My, how the world has changed. So, let’s just start with me admitting I am not one of those individuals that enjoys cleaning. Nope. Not even a little bit. Next, let’s just add that because of my own allergy and asthma related symptoms (combined with Tony’s desire to lick many surfaces best left unmouthed), I typically used to clean most everything but the toilet with a vinegar-water solution. Unless, of course, biohazards or infection are involved, and then I go with whatever is called for to minimize disease spread. Current conditions in our community necessitates disinfectant for every cleaning.
Nobody in our home has had COVID-19… that we are aware of. While my husband works in healthcare, he always uses the training, protective equipment, and standard precautions called for with any patient interaction. He has never brought anything home to us. I am honestly more worried about possible exposure on Andy’s trips into the grocery store (where symptoms of others around him are unknown) than I am about his potential exposure at work. That being said, I have risk factors that increase the possibility for more severe illness should this virus come to our house, so I aim to prevent infection and provide the safest possible work environment for therapists who have chosen to work in our home at this time.
What I am about to outline as our current process has pieces that fall under the “extreme caution” heading. They may not all be strictly required to prevent infection with this virus, but they do provide peace of mind to some. I think an important part of providing a safe work environment is to understand what measures those you are working with want to see taken to feel more comfortable. My personal opinion regardless is that when it comes to an emerging virus like COVID, often the gaps in known data as we are all making discoveries together warrants a heavier hand with infection control.
In our house, everyone is seen as a possible asymptomatic carrier. That means what is done to one is done to all. No plan that only screens out certain individuals for contact can hope to succeed with a highly contagious pathogen that comes with asymptomatic illness and spread in some individuals. And, effective infection control applies to both what happens in the home and how public encounters are handled.
Most trips into public are handled by Andy because of my risk factors, but I did have to take an unplanned trip into the dentist last week to repair an older filling that broke off. I wore in one of my own masks. I brought my own pen, making sure not to handle their papers or clipboards. I stood while waiting in the lobby. I brought hand sanitizer and something to clean their toilet seat and handle before and after I used it. I turned off the faucet with a clean paper towel so I didn’t directly touch the knobs with my newly cleaned hands. I used a clean paper towel to open the door knob and shut off the light switch and discarded this in a trash can on the way to the exam room.
When I returned home, I dumped the clothes I was wearing immediately in the laundry, showered, cleaned off necessary touched surfaces, and bleached down the shower. Towels were put in the dirty laundry and replaced out with fresh ones for my honey’s post-work shower. If hand washing is done well, cleaning off the light switches and knobs in such a case shouldn’t be necessary, but it is one of those comfort measures that becomes a symbol to everyone around you that you are doing everything you can to reduce risks.
Every morning, I clean and disinfect all of the common surfaces and touch points within the home, especially those that are used by therapists coming into our house. This includes things that might not be commonly considered, such as the lids on packages of cleaning wipes. All toys are disinfected after each therapist. Good infection control, in my opinion, requires being mindful of the details, and it requires cleaning before and after each person. For shifts that overlap, I have the soon-to-be-leaving therapist wait in the opposite end of the downstairs area than the incoming therapist will be walking into while I clean those items and surfaces. I clean the area the outgoing therapist was in after she has left for the day.
All of our temperatures are taken daily, and I take the temperature of every therapist showing up on our doorstep. The thermometer is cleansed before and after each therapist. Please note, some COVID positive individuals don’t ever get fevers, so this also is not a guarantee, but rather a symbol that you are doing everything you can to think of the safety of those you interact with.
I give each therapist a squirt of hand sanitizer after I take their temperature, at any point on the shift they feel it is necessary, and at the end of each shift. Tri-fold disposable paper towels are provided for them to wash their hands as much as they want to, which limits the risk of them being recontaminated by a cloth hand towel that sees multiple users. I also frequently use spray hand sanitizer on Tony’s hands. Please note, individual agencies aren’t providing those items, we have had to locate and make those resources available at our own expense.
Gloves are available should they feel most comfortable using them during any therapy task, but I only require them for modules (such as tooth brushing) that could involve direct contact with Tony’s bodily fluids. Masks are required for everyone to wear, though everyone knows Tony still won’t tolerate one for more than a few seconds. Currently, I am making masks myself for everyone who works here if they do not have access to their own masks. Everyone is instructed not to do any paper documentation of data, but to rather use their own devices. If desired, we set up therapists with a ROKU app so they don’t have to touch our remote, as TV is often used as a motivator for Tony.
I do all of this and more (like daily changing out bed linens/blankets as needed), but nothing I or anybody else can do will fully guarantee protection from infection to anyone. Most people have numerous points of interactions and contact, and it is exceedingly difficult to be perfect with infection control 100% of the time. Mindfulness and precision are perpetually required under pandemic conditions, which can create a certain degree of mental fatigue. But solid infection control does lower risk of infection. One of the best things you can do is keep abreast of credible scientific research and the guidance of experienced physicians and researchers.
I realize opinions and practices will vary, but in our home, we don’t have the luxury of doing anything else but taking this seriously. And, I know that for some of the therapists who work with our family, the reason they feel so comfortable coming into our home is the level of precautions we are taking.
I am going to end on the words of Florida resident Brian Hitchens, as they were presented by HuffPost. Mr. Hitchens, by his own account, wasn’t taking the risk of infection all of that seriously- until both he and his wife ended up in their local ICU. She’s still on a ventilator. “‘I thought it was maybe the government trying something…I’d get up in the morning and pray and trust in God for his protection, and I’d just leave it at that. There were all these masks and gloves. I thought it looks like a hysteria,’ he added. ‘Please listen to the authorities and heed the advice of the experts,’ he implored people in his Facebook post. ‘Looking back I should have wore a mask in the beginning but I didn’t and perhaps I am paying the price for that now….If you have to go out please use wisdom and don’t be foolish like I was so the same thing won’t happen to you like it happened to me and my wife.’”
Most people who get this virus will be ok, but some will face life-altering illness or death. I hope each of us can remember that what we do isn’t just about us. Some things, like masks and infection control, are also about protecting others if we are infected and contagious but asymptomatic.
