A malfunction that occurred in the San Diego VA hospital’s isolation rooms may have exposed patients and staff in the ICU to the novel coronavirus, inewsource has learned.
The incident occurred during a planned power outage last week to test the hospital’s backup generators, according to a complaint filed with the federal Occupational Safety and Health Administration on behalf of the hospital’s nurses.
Why this matters
Roughly 700,000 people have contracted the novel coronavirus around the world, including 140,000 in the U.S. and 600 in San Diego.
As the virus continues to spread, healthcare facilities are preparing as much as possible to keep medical staff healthy and slow the rate of transmission.
During the test, “ventilation protective measures were not sustained” in the isolation rooms where confirmed COVID-19 patients were being treated, potentially exposing people in other areas of the ICU to the highly contagious virus, said the complaint, filed by National Nurses United.
inewsource asked the San Diego VA about the incident Friday and it had not responded by Monday evening.
COVID-19 patients in isolation rooms sometimes undergo “aerosolizing procedures,” such as intubation or bronchoscopies, which can cause the novel coronavirus to become airborne. The heating, ventilation and air conditioning system, or HVAC, normally takes that infected air and pumps it out of the hospital to avoid spreading it around the facility.
Healthcare workers who enter isolation rooms during aerosolizing procedures are required to wear N95 respirator masks to prevent breathing in the virus. But staff in other areas of the ICU who were potentially exposed during the HVAC malfunction may have been wearing less protective surgical masks, which don’t safeguard against the virus when it’s airborne.
The planned San Diego Gas & Electric power outage occurred on March 22 from 7 a.m. to 5 p.m., according to an email obtained by inewsource. It was sent to staff two days before the outage.
The email said workers in the engineering department had “made their final walk through of the ICU, to insure our readiness for this event.” Except for microwave ovens and refrigerators, it said, “all other essential ICU electrically powered items will be fully operational.”
OSHA told the nurses union Thursday it had received the complaint and gave the U.S. Department of Veterans Affairs five business days to “correct the hazards.”
More than a quarter million veterans in San Diego and Imperial counties are eligible to receive care from the San Diego VA healthcare system. As of March 24, five patients and five staff have tested positive for COVID-19, and another 138 patients are “under investigation” and waiting test results.
National Nurses United, which has more than 150,000 members, sent a statement to inewsource Monday describing multiple issues with the San Diego VA’s handling of the growing pandemic, including the ventilator malfunction.
“We hope that OSHA will also investigate our concerns about the functionality of some of the negative pressure rooms located at this VA facility,” Corey Lanham, the union’s VA division director, said in the statement.
Lanham also noted concerns about the staff and patient entrances into the La Jolla hospital. The entrances are separated during the day to prevent healthcare workers from contracting the virus from potential patients, but the two are combined during evening shifts. Union officials are asking for those separate entrances to be maintained 24 hours a day.
The statement also described an inadequate amount of protective gear for healthcare workers, especially those performing initial patient screenings to check for COVID-19 symptoms. The concern was noted in the union’s OSHA complaint.
“Having the appropriate (gear) is for the protection of the staff conducting the screening, as well as the prevention of exposure to those who are being screened,” Lanham said.
The VA Office of Inspector General published a report last week highlighting lapses in the San Diego VA’s preparedness to combat the novel coronavirus, including an insufficient number of masks, gowns and nurses, as well as a failure to screen patients at two outpatient clinics for COVID-19 symptoms.