UC Davis Med Center employees infected with coronavirus. Hospital expects ‘many more’

Staff members of the UC Davis Medical Center, including one emergency room nurse, have tested positive for COVID-19, the “first of what will be many” infections among workers at the hospital as the disease spreads throughout the community, according to an internal email obtained by The Sacramento Bee.

On Monday, David Lubarsky, CEO of UC Davis Health, alerted hospital employees that some of their colleagues had been infected. In his memo to staff, he also defended the hospital’s infection-control practices and addressed critics who said the hospital had been performing too many “non-essential” surgeries during the pandemic.

Lubarsky did not identify the staff members who had been infected. But one Medical Center employee, a 48-year-old emergency room nurse, told The Bee that she received a positive coronavirus test result on Monday.

Lubarsky said in his memo that the infected staff members “very likely” caught the virus outside the hospital. But the nurse, who asked not to be identified, said she believes she caught it on March 15, from a patient brought to the ER from a skilled nursing facility.

Three days after she said she was exposed at work, she said she began coming down with a dry cough that wouldn’t go away. She was off work at the time. The next day, her cough grew worse, she developed a mild fever, and she began having shortness of breath and lethargy.

“I was so tired,” the nurse said. “My bones ached.”

By day three, it grew difficult to climb stairs or walk to the restroom, and she could barely carry on a conversation, she said. She eventually ended up hospitalized for two days. She was just discharged Monday night — the same night she finally received official confirmation that she had COVID-19.

The nurse said she believes she will be one of the 97 percent of people who will recover from the illness, but she’s worried about her 11-year-old daughter and her husband, a smoker with diabetes. She said she did not work at the hospital when she had symptoms.

Hospital spokesman Charles Casey said Tuesday no female employees have reported to human resources as required they tested positive for COVID-19, but “based upon The Bee’s report, we are investigating whether any health care worker has tested positive and has not reported it to us.”

Over the past several weeks, UC Davis Medical Center has been at the forefront of the region’s response to the coronavirus crisis. A Solano County resident who was the nation’s first confirmed case of coronavirus from “exposure in the community” was treated at the facility in February.

In early March, the hospital said 89 employees who were placed on in-home isolation precautions due to COVID-19 exposure were “doing well and will be returning to work.” All tested negative for the virus.

Monday’s announcement shows how the infection has now crept into the medical community in Sacramento. Lubarsky was clear in his memo: Expect more cases as the Medical Center staff interact with their family and others.

“Last week, we had the first of what will be many members of our UC Davis Health family who test positive for COVID-19,” he wrote. “That person, and a few others we’ve learned about since Friday, have all been very likely community-acquired infections, from family members or others living in close quarters to them.”

Lubarsky did not say how many UC Davis Medical Center staff members had contracted the novel coronavirus, but he said they were cases detected as “backlogged test results” began to come in. He noted that “an increasing number of people in the community” have become infected.

“We are going to see a dramatic rise in the number of people testing positive,” he said. “In the coming days and weeks, there will be literally dozens of our team members who will have to call in sick and stay at home to rest and get well.”

In an email to The Bee, Casey declined to say how many employees were infected and in what departments they worked, saying it was “protected health information.”

Lubarsky told the staff that “while we practice contact/droplet precautions here at work, we simply can’t be as protected outside of work.”

Some UC Davis doctors and health care workers said they are growing frustrated about having the right protection when they interact with patients. The ER nurse who contracted COVID-19 said she wants the hospital to provide better equipment for her colleagues on the front lines.

“Basically we’re walking into the virus itself,” she said. “Just by the nature of what we do. There’s a lot of evidence that suggests you can walk around with no symptoms at all and still spread the virus, so the idea that we can work in an emergency room and not have to gown up with (personal protective equipment) until we have a patient that meets certain criteria is to me preposterous, I think we should just always have the gowns and gloves available.”

Casey, the hospital spokesman, said UC Davis has “a sufficient and ready supply” of equipment available. “And we expect all health care workers to use it properly,” he said.

Too many elective surgeries?

Lubarsky’s announcement Monday comes three days after Dr. Diana Farmer, the chairwoman of the UC Davis surgical department, took to Twitter to refute claims that the hospital was continuing to perform non-critical procedures.

In his memo Monday, Lubarsky also defended the hospital’s decision to continue to perform surgeries, saying the types of procedures the hospital is providing are vital and saving lives. Lubarsky argued the procedures UC Davis has been doing are critical, even during a pandemic.

“These are not the typical ‘elective’ surgeries performed in other hospitals,” Lubarsky wrote in his email. “That’s not what we do at UC Davis Health. We are following national guidelines for essential surgeries – guidelines developed in part by our own experts.”

He said 32 percent of the surgeries being performed are urgent and related to trauma, injuries or “physical repair.” Nearly a quarter of the surgeries were for cancer treatment. Fifteen percent were to treat pain such as removing kidney- and gallstones. The remaining, he said, were necessary procedures such as repairing obstructed bowels, removing feeding tubes and catheters.

He noted the need to continue to perform organ transplants.

“With donor organs being the limiting step in life-affirming kidney transplant surgery, we cannot simply throw these organs out because we are concerned there may be a problem in the future,” Lubarsky wrote. “Essential surgery like this should be the last thing we give up as we prepare for COVID 19 patients.”

National guidelines have increasingly discouraged so-called “elective surgeries.” The U.S. Surgeon General called on people to hold off on their scheduled procedures. The U.S. Centers for Medicare and Medicaid Services likewise called for significant limits “until further notice.” And the American College of Surgeons last week pleaded with providers to preserve medical equipment for front-line hospital staff bracing for patients with COVID-19.

It’s difficult to know how common elective procedures are nationally, said Gerald Kominski, a professor at the UCLA Center for Health Policy Research. And while there’s a gray area about how “elective” they really are, they need to be significantly reduced for two key reasons.

“One is they use precious (personal protective equipment) that, as everyone knows right now, is in severe shortage,” Kominski said Tuesday. “The other risk consideration is that every patient that shows up at the hospitals who does not need to be there is potentially a carrier.”

Hospital administrators rely heavily on elective surgeries to keep their institutions financially solvent, said Art Caplan, director of the medical ethics program at New York University’s Langone Medical Center.

“If I’m a hospital administrator ... I’m using some of this elective stuff to balance my ability to respond should we get into a (financial) crunch … if we’re trying to buy resources, if we have to buy ventilators, if we have to pay a lot of overtime or hire more security — whatever we might need to do,” Caplan said. “But I still think the prudent decision is to be conservative over the next month and see where we are.”

Doctor concerned about surgeries

A UC Davis Medical Center doctor who spoke with The Bee said surgeries that could wait until after the pandemic keep happening.

The doctor said UC Davis on Monday performed about 75 percent of its normal “ambulatory” surgical volume. These sorts of routine outpatient procedures such as arthroscopic knee and elbow surgeries are typically scheduled weeks in advance.

“While the name of a procedure … may or may not appear serious to some people, in reality, each case decision involves a surgeon patient and a group of medical professionals deciding if the case can wait,” Casey, the hospital spokesman, said in an email. “These surgeries, especially cancer removal, pain-relieving, trauma repair are not seen as ‘elective’ by patients.”

The doctor countered the problem with doing scheduled procedures now is that patients who may be carrying the new coronavirus may not show symptoms, spreading the virus to hospital workers.

The surgeries also shrink the hospital’s supply of protective equipment such as masks and gowns, said the doctor, who asked to remain anonymous to protect his job.

“The truth is we are not testing enough patients and not doing any surveillance of health care workers to detect asymptomatic carriers at work,” the doctor wrote in an email, “so the more patients we have in our hospitals and outpatient clinics, and the more healthcare workers we have interacting with them, the more we allow for ‘community transmission’ to occur at UC Davis facilities.”

This story was originally published March 24, 2020 at 4:54 PM.