COVID-19 Q & A

Updated September 22, 2020 - 8:50am

Mary Greeley employees are asking a lot of great questions related to the COVID-19 situation. We are doing our best to get all these questions answered in a timely fashion. These questions and answers will be updated regularly.

Not all employees have remote access to email. Check with your supervisor if this is available to you. Meanwhile, there are several ways employees can keep up to date when they are away from the hospital.

The Gram is available on Mary Greeley’s external website: www.mgmc.org/gram

The COVID-19 staff information posted on the Intranet is also available via the website: www.mgmc.org/update

We post a lot of updates, including COVID-19 info, on Facebook Workplace. To join Workplace, go to www.workplace.com and log in using your Mary Greeley email.

PLEASE REVIEW QUESTIONS ALREADY ANSWERED BEFORE SUBMITTING YOUR QUESTION.

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Recently Answered Questions

There are a lot of people that are/will be skeptical about the COVID-19 Vaccine when it becomes available. I assume you will make this mandatory for employees. What actions will be taken if an employee refuses to receive the COVID-19 Vaccine when it becomes available?

Thanks for your question. CDC, Iowa Department of Public Health, and our local health departments continue to work tirelessly on vaccination plans. At this point, there are no concrete plans in place, and we would hate to speculate what our plans could be. We are working with Story County Public Health and other health care organizations around us to understand what will be available to us, when it will be available to us, and who will receive the vaccine. As soon as we have more detailed and understood plans, we will let everyone know.

If we have to stay home to take care of a sick child who tests positive for COVID do we have to burn up our PTO, or is it covered under something else?

This situation would qualify for FMLA, but FMLA does require the use of PTO before unpaid time. Below is this section of the FMLA Policy HR460. It also include information about FFCRA, but as essential healthcare workers we are not subject to this law.

An employee who is taking FMLA leave because of the employee's own serious health condition must use all paid PTO and sick leave prior to being eligible for unpaid leave. An employee who is taking FMLA leave because of the serious health condition of a family member must use all paid PTO prior to being eligible for unpaid leave. Sick leave may be run concurrently with FMLA leave if the reason for the FMLA leave is covered by the established sick leave policy.

Disability leave will run concurrently with FMLA in situations when the employee qualifies for both. (i.e. for the birth of a child and for an employee's own serious health condition, including workers' compensation leave to the extent that it qualifies. An employee who is taking leave for the adoption or foster care of a child must use all paid PTO leave prior to being eligible for unpaid leave. An employee who is using military FMLA leave for a qualifying exigency must use all paid PTO prior to being eligible for unpaid leave. An employee using FMLA military caregiver leave must also use all paid family sick and PTO prior to being eligible for unpaid leave.

The FFCRA (Families First Coronavirus Response Act) that spells out leave entitlements due to COVID-19 specifically excludes essential healthcare workers and first responders from being subject to this law.

Additional COVID-19 Questions

Pay, Benefits & PTO

Mary Greeley just announced bonuses for all staff. I am truly thankful for this, however, has there been any consideration to giving bedside nurses who work at the frontline with COVID additional pay/bonus. I am not a bedside nurse, but have seen firsthand the hardship and stress they have endured working for months taking care of these very high acuity patients. The 6th floor nurses have been amazing at adapting to this change and caring for these very sick patients. I am just wondering if there has been consideration to giving them extra recognition with additional bonuses to show support?

The work by nurses on the frontlines is deeply appreciated. There have also been many ancillary and support departments that have also been on the frontlines. Nearly every employee in the organization has had additional stress or changes put on their work. Healthcare is a team sport and we want to recognize all members of the team. We may have different roles, but we are all working together to support our patients and each other through COVID.

There are many employees here that don't have PTO because it is used from chronic illness, babies, previously planned absences or they just don't have PTO, such as PRN and weekend package staff. Is Mary Greely taking steps to help support those staff to encourage them to stay home if they have flu/cold-like symptoms? My concern is that some cannot take unpaid time and if they don't have PTO are going to be more likely to not be honest with symptoms so as to not be sent home.

Mary Greeley will handle each situation on a case by case basis to ensure we are doing what's right in each situation. There are many different pay and benefit programs that will figure into how someone will be paid if they become ill including PTO, Short Term Disability and Workers Compensation. Iowa Workforce Development unemployment insurance may also apply for those individuals without any benefits even as an active employee. The U.S. Congress's Emergency Coronavirus Bill may also provide some help.

On Saturday, the House of Representatives passed an emergency coronavirus bill that included varying levels of paid sick leave for impacted workers. This bill now needs to run through the Senate and have the President sign it into law, which he has already indicated he is willing to do. The details on how this will be administered are still unclear.

We will continue to monitor the rapidly evolving situation to ensure we are taking excellent care of our Mary Greeley family! Any employee that feels ill should first call their primary care physician and then contact Employee Health by calling 515-239-6905.

I have heard that short term/work comp will be decided on a person by person basis. How will this be decided? We are going to be the epicenter of illness. How will you be able to tell if someone developed illness here vs out in the community?

The workers compensation insurance carriers will be required to investigate each work comp claim to specifically tie to a patient who had active Covid-19 exposure where PPE was not being utilized. In addition to our benefit programs Congress is working on some financial relief for employees.

If my children or family have to be quarantined due to illness or suspected illness what is my expectation for work? Will I need to quarantine with them to help prevent spread? If so will I be able to get short term disability to help with financial concerns?

On Sunday, March 15, the IDPH implemented new recommendations for healthcare staff. The new recommendation states that asymptomatic healthcare workers with potential/real exposure can still work while wearing a facemask. It is recommended that these staff continue to monitor symptoms twice daily, and if they become symptomatic they should stay at home and contact their physician.

Is there any update on plans for childcare? Some daycares are already talking about temporarily shutting down.

Child care, adult dependent day care, and pet care are areas we are actively working on. We have involved community leaders and MGMC staff in to develop solutions. Please stay tuned for details.

Is there a plan for salaried employees' pay compensation if the need arises where they are working way more than 40 hours a week during a surge of patients?

In the event that we see higher than normal census and patient acuity levels due to COVID-19, we may need staff, both hourly and salaried employees, to potentially work additional hours. While we cannot say at this time what that might look like, the safety, health and well-being of our staff is of utmost importance, and we will do our best to manage staffing so employees stay well and rested.

Will we have to use our PTO if we are exposed and mandatory quarantined? Or will we be provided paid leave during quarantine?

These situations would be handled on a case-by-case basis. There are a variety of options to be considered depending on the circumstances. Please contact Employee Health if you are in this situation.

In regards to medications and our insurance since we are self-insured, are you allowing to refill our medications early in the event we have to self-quarantine or should not make extra trips out?

Yes. We have removed the limitation from our medical plan so employees can refill prescriptions early.

Will staff who have PTO be required to use it in the event of COVID illness, especially if exposure was at work? It seems that the employees without PTO will have other options but not those who have PTO saved for future use.

If an employee becomes ill they will most likely be eligible for short term disability. If not, the new unemployment compensation policies should provide needed assistance.

Clearly this crisis is causing worry. As healthcare workers, we do our best not to get scared - but we're entering uncharted territory. Has there been any thought to the mental health of our employees? I know we can access our EAP, but would it be an option to possibly bring counselors in to the hospital for staff to talk to?

The health and well-being of our employees is always top-of-mind, especially during as intense a time as we are facing now. We are looking for on-site counseling options and hope to announce a resource soon. Our Employee Assistance provider is extremely busy with client calls and do not have the resources available to come on site at this time. They are very skilled at providing counseling and guidance over the telephone. They are also available 24 hours a day 7 days a week. EAP can be reached at 515.244.6090 or 800.327.4692.

Has anything been decided on hazard pay for employees that are caring for patients with COVID or suspected COVID? Both directly and indirectly?

There will be no hazard pay. With the use of proper PPE the risk of exposure is mitigated.

I am close to maxing out on PTO and have vacations planned in order to use some of the PTO. Those vacations may now not be granted d/t our COVID emergency. Will I still lose my PTO once I reach the maximum? Is there something in place so that doesn't happen?

Unfortunately, yes, you may lose the PTO if you are unable to use it. One thing to consider, however, is donating it to staff who may need it during this critical time.

Just wondering if we have to take time off because of lack of work (as in cases cancelled for numerous days) do we have to take PTO or how would it be handled?

We will need all employees to help us through this situation. The chances of there being any lack of work is quite minimal. We honestly do not foresee that happening. We are working with department heads to determine needs and opportunities where staff can lend their skills in other departments.

I read on the news that hospitals across the nation may not be able to make payroll after a few weeks due to lack of revenue from scheduled surgeries. Is Mary Greeley in this position?

Mary Greeley is not in this position. Mary Greeley has been fortunate to have been very fiscally responsible over the years which has led to being in a strong financial position. This means we are able to weather this pandemic and focus on caring for our patients.

If half the department is working from home, can the half still working from the hospital get hazard pay?

At present, hazard pay is not under consideration.

Why won’t Mary Greely just make sure we are taken care of if we get sick? Boone County Hospital has promised staff regular pay if they get COVID -- no worries, no applying for benefits, they don't use PTO. Many staff here have possibly been exposed to COVID.

The report on Boone County Hospital is not accurate. If a Boone County Hospital employee has COVID-19, they will need to use their sick leave and PTO. The same will apply to Mary Greeley employees. This is why we are stressing the use of proper PPE and limiting the number of staff who interact with a COVID-19 patient.

Very worried about repercussions about attendance policy. Have no current hits but one quarantine would put me in jeopardy of losing my job by the points system. I am a good employee who wants to help and who NEVER calls in unless dire and have been directly exposed with high potential to have to quarantine. I want to help people not lose my job over this because of a policy.

A physician-required quarantine or COVID-19 illness will NOT result in disciplinary action. These are medically required measures and even before COVID-19 medically necessary absences would not be considered as an attendance violation per our policy. Please do not worry about these scenarios – if you are worried please reach out to human resources so we can give you accurate answers.

There is a rumor floating around that staff’s vacation is being denied and already granted vacation is getting pulled due to the pandemic. Is any of this true?

Thank you for bringing this rumor up! This one is simply not true. Any employee with questions about their PTO should talk with their leader. 

If we are told to work from home, can we work 2-3 days from home and 2-3 days at work? Or once you are gone, you're gone until called back?

This is managed by each department based on their needs. Please discuss with your leader.

I currently am a 40-hour-a-week employee. They are reducing my hours next week to 12 hours. They are going to try and find me more hours in other areas but no guarantee. Can I apply for unemployment for reduced hours due to COVID-19 and not use my PTO hours? With several weeks ahead of us, just want to be sure I have some sort of income coming in.

Yes, if someone is being low censused due to a lack of available work, then they may apply for unemployment even if they have PTO available. 

While we are quiet leading up to more coronavirus cases being admitted and our hospital census is low do RN's or any staff who would like time off  HAVE to take PTO or is it an option to have time off without PTO?  Will preference be given to staff that want to use PTO or can anyone take time off regardless of if they use PTO or not.

During this quiet leading up to more coronavirus cases being admitted and our hospital census is low those staff members who would like to take time off should let their leaders know.  That way if we need to use Low Census we will prioritize these folks first before moving to a mandatory rotation for low census.  Anyone taking time off due to low census has the option to use PTO, unpaid time, or apply for unemployment. 

As a new full time employee being required to low census, will I lose medical/benefits if I don't have PTO to cover the gap to full time status?

Great question and thanks for asking. No, low census does not change anyone’s actual employment status. This is true anytime we use low census throughout the year, not just in response to COVID-19.

I have had to take low census in my area for several weeks now. I use PTO. It doesn't seem fair that others in my area are given 40 hours a week. Is there to be a rotation of any kind with the use of low census? I have not yet been put in the labor pool. If put in the labor pool and I give the availably of hours, do you get options where you may be placed and can turn down if offered? Or do you have to take whatever and where ever is offered.

Talk to your leader about your concerns regarding low census rotation. All staff are considered for the labor pool openings before they are low censused. Before leaders low census staff the leader submits the employees’ names and typical hours to see if there are any labor pool needs to be filled. While the labor pool tries to accommodate an employee’s preferred hours, the availability of work may not match so shifting may be required. Once a schedule for the labor pool has been determined this info goes back to the leaders to discuss with the individual employees.

Staffing

Many employees have come back onsite, but now it seems as though COVID in our community is the worst it has been. Even several MGMC employees have it. Should those of us who have come back consider returning home?

To date, none of our exposures to COVID in house have resulted in an employee testing positive. All employees can safely be at work, however they must wear their face masks at all times, social distance especially when in break rooms, and use good hand hygiene. All employees have been given face shields as well, and these should always be worn in patient encounters and highly encouraged at all other times. Some employees – 15 to date – have tested positive due to community spread. Several have recovered and have returned to work. The others are still off as of July 3. 

Are you requiring staff to work with COVID-19 patients if over 60 y/o or if they have co-morbidities like asthma? I feel this is an unsafe situation if the answer is "yes" as you may be causing more illness. I understand if there is no one else, otherwise I feel other staff should step up.

Staff who are considered at risk will not be assigned to care for COVID-19 patients at this time.

Some employees have the ability to do their jobs from home. Has there been any thought to remote access? Especially if they have to quarantine due to family or potential illness.

There are certainly some staff who could work remotely. One concern, however, is cybersecurity. It is likely the hospital's cybersecurity will be stronger than at most homes. Information Systems and Human Resources are developing action plans to respond to the potential need for some employees to work remotely and we are enhancing our ability to provide secure laptops to staff who may be designated to work remotely as a result of the current situation. Supervisors have been asked to identity positions that could work remotely.

Throughout this whole situation we have talked about at risk groups including those that are immunocompromised. Within our own staff there are people that are immunocompromised. What is the plan for our at risk employees?

Any at-risk employee should use standard precautions as they would at any time. At-risk staff would not be assigned to any COVID-19 patients. If there are special needs and considerations, please let your leader know.

The UK just announced that pregnant women are now in the 'most at risk' category. Are we doing anything to protect our pregnant staff? Should they be able to take work off to protect themselves and unborn baby?

On March 16, the UK released an extended list of people would be considered “at risk” and added pregnant women to the list. Reporting on the topic of COVID-19 risk to pregnant women is varied and the research is inconclusive at this point. Mary Greeley Medical Center is following CDC and IDPH guidance and currently there is no recommendation that pregnant women should not work in healthcare settings. With that being said we would make every possible effort to not have a pregnant employee care for active COVID-19 patients. As everyone is aware, this situation and guidance is changing rapidly. Should guidance change we will adjust our practice.

Is there a plan for a training for those of us nurses in outpatient and other areas (likely to shut down or reduce operation at peak outbreak) who would be put on inpatient units when needed? It would be great to get an update on IV pumps, EPIC inpatient charting, supplies, etc... now so we are ready instead of waiting until nurses and trainers are already over burdened.

The HR/Education team has been working very closely with the workforce committee to design a training plan for nurses who will likely be deployed to inpatient units as some of our outpatient services become limited. Daily training has been initiated as of March 18th, with prioritization given to those who have already become available or will soon become available to serve. Staff who are trained will be assigned to tiers 1-3 based upon established criteria:

  • Tier 1: Outpatient clinical RNs who have worked in the west tower in the past 6 years OR non-clinical RNs who have practiced in the west tower in the past 2 years OR nurses who believe they could serve in the capacity of a full RN.
  • Tier 2: Nurses who do not meet the above criteria, but could serve on an LPN level.
  • Tier 3: Staff from outpatient areas who are available to serve in a helper or PCT function.

Staff members from areas like Diabetes Ed, Cardiac Rehab, and Pain Clinic will likely be designated to a tier 3 function and trained as they become available.

For additional information on tasks that can be performed by each tiered staff member, please see the delegation tasks spreadsheet. The HR/Education team is here to support those who are impacted by these changes, and will gladly answer any additional questions that pertain to training.

When the time comes that they are asking outpatient nurses to help work on the inpatient units, will it be mandatory or will we have the option to say no? And if we say no due to having small children etc, would we still be compensated?

In short, yes, it will be mandatory. This really is an all hands on deck situation. We will need all employees to help us through it. As a 24/7 operation with a variety of options for both clinical and nonclinical staff, we can accommodate whatever schedule people might need to ensure their availability.

I understand that things are changing daily but I am becoming concerned regarding our plan for immunocompromised staff. A couple of days ago it was stated to limit that staff exposure and according to the CDC to try and limit exposure by reassignments/working from home etc. I am now hearing that since there are a lot of people saying they can't work with these patients that we can't guarantee a plan. Is there now plan to limit exposure now or is that still a goal. I feel there needs to be a set plan that staff has to go by or specific plans for certain risk categories as they are all different. I am worried I am putting myself in a position that is compromising to my own life as if I get sick I may not be able to recover due to a compromised immune system, low white count and ANC.

Immunocompromised staff work every day in the environment. Per CDC guidelines, an immunocompromised person with proper PPE can work in healthcare. It is considered permitted and staff. That being said, any staff who has an individual concern is encouraged to discuss it with their leader.

We have a lot of staff, at all levels, on vacation out of state and out of country coming back from spring break next week. How are we going to handle their return? I know other organizations are placing these people on administrative leave/testing for COVID-19, or wearing a mask. How are we preparing for this? People may not know if they have been exposed to this, and they could expose employees to it.

All employees and visitors will be screened prior to entering the facility. Per the Iowa Department of Public Health, healthcare providers are considered essential to our community. Therefore, employees that traveled internationally within the last 14 days and are not exhibiting any symptoms will be required to work with a mask. Please notify your supervisor and employee health if you have traveled internationally or have been in close proximity to an individual that has been diagnosed with Covid-19. You will be required to complete a symptom monitoring document for 14 days.

Has there been any thoughts to equipment needs for nurses getting pulled to the floor that have not been there in some time? This would include scrubs and stethoscopes. Non clinical nurses don’t all have these things and I am wondering if these will be supplied or if I should obtain these things myself.

The dress code of some outpatient clinical staff is street clothes, if/when we are reassigned to clinical positions in the hospital, such as helpers or PCTs, are scrubs typically worn for these positions? If so, does that hospital have any that we could instead of wearing our street clothes? Thanks!

You should work with your leader on your “what to wear” plan. Scrubs can be obtained from Amazon for about $25 per set. If you only have one set of scrubs you may need to wash scrubs every night. If this presents a financial hardship, please connect with your leader and they will connect you with resources. We are in the early phases of having people bring in gently used scrubs for this situation. If you work in an area in which you already wear hospital provided scrubs it is okay to continue that, but if you do not please do not make this your plan. There are not enough scrubs or capacity to keep up with the hospital wide demand.

As far as stethoscopes, this will not be necessary for most staff. In the instance that one is need, there are disposable ones available for use if that situation arises.

What consideration is being given to non-clinical staff who are 60+ to be able to work from home as opposed to going in to the labor pool? No underlying health issues, but just concerned due to age.

Leaders submitted lists of those staff member roles that may be able to be performed remotely. This list was provided to the IS department Wednesday afternoon (3-18-20) and they are currently working through equipment and connectivity needs to see what all we can accommodate. More details will follow as the plans are put in place.

As an organization, we are allowed only six sick occurrences throughout the year. With the 6th one being a written warning. What happens with those individuals that get sick with COVID-19 and have 5 occurrences as it is? Are we waiving those during this time period? I feel that many nurses may "hide" symptoms and come in any way to avoid being reprimanded.

We have complete confidence that our staff would not put our patients and their co-workers at risk for COVID-19 just to avoid our attendance policy. That being said each situation will be handled individually to ensure we are being fair and doing what’s right.

Have we reached out to any local hotels to see if they would be willing to make accommodations for staff who do not wish to go back home at the end of their shifts?

Most area hotels offer some level of discount for Mary Greeley staff and several have called during this current situation to offer support. Since discounts tend for vary, we recommend that you call the area hotel of your choice to inquire about any offers. You can find a list on the Intranet. Just to a search for “lodging.”

The unit where I work had a patient that tested positive and staff was exposed. This weekend will be the 14 days without any symptoms. What do I tell the screeners? Do I still have to wear a mask?

You can stop wearing a mask once your 14 days of symptom monitoring has expired.

Facilities & Operations

Will an outpatient be allowed to be accompanied by one person? If not where can that person be waiting for updates on surgery status and driving that patient home?

This question was submitted after the new visitor restrictions were put in place. These restrictions allow visitors only under specific circumstances. This applies to outpatients as well as inpatients. Someone who is waiting for someone having any outpatient procedure will be asked to wait outside of the hospital. Typically arrangements are made to contact the person waiting for the patient.

Is the employee fitness center open?  

It remains closed for the time being. The space is too small and not supervised by anyone, so infection control is a big concern. It will be very difficult to maintain the governor’s mandates as it related to fitness centers in this small space.

MGMC's Daily COVID-19 Update was to be refreshed M-W-F. Knowing the current status of COVID-19 cases at MGMC might help employees better gauge how close we are getting to a change in organizational status/phase. Can you help staff understand what factors make it difficult to update these numbers as promised? Perhaps it would be more accurate to call it the COVID-19 Update and remove the word "Daily"?  

We will remove “Daily” to avoid any confusion. The Incident Command team is not meeting every day at this point thus the reports are generally issued every other day. As for current status of cases, the information is typically included on daily census report. If you don’t have access to this, you can always check with your direct supervisor.

Is there a reason that the “Daily COVID Update" isn't updated daily? It's 4 days behind as of today?

The most recent was posted a day late. Sorry about that. Currently, the update is sent out/posted every other day.

What's going on with quarterly update? Are we not having one this quarter, or are arrangements still being figured out for how we can have it safely?

The traditional update scheduled for May was not held as there was information about our COVID-19 response being disseminated through town halls, Gram and the intranet. There will be more town halls scheduled soon. Please stay tuned for details.

I have heard that a lot of supplies are on back order. Such as PAPRs, masks, hand sanitizers. What steps are we currently taking to help insure safety of staff and patients that will be here not for COVID?

Shortages are a concern and one that we are closely monitoring. From the time we began seeing COVID-19 appear in China, MGMC has been stocking up vital supplies, including important PPE supplies. We have submitted maximum orders regularly to help ensure we have supplies available. We have also inventoried everything we have on hand and are putting steps in place to conserve where possible. We have word that a new shipment of PPE is on its way, though it will take several weeks to arrive.

Can dietary speak to what extra precautions they will be taking when preparing food for staff and visitors?

Dietetic Services always stresses safety in the preparation of food for patients, visitors and staff. It is an expectation for all Dietetic Services staff. That said, safety is being emphasized more than ever under the current situation. The cafeteria has suspended all self-service, it is take-out only. There is no seating in the cafeteria and the beverage station is closed.

Should MGMC take patients from other hospitals if they have confirmed/possible COVID-19 patients? Especially if MGMC gets patients from the ED of the hospital and patients are getting treated/diagnosed there?

If we have the capacity, we have a responsibility to accept patients who are transferred here from other hospitals and facilities. CMS has put out a statement saying that at the present time, all EMTALA regulations still apply. Thus, if we have the capacity and capability, we are obligated by EMTLA to accept these patients.

Where are the patients who have been suspected of Coronavirus going in the hospital? What is our plan for those patients?

We are following CDC guidelines for suspected COVID patients. When the patient presents to MGMC, they are immediately masked, and placed in a negative airflow room (if available). The door to the room will remain closed, and all staff will follow airborne precautions at this time. The Emergency Department, inpatient nursing units, and ancillary/outpatient departments will begin drilling these workflows today (many have already started this).

Should patients and families be allowed to bring outside food and/or drinks to our radiation oncology department? I think it should be advised against since we are dealing with a droplet transmitted virus and patients and family members can be asymptomatic for days prior to diagnosis.

We would not restrict patient/family bringing food as there have not been any known transmissions via food consumption. Spread is primarily person to person via respiratory droplets from sneezing or coughing.

How will shift huddle be handled as huddle rooms are very close quarters and often include 10 or more staff?

We are confident that our safety and emergency planning meetings fit within the goals of the requirement. This requirement is focused on community events, not fire, police or healthcare gatherings to plan public safety and healthcare needs.

Can we leave the medical center from any door or is that restricted too?

You should be able to exit through any door. If you exit through a door that is closed as an entrance, please do not allow people to enter through it as you leave. Also, the skywalk is closed as an entrance and we are asking that people avoid using it to exit to the parking ramp.

How are chaplain/pastoral visits being handled for patients? Are our community pastoral care teams allowed to visit, are there are exceptions to the rules (such as imminent death, wanting last rites, etc).

Current hospital visitor restrictions would prohibit visits from outside clergy or volunteer parishioners, unless the person was a patient’s designated visitor for the duration of their stay. Special circumstances as described in this question would always be considered, of course. We’ve had contact with a couple of local churches. Most seem to be practicing social distancing and clergy and volunteer parishioners have chosen not to visit patients at this time.

Our rooms have 2 patients per room and 1 bathroom for the room. What is our plan to manage this moving forward so we don't have to close beds?

At this time, it is not our plan to close BH beds or limit admissions, because backing BH patients up in our ED while others may be coming into the ED with positive viruses would not be ideal. Here are some actions we are doing:

  1. assessing vulnerable patients and determining if they should have their own room
  2. increased screening of all patients, including taking temps 3x per day
  3. screening all incoming patients
  4. maintaining (683) open in case we need to isolate a patient
  5. if any patient develops symptoms we will immediately isolate and staff implement droplet precautions and contact Infection Control

This plan is subject to change based on ongoing information from Infection Control and Incident Command

There are staff with friends/family in the community that are looking for ways they can help the organization. Community members are asking if we are needing help staffing the doors with people to screen. Are we to the point we are needing the community's help with this yet?

We anticipate a need for temporary positions during this challenging time. We will be posting temp position soon and anyone is welcome to apply.

Wondering why we can't have someone at the west doors for a couple hours like 5:30 to 7:30 and maybe for 2nd shift a couple hours? Parking ramp was already pretty full by 6:30 since no one wants to walk in the dark clear around the hospital. It seems like we could try to be accommodating to our employees a little.

We realize the changes to doors may be frustrating for some employees. We will review these safety measures to ensure everything is working effectively and efficiently. We will keep this request in mind as we review.

A scientist and friend at K State said that hospital CEOs have made formal requests to the President of the University for PPE. By doing this the President was able to ask various departs at K State to offer any PPE held in storage and not being used while classes are cancelled or on-line. Have we made a formal request to the President of ISU for PPE?

We have been working very closely with ISU, the Student Health Center (Theilen), USDA, Vet Med, and the Ames Community School district (among many others) in the recent weeks. Any and all extra PPE is being donated and allocated through our Story County Public Health department. We are also starting to work with area businesses that can help us create important PPE (think CAPR masks) and equipment pieces through 3D printing. The community outpouring of support is truly inspiring. Local construction companies and area businesses are donating their masks and protective equipment as well. 

Is there any consideration to giving discounted meals for employees during this time? It is hard for us to get to grocery stores during their reduced hours and currently the price of cafeteria food is very expensive for what you get. I know you are looking to do a free $6.00 voucher and I'm grateful for that. Just wondering if MGMC has thought about helping by further discounting food in the cafeteria.  

Employee meals are already discounted in the cafeteria. The $6 voucher is intended to make up for the cancellation of the March 17 employee meal. The vouchers will be issued soon. Several area restaurants are offering healthcare workers discounts. You can find a list of them on the Intranet COVID-19 update page under Local Restaurant Discounts.

Can we make an exception for staff to utilize the lower levels of the parking garage? Even if it’s just levels 1-2.5? Since there are noticeably less cars overall and everyone is required to go to the first floor entrance, it could be a small "perk" for staff.

Thank you for the question. We continue to ask our employees to park at levels 2.5 and above. The reason being, if we allowed employees to park anywhere in the ramp, there is a very good chance that levels 1-3 would be full by 8 a.m. This would force our patients and few visitors coming in to park on higher levels of the ramp. The majority of these patients have difficulty ambulating and/or are in serious need of urgent medical care. Thank you for understanding.

What happens if we have protesters here at Mary Greeley?

While protests related to the pandemic have been happening in some areas of the country, there have been none reported in our area. It is also unusual to have protests of any sort at Mary Greeley. The right to protest would be respected as long as it is peaceful and does not impede the medical center’s responsibilities to care for patients. Also, ISU Police are at the hospital every day and Ames Police are doing increased daily patrolling during the other 16 hours.

I was walking in the hallway to the west tower and saw two patients being discharged and being wheeled out in a wheel chair by a PCT. Neither of the patients was wearing a mask, procedure or cloth.  Everyone that enters must wear a mask, why are the patients being discharged not given a mask to wear till they are in their vehicle?  

Thank you for bringing this to our attention. The patients should have been wearing face masks. A reminder of this has been issued through the COVID-19 incident response team. 

I'm concerned about what is going to need to be done to keep MGMC with a positive operating margin. Brian updated several weeks ago when McFarland announced layoff and furloughs that things were fine, but no updates since. When will we know more about how we will be financially impacted?

As expected, Mary Greeley has not been immune to the financial impact of the pandemic. Over the past six weeks, we have seen a drop in revenues of about 60 percent. Our March financials showed a negative operating margin of 6 percent. We have prepared various scenarios for the remainder of this fiscal year. Our best estimates currently show us ending this fiscal year with a negative operating margin due to the decreased volumes of elective procedures, however, we will still sustain positive operating cash flow which allows us to continue to pay our staff and suppliers.

The bigger question we are dealing with is how to budget for fiscal year 2021. Only two months ago, we were in the process of finalizing our 2021 budget which would have targeted a 3 percent operating margin. Currently, we are working on scenarios that will try to show us getting to a breakeven operating margin. These scenarios will be shared with our Board in May and likely will not be finalized until June. While there are certainly a lot of news reports expressing a dire situation for many hospitals and clinics, Mary Greeley entered this situation in a position of financial strength. Mary Greeley is committed to our culture of great patient care and our highly-engaged staff who deliver that care. We continue to be in a good position today.

It is now May 1 and "parts of our state are opening up".  What are the implications if I chose to leave the state of Iowa?

Not clear on what is being asked here, but if this question refers to screening process, the travel question has been removed as COVID-19 has been deemed community spread. Symptom and exposure questions are still being asked. Staff are advised not to travel to COVID-19 hotspots.

Why is having enough disinfectant and cleaning products not one of the requirements to resume elective procedures? We are currently out or almost out of many of the products like Oxivir and have no expectation of getting in adequate amounts any time soon. While we have some replacement options, many of them have longer dwell times and those are dwindling down quickly as well.

The governor’s newest declaration states hospitals must have adequate inventories and access to a reliable supply chain without relying on state or local government stockpiles. While the Oxivir products are in extremely high demand and short supply, there are many other disinfectants that we have on hand and can be utilized as a highly effective alternative during this time. Over the past weeks, as supply chains were shifting, we took every opportunity to purchase hospital grade disinfectants that will allow us to continue disinfecting effectively. At Mary Greeley Medical Center we are very accustomed to a convenient (disposable) and quick turn-around time (3 minute) product. During this unusual and unpredictable time we will forgo some luxuries of the disposable wipe and quicker dwell time. However, we are in a good position with our disinfectant inventory. Depending on how long it takes to stabilize the national supply chain, we may need to make other substitutions but for the time being but we are certainly well equipped with highly effective products. 

When will we be reopening the seating area in the cafeteria? Our lounge is not large enough for us to be 6ft apart during meals and with elective procedures and surgeries restarting, there will be more of us working. It would be nice to be able to spread out more.

Your concerns are certainly understandable. We hope to open some seating in the cafeteria early next week. Seating will be configured to promote 6-foot physical distancing. People will be asked to maintain physical distancing and wipe down the area where they sat before leaving the cafeteria.

How are we deciding which elective procedures can be scheduled?

Outpatient procedures are being scheduled by physicians. Physicians are being assigned block time and they are scheduling based on who they feel are their most immediate cases.

MGMC has to comply with several state requirements for resuming elective procedures, including having an adequate PPE supply, screening protocols for our pre-procedural patients, and maintaining bed availability for a potential COVID-19 surge in our Med/Surg/ICCU departments. Our current criteria for these elective procedures include:

  • Resuming appointments & procedures at 50% of the previous volumes
  • Only essential staff will work in the procedural areas/rooms to conserve PPE (i.e. minimum staffing required to complete the procedure)
  • Only true outpatient procedures and surgeries will be performed (no bedded patients). With the above requirements, we cannot utilize additional inpatient rooms at this time
  • The only inpatient surgery or procedure allowed in Phase 1 would be those that if not completed timely would be an immediate:
    • threat to the patient’s life if the surgery or procedure is not performed;
    • threat of permanent dysfunction of an extremity or organ system;
    • risk of metastasis or progression of staging; and
    • risk of rapidly worsening to severe symptoms.
    • Full visitor restrictions will remain in place (no visitors will be allowed except for the few exceptions)
    • Patients will need to follow all physical distancing protocols and will not be allowed to sit in lobbies or waiting rooms. They will go directly to the receiving department
    • Clinics will limit the amount of patients scheduled at the same time (i.e. alternating registration times)
    • Symptomatic patients or those patients that have had a confirmed COVID-19 contact will not be allowed (unless it’s an emergent procedure)

How is it possible that the hospital was consistently high in census with bed planning meetings daily, but once COVID happened we have plenty of beds? Did we really admit so many patients after elective procedures?

While the decrease of our surgical volumes has played a role in our declined census, this is only part of the story. Nationwide, healthcare systems have seen a dramatic decrease in their ED and Inpatient admissions. Several factors could play a role in this. Many individuals are too scared to seek medical treatment during this time. We also know that clinics are partially closing their offices and offering Telehealth visits instead. The entire State of Iowa is seeing decreased admissions during this time.

How does the hospital handle a patient that is positive for COVID or waiting for the test to come back and is combative and harming self or others?
---Should response team have N-95s?
---Should response team have face shields?  
---Should the plastic riot shield be used?

Responders would handle this as with any other patient in isolation. Those that are fit for N95 (MICS and ED) could wear their N95 and other defined PPE for COVID-19. All others would wear procedure mask, eye protection, gown and gloves, which are available on the floors. The riot shield would only be used if it is necessary to contain the patient, not for use as PPE to prevent infectious disease exposure.

Exposure, Transmission & Testing

Is there a reason we aren't able to bring our own goggles? The face shields give me a headache but I was told there aren't enough goggles for me to get them.

Goggles and face shields have been shown to reduce transmission of infectious diseases, including COVID-19. The type of eye protection does play a significant role in this added protection. It is important that the goggles are medical grade with a protective seal around the eye to prevent droplets from entering under or around them. There are some roles at MGMC were goggles may be more appropriate and our supply chain can help supply them to staff in need of goggles. Our supply of face shields is great. We currently have over 9,000 face shields. Our supply of goggles is much more limited, and therefore we are asking that only those with specific needs be distributed googles. Please talk with your supervisor if you are in need. 

This is going to sound silly, and I'm not sure there really is an answer - but with community spread and MGMC employees having COVID...should we be scared? The past week or so, I have actually been nervous to come to work.

Being concerned about the COVID-19 situation is not silly at all. We are taking all the precautions we can at the hospital in response to the pandemic, including screenings, ensuring PPE is being used and managing the flow of people coming to the hospital. As of 07/03/2020, no employee has contracted COVID-19 through a work exposure. We appreciate everyone’s diligence towards our infection control procedures.

For many weeks we have done elective outpatient surgeries at a minimal with no COVID-19 testing. Now we are testing patients for COVID-19 for outpatient surgeries the day of. – having the patient come into our hospital exposing staff at check in, registration, ACS staff, OR staff. Shouldn't this be done 24 hours prior for scheduled surgery? Will we have enough tests for people that need to be tested because they are actually sick? With Des Moines choosing to test every patient which the media has reported.

We started pre-screening clinics this week for high-risk procedures. These select patients are being scheduled for the drive-thru clinic offered 48 hours in advance of their procedure. There are a small number of patients that are unable to drive to MGMC 48 hours in advance for this screening. These patients may be screened with a test once they arrive at the hospital and as our supply allows. All scheduled patients are screened for symptoms and exposures up to 4 times prior to their procedure. Patients that screen positive to symptoms or exposure may be asked to reschedule their procedure, depending on the urgency/need of the procedure. Once patients arrive to MGMC, they are masked.   

Testing at Mary Greeley is still limited and we are reserving enough of our in-house testing for symptomatic/ill patients. The majority of the pre-procedural testing is done utilizing our outside reference lab.

If you have a negative respiratory panel, should you be tested for COVID-19 if you continue to have symptoms? Who does this?

That would be up to the physician who ordered the respiratory panel. If all tests were negative, we are holding the specimen for additional COVID-19 testing if requested by the physician. The test is sent to the state lab if it meets one of the criteria below. If it does not meet one of the criteria below, then it could be sent to Lab Corp.

  • Hospitalized patients with fever, pneumonia or ARDS with no alternate diagnosis.
  • Older adults (>60 years of age) with fever or respiratory symptoms (cough, difficulty breathing) and chronic medical conditions (e.g., diabetes, heart disease, immunosuppressive medications, chronic lung disease, or chronic kidney disease).
  • Any persons (including healthcare providers) with household contact with a laboratory confirmed case of COVID-19 in the 14 days prior to becoming ill with fever or respiratory symptoms (e.g., cough, difficulty breathing).
  • Any persons with a history of international travel from an affected geographic area or have taken an international cruise in the 14 days prior to becoming ill with fever or respiratory symptoms (e.g., cough, difficulty breathing).

Can COVID-19 be transmitted to animals?

There is no indication that companion animals can spread COVID-19 according to the CDC. It is recommended that you wash your hands after being around animals.

How long does COVID-19 stay on surfaces?

According to research reported in the press, the virus is most likely spread from person to person. However, it may remain on surfaces for several hours to several days. It depends on the surface. This is one more reason to regularly clean surfaces with a disinfectant cleaner and regularly wash your hands. High-touch surfaces need particularly attention. These include countertops, keyboards, doorknobs, and bathroom fixtures. And don't forget your cellphone.

So, I was around a person this weekend and now find out they were around someone a few days before that who has tested positive for COV-19. I know I'm supposed to wear a mask and be able to work but wonder how long I need to do that if I don't have any symptoms.

If you were in close proximity to the individual who tested positive and are asymptomatic, you can return to work but must wear a mask. In the scenario described above, you do not need to wear a mask if you are asymptomatic. If you become symptomatic, you should go home and contact your provider.

If staff were to develop any symptoms of COVID-19: Fever, cough, etc. How long are we required to stay home? Do we need to come in and be tested?

If you develop symptoms of COVID-19, do not come into work. Contact your provider. You will also need to notify your supervisor and employee health for further instructions.

I've noticed that the amount of Purell our hand sanitizer's dispense dries in 5-10 seconds rather than 20. Should they be adjusted to dispense a larger quantity? It seems like the ones at McFarland Clinic do.

The dispensers are set to provide an effective amount while conserving supplies and avoiding waste. People are welcome use the dispenser twice to ensure they get an amount they feel confident about.

Why is this Pandemic different than the one in 2009?

Complicated question to answer in this space. There is a lot of reporting on this issue. A Google search on the topic should provide some enlightening information.

Once Mary Greeley has confirmed patients in house that have tested positive, are we considered "exposed" to coronavirus? My concern is with elderly parents, how do we make sure that we don't inadvertently expose them as they already need help on a daily/weekly basis and are not leaving their homes.

You are only considered “exposed” if you have close personal contact with a patient for an extended time, and are not wearing appropriate personal protective equipment. Per CDC and IDPH, close contact is defined as:

a) being within approximately 6 feet (2 meters) of a COVID-19 case for a prolonged period of time; close contact can occur while caring for, living with, visiting, or sharing a healthcare waiting area or room with a COVID-19 case

– or –

b) having direct contact with infectious secretions of a COVID-19 case (e.g., being coughed on)

In addition, it is thought that transmission is primarily through droplet spread so, as a healthcare worker, it’s very important to self-monitor for early signs and symptoms. If you experience any, contact your personal care provider and MGMC employee health to assess.

We have a lot of staff, at all levels, on vacation out of state and out of country coming back from spring break next week. How are we going to handle their return? I know other organizations are placing these people on administrative leave/testing for COVID-19, or wearing a mask. How are we preparing for this? People may not know if they have been exposed to this, and they could expose employees to it.

All employees and visitors will be screened prior to entering the facility. Per the Iowa Department of Public Health, healthcare providers are considered essential to our community. Therefore, employees that traveled internationally within the last 14 days and are not exhibiting any symptoms will be required to work with a mask. Employees who have traveled internationally should notify their supervisor and Employee Health. This also applies if an employee has been in close proximity to an individual who has been diagnosed with Covid-19. These employees will be required to complete a symptom monitoring document for 14 days.

Essential Services Personnel includes the following categories:

  • Healthcare providers
  • Law enforcement
  • Fire & EMS personnel
  • Long Term Care personnel
  • Residential Support Facility personnel

The Q&A page states that you do not have to wear a mask if you have a known exposure but are asymptomatic. However, it has been proven that this can be spread for up to 2 weeks before a carrier would show any symptoms? Shouldn't anyone with a known exposure be wearing a mask for 14 days regardless of symptoms?

The question referred to concerns being around a person who was exposed to another person who had COVID-19. This is not a direct exposure situation, but one with a degree of separation. An employee could return to work without a mask. The answer to that question was correct. To review, though: If an employee has traveled internationally the last 14 days or has been in close proximity to a person diagnosed with COVID-19, they are to return to work if asymptomatic but are required to wear a mask. They will also have to contact employee health and complete the symptom monitoring document.

Are there any recommendations of what staff should be doing at the end of their shift to avoid bringing transmissions of Covid-19 home with them?

Bringing an extra set of clothes (including shoes) you can change into before you leave work or before you enter your home is one recommendation. The clothes you wore to work should go into some sort of bag and then into the wash once you get home.

Wipe down your phone, badge and anything else you might have had at work with you – a purse, backpack, etc.

Wash your hands before you leave work and again when you arrive home.

Could we increase the frequency of cleaning of the nurses stations on the units with rule out COVID-19 patients to decrease risk to staff? There seems to be little to none disinfecting done on night shift unless done by nurses and we don't always have time until after we have all used the stations multiple times.

Environmental Services is scheduling systematic cleaning of the nurses stations on all shifts. As the activity increases; so will frequency. It is highly suggested, however, that staff wipe down areas between uses of computers and other station areas.

Why now have we decided to just have COVID-19 rule out patients only being put on droplet and contact where in the beginning we were doing airborne precautions. Doesn't the WHO say airborne I know Italy uses that.

Current evidence is that person-to-person transmission of COVID-19 occurs primarily during close exposure via large droplets produced when coughing or sneezing. A procedure mask/facemask is appropriate for this type of transmission. The contribution of small respirable particles (i.e. aerosols), which require an N95 for protection, is currently uncertain. In addition, we are experiencing shortages of certain types of masks. As such, we have elected to prioritize use of respirators to aerosol-generating procedures (e.g. intubation/extubation, nebulizer treatments, etc) where the risk is higher.

If patients get tested days after being admitted and were not considered a potential COVID patient before (therefore no PPE used) and test positive, then what? Those rooms did not require PPE and staff was told to save PPE for potentials and patients with COVID before, leaving staff exposed.

New procedures are being put in place today (Monday, March 23) to treat any patient with influenza-like, upper respiratory symptoms (e.g. cough, shortness of breath, fever) as a potential COVID patient. A Contract Precautions/Droplet Precautions sign will be placed at these patient rooms, directing staff to use proper PPE.

While the screening process is still new, should we be thinking about asking more detailed questions regarding symptoms a person has been experiencing (visitors & staff). Several employees I know have become ill in the last couple of weeks and they have not been questioned regarding their own health symptoms which may or may not be related to COVID-19. I believe these types of questions are being asked in several other establishments (govt buildings, clinics, hospitals).

We have staff and physicians that have been gone for spring break traveling state wide and out of the country will self-quarantine be mandatory for those individuals?

We continue to review and revise the screening process. Staff and providers who have traveled out of state and who are asymptomatic will be asked to wear a mask. If they are symptomatic, they will be asked to return home.

What are the changes being made to environmental service for cleaning COVID-positive rooms? Do the curtains need to be changed out if another COVID-positive patient is immediately going into that room? Or do we need to use paper curtains that are easily and quickly changed out?

We will continue to change out curtains with each isolation room turnover. Some areas have removed isolation curtains if not absolutely necessary.

When sitting one-to-one with a potential COVID patient with proper PPE for 4 to 8hours, is that consider prolonged exposure? Does that mean I’ve been exposed?

If you are wearing proper PPE for the described period of time, you would not be considered exposed.

The question came up this morning as to whether or not we should be bringing our own cups from home to work still?

There is no evidence that bringing your own cup from home is an infection control issue. You just need to keep this sort of thing in your break areas and away from patient care areas. It is also recommended that you periodically wipe the cup down, just as you would want to do with other items that you have with you at the hospital, including your phone and name badge.

What are the appropriate actions to take if a patient’s visitors refuse to wear PPE to visit r/o patients?

Inform the visitor(s) of the risk they are taking by not wearing the PPE in the patient’s room. Also inform them that if they refuse to wear it in the patient’s room, they must wear it when they leave. This for the safety of staff, and other patients and visitors. Also inform your supervisor. The person may be asked to leave the hospital if they refuse to wear required PPE.

I have someone making masks for the foundation as a non-direct staff and screening at the doors can I wear a clean homemade mask at front door? It says nothing just is homemade.

No. You need to wear a standard mask, not a homemade one.

Is it a safe practice for a staff to enter a potentially positive patients room with PPE and then keep PPE on thru the halls and nurses station, take it off in the nurses station and keep it in an open garbage can in the nurses station? And or take Accucheck machine and Welch Allens in and out then use it on other patients?

No, that is not a safe practice. Please refer to the Standard Work on appropriate donning and doffing of PPE. In general, gown and gloves should be removed inside the patient room, and airway protection (mask and face shield) should be removed directly outside the patient room. Wearing contaminated PPE throughout the nurses station is dangerous and prohibited. 

Equipment that is used in a suspected or positive COVID-19 patient room should be disinfected immediately outside the room. In certain situations where that is not possible, a designated “dirty” location should be established to place the equipment and allow cleaning.

Please contact Infection Prevention and can we assist to work through best practices for unusual situations on your various units.

How many CAPR's do we have at MGMC!? Please clarify when CAPR's will need to be used!

We currently have 19 CAPR units. We have 8 CAPR Carts (with 2 units each) stored in Materials Management, as well as one unit each in ED, ACS and Lab.

CAPRS need to be used whenever you are involved in an aerosol-generating procedure and for the allotted time post-procedure (35 minutes in an airborne room or 70 minute in a standard room). Examples of aerosol-generating procedures include: intubation, extubation, bronchoscopy, nebulizer treatments, and upper endoscopy procedures.

We were only given goggles on our unit to use and not the full face shield. We were also told that we could wear a mask that has a splashguard attached and over the eyes. How are these alternatives a safe equivalent when the full face shield extends from the forehead downward and by design prevents droplets from falling into/behind the shield, but the goggles leave a gap between them and the mask and the splash guard is completely open at the top of the head for droplets to fall behind?

All three options you mentioned (eye shield, goggles, and mask with attached eye shield) are appropriate depending upon the procedure or care that is performed. We have options available to tailor the equipment that works for the individual. Certainly, if the goggles do not fit your face and leave gaps, you are not protected and should not use them. Likewise, a mask with an attached eye shield may be adequate for less invasive patient care activities. Please work with the leadership on your unit to find alternatives that provide adequate protection.

The video and standard work instructions that were put out for how to put on/take off PPE is misleading when it comes to the face shield. According to MGMC's Q&A page, the face shield is only needed during aerosolizing procedures, otherwise basic droplet/contact precautions are to be used, which only calls for gown, gloves, and regular facemask. Can you please clarify for staff?

Sorry for the misunderstanding. Eye protection is required at all times when caring for a suspected or confirmed COVID-19 case. During standard patient care, wear gown, gloves, procedure mask and eye protection (shield or goggles). During and after aerosol generating procedures, use a gown, gloves, and N-95 with eye protection or a CAPR. Please see the IP Town Hall for further clarification.

When caring for COVID rule out and positive patients should we be wearing hair protection? I have heard many other hospitals implementing this. 

Hair covers are not included as PPE and are not recommended at this time.  Per the CDC, proper PPE for suspected or confirmed COVID-19 patients consists of gown, gloves, N95/face mask and eye shield/goggles.   

Do fruits and vegetables from the grocery store need to be cleaned with anything besides water?

Bottom line is to continue following the normal food safety practices recommended for food in your own home. Wash your hands, surfaces, and utensils frequently. Water is fine for cleaning produce, use a brush if washing a food with rough surfaces, such as potatoes and carrots. Peeling will remove any outer exterior that anyone else touched (think peeling a banana, peeling oranges); and cooking will kill off lingering bacteria/viruses. At this time, there is no evidence that COVID-19 can be or has been transmitted via the food or water systems.

For those that would like to be extra cautious with cleaning produce, a safe method is to make a vinegar/water solution to clean. Mix together 1 part vinegar to 3 parts water. Example: 1 cup vinegar, 3 cups water. Wash produce in this to remove dirt and bacteria, then do a final rinse under cold running water. Smooth produce, such as apples, can be spritzed or quickly rinsed in the vinegar solution, whereas rough produce, such as broccoli and cauliflower you can soak for about 2 minutes before doing a final rinse with plain water.

Can alcohol pads be used to clean the goggles and shields?  The wipes leave a film.

Yes, but the shields/goggles first need to be cleaned with Oxivir wipes and allowed to dry. Once they are dry, you may wipe off with alcohol wipes to remove the film.

I understand some local hotels are giving a discount for employees during the coronavirus crisis. $50 is still a very high price for employees to pay for a few hours of sleep. Are there any other options available for those of us that are not wanting or unable to go home?

While local hotels have significantly reduced their rates, we understand the costs for staying at a local hotel might still be high for some. It is best option we have at this time. We’re sorry for any inconvenience that may cause some employees. We have looked at providing lodging options at the hospital but this is a challenge given potential needs should be experience a surge of COVID-19 patients.

How do we handle friends and family members who believe that COVID-19 is a "hoax" or strictly political? There is so much misinformation out there that people are believing. It is very overwhelming and taxing having to listen to nonsense after work, especially when I have been learning real facts from doctors, infection prevention specialists, and reputable sources. People close to me would rather look at Twitter, read conspiracy theories, or news stories for information on the virus. It is mind boggling. How do I get them to understand that COVID-19 is a serious issue, not a hoax, and it is NOT "just as deadly as the flu"?

Sadly, this is the world we live in today. Truth and fiction routinely battle it out on social media. COVID-19 is a complex issue and a complex disease. For people on the frontlines of the fight against COVID-19, misinformation can be disheartening and frustrating. This might be particularly true for people who are in an areas, like Iowa, that aren’t being hit as hard as some major metropolitan areas, such as New York City. Still, there’s nothing wrong with respectfully listening to another’s opinion, no matter how much you may disagree with it. Listen calmly, ask where the person is getting their information, and then, if you’re comfortable, offer what you know from your own experiences. You might not sway any thinking, but at least you’ve provided a perspective from someone closely involved with the response to the disease. There are many articles and opinion pieces about this topic, some written by nurses and physicians, which can be found on various online media sites. A little searching may lead you to helpful articles. In the meantime, please know that the work you and your colleagues are doing at Mary Greeley is important and appreciated. You are playing an important role in the health and safety of everyone in the communities we serve.

Could we make sure that Dietary knows to use all disposable plates, utensils, cups, etc. for our COVID patients? There has been no explanation about what to do with trays in COVID rooms and it feels unsafe to bring them out.

We decided not to use of disposable items for patient meals early in this pandemic. There is no evidence that disposable plates and utensils aid in infection prevention. It also can cause waste to accumulate. There should be processes in place on all floors to gather trays and plates for proper cleaning. If you are unaware of the process on your floor, please check with your supervisor.

As I have seen in Gram that some surgeries are starting back up, is prophylactic COVID testing going to be done pre-op?

Staff, provider and patient safety is our top priority. While the governor has opened up elective surgeries in the state, our ability to test is still very limited. Until further testing is available, our infection control practices will remain incredibly stringent to keep everyone safe. As an example, we are screening our pre-op/pre-procedure patients up to four different times prior to the procedure. If patients have any symptoms or exposure, we will postpone the procedure. Staff will don all CDC recommended PPE while in these procedures, visitors will still be restricted, and we are adhering to all recommended cleaning procedures. We are also bringing back procedures and clinics at 50% of their previous capacity.

Is the coronavirus a flu?

COVID-19 and influenza are both infectious respiratory illnesses with similar symptoms. However, they are caused by different viruses.

I work in a clinical area, so every morning when I come in, I carefully take a mask out of the box to wear all day. Today, the screener tried to hand me a mask and said we could no longer get our own. I prefer no one else touching the mask that is going directly over my airway, especially a screener who has just been inches away from dozens of people coming through the door. Is there a better way this can be handled?

There is no requirement for how masks are distributed. However, we don’t want a bunch of other people’s hands in the mask box or bucket. Nor is an open box of masks sitting on the table desirable. Your concerns have been shared with the screening coordinators. It should be noted there is hand sanitizer available on the table. You could share your concerns at the screening station and politely ask the screener to use it before handing you a mask.

Can you explain what was published in the Ames Tribune about the patient who received a plasma infusion?

Not clear on what needs to be explained but the Ames Tribune story was the result of a press release issued by LifeServe, which is handling convalescent plasma donation. The Ames Tribune story can be read here: https://www.amestrib.com/news/20200427/first-patient-in-ames-receives-convalescent-plasma-to-fight-covid-19-as-confirmed-cases-in-county-rises-to-25. The LifeServe release is not posted on line but email sullivans@mgmc.com if you’d like to see a copy.

Are we testing everyone who asks for a COVID tests or turning away people? Can a person have a COVID test without someone approving the test and if so why?

Mary Greeley does tests only when they are ordered by a physician. We are also setting and following protocols to manage our in-house testing abilities for symptomatic inpatients and other emergency needs. If a quick turnaround test is not necessary, we are still using our reference lab.

Both diagnostic and screening tests are being performed. Diagnostic testing is ordered for patients based on their symptoms and exposure to COVID-19. Diagnostic testing requires that we implement isolation procedures until the results are known. COVID-19 screening tests are currently being ordered for patients that are not able to discharge to a care facility without this testing. In the future (once additional testing is available), we look to expand our screening to patients coming in to the hospital for aerosolizing procedures. Screening these patients pre-procedure will allow us to cut down on our amount of PPE utilized during the procedures and will make us more efficient in our procedure processes (for the known-negative patients).

MGMC is receiving 120 test kits/week, how are the number of test kits MGMC receives decided? How does this number compare to other hospitals/clinics?

The 120 test kits was the availability amount the vendor, Cepheid, could provide us. Hopefully, this number will continue to increase. Some hospitals have more tests and many still do not have testing available.  

Would it be possible for Dr. Fulton to do another webinar on current information and most recent AMA / CDC recommendations about the coronavirus?

There is one planned for Thursday, May 21, over the noon hour. Details to come.

I was walking in the hallway to the west tower and saw two patients being discharged and being wheeled out in a wheel chair by a PCT. Neither of the patients was wearing a mask, procedure or cloth. Everyone that enters must wear a mask, why are the patients being discharged not given a mask to wear till they are in their vehicle?

What is MGMC's policy about wearing a face mask as an outpatient? The current guidelines state that "patients" do not need to wear a mask as long as they are not showing any signs or symptoms of COVID-19 or other respiratory illness. This statement must be in reference to inpatients who are in their own hospital room. How should situations be handled if an outpatient refuses to wear a mask, wears it incorrectly, or removes it during their clinic visit?

We provide a cloth mask for all outpatients and request that it be worn throughout the hospital. Some outpatients may need gentle reminders of this or some guidance on how to wear the mask. Inpatients are provided either a cloth mask, or if symptomatic, may have received a procedure mask. Regardless, for universal masking, all should be wearing a mask while in the common areas of the hospital.

Could you elaborate on how contact tracing is happening in Ames? And, should individuals do anything, such as keep logs on contacts outside the home?  

The Iowa Department of Public Health (IDPH) does the contact tracing. Individuals who have tested positive and are symptomatic are asked who they have been in contact with for more than 15 minutes and at a distance less than 6 feet. In such cases, IDPH would be looking at the 48 hours prior to the onset of symptoms and 10 days past the onset. Anyone who is considered to have been exposed are then contacted, informed about symptoms and advised to self-isolate for 14 days. They are also encouraged to get tested. If an individual has a positive test with no symptoms, IDPH goes back 10 days from the testing date to 10 days after with the same criteria and follow up.  If someone is sick or exposed they stay home. There would be no need to keep a log, unless directed otherwise by an employer, for example.

With outbreaks occurring at local nursing homes they are testing all staff and residents. At any point will all Mary Greeley staff be tested to help prevent outbreaks amongst our staff?  

The testing right now is highly coordinated with the state of Iowa for long-term care facilities. MGMC continues to have limited testing supplies. When testing becomes more widely available, we may look into staff testing. If an employee is symptomatic, or has had an exposure without proper PPE, they should follow up with their primary care physician.