Becker's Clinical Quality & Infection Control

8 INFECTION CONTROL 33 staff, 22 patients positive for COVID-19 after Massachusetts hospital employee visits virus hot spot By Gabrielle Masson T wenty-two patients and 33 employees at a Massachusetts hospital tested pos- itive for COVID-19 aer an employee traveled to an out-of-state virus hot spot in July, reported MassLive.com. e outbreak occurred in a non-COVID unit at Springfield, Mass.-based Baystate Medical Center, Baystate Health President and CEO Mark Keroack, MD, said during a July 27 news briefing. Hospital staff members had gathered in break rooms without wearing masks or observing social distancing protocols. "ese simple lapses were able to happen in spite of our screening employees for fever and other symptoms before every shi, mandating mask usage and social distancing throughout the facility," Dr. Keroack told e Boston Herald. "is event reinforces that COVID-19 is highly contagious and requires vigilance in order to contain its spread." Baystate Health has contacted all patients who were on the unit July 15-23. e hospital also tested employees and traced their contacts. No new positives came from employees who were not part of the original group, which shows steps taken by the hospi- tal "have arrested the spread of this cluster," according to Dr. Keroack. ose steps included strengthening monitoring of staff to ensure workers are following appro- priate mask and social-distancing guidelines, designating new break areas for employees and enacting a more restrictive travel policy. "We're deeply disappointed that this out- break has occurred," Dr. Keroack told e Boston Herald. "And we're committed to an ongoing review of our safety practices to ensure that they're aligned with the current guidelines and science." n Vaccines 'remarkably safe,' study finds By Mackenzie Bean T wo decades' worth of data shows vaccines are "remarkably safe," a study published in Annals of Internal Medicine found. Researchers at the Tel Aviv Sourasky Medical Center in Israel examined the initial and subsequent safety-related label changes for 57 vaccines that received FDA approval between 1996 and 2015. During this time period, the FDA required 58 label changes reflecting safety issues with vaccines. More than one-third of changes involved expand- ing restrictions of vulnerable patient groups who should not receive the vaccine. Twenty-two percent of labeling changes involved allergy warnings. "A large proportion of safety issues were identified through existing post- marketing surveillance programs and were of limited clinical significance," researchers concluded. "These find- ings confirm the robustness of the vaccine approval system and post- marketing surveillance." n Viewpoint: How to respond to patients who refuse to wear masks By Mackenzie Bean T he COVID-19 pandemic is raising liability questions for providers on how to handle situations in which patients refuse to wear a mask, attorney and former nurse practitioner Carolyn Buppert, MSN, wrote in an op-ed for Medscape. If patients refuse staff members' request to wear a mask in a healthcare facility and they are not in visible distress, Ms. Buppert suggested the fol- lowing responses: • Send the patient home and offer them another visit if they wear a mask or when the pandemic is over • Offer the patients a telehealth appointment If patients decline to wear a mask for medical reasons, providers should test their ability to breathe while masked using a pulse oximeter. "'Put the mask on, and we'll see how you do' is a reasonable response," Ms. Buppert said. She said there is no legal basis for healthcare organizations to be accused of patient abandonment if they refuse to treat an unmasked patient. This is not an act of denying care, but rather an effort to establish reasonable conditions for receiving care, she argued. Allowing unmasked patients to stay at the facility could make health- care organizations liable for negligence if other patients are exposed to COVID-19, since the organizations have a duty to provide reasonably safe public spaces, Ms. Buppert said. n

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