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Health, Science & Tech

UPMC Western Psych Staff Concerned About COVID Policies

this_march_8__2012_file_photo_shows_the_western_psychiatric_institute_and_clinic_on_the_university_of_pittsburgh_campus.jpg
Keith Srakocic
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AP
This March 8, 2012 file photo shows the Western Psychiatric Institute and Clinic on the University of Pittsburgh campus.

Health care workers at UPMC Western Psychiatric Hospital say some of the hospital’s COVID-19 practices don’t sufficiently protect patients or staff from contracting the coronavirus – and that social-media posts from a supervisor questioning the severity of the pandemic have made the situation even more nerve-wracking.

“[Staff] are constantly getting sick. It’s stressful,” one employee told WESA. “Morale is so low….Once you’ve left work, it stays with you.”

Five health care workers at Western Psych, who requested anonymity to protect their jobs, say that while surgical masks, gowns and gloves are available, N95 masks are a rarity. Some say that only nurses who work with COVID-19 patients in the ICU are given N95s (which offer more protection against the virus), while other staff caring for COVID-19 patients – like student behavioral assistants, therapists and psychiatric assistants – have surgical masks.

Western Psych specializes in mental health and addictive disorders, and staff say the need for protective gear is heightened by the fact that their patients present special challenges when it comes to physical distancing and other precautions.

One nurse, for example, spoke of a patient “wearing a mask over their forehead and over their eyes. They're not giving us N95s to wear, and if our patients aren't wearing masks, that does us no good if we're not wearing an N95.”

“We’re getting spit on, kicked, punched by patients daily,” another worker said. Patients “don’t want to wear their mask. … We have to deal with a lot of bodily fluids and I think it’s unsafe.”

In a statement, UPMC did not directly respond to specific questions about conditions at the hospital. In its entirety, the statement read:

“Our staffing has and is meeting demands, and our hospitals continue to provide safe care for all patients. However, we recognize that this is a stressful and very challenging time for our dedicated caregivers. They have worked tirelessly caring for patients. We proactively engage and communicate with our staff in many ways and through various channels to educate everyone on current guidelines, best practices and protocols, and to make sure leadership is accessible to answer any questions. Beyond our extensive efforts to create open communication, we encourage staff with any specific concerns to bring them to his or her manager so that we can help and provide support and appropriate resources.”

From an epidemiological standpoint, Duquesne University associate professor Bridget Calhoun said she’s not surprised that only ICU staff get N95s. Calhoun, an infectious-disease expert, said that has generally been standard practice since the pandemic began last spring. But she noted that while N95s require fitting to make sure they fit properly, KN95 masks don’t require fitting and can be purchased by the general public.

‘Lives on the line’

The Western Psych workers who spoke to WESA said they are also concerned that staff caring for COVID-19 patients are frequently asked to work in other areas of the hospital, and could be spreading the virus.

Hospital guidelines shared with Western Psych employees and reviewed by WESA state that when a patient tests positive, the area of the hospital they were in is designated a “yellow zone” where staff must wear extra personal protective equipment (PPE) as well as a mask. Staff who interact with a COVID-19 positive patient do not automatically get tested for the virus. Areas where there aren’t known COVID cases are considered “green.”

“Staff should minimize movement from higher risk areas to lower risk areas,” the guidelines read. “During crisis or emergency situations, staff can enter an area of higher risk.”

But staff say in practice, they frequently move between areas with known infections and those without.

“We’re interacting with each other constantly,” one employee said. “[Supervisors] are pulling us to other units. So, you may have worked in a yellow zone one day and then the next day you’re pulled to a unit that is considered 'green.' That doesn’t make sense.”

The policy doesn’t say how long staff must remain in a yellow zone before they’re allowed to be in lower-risk areas. Workers who spoke with WESA believe the protocol should align with the recommendations the U.S. Centers for Disease Control makes to the general public: to quarantine for 14 days after exposure. Therefore, they say, staff who have worked in yellow zones should not work in green zones until 14 days have passed.

Calhoun said such protections aren’t realistic, given the sheer number of COVID infections among health workers and the population as a whole.

“We have a proportion of the workforce – both physicians and non-physicians – who are also in quarantine or who may be sick themselves,” she said. “It’s a pandemic [which] makes that nice, packaged process that we’ve all learned about in our epidemiologic training far more difficult. We have to try to balance the reality of our health care system and the demand that’s burdening our health care system.”

Simon Haeder, a Penn State University assistant professor of public policy who specializes in health policy administration, agreed that the pandemic is straining hospitals. Much of the blame, he said, lies with governmental failures that have plagued the virus response. But he said administrators sometimes make things worse.

“We’ve been doing this for almost a year and it hasn’t really gotten any better and in a lot of ways it’s gotten worse” due to factors like chronic PPE shortages and staff retirements, he said. But while hospitals “are in a bad place too,” often “they really have just decided to ride their workforces as hard as they can and hope for the best.” That has led to short-term cases of exhaustion and burnout, he said – and it could have longer term consequences that aren’t yet apparent.

“If you seek input from your staffers and you don’t just do it as a ‘fig leaf’ kind of thing, but you actually listen to them, I think you can rein in a lot of the frustrations that the workforce is justifiably feeling,” he said. “They’re not just feeling like they’re a cog in the machine and have no input of their own. I mean, their lives are on the line, right?”

Social-media posts add to concern

At Western Psych, some workers say their own misgivings have been worsened by anti-mask and anti-vaccination posts on the Facebook account of a hospital administrator.

The supervisor is an acting unit director at the Oakland facility, and oversees the Child and Adolescent Unit on an interim basis. In addition to filling in as an acting unit director, she is also a weekend administrator on duty, which means she manages weekend staffing at the hospital.

The posts were public when they were discovered by staff, and screenshots were shared with WESA.
 

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Credit screengrab of Facebook post
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One of the Facebook posts that alarmed health care workers at UPMC Western Psych.

In July, the supervisor shared a post on Facebook that quoted former U.S. Rep. Ron Paul on Parler, the conservative social-media site, saying that “the CDC warns that COVID is at the stage where it cannot be classified as an epidemic due to declining deaths. Still, more masks are required and petty dictators all around are calling for a return to lockdown. Can the truth ever be heard above all the lies?”

The post dates back to a summer trough between peaks in COVID-19 deaths. But the death rate has accelerated since then, with the disease having killed more than 400,000 Americans so far. The CDC still classifies it as a pandemic.

The Facebook account also featured a Wall Street Journal opinion piece called “The Failed Experiment of Covid Lockdowns” that argued social distancing and lockdowns did not affect the spread of the virus.

Another post shared a meme that shows Kermit the Frog drinking tea with the caption “China has been wearing masks in public for years and still got sick but that’s none of my business.”

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Credit Facebook screengrab
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Facebook screengrab
Another Facebook post which raised concerns among staff.

Masks have been shown to be an extremely effective tool at reducing the spread of the virus.

Since staff first discovered the posts in late December, the Facebook account has either been deactivated or had its privacy settings changed. The supervisor did not respond to multiple calls, texts and emails for this story.

WESA asked UPMC multiple questions about the supervisor’s social-media activity. UPMC asked WESA to share the screenshots in order to investigate the claims. WESA did so, but UPMC did not address the alleged social media in its response to WESA’s queries.

“Everyone is entitled to their own opinion,” said one Western Psych worker who saw the posts before they were made private. “But when you’re in charge of sending someone to test for COVID and you’re posting things about believing in COVID conspiracies/not believing in the vaccine, it scares me. And I know it scared a lot of other people too.”