Schneider said the lack of information creates distrust among health-care workers and could hurt patients. He is among physicians, nurses and advocates calling for increased visibility on data from hospitals in the region, which have developed internal protocols in response to the pandemic but have no uniform system for disclosing the numbers of staff and patients confirmed to have the coronavirus.
“What fuels the emotional angst is that we don’t know,” Schneider said. “Give us some numbers.”
Interviews with and policy statements from officials at 11 hospitals in the District, Maryland and Virginia showed that most follow a similar procedure: When employees develop symptoms of the virus — often fever, aches or respiratory distress — they notify the hospital’s occupational health department, which alerts people who may have been exposed. But hospitals have taken dramatically different approaches on how they share information about infected employees and patients.
Schneider said LifeBridge Health, which operates five Maryland hospitals in the greater Baltimore area, is one of the most transparent systems he works in. The number of coronavirus-positive patients in the hospital system, along with the number who tested negative, is reported to staff on a 4 p.m. call every day, said executive vice president Leslie Simmons.
On March 18, LifeBridge emailed staff to say an employee at Northwest Hospital in Randallstown had tested positive, Simmons said — the first known case among staff.
“What I never want to do is frighten anyone,” Simmons said. “But I do not want to hide anything from staff.”
LifeBridge spokeswoman Sharon Boston said that there have been additional staff members who have tested positive since then but that there have not been other staffwide emails. She said the first email was necessary to stop rumors and inaccurate information that had spread in the hospital.
Many other medical facilities do not tell their employees how many colleagues or staff have tested positive for the virus, which as of Tuesday evening had infected more than 17,700 people in the District, Maryland and Virginia.
Most hospitals in the region have declined to say publicly how many staff members or patients have tested positive, citing privacy concerns and saying the numbers rapidly change. Several major D.C. hospital systems, including George Washington University Hospital, Children’s National Hospital and United Medical Center, did not respond to requests for information about how they track potential staff exposure.
Edward Smith, executive director of the D.C. Nurses Association, said there should be a uniform policy when it comes to notifying health-care workers about colleagues who have tested positive. Interviews with health-care workers showed many feel kept in the dark by leaders at their organizations and fear a lack of information could hurt their families, or their patients.
“If I am exposed and I’m not notified and I’m still going into work, that’s another possible exposure,” Smith said. “If I am notified but not being quarantined and not tested, that’s another possible exposure.”
Naa Owusu-Kwarteng, an oncology nurse at MedStar Washington Hospital Center, said employees are not told when co-workers test positive for the virus, even though they work in close proximity — sharing equipment including blood pressure cuffs and thermometers.
“I don’t know what I’m taking home,” Owusu-Kwarteng said.
At a MedStar clinic in Dupont Circle, two staff members said they were not told that a doctor tested positive until more than 10 days after the doctor called in sick. The employees, who spoke on the condition of anonymity because they feared getting in trouble, said staff — especially those who worked closely with the doctor — should have been informed earlier.
A clinical pharmacist at a MedStar hospital in Maryland said he learned from co-workers that another employee in the pharmacy tested positive earlier this month.
“We’re on top of each other in the pharmacy, we’re only like three feet from each other,” said the pharmacist, who also spoke on the condition of anonymity to avoid retribution. “It seemed like there was a disregard for us there.”
MedStar spokeswoman Marianne Worley said she could not comment on individual cases. She said if any staff member has symptoms of the coronavirus or concerns about exposure, they are told to contact the occupational health center and are given access to rapid screening and testing.
Officials at some hospitals acknowledged that striking the right balance between transparency and privacy can be difficult.
At Johns Hopkins Health, employees must sign a paper saying they do not have symptoms when they begin shifts. Epidemiologist Aaron Milstone said that the system tries to be transparent and that he personally has made calls to patients telling them they have interacted with employees who had the coronavirus. But he said determining who needs to be notified is a challenge.
“We feel like we are doing a great job of protecting our staff,” Milstone said, noting that most employees who have tested positive are believed to have contracted the virus outside the hospital. “But it’s in the community, so what happens when we go home is a challenge — for all of us.”
In the Inova system, which operates Northern Virginia’s only Level 1 trauma center, in Fairfax County, symptomatic employees who contact the occupational health office are referred to the respiratory illness clinic for testing, spokeswoman Jen Siciliano said.
If the test comes back positive, the system investigates which colleagues and patients may have been exposed and tells them to watch for symptoms, Siciliano said. Employees who wore personal protective gear at the time of exposure, she said, are generally not at risk.
Officials at Virginia Hospital Center in Arlington and Luminis Health, which includes Doctors Community Hospital in Prince George’s County, said they follow similar protocols.
Workers who test positive in Sentara Healthcare’s 40,000-person system, which includes a medical center in Prince William County, must give the company’s occupational health service permission to contact their supervisor and begin contact tracing, said Mary Morin, vice president of clinical effectiveness.
“I’ve never heard of someone with a potential exposure situation who hasn’t given permission,” Morin said. “They’re scared they may have hurt a co-worker or a patient.”
A team of experts contacts each potentially exposed person to determine their risk level, she said. Every other day, a nurse calls anyone asked to quarantine, to check on them and see whether they are experiencing symptoms.
“The calls,” Morin said, “send a message from our health system that we care about them — it sends a personal touch.”
Staff in some medical centers and hospitals said that in addition to wanting more notice when a fellow employee tests positive, they would like to see more information provided about the number and condition of covid-19 patients being seen in their facilities.
At Laurel Medical Center, which is run by the University of Maryland Medical System, a nurse said employees have not been told how many patients have tested positive for the coronavirus, although they heard from co-workers that there has been at least one.
The nurse, who spoke on the condition of anonymity to speak candidly, said administrators declined to provide details about the case, even as the state aims to add 135 beds at Laurel to treat covid-19 patients in preparation for a potential surge.
UMMS spokeswoman Jania Matthews said the system’s policy is that any employee who was not wearing personal protective equipment when they were exposed to a covid-19 patient would have been alerted. She said in a statement that the system has been transparent with staff, including providing updates on patients and safety precautions that do not violate the Health Insurance Portability and Accountability Act, or HIPAA.
Schneider, the vascular surgeon, said a lack of accurate information about covid-19 patients being treated — in addition to a lack of data on the number of intensive care unit beds filled and number of ventilators being used — leads to fear that might be misplaced.
He said his practice, which includes 11 doctors, has had several patients recently who have lost limbs because they waited too long to seek treatment for blocked arteries, fearing that hospitals were overwhelmed with coronavirus cases.
Had there been more complete information showing that Maryland’s hospitals have capacity, Schneider said, those patients might have sought help sooner.