FAQs: COVID-19 (novel coronavirus)

March 19, 2020  //  FOUND IN: Updates & Resources,

Last update: 3 p.m., Monday, Aug. 2

In response to the ongoing COVID-19 situation, faculty, staff and learners at Michigan Medicine have asked many questions regarding their work and personal lives.

Here is a closer look at many of the frequently asked questions, along with the answers that can be formulated as of now.

The organization will continue to update policies and procedures as the situation evolves.

Please note, the FAQs are divided into categories. Click on each category to jump to that section:

Facilities

Q: With a significant number of entrances around the main medical campus closing, which ones remain open?

A: The organization is closing all unattended entrances on the main medical campus and requiring entry via an attended entrance by either using the mobile screening tool, paper form or by directly answering screening questions. This change will be effective Sunday, June 21, and will ensure facilities are as safe as possible.

An up-to-date list of entrances includes:

  • Mott main entrance (open 24/7)
  • Taubman/University Hospital main entrance (24/7)
  • Taubman Center Level 2 near P2/P3 (5:30 a.m. – 7 p.m. daily)
  • Rogel Cancer Center staff entrance (6 a.m. – 6 p.m., Monday-Friday)
  • Rogel Cancer Center main entrance (afterhours/weekends for staff)
  • Medical school/Rogel Cancer Center link/P1 skywalk (24/7)
  • Med Sci Building II (6 a.m. – 6 p.m., Monday-Saturday)
    • Starting Sunday, Aug. 9, in-person screening at this entrance will change from 24/7 to 6 a.m. to 6 p.m., seven days a week.
    • Staff who enter at this location from 6 p.m. to 6 a.m. to reach the hospitals and clinics should be screened at the 2nd level intersection between the medical school and Rogel Cancer Center.
  • Frankel Cardiovascular Center main entrance (24/7)
  • Adult Emergency Services (patients only, 24/7)
  • Children’s Emergency Services (patients only, 24/7)
  • Radiation oncology (patients only, 24/7)
  • C&W employee entrance (open for all staff, 5:30 a.m. to 9 p.m., seven days a week)
  • UH South employee entrance
    • Beginning Aug. 3, this entrance will be a “self-screening” entrance
      • Staff using this entrance are required to use the self-screening tool (https://healthscreen.umich.edu/)
      • Staff choosing not to use the self-screening tool will be redirected to other employee entrances
    • This entrance will be open Monday thru Friday, 5 a.m. – 9 a.m., to alleviate congestion during the morning rush
    • Employees can exit at this location 24/7
  • Taubman Center Floor 1 Entrance from P2 Parking Structure
    • New entrance opening Monday, Aug. 10.
    • This entrance is for patients, visitors and employees and will be open from 6 a.m. to 10 p.m., seven days a week.
    • This entrance will allow access to the 1st floor of the Taubman Center from within the P2 Parking Structure, alleviating congestion at the main entrance and improving patient and visitor wayfinding.
    • Employees who use this entrance should use the self-health screening tool to reduce congestion (https://healthscreen.umich.edu/)

Q: As a faculty or staff member, can I use the Emergency Services entrances?

A: No, Emergency Services entrances are for patients only. Thank you for your cooperation.

Q: Are employees being screened upon entrance?

A: A new mobile tool has been developed to replace verbal health screenings to avoid bottlenecks at Michigan Medicine employee entrance points. The tool, which can be accessed via phone on the website healthscreen.umich.edu, or through the ResponsiBlue app will ask questions about symptoms, risk factors and job function. Based on the employee responses, users will either see a green screen with a check mark, indicating they can proceed through the screening point and report to work, or a red screen, indicating that they should stay home and contact OHS.

Employees should answer the online screening questions before leaving for work. By not closing the browser, the green screen will be available to display to security once employees are on-site.

Should employees not have a phone readily available, they will be required to complete a paper form in compliance with MIOSHA requirements screened verbally by Michigan Medicine personnel.

In addition to symptom screening questions, workforce members will also answer questions in the self-screening app about household exposures to COVID-19 and international travel. Individuals who answer “yes” to those questions will be asked to call Occupational Health Services for further instructions. Those with a household exposure may be tested for COVID-19. For more information, please see the FAQs about employee screening and work restrictions for Michigan Medicine employees.

Click here for more information.

In addition to symptom screening questions, workforce members will also answer questions in the self-screening app about household exposures to COVID-19 and international travel. Individuals who answer “yes” to those questions will be asked to call Occupational Health Services for further instructions. Those with a household exposure may be tested for COVID-19. For more information, please see the FAQs about employee screening and work restrictions for Michigan Medicine employees.

Click here for more information.

Q: Is the courtyard open to walk around?

A: Yes. The courtyard entrances in University Hospital and University Hospital South have been opened for employees to access and enjoy the outdoors as the weather improves. The outer perimeter gates of the courtyard will remain secured 24/7. Employees are expected to continue wearing masks and maintain 6-feet social distancing practices within the courtyard area. DPSS will secure and monitor the courtyard at all times to ensure the safety of our employees.

Q: Can we hold scheduled gatherings in the courtyard?

A: The organization is not allowing scheduled gatherings in the hospital courtyard. The hope is to keep the courtyard as open and available to as many people as possible, while still ensuring social distancing designed to keep people safe. Thank you for your cooperation in this matter.

Q: What about access to the medical school?

A: All exterior doors to the Medical School currently on a Monday – Friday lock/unlock schedule will be secured 24/7 until further notice. All occupants including staff, faculty, students and contractors will be able to access card read doors with a valid MCard. Please contact and manage your anticipated visitors prior to their arrival until further notice.

Q: As services ramp back up, what is the policy regarding elevators?

A: As we begin to see increasing numbers of people in the hospitals and clinics, it is important to observe social distancing on all elevators. To maintain an appropriate social distance, elevators should be limited to four people at a time. This may mean longer waits for elevators, especially during shift changes and other high traffic times. Please be prepared for this delay and maintain safe distancing while you wait in the elevator lobby. If you are able, you may want to consider taking the stairs instead of the elevator.

Signage is currently being developed and will be posted in elevator lobbies to inform employees, patients and visitors of these new elevator capacity guidelines. As in all public spaces across the health system, mask use is required on elevators.

Logistics, parking and transportation

Q: What is the latest on parking and transportation?

A: Parking permit enforcement has been restored for all parking areas on North, Medical, Central and Ross Athletic campuses. Parkers are required to observe all parking control signs that indicate permits required and enforcement hours.  University Transit and Michigan Medicine shuttles continue to operate. Visit ltp.umich.edu for the latest updates, including service modifications over the extended student break and holiday season.

Q: Will shuttles and buses keep running at Michigan Medicine?  Consider eliminating and just keeping the question above.

University Transit and Michigan Medicine shuttles continue to operate. Visit ltp.umich.edu for the latest updates, including service modifications over the extended student break and holiday season.

Q: Do I need to wear a mask on university buses?

A: Yes. Per recent Executive Order, Michiganders are required to wear a face covering whenever they are in an indoor public space. The University of Michigan Face Covering Policy for COVID-19 applies to all U-M faculty, staff, learners and visitors, including Michigan Medicine. This policy makes it a requirement to wear a face covering that covers the mouth and nose anywhere on and within all U-M properties and locations, including inside buildings, outdoors and on U-M transportation. 

Riders should note the safety measures currently in effect:

  • Face coverings are required. No mask, no service.
  • Transit routes designed for passenger trips to be completed in approximately 15 minutes or less.
  • Moveable shields installed as a barrier between passengers and drivers.
  • Drivers will take advantage of stops to open doors for increased ventilation.
  • Increased air filtration and open windows for all buses.
  • Cleaning and disinfection protocols for frequently touched surfaces inside the bus.

Q: Can I have packages delivered to my workplace?

A: Please eliminate deliveries to offices or workspaces from companies like Amazon or FedEx that are not related to patient care or Michigan Medicine business.

Human Resources

Please note, Human Resources has published an FAQs page in relation to COVID-19.

Economic Recovery Plan

Please note, ERP FAQs can be found by clicking here.

Education

Q: What safety guidelines are recommended when including learners in the clinical environment?

A: To keep everyone safe, we must customize our care setting to balance the health and needs of our patients, learners and providers, as well as access to resources. Unlike in March, the health system is active and full, with the majority of patients being seen for non-COVID-19 conditions, creating additional density challenges. Please use the following principles to inform decision-making.

Please be inclusive of learners in patient care and learning as they are essential members of the health care team. Be thoughtful as to the number of learners participating on an in-person team visit, whether in the inpatient, ER or outpatient settings, to optimize safety of the patients and the team. When making decisions, consider the educational needs of the visit, for example to demonstrate or verify an exam finding, or to observe a learner’s interactions with a patient or a critical conversation.

In general, team visits should be limited to a faculty member with 1-2 learners (e.g. fellow, resident or student). If this is a challenge, consider how technology might be used to meet educational goals. For example, try using FaceTime or Zoom to allow the learner to participate from outside the room. You might also assign learners to a subset of patients to allow for an increased number of smaller rounding teams.

When it comes to work areas and team rooms, try to maintain six feet of distance between workstations where possible.  When 6 feet of distance cannot be reliably maintained, proper mask use is critical. Masks should be worn in accordance with the “Michigan Medicine COVID-19 Universal Mask Protocol for Workforce Members” document. Per the policy, there should be space and distance for learners and all other team members to take breaks for nutrition, understanding that masks will need to be temporarily removed for these breaks. Finally, make sure hand sanitizer and disinfectant are readily accessible.

If you are uncertain about how to apply these principles in the clinical learning environment, please contact Infection Prevention at 936-6355 or UM-ICE@med.umich.edu

Patient care

Q: Can you talk about the current wave of COVID-19 and how this will impact patient care?

A: A great deal of planning has been done since the initial wave of COVID-19 arrived in March 2020. This planning has addressed testing, capacity and supply management, and operational changes necessary to balance the care of COVID and non-COVID patients. In our ambulatory care clinics, video and phone visits provide flexibility and safety for patient care that doesn’t require in-person evaluation.

Decisions about operational changes involving inpatient and outpatient care in the weeks and months ahead will be based on the number of COVID-19 cases, with the goal of providing care to all patients while ensuring the safety of patients, visitors, faculty, staff and learners. 

Q: How is Michigan Medicine managing hospital capacity?

A: The organization is proactively managing patient volume to balance the needs of COVID and non-COVID patients, and to maintain critical operations. This includes enhanced review for all admissions. Clinics and operating room staff will receive direction from their supervisors regarding when and how this may impact their areas. 

Q: Are we going to have separate units in the hospital for COVID+ patients?

A: We continually evaluate how to safely and effectively care for both COVID and non-COVID patients using existing capacity for negative pressure rooms, HEPA filters and other special considerations. Currently, most units in UH/CVC are capable of caring for COVID-19 patients. In addition, plans are in place should the situation warrant reactivation of designated COVID units.

Q: Are there plans in place to add beds within the organization?

A:  No, at the current time there are no plans to add extra beds within the organization but extra resources have been deployed to manage the increased needs of COVID-19 patients. The number of ICU beds have been increased by converting a moderate care unit to an ICU unit, and moderate care capacity has been supplemented by converting a portion of general care beds to moderate care beds across a number of units.

Q: Are there new instructions that should be given to patients upon discharge?

A: Due to the frequent changes from the CDC in the care of patients, we have created specific patient instructions when discharging patients from ambulatory, emergency or inpatient settings. Please use these instructions in the discharge care for patients.

The language has been reviewed by a multidisciplinary group and vetted by IPE teams to ensure consistency with the CDC’s latest recommendations. The goal is to maintain a minimal number of documents that provide enough information for patients to care for themselves. Unusual circumstances will be handled with provider conversations and tailored instructions to the patient.

These documents will be reviewed and adjusted by IPE on a regular basis to match CDC recommendations.

To find the patient instructions in MiChart, please use the keywords covid umh.

Q: How are ambulatory care clinics being affected?

A: At this time, outpatient clinics remain open and are accommodating in-person and virtual patient appointments as appropriate. Some non-essential appointments are being rescheduled, or, in many cases, turned into E-Visits or Video Visits.

As in the spring, in order to limit exposure for patients, their families and staff, and redeploy staff as needed throughout the health system, adjustments may be made to outpatient clinics. All clinics are still accessible by telephone. If patients have questions about appointments, they can call their clinic or send their provider team messages through the Patient Portal.


Q: What should I tell patients about Michigan Medicine’s plans to safely provide care?

A: Patients should be reminded that the organization will attempt to accommodate their procedures and other care needs as soon as possible. During this time, Michigan Medicine is doing what it can to manage the care of patients while minimizing the risk of disease spread. The safety of patients and employees is the top priority.


Q: Is there a phone number or hotline patients can call if they have symptoms, testing or management questions?

A: Michigan Medicine patients should call the COVID-19 Hotline for questions about symptoms, home management and specific steps to receive care or testing. The hotline is 734-763-6336, available 24/7. 


Q: How are we supporting other health care organizations in the area?

A: We have been very open and transparent with the care protocols and expertise we have developed in caring for COVID-19 patients and have shared this information across the state. We continue to support health systems across Michigan who have transferred patients with COVID-19 requiring critical care to our health system. Our centralized process for management of transfer requests facilitates prompt communication with our referring hospitals and acceptance of transfer requests. We have also implemented a new COVID-19 Colleague Connect Support Line to provide Michigan hospitals with 24/7 access to a quaternary-level critical care intensivist and ICU nursing experts to answer questions from other Michigan hospitals related to the management of critically-ill patients with COVID-19. 

Treatment and testing

Q: Is Michigan Medicine using hydroxychloroquine to treat or test treatment for COVID-19 patients?

A: Yes, Michigan Medicine is currently using and evaluating the efficacy of hydroxycholoroquine (Plaquenil). There are concerns that it may not be helping patients and that it has significant negative side effects; therefore, further assessment is ongoing.

Q: What is the direction on filling prescriptions for hydroxychloroquine? People with prescriptions (e.g. to treat autoimmune conditions) are being told they will not be filled.

A: LARA (Department of Licensing and Regulatory Affairs) for the State of Michigan issued the following on March 24: “Pursuant to Michigan Administrative Code, R 338.490(2), a pharmacist shall not fill a prescription if the pharmacist believes the prescription will be used for other than legitimate medical purposes or if the prescription could cause harm to a patient.” Patients already on the medication for an autoimmune condition should continue to receive their scripts. Patients with concerns or questions should reach out to their prescribing physician.

Q: Is Michigan Medicine using serum therapy?

A: There are reports of some attempts to use the plasma of patients who may have antibodies to COVID-19 as a treatment for the infection. Michigan Medicine is not currently doing this, as there are significant potential risks and a limited ability to determine if someone has antibodies.

Q: Should Advil/ibuprofen/Motrin be taken if tested positive?

A: The data on NSAIDS like ibuprofen connected to COVID-19 is extremely limited. There are concerns that it could affect a patient’s response to the infection, but it is also important to treat the dangerously high fevers which occur with COVID-19. For that reason, the organization is using acetaminophen (Tylenol) as the first-line treatment for fever, but still using ibuprofen and other NSAIDS when that is not enough.

Q: Are all patients being tested for COVID-19?

A: For the safety of patients and staff, Michigan Medicine will begin proactively testing all patients admitted to our hospitals regardless of presence or absence of symptoms. In addition, during the week of May 4, we will begin testing for COVID-19 prior to procedures performed in our operating rooms or procedure areas.   

Asymptomatic patients without exposure risk factors do not need to be placed in special pathogens precautions while awaiting COVID-19 test results.

Here are some resources with more information:

Inpatient Testing Toolkit

Emergency Department Testing

Q: How will my patient get tested?

A: Each procedural area will be responsible for reviewing their upcoming schedule, contacting patients and ordering COVID-19 Drive Through testing which can be performed at whichever site the patient selects (Canton, Brighton or West Ann Arbor). The attending performing the procedure will receive a result in their inbox. We are asking that your patient get tested 48-96 hours before their procedure.

Q: What is the likelihood of a false negative COVID-19 test?

A: While no test is perfect, Michigan Medicine’s in-house assays perform well and are able to detect very low levels of the virus in samples (0.1-0.5 copies/ul). Most of the patients are strongly positive. The rare false negative may occur because of limited sample collection or because the patient is early in their disease.

Q: Can we use alternative speciman types, such as oral or nasal swabs?

A: At the moment, only nasopharyngeal swabs have been validated for diagnosis of COVID-19. We are working on validating oral or nasal specimens to show detection of virus.

Q: I heard there is a new 5-minute test. Are we looking into using that?

A: We currently have multiple assays with differing analysis and timing. This combination of tests allows us to have the capacity and turnaround times to meet our patients’ needs. We continue to evaluate new tests as they are developed to improve both turnaround time and capacity. We are not using the Abbott 5-minute test at this time.

Q: What is the status of antibody testing?

A: Currently, the Michigan Medicine laboratory is in the process of validating COVID-19 serology testing.

In the coming days, some employees who were previously tested for COVID-19 will have the opportunity to provide a blood sample for COVID-19 serology. In addition, some employees who currently have symptoms and are being tested for COVID-19 will be asked if they wish to voluntarily provide a blood sample at the time of initial testing for COVID-19 and again two weeks later.

Plans for more widespread COVID-19 serology testing for Michigan Medicine workforce members are under development and will be communicated in the future.

Q: Are there any changes to how we treat patients with VRE?

A: In order to conserve gowns during the COVID-19 pandemic, the CDC recommends that facilities consider suspending contact precautions for endemic multi-drug resistant infections such as vancomycin resistant enterococcus (VRE). Beginning Friday, April 3, patients identified to have VRE infection or colonization will NOT require contact precautions. Follow Standard Precautions for these patients. Units that currently screen for VRE colonization on admission, weekly and at discharge will continue to screen patients so that we can monitor for any changes in transmission. 

Q: What are the guidelines regarding Aerosol-Generating Procedures (AGPs)?

A: The list of potential Aerosol-Generating Procedures (AGPs) has been revised based on recommendations of a multidisciplinary group including Infection Prevention and Epidemiology (IPE), Respiratory Therapy, and Pulmonary Medicine. 

The Special Pathogens Precautions pale yellow signs have been updated to reflect these changes. AGP Stop Signs should still be posted and appropriate PPE guidance followed whenever these procedures are performed.  Please contact IPE with any questions.

Q: Is RPAN testing available?

A: RPAN testing is now available at ambulatory sites.  RPAN testing should be reserved for immunocompromised patients with viral respiratory symptoms for whom the results would impact clinical care. COVID-19 is not included in the RPAN order and must be ordered separately, but both RPAN and COVID-19 PCR testing can be performed using the same NP swab sample. 

Q: Have other critical care guidelines changed?

A: Michigan Medicine has updated critical care guidelines in the following areas:

  • Michigan Medicine COVID-19 Adult Critical Care Consensus Recommendations
  • Policy and Protocol for obtaining Compression Duplex ultrasonography for diagnosis of VTE during the COVID?19 Pandemic
    • COVID-19 Algorithm for PE Assessment
    • COVID-19 Algorithm for DVT Assessment
  • Overview of ARDS Ventilator Strategies for COVID-19
  • Michigan Medicine Tracheostomy Guidelines in COVID-19 Era
  • Use of Sedative, Analgesic and Neuromuscular Blocking Agents in the Intensive Care Unit During the Novel 2019 Coronavirus Pandemic – Michigan Medicine Guidelines

The new guidelines are posted at Critical Care Protocols for COVID-19 Patients.

Q: Is there temporary housing available to COVID-positive patients?

A: Michigan Medicine will provide temporary lodging for COVID-19 positive patients, and those patients who need quarantine due to COVID-19 following discharge. The process will mirror the existing patient lodging process and be run by the Patient and Visitor Accommodations Program (PVAP). Requests for temporary housing must be submitted by discharge planning, complex care management or social work. If you have a COVID-19 positive patient, please work with these groups to determine eligibility for temporary lodging. If you have any questions about patient or employee lodging, contact Alfreda Rooks at 734-645-1303 or email arooks@med.umich.edu.

Q: I’ve heard of a serology testing pilot. What are the details?

A: Michigan Medicine will be participating in the CDC SARS –CoV2 health care worker serology testing pilot. As part of a regional pilot program, specimen collection at Michigan Medicine will occur daily from May 26-June 1, between 5 a.m. and 2 a.m. The CDC has contracted Quest Diagnostics to manage the specimen collection, which will take place in the Taubman Blood Draw Station on Taubman Level 2. The pilot goal is for up to 3,000 Michigan Medicine select staff from the ED, OR, and ICU areas to participate. Team members eligible to participate will be contacted by their managers or department leaders. Staff will receive their results within 48 hours and Michigan Medicine will also receive aggregated results of its health care workers.

Q: Why aren’t all employees eligible for the serology testing pilot?

A: The large-scale serologic survey, or serosurvey, pilot is being conducted by the Detroit metro area health authorities Regions 2 South and 2 North, in collaboration with the Centers for Disease Control and Prevention (CDC) and the U.S. Department of Health and Human Services. Michigan Medicine was not involved in determining which front line workers could participate.

Those eligible include health care personnel whose primary workplace is the Emergency Department, OR and ICU. This includes all personnel who provide wraparound services such as x-ray, dietary, lab, environmental services, security, chaplains, and other supportive services necessary for daily operations.

If you think you qualify for this survey, contact your supervisor to receive registration information.

Q: Are we using Break the Glass for COVID-positive patients?

A: As of May 20, the automatic Break The Glass (BTG) feature will be enabled for all patients with suspected (infection status: R/O COVID) or confirmed (infection status: COVID positive) COVID-19 infection. BTG has been part of MiChart since 2017 and requires (1) choosing a reason from a list for accessing a chart, and (2) entering one’s Level 2 password upon entering a BTG chart. This takes approximately 10 seconds and protects both the patient and the MiChart user from accidental unauthorized access. If a clinician is on the patient’s treatment team or has the patient on his/her clinic schedule, the prompt will not appear. Additionally, once the reason and password are entered, the user will not be prompted to BTG on the same patient for 30 days.

BTG was initially enabled for patients with suspected or confirmed COVID-19 infection in early March. However, given the extremely high numbers of patients for whom the prompt was appearing, the decision was made to disable BTG temporarily for this population in early April. Since the hospital COVID-19 census has dropped to approximately 50 patients (from a high of nearly 250), BTG will be reinstated.

Thank you for helping us protect our patients’ privacy and confidentiality in this challenging time.

Personal protective equipment (PPE)

Q: Do I need to wear a mask?

A: Yes. Employees able to medically tolerate one must wear a covering over their nose and mouth when in any public spaces where patients may be present. This includes buses and shuttles traveling to and from work, building elevators, parking structure elevators, cafeterias, and any other enclosed public areas. 

Medical masks are required for the protection of health care workers for any patient facing activities. This includes:

  • Direct patient care
  • Being in a patient room/care area
  • Face to face interactions with patient such as greeters/check in staff

Cloth masks can be worn in clinical buildings by those not having direct patient interactions.  For example:

  • Workforce members that work in offices or areas that do not have direct patient contact
  • Health care workers entering a facility until they are able to obtain a medical mask from security

Masks are now considered specific dress attire referenced in the UMHS Dress and Appearance Policy:

  • Uniforms and specific dress attire may be required based on the position and responsibilities.

Employees who do not comply with this policy will be subject to progressive disciplinary actions, and continued non-compliance could result in dismissal. 

Learn more about how to wear medical masks and cloth masks appropriately.

Q: Why can’t nurses and other staff be issued an N-95 for use?

A: Employee safety is the highest priority. Due to the limited supply of PPE in Michigan and across the country, PPE conservation is critical to maintain appropriate supplies for the duration of the pandemic. We are asking everyone’s efforts to preserve PPE by following IPE recommendations, which are determined by risk of transmission. Enhanced PPE is used in higher risk situations. More information here.

Q: What is the organization’s supply of N-95s and projected inventory?

A: N95 inventory, along with other PPE items, is fluid and is reflected on the All Employee Dashboard.

Q: What can I do to prevent N95 masks from being soiled?

A: We’ve had to discard multiple N95 respirators due to soiling from make-up during fit-testing and reprocessing. In an effort to conserve as many masks as possible, please refrain from wearing make-up for fit-testing and or while working. We also utilize face shields to protect N95 respirators from being soiled.

Q: Can I make/wear my own fabric mask?

A: Staff can wear fabric masks in non-clinical buildings (See IPEs Universal Masking for Workforce Members).   

The Joint Commission and the American Medical Association have issued statements regarding health care workers wearing their own PPE. Both organizations support this only when health care organizations cannot supply the necessary equipment for employees to protect themselves from risk of infection. 

Because Michigan Medicine does have adequate supply of standard medical grade PPE that is safe, including adequate supplies of N95 masks, we will not permit use of equipment brought in from home. Personal masks brought from home cannot be guaranteed to meet the protection provided by hospital supplied masks. There are concerns that some sources of masks may be counterfeit or not meet protective standards. In addition, unless individual mask brands and models are fit tested, N-95 masks do not provide the appropriate level of respiratory protection. Please see the links below to support the decisions and policies for decision making to protect our employees from risk of infection.

Q: What else do I need to know about masks?

A: Everyone should wear a mask in public areas where patients may be present. This includes…

Q: Is there enough PPE on-hand at Michigan Medicine?

A: There is currently enough Personal Protection Equipment and the organization has not denied anyone proper PPE.

Michigan Medicine follows the guidelines of the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) in terms of the PPE provided. These guidelines are based on research published in leading medical journals.

Q: Can I get training on proper use of PPE?

A: Please take a few minutes to watch these videos

http://www.med.umich.edu/i/ice/resources/ambulatory_guidance.html

http://www.med.umich.edu/i/ice/resources/clinical_guidance.html

Q: What are the latest PPE recommendations for operating and procedure rooms?

A: Updated information regarding best practices on PPE in operating and procedural rooms can be found at these links. The links must be opened in Internet Explorer:

And click here for a video message on PPE for surgical and procedural care from Mark Prince, M.D., chair of the Department of Otolaryngology, Head and Neck Surgery.

Q: Can I be fit tested?

A: In the spirit of ensuring Michigan Medicine is compliant with new PPE guidelines from the Michigan Occupational Safety and Health Administration (MIOSHA), UMMG leaders are in the process of identifying workflows to ensure appropriate staff members are fit tested for N-95 respirators.

According to the new guidelines, any health care worker who provides direct patient care to patients with confirmed COVID-19 or persons under investigation (PUIs) will need to wear gown, gloves, N-95 respirators and eye protection. This is in addition to existing Michigan Medicine guidelines on using an N-95 respirator, gown, gloves, and eye protection for aerosol-generating procedures.

At Michigan Medicine, a PUI is defined as any patient with symptoms concerning for COVID-19 who will be undergoing testing due to meeting the organization’s testing criteria.

If you work in an ambulatory care area and qualify for N-95 fit testing, your leadership team will be in touch to help schedule you for fit testing should that be necessary.

Q: Can something be done to help with skin irritation or breakouts from masks, especially behind the ears?

A: There are several strategies to help with irritation related to prolonged use of earloop masks. Health care workers can use topical barriers such as Vaseline at the sites of skin irritation. Some health care workers have also used elastic extenders between the loops instead of placing them behind their ears. 

Q: What about dealing with pressure injuries?

A: Here are a few tips to help with pressure injuries associated with masks:

  • Wash skin with a gentle cleanser prior to coming to work, and avoid use of cosmetics (makeup can also interfere with reprocessing of N95 masks).
  • If a dressing is used, make sure it does not interfere with the seal of the mask.
  • Treat abrasions from masks with moisturizer, skin sealant, tissue adhesive (e.g., Dermabond) or a thin dressing (do not apply skin sealant or tissue adhesive near the eyes or mouth).

Q: Can I reuse goggles and eye protection?

A: Due to potential shortage concerns, it is important to appropriately conserve supplies. Employees should follow the appropriate protocols to clean and reuse eye protection such as goggles and shields.

Q: Are there specific recommendations regarding attire for workforce members caring for patients with COVID-19?

A: The SARS-CoV-2 virus which causes COVID-19 is primarily spread from person-to-person through respiratory droplets. There are currently no data to support transmission via objects, although the virus can survive on surfaces such as plastic and steel. Porous surfaces such as clothing are less likely to harbor the virus for long periods of time. Additionally, clothing has not been associated with transmission of other respiratory viruses such as influenza. Finally, the PPE worn when encountering patients with suspected or proven COVID-19 includes gloves and a gown. Worn correctly, PPE prevents contamination of skin and clothing, and current evidence supports that use of appropriate PPE is highly effective at preventing transmission of the virus. 

Based on this evidence, here are the recommendations regarding clothing worn at work:

  • Those encountering patients with suspected or proven COVID-19 infection should wear the appropriate PPE.
  • If your job requires the wearing of scrubs, you should continue to do so. Scrubs are not required in the care of those with suspected or proven COVID-19 infection. If you did not routinely wear scrubs as part of your work routine prior to the COVID-19 outbreak, you should not require scrubs now.
  • Shoe covers and head coverings are not recommended PPE as transmission is via respiratory droplets and direct contact with infectious secretions.  
  • If workforce member clothing becomes soiled through exposure to blood or other potentially infectious body fluids, it should be changed and laundered. 

Q: Are my street clothes or scrubs at risk of being contaminated?

A: If you are wearing appropriate PPE, your regular street clothing and/or scrubs should not be contaminated. Hospital-issued scrubs will not be available for all patient care workers. Goggles and face shields can be reused after being wiped clean with oxivir.

Q: Where can I learn more about PPE in the inpatient setting?

A: Safety Management Services, in conjunction with IPE, has created a website to offer even more guidance regarding PPE in the inpatient setting.

Q: What is the policy regarding Special Pathogens Precautions?

A: N-95/PAPRs should be used for all patients who require intubation regardless of symptoms or Special Pathogens Precautions unless they have had a negative COVID-19 test AND have no new concerning signs or symptoms since the time of testing. N-95/PAPRS should be used for emergent intubation of patients who develop new or progressive respiratory decompensation during hospitalization as these symptoms could be concerning for new infection.

Hospitalized patients who test positive for COVID-19 should remain in Special Pathogens Precautions until they have resolution of fever, clinical improvement of respiratory symptoms, and two negative nasopharyngeal swabs collected more than 24 hours apart (if not ventilated and without tracheostomy) or two negative NP swabs collected more than 24 hours apart plus a negative tracheal aspirate (if ventilated or s/p tracheostomy).

Q: How should I dispose of my masks after my shift is over?

A: Please do not litter or leave used PPE in parking lots and structures, or on medical campus grounds. If a trash container is full and needs to be emptied, call the CLEAN LINE (2-5326) to report the location of filled trash bins. Alternatively, non-emergency requests for facilities and support services can be submitted on the EVS Support Services Link page.

Visitor policies

Q: What is the visitor policy?

A: To protect patients, faculty and staff during the global COVID-19 pandemic, we have suspended visiting in our hospitals and health centers. Limited exceptions will be made in the following areas: Pediatric inpatients, adult developmentally delayed inpatients, adult and pediatric inpatients at end of life, adult and pediatric inpatients at discharge, labor and delivery, outpatient surgery and procedures, outpatient clinics, all emergency departments.

These visitor policy restrictions have been updated to include:

  • Adult primary caregivers of pediatric patients with prolonged inpatient admissions can be allowed to switch out at one week intervals to facilitate appropriate support throughout the patient’s admission.
  • During labor, a COVID-19 positive patient may have one support person.

The complete policy can be accessed here.

Q: What is the policy for end-of-life care and patients being discharged?

A: A maximum of six designated visitors total, up to two at a time, can visit patients at end of life. Minors may be designated EOL visitors if supervised.

  • COVID+/PUI: Limit to two designated visitors. Visitors must wear appropriate PPE, and must be informed of risk. Staff will provide PPE assistance.

Adult and pediatric patients at discharge

A maximum of three visitors who require home caregiver training in anticipation of inpatient discharge, based on the recommendations of the care team.

One visitor (? 16 years old) to accompany adult patients for hospital discharge, on the day of discharge. Two primary caregivers to accompany pediatric patients for hospital discharge, on the day of discharge.

Q: Who will initiate conversations about visitor limitations?

A: Front-line staff/attending teams will conduct initial compassionate conversation about visit limitations – and can make exceptions to the policy for extenuating circumstances by consulting local clinic/unit leadership. For assistance:

We understand these are unusual circumstances and that these actions cause hardship for our patients. However, our top priority is the safety of our patients and of our staff. We believe these efforts will reduce chances of infection spreading. We will continue to evolve these guidelines as the situation changes. Thank you so much for taking exceptional care of our patients, families and each other.

As always, if patients or visitor(s) are exhibiting concerning/aggressive behavior, call 734-763-1131.

Q: How can we offer visitors support?

A: Visitors can be offered support through the following resources:

  • Spiritual Care/emotional support: 734-936-4041. For urgent consults or after-hours requests, call operator at 734-936-4000 and request the chaplain on call be paged.
  • Virtual visits: Connecting family members to their loved one through regular phone/video connections, supported by staff.
  • Social Work: Call 734-764-6893 or email SocWk-Gapstaff@med.umich.edu

Q: Do patients and visitors have to wear a mask? If so, can it be their own masks?

A: Yes. Ambulatory patients and inpatient visitors who come to our facilities and are asymptomatic are permitted to wear their own masks. Gov. Gretchen Whitmer’s revised stay at home order, effective April 27, mandates that Michiganders wear masks in public enclosed spaces. Therefore, it is likely visitors will be wearing masks when they arrive at our buildings.

Q: Do visitors need to wear masks when in patient rooms?

A: Family members and visitors are required to wear a mask in a patient room when in the presence of health care workers.

Q: Are employees required to follow the visitor policy when it is not their shift?

A: Yes, the organization’s visitor policy is effective for all people, including employees. You may not utilize your badges in order to visit colleagues at Michigan Medicine outside of visiting hours. Your cooperation in this matter will play a major role in the organization’s continuing efforts to reduce risk of transmitting COVID-19.

Workforce and potential exposure questions

A full FAQ document regarding employees or team members who have concerns about potential exposure can be found here.

Further questions are listed here:

Q: Are there CME options available related to COVID-19?

A: The CME office has created a new landing page for online CME offerings related to COVID, including one from Anesthesiology and the two that our RICU hospitalists created that are featured on our Michigan Health Lab blog. You can see the landing page here.

The CME team is actively working with departments and divisions to identify additional presentations and materials that can be offered for free online viewing by anyone.

Q: As a front-line employee, can I get assistance with laundry or dry cleaning services?

A: To support employees who are spending long hours at the hospital, Michigan Medicine has identified local laundry and dry cleaning services that are able to pick-up and deliver laundry at employees’ homes or near Michigan Medicine.

Please contact the service that is most convenient for you. There is no charge for the pick-up or delivery, only for the laundry/cleaning services. 

Iris Dry Cleaners

  • 2268 S. Main St., Ann Arbor,
  • To schedule, call Jay: 616-990-7991

Eureka Cleaners

  • Locations around Ann Arbor
  • To schedule, call Jin: 734-239-4319

Martinizing of Ann Arbor

  • Multiple locations (Plymouth Rd, Stadium and Packard)
  • To schedule, call: 734-637-4757

Q: Stores are out of stock on cleaning supplies. Are there resources for employees to get cleaning supplies? 

A: Michigan Medicine does not have a way to provide employees with personal cleaning supplies. Employees may refer to CDC guidance available here about disinfectants that can be used in the home setting. This includes a list of products that are approved for use against the COVID-19 virus and directions to prepare bleach solutions.  

Q: Can I donate blood to help?

A: There is a crucial need for blood donations. Donations have plummeted and organizations have canceled blood drives. Appointments can be scheduled at redcross.org.

Q: What is appropriate for me to share on social media?

A: There is a vast network of employees on social media, and while all efforts to spread knowledge and awareness during this uncertain time are appreciated, please allow the Michigan Medicine official channels to take the lead on the most pressing messages.

Exercise caution in the sharing of conversations and emails that are intended for a small or internal Michigan Medicine audience rather than a much larger social media world. Protecting patient privacy is a top priority at Michigan Medicine, and the organization must avoid inadvertent disclosures via selfies or other photos on social media.

Michigan Medicine’s social media policy can be accessed here.

The public is hungry for information, and the Michigan Medicine social media channels are used to strategically share these messages. All messaging through these central channels is suitable for sharing.

Field hospital

Q: When will the field hospital open? Or will it at all?

A: Plans to open a field hospital at the South Athletics Facility are on hold.

We are in communication with state officials to coordinate and determine future need. Our ongoing focus is on our current capacity and readiness to serve patients in our existing hospital facilities.

If a field hospital is opened …

Q: How can volunteers help? What is the process to volunteer? 

A: We are in the midst of assessing the staffing resources needed, both clinical and non-clinical, for the field hospital. Clinical department chairs have already surveyed their faculty and we now have that physician registry. A similar exercise is underway for nursing and other departments. Non-clinical individuals who are interested in volunteering at the field hospital and have relevant experience in support services for hospitals may send a message to: HR-Pandemic-Staff@med.umich.edu.      

Q: What is the plan to transport patients to the field hospital from UH? 

A: Leaders from the Survival Flight team, Care Management and others in Michigan Medicine are working with Huron Valley Ambulance (HVA) on the plans to support the safe transport of patients to the field hospital.  

Q: Is there a plan for radiology in the field hospital? 

A: We are currently planning for portable x-ray and ultrasound onsite.  Radiology Department leadership is working on the implementation plan.

Q: What is the nurse staffing model in the field hospital?  

A: Nursing leadership is working on the staffing model, and will be refining it as we better understand what resources are available internally and otherwise. We continue to need all hands on deck!

Q: Will there be general rehab for patients who can’t go home yet? 

A: Yes, we anticipate having bedside rehab for patients at the field hospital.

Q: Will central services (PFANS, EVS) also supply the field hospital?  

A: This is being evaluated, and we will know more after meeting with the Army Corp of Engineers this week and understanding what manpower could be provided through FEMA.

Temporary housing

Q: Is temporary housing available to employees? And if so, who is eligible?

Temporary housing is available to employees who are positive for COVID-19, do not have symptoms severe enough to be hospitalized but cannot self-isolate/quarantine safely at home. It is no longer available to employees in need of respite.

Q: How do employees request lodging assistance?

A: If an employee believes they may need temporary housing, they should first inform their supervisor and then contact Occupational Health Services at 734-764-8021. If OHS confirms a positive diagnosis, the employee must then verify their need for temporary housing with their supervisor who will submit the necessary form to the COVID-19 Temporary Housing Team.  

Q: Where are the lodging accommodations located and what’s included?

A: Lodgings include commercial locations, and placement will be determined by the COVID Temporary Housing Team. Amenities will vary based on site, and information will be provided upon assignment. If you have special requests, please request them at the time of booking.

Q: Are employees paying for lodging?

A: Employees who have followed the process to request lodging (first contacting supervisor, then Occupational Health Services with a follow up to supervisor who requests temporary housing) will have their room paid for. Those who are not positive for COVID-19 but still wish to seek temporary housing can contact Michigan Medicine Lodging outside of this process and they will be responsible for self-payment.

Q: How long does it take for a housing assignment once the form is submitted?

A: Confirmation of a reservations assignment will be returned within two to four hours after the request is made. This may be longer based on volume. The reservation office will be open every day from 8 a.m. – 10 p.m.

Q: How long can employees stay in the temporary housing?

A: Temporary lodging is available for up to 14 days for employees requiring quarantine due to a positive test.

Q: Are employees responsible for incidental expenses?

A: Yes. Incidental expenses (e.g. food) are the employee’s responsibility.

Q: Can I be placed at the same location as my coworkers?

A: Lodging will be assigned based on availability and cannot be grouped.

Q: Are my family members allowed to visit me in the hotel?

A: No, the purpose for this program is to provide our employees with a safe place to stay who may have immunocompromised family members at home or need to self-isolate; all to prevent the transmission of COVID-19.

Vaccinations

Q: Are vaccines required for Michigan Medicine employees?

A: Yes, vaccines are mandatory for Michigan Medicine faculty, staff and learners. Click here for a full FAQs regarding this policy.

More information

Q: Where can I learn more information?

You can find a lot of information regarding university policies and COVID cases on campus on this U-M website.  Additionally, Michigan Medicine’s Department of Infection Prevention & Epidemiology has set up a page with a number of valuable resources for employees, ranging from clinical and ambulatory guidelines to weekly updates. 

Michigan Medicine Headlines is also regularly publishing information and has set up a specific page that compiles all COVID-19 communications.

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