Becker's Clinical Quality & Infection Control

22 PATIENT & CAREGIVER EXPERIENCE HCA Healthcare physician dies of COVID-19 after wearing same mask for weeks By Maia Anderson A n HCA Healthcare physician died of COVID-19 aer reusing her N95 mask for weeks, if not months, e Guardian reported Oct. 7. Adeline Fagan, MD, was a resident OB- GYN at HCA Houston Healthcare West who tested positive for COVID-19 in early July. In July, Dr. Fagan was working in the emergency department treating COVID-19 patients and, due to supply shortages, wore the same mask for "weeks and weeks, if not months and months," her younger sister told e Guardian. CDC recommendations state an N95 mask should be reused five times at most. On Sept. 19, at the age of 28, Dr. Fagan became one of more than 250 medical staff who died in Southern and Western hot spot states during a COVID-19 surge over the summer. One in three healthcare workers who have died of the virus na- tionwide had reported concerns of inade- quate PPE, according to e Guardian. A national nurses union has complained of HCA Healthcare's alleged "willful violation" of workplace safety protocols, including pushing infected staff to con- tinue working. HCA Healthcare told e Guardian it wouldn't comment on the allegation that inadequate PPE supply contributed to Dr. Fagan's death. "Our protocol, based on CDC guidance, includes colleagues turning in their N95 masks at the conclusion of each shi, and receiving another mask at the beginning of their next shi," a spokes- person said. n 'Post-COVID' clinics gain traction among health systems By Mackenzie Bean A small but growing number of health systems are launching dedicated clinics or programs for COVID-19 patients with lingering symptoms, Kaiser Health News reported Sept. 30. Aurora, Colo.-based UCHealth opened its post-COVID clinic this summer to study and treat patients who face lingering physical and mental side effects from the virus, including lung damage, anxiety or neurological issues. "We need to think about how we're going to provide care for patients who may be recovering for years after the virus," Sarah Jolley, MD, a pulmonologist and director of UCHealth's Post-Covid Clinic, told Kaiser Health News. Some researchers and clinics estimate about 10 percent of COVID-19 patients may have lingering side effects, according to Zijian Chen, MD, medical director of Mount Sinai Health System's Center for Post-COVID Care in New York City. Considering that more than 6.5 million people in the U.S. have already tested positive for the virus, the number of people who may experience long-term symptoms could be "staggering," Dr. Chen told Kaiser Health News. "How much medical care will be needed for that?" he asked. Other academic medical centers that have opened clinics to aid patients with long-term symptoms include the University of California-San Francisco, Stanford (Calif.) University Medical Center and Philadelphia-based Penn Medicine. Cleveland Clinic also plans to open one in early 2021, according to the report. n Physicians grapple with treatment uncertainty for COVID-19 long haulers By Mackenzie Bean C are teams are facing the dual challenge of responding to COVID-19 pa- tients' immediate medical needs while also discerning how to help survi- vors facing long-term symptoms, The Washington Post reported Oct. 16. Physicians have a broad array of research and knowledge to guide management of such long-term diseases as diabetes or renal failure but care teams only have 10 months' worth of knowledge about COVID-19 to inform treatment for the thousands of patients with prolonged symptoms, known as "COVID-19 long haulers." What physicians do know is that a broad range of patients experience long- term health effects after contracting COVID-19, regardless of their age or illness severity. The symptoms also span every organ in the body, according to Jennifer Possick, MD, medical director of the Winchester Chest Clinic at Yale New Haven (Conn.) Hospital. Denyse Lutchmansingh, MD, a pulmonologist at Yale New Haven Hospital, said it's been difficult to not have clear answers for these patients. "They are happy to feel heard. They are happy that people are trying to help them, but at the end of the day, [they would] like to be told for sure, 'This is what is going to happen to you, this is not what is going to happen to you,'" Dr. Lutchmansingh told The Post. "And that's the part that's difficult for us in medi- cine, because it's not completely clear." n

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