Healthcare Providers in the COVID-19 Era: Keeping Clean When Coming Home

Given overcrowded hospitals and limited availability of personal protective equipment (PPE), showing up for work can feel like entering a battleground without ammunition for many physicians during the COVID-19 outbreak [1]. Despite this, doctors and nurses show up every day ready to do their jobs. While we have committed to the Hippocratic Oath, our families have not. How can we do our duty while preventing exposure of our loved ones at home [2, 3]?

Some physicians have begun practicing self-isolation tactics, or have moved into apartments away from their families. But given that the risks of exposure might last for months, and the best evidence thus far implies that healthcare worker exposure comes from the viral transmission through droplets and contact with fomites [4,5], a pragmatic process for safely returning home is greatly needed [6].

Methodology

A convenience sample of frontline healthcare providers consisting of emergency physicians and nurses in the San Francisco Bay Area outlined their processes for safely returning home after working at the hospital. This feedback was coupled with available best practices for preventing the spread of infection. It was then consolidated by designers at the Stanford University d.school’s Designing for Social Systems program who translated the recommendations into an easy-to-read graphic. The graphic was then reviewed by the above providers for validity, and their comments and feedback were then integrated into the final version here.

The aim of this effort was to help limit the spread of the coronavirus by maintaining a clean and safe home environment where frontline healthcare providers may spend time safely with their family members and prepare for the long road ahead [6].

Visual Checklist on Keeping Clean

References

1. Jacobs A, Richtel M, Baker M. ‘At War With No Ammo’: Doctors Say Shortage of Protective Gear Is Dire. The New York Times. March 19, 2020.
2. Giglio M. The Biggest Worry for Doctors Fighting the Pandemic. The Atlantic. March 22, 2020.
3. Rose C. Am I Part of the Cure or Am I Part of the Disease? Keeping Coronavirus Out When a Doctor Comes Home. New Engl J Med. March 18, 2020. doi:10.1056/nejmp2004768.
4. Parodi SM, Liu VX. From Containment to Mitigation of COVID-19 in the US. JAMA. March 13, 2020. doi:10.1001/jama.2020.3882.
5. Jing C, Sun W, Huang J, et al. Indirect Virus Transmission in Cluster of COVID-19 Cases, Wenzhou, China, 2020. Emerging Infectious Disease. 2020;26(6).
6. Adams JG, Walls RM. Supporting the Health Care Workforce During the COVID-19 Global Epidemic. JAMA. March 12, 2020. doi:10.1001/jama.2020.3972.

Author information

Christian Rose, MD

Clinical Informatics Fellow
Stanford University;
Emergency Physician, Kaiser Permanente

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