COVID Protection Policy For Healthcare Appointments

We are very conscious about COVID in my household. We have a ‘COVID Protection Policy’ on my husband’s website to let clients know the protections he’s taking and why (TonyDuke.ca/covid-protection-policy).
I’ve adapted our procedures for more general use and geared them for healthcare settings. Of course they apply for any indoor setting such as your workplace.
You can download this information in 2 formats:
A One-Page PDF Summary
This is a one-pager with a link to this blog post should people want to read the full policy.
COVID Protection Policy Word Document
This is the full 5-page policy and includes links to peer-reviewed scientific papers.
Why Have a COVID Protection Policy?
There are 3 main reasons why it’s important to take COVID precautions, especially for those of us who must navigate healthcare spaces regularly. These aspects of COVID and the pandemic (lack of) responses are handled in the ‘Protection Policy’ and determine the precautions we take.
1. COVID is Airborne
Because COVID is airborne, it is dangerous to ‘share the air’ without protections. This is especially important in healthcare settings because being ill or having a chronic condition puts us at risk of worse outcomes with a COVID infection.
- COVID remains in the air for significant amounts of time depending on a number of factors including ventilation and CO2 concentrations. In an unventilated space, people have been infected by others who were in the space hours earlier. Just because a room is empty doesn’t mean it’s safe.
- There are many situations where a patient must remove a mask in order to get the testing or treatment they need. If/when this becomes you, it is important that safety protections are already in place. With an airborne virus, this means that healthcare spaces must take both near-field and far-field transmission into account in their own protections (hint: air ventilation and filtration and masking are important).
- Near-field transmission happens between people who are standing in close proximity. This means that a doctor, nurse, dentist, etc. can transmit the virus to you – or vice versa! The risk is increased when one or both of you is not appropriately masked.
- Far-field transmission happens when a virus is lingering in the air in a space. This is reduced when indoor air is adequately ventilated and/or filtered. Engineers determine what ‘adequately’ entails and they upgrade ‘Indoor Air Quality‘ (IAQ) standards to reflect new situations and information.
2. COVID is Prevalent
If COVID was under control, removing a mask or depending on one-way masking would be less risky. But COVID isn’t under control. Governments have moved away from the COVID emergency protocols, but the WHO has been very clear that the pandemic is not over. There is a difference between a politically declared emergency and the prevalence/spread of a human pathogen.
This does not mean the pandemic itself is over, but the global emergency it caused is – for now. (~World Health Organization)
Public Health Officers have stopped doing regular updates, despite the ongoing pandemic. Thankfully, Canadians still have a reliable source of COVID forecasting information thanks to the ongoing efforts of Dr. Tara Moriarty (University of Toronto) and a team of medical volunteers at COVID19Resources.ca.
- Find ongoing reporting of COVID rates in Canada and each province on COVID19Resources.ca. Look under ‘Public Resources’ –> ‘Canadian COVID Hazard Index’. You can find your province by clicking on the numbered tabs on the left-hand side of the table.
- NOTE: A communicable disease is considered to be ‘circulating in the community’ when:
3. COVID is Not Mild
A third major factor that makes it important that we take our own measures to access safe healthcare is that COVID is not mild. COVID is not a cold, or the flu. COVID is a neurovascular disease that affects every organ in the body. Even a mild initial infection can have significant impacts in the following days and years for a significant number of people. And the risks are cumulative – they go up with each COVID infection. Long COVID often goes unrecognized by physicians and there are no widespread effective therapies. The only way to ensure you do not develop Long COVID is to avoid being infected by COVID.
UPSHOT: It’s imperative to do what you can to avoid COVID. Even when others are not.
How to Reduce Your Risk of Contracting COVID
Protecting ourselves from COVID in healthcare settings is now part of our ‘New Work‘ as patients and care partners. We have to take active steps even if it means coming into conflict with the very people who are supposed to be providing safe care.
There’s no sugar-coating it. This is hard. It’s distressing to realize you could be infected with COVID by people who should be wearing appropriate safety gear. (An essay on this topic by ‘The Disabled Ginger’ was recently picked up and published on Healthy Debate.)
At my house, we have our own policies and procedures about engaging our healthcare teams and making our expectations for patient safety clear to them. We update them when we find new resources.
Be Prepared
We need to know ahead of time what we are walking into so we can negotiate safer appointments before we end up in a risky situation. Here’s what we do:
- I speak with the medical office beforehand to ask about their airborne precautions. These include:
- Using masks with good fit and filter (i.e. (K)N95 and better respirators). We use N95s and we ask about the medical staff, and
- Having good ventilation and air filtration. Few medical offices that have information about the quality of their indoor air and/or use HEPA or equivalent air filtration units. Fortunately, CO2 can be measured with a monitor.
- We have an Aranet monitor and use it . If/when the readings become too high we will leave an unsafe space, especially when others are not masking or there are no stand-alone air purifiers. We let the staff know this before we enter the space that leaving is an option.
- Depending on the answers, we negotiate for safer healthcare appointments. This can mean:
- A phone appointment,
- A parking lot appointment,
- Getting the first appointment of the day so that the air has had some time to be filtered, or
- Cancelling an appointment.
- One tool we are going to try using is the ‘Request for COVID Accommodation in Healthcare Facility’ form published by the Canadian COVID Society. Every province has Human Rights legislation that includes a ‘duty to accommodate’. This is also part of the Canadian Medical Association’s code of ethics. This form requests the accommodation and makes the duty to accommodate clear.
Which of these you do depends on your own situation. It’s up to you to determine the best course of action with the information you have about COVID prevalence where you live, the COVID protections in the healthcare situation as well as your own health situation and the relationships you have with your healthcare providers.
Do you have a COVID protection policy when it comes to healthcare interactions? What do you take into consideration? Let us know.
2 Comments
Carrie Varga · December 6, 2024 at 5:19 pm
Very thoughtful and well thought out content that considers a variety of situations and options. Thanks!
Beth Campbell Duke · December 7, 2024 at 7:59 am
Thanks for commenting, Carrie. I appreciate it!
Comments are closed.