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What precautions health care facilities should be taking to protect their workers

What else can be done to protect frontline health care workers and reduce the spread of the novel coronavirus? Dr. Atul Gawande has just published a piece outlining the specific insights he has derived from the outbreak experiences of Hong Kong, Singapore and South Korea. A surgeon at Brigham and Women’s Hospital in Boston and the CEO of Haven, Dr. Gawande joins Judy Woodruff to discuss.

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  • Judy Woodruff:

    That all brings us to a larger look at what can be done in the U.S. to protect front-line workers and lessen the spread of COVID-19.

    In a piece just published for "The New Yorker," Dr. Atul Gawande writes about very specific lessons he sees from Hong Kong, Singapore and South Korea. Dr. Gawande is a surgeon at the Brigham and Women's Hospital in Boston and the CEO of Haven, a joint health care venture created by Amazon, Berkshire Hathaway, and J.P. Morgan. And he is a staff writer for "The New Yorker."

    And he joins me by Skype from Boston.

    Dr. Gawande, thank you so much for talking with us.

    So, we just did hear from an E.R. physician and also the CEO of a hospital about how difficult conditions are for the workers in these hospitals and health care settings. You have been looking at lessons learned possibly from Asia.

    What are you finding?

  • Atul Gawande:

    First understand that what we are seeing in Italy is that the hospitals themselves have become a source of infection.

    By contrast, in Hong Kong and Singapore, they were able to control the infections very effectively. They had a playbook, and it worked. They managed to keep infections spreading inside hospitals to patients or to clinicians. And so we need to follow that playbook.

  • Judy Woodruff:

    And what are some examples of what you saw? And you have written about this — about the type of masks they wore them, and how long they wore them, about simple things like handwashing. What did you see?

  • Atul Gawande:

    Well, first of all, they started by saying, when you come in to work, they would do a health check on every health care worker to see, do you have any symptoms, like a fever, a cough, or any other kinds of flu-like symptoms?

    And then you would have to stay home. Number two, everybody wore a surgical mask when they came into work and kept that mask on all day, partly for the protection of the health care worker, but also because we are picking up infections in the community as workers ourselves, and we don't want to spread it to colleagues and to others.

    There is — a third one is that you really need to separate the respiratory patients in their own clinics, in their own wards, if you have a respiratory, from the people who have non-respiratory symptoms. Keep them out of — different teams, different line of traffic. And we need to be preparing to do all of these things.

  • Judy Woodruff:

    And through all of this, is — are we getting — are you getting a better understanding of how long this virus lingers and how long it lingers on different kinds of surfaces?

  • Atul Gawande:

    Well, so it does linger long enough that we know we have to do regular cleaning, clean between each patient who comes in the room on the surfaces.

    But, second, one of the interesting things, it also shows us that you don't have to be totally draconian. In Singapore, for example, when you had — they didn't automatically quarantine everybody who were exposed to a coronavirus patient.

    They only sent you home to be in quarantine if you were within six feet of the patient for more than 30 minutes with no mask on. And that was effective.

    And what that tells you that if you have a brief momentary exposure within six feet to someone who has coronavirus, that you don't have to fear that that is necessarily going to cause the same spread. It comes from substantial time together.

  • Judy Woodruff:

    So the duration of exposure, you are saying, really could make a difference?

  • Atul Gawande:

    The duration of exposition sure and how close you were. And, of course, makes sure that you — if you had your hands touching anything that might have secretions on it, that are you washing your hands.

  • Judy Woodruff:

    And, finally, Dr. Gawande, I'm sure you are aware of the — there's been some reporting about the debate between President Trump and some of the people around him about whether these very restrictive measures that are being put in place in the United States, state by state, may be doing more harm than good.

    Some people are questioning whether people will be better off if the economy, if the entire employment picture isn't allowed to collapse, and some of these restrictions are lightened up.

  • Atul Gawande:

    Well, I think, in two weeks, we're going to see the onslaught of cases, and we're going to understand we are not ready to lift the restrictions.

    We are — what happened in Wuhan after lockdown was, it was three to four weeks later that you hit the peak of the overrun of the hospitals. Then, if we are successful staying at home, and locking down the way we have, we should see that that peak starts to come down, and then we start seeing evidence of that.

    We will hopefully have testing moving and more supplies, and that will allow us to begin to look at ways to get people back to work.

    My bottom line here is, I'm so interested in what is happening in making health care workers safe, because if those measures make them safe, those measures will allow all of us to get back to work again.

  • Judy Woodruff:

    But you are saying that is going to take several more weeks before we have any idea of that?

  • Atul Gawande:

    I expect that, in the next two to four weeks, we will understand whether these combination of measures keep us from infecting fellow colleagues and getting infections from patients.

    If those work, that will show us over the next few weeks ways we can start moving people back to work.

  • Judy Woodruff:

    Dr. Atul Gawande, thank you so much.

  • Atul Gawande:

    Thank you.

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