Becker's Clinical Quality & Infection Control

13 INFECTION CONTROL Should physicians ditch the white coat during the pandemic? Twitter thread sets off debate By Anuja Vaidya S hould physicians continue to wear white coats amid the COVID-19 pandemic, or will wearing them contribute to the virus' spread? A debate on this topic raged on Twitter among healthcare professionals. On March 18, Michael McClurkin, MD, a psychiatry resident at Yale School of Medicine in New Haven, Conn., tweeted: "is may hurt some feelings but ... I think the white coat should be retired. ey're not hygienic. Especially in a pandemic when the virus can live on objects for days/ hours? What do people think? #COVID19 #medtwitter" is set of a firestorm of replies, with healthcare professionals debating the pros and cons of donning the iconic white coat. Some agreed with Dr. McClurkin. One Twitter user, Alisa Niksch, MD, (@alisa- doc1), a pediatric cardiologist, tweeted "Never was trained to wear one! [University Hospitals'] Rainbow Babies and Children's Hospital [in Cleveland] actually discour- aged wearing a white coat unless wearing scrubs outside the OR. So, it just stayed in a closet for the most part. Agree-it's scary and just gets dirty too oen." Another user, Kelbie Bauer (@KelbieA), a physician assistant, tweeted "Yes! Absolutely! Just look at the cusps and bottoms of our coats. Dingy and gross." Survey results, published in January in the American Journal of Infection Control, show many physicians wear their white coats for a week or more before washing them. Dr. McClurkin reiterated this point in response to a Twitter user who suggested it was easy to get white coats cleaned. "Not if you're a resident working 80 hours a week, with 1 day off a week, and no access to the in-hospital cleaning services only attend- ings have," Dr. McClurkin tweeted. Some Twitter users disagreed, however. J'Leise Sosa, MD, (@drsosaobgyn), an OB- GYN, tweeted, "Disagree. In the pandemic, anything we wear poses a risk of contamina- tion unless we can change aer each pt [pa- tient]. A white coat shields my exposed skin and portions of my scrubs so that when I take off clothes at the end of day, I hopefully have fewer bugs to take home to my family." Many who replied on the Twitter thread said that it would be best if healthcare profession- als just stuck to wearing scrubs. "For now everyone should be wearing scrubs and removing before entering homes," tweet- ed Kevin S. Shah, MD, (@KevinShahMD), a Utah physician. Another Twitter user, Yamini Natarajan, MD, (@NatYamini), a gastroenterologist in Houston, agreed with Dr. McClurkin's tweet, but also pointed out that with a personal protective equipment shortage in the coun- try, healthcare workers are being asked to reuse several items. "I agree! But I do think this topic doesn't replace the need to address crucial #PPEshortage — facilities are asking providers to reuse masks, which poses similar risks," she tweeted. n CDC: 3 ways to decontaminate respirators By Mackenzie Bean T he CDC on April 1 issued a guidance on how to decontaminate filtering facepiece respirators for reuse amid shortages, reported AHA News. The agency does not recommend the reuse of respi- rators as a standard of care, but said the practice should be considered when shortages occur. The CDC identified these three decontamination methods as the most promising, based on the limited data available: • Ultraviolet germicidal irradiation • Vaporous hydrogen peroxide • Moist heat Steam treatment and liquid hydrogen peroxide are two other promising methods, although some limitations exist, the agency said. n Some COVID-19 patients only show digestive symptoms, study finds By Anuja Vaidya A subgroup of COVID-19 patients may show symp- toms of digestive issues, such as diarrhea, accord- ing to a study accepted for publication by the American Journal of Gastroenterology. Researchers in China examined 206 patients with mild cases of COVID-19. Forty-eight of the patients only showed a digestive symptom; 69 showed both digestive and respiratory symp- toms; and 89 showed only respiratory symptoms. They fol- lowed patients until the patients tested negative for COVID-19 at least twice, more than 24 hours apart. Among the patients with digestive symptoms, 67 had diarrhea lasting one to 14 days. About 62 percent of patients with a digestive symptom had a fever at the same time. Researchers also found that COVID-19 patients with digestive symptoms sought care later than those with only respirato- ry symptoms. They also were more likely to test positive for COVID-19 in their stool. n

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