      ● Showering facilities at the end of each shift.
      ● Provision of meals and drinks for frontline staff"

      This document is a consensus statement from 50 of the brightest minds in Australian \ NZ ICU.

      • Don't wear your scrubs home. Utterly stupid.

        Our scrubs are just uniform as we are not in a hospital setting. Our scrubs used for day surgery or hospital visits are only put in in the hospital and must be off before leaving.

        The advice provided was not to supercede work protocol, it is in addition and applies from the moment you leave the work premise. Even if I just showered at work, that walk from shower to car can still contain aerosols or splatter. It is best to treat the garment as contaminated and proceed accordingly.

        • Yes but most hospital staff are not in theatres. AKA they supply their own scrubs.

          Do whatever you want.. Expose your family to more risk. Totally your call.

  • Im sure they will take all precautions there
    No need to ask the OB community here.
    The Health Dept knows best on this one

  • You need to set up disinfectant booth like this outside your house.

  • Take a good shower before you leave work, then a good shower when you get home. Wear a face mask so you don't infect anyone at home.

    You are highest risk therefore it is better for you to take precautions than anyone else in the house.

    Good on you for trying to find out the risk. Most people still don't get it that it isn't wearing a mask that stops the spread of the disease but actually cutting down on contact with strangers who you don't know their contact history.

    If you are in a job within contact with a lot of strangers then wear a mask. If I'm isolated at home all day working why would I wear a mask? A little common sense goes a long way.

    • The problem with wearing masks at home is that you will be taking it on and off to drink/eat. That increases the contact to face and then subsequent hand contact to many other things.

      • Wash items you've been in contact with and your hands, swap to a new mask. Either that or depending on family members you'll have to make them all wear masks and clean up after themselves. Invisible germs.

        Essentially self quarantine. If there is a separate room, set it up and sleep in it. Least costly way other than staying outside of the house.

      • Surgical masks generally only serve to try to prevent you from coughing on other people and spreading the infection. They can help with this and as such may be useful. Guidance is changing on this topic at a rapid pace.

        • That would operate on the assumption that the individual wearing the mask is more likely to be already infected than the risk of the same individual being infected by touching their face.

          Then there's the risk or the hands touching the infected person's mask/face and touching other surfaces.

          (I honestly don't know which risk is greater, but I'm operating on hands infecting persons being higher).

        • They work both ways, but there is little solid evidence to support an argument, only anecdotal. Droplets from talking (loudly), coughing, sneezing, persist in the air for several minutes. These droplets carry the virus

  • For those saying that there will be training, don't count on it. For example, nurses working screening people at Sydney airport as people arrive in Australia received no specific training from NSW Health.

    So definitely do your own research. The advice that I have seen is for all essential workers coming home to strip and immediately shower INCLUDING WASHING HAIR. Working in a COVID-19 clinic means chances of being in contact with it is increased, So I would definitely be taking even more precautions to keep my family safe.

    • I agree. "Quarantine" yourself as much as possible/feasible during this time at home.
      eg:
      - stay in a different room with its own window
      - do not share any room with them if possible
      - use separate toilet/bathroom,….
      - Check your temperature 2-4 hourly
      ….
      We don't know your exact situation, living with partner and kids we assume,(age?…)
      if you have any elderly, then definitely consider u or them (elderly) to leave in 2 different "areas" eg you to live at an air bnb

  • Tell them you are pregnant