As Medical Assistants Head Back to Work, Increased Infection Control Procedures are Being Added to the Job Description

Plenty of medical assistants have been absolutely buried with the demand from COVID-19 treatment in hospitals nationwide. They already know all there is to know about infection control procedures—those procedures are exactly what has been keeping them safe this entire time.

But not all medical assistants have been so busy the past few months. Huge segments of the medical industry have been all-but-mothballed during the hottest part of the crisis, a combination of:

  • Stay-at-home orders cancelling elective procedures
  • Hospitals clearing the decks for COVID-19 patients by discharging other types of patients
  • Patients staying home and deferring consultations or treatments for fear of infection

But healthcare is a critical service, one that can’t stay closed down for long without some serious long-term effects. That means medical assistants will be among the first people in the country to head back to work. And they’ll be going into a field where it’s all but impossible to avoid close contact with strangers.

All of those MAs, not to mention the cohort graduating this year and next, can really use a refresher on best-practice infection control procedures for COVID-19.

What Makes SARS-CoV-2 So Infectious in the First Place?

MAs deal with possibly infectious patients all the time. What’s the big deal with COVID-19 patients, then?

It boils down to two factors:

  • The virus is very easily transmitted
  • The disease itself has a higher fatality rate than many diseases

But why does it spread so easily?

First, COVID-19 patients have been shown to shed the virus prior to showing symptoms. That makes procedures that rely on taking extra precautions only when patients are observed with a fever, cough, or other signs inadequate. Because there are many such carriers, who don’t know to confine themselves other otherwise take precautions, it makes almost any patient a potential infection source.

Second, the properties of the SARS-CoV-2 virus itself appear to simply have a better design for latching onto host cells. The spikey protein structure everyone has seen in visualizations of the virus seems to be extremely effective at getting a grip on the body’s ACE2 receptors, found in lung cells.

Third, it seems to spread primarily through droplets either produced by coughing or even just ordinary speech, and possibly even in aerosol form, which makes it very easy to breathe in and deliver right to those waiting ACE2 receptors.

That combination has resulted in some 9,200 infections among American healthcare workers by mid-April, according to the CDC, which has so far resulted in 27 deaths.

Which is a pretty good reason to bump up your infection control expertise before you head back in to the office.

What Steps Should Your Office Take to Control Infection Paths for SARS-CoV-2?

Fortunately, everything you learned, or are learning, in school about infection control still works with SARS-CoV-2. It is still just a virus, and still vulnerable to the same things that control other viruses.

The real challenge is putting all those control processes together on a large scale. When everyone that walks in the door is a possible vector, you have to step up your game to keep transmissions down.

SARS-CoV-2 Control Starts Outside The Door

That means you start your process before patients even walk in the office. The CDC recommends all healthcare settings adopt universal source control. That means:

  • Asking about symptoms before allowing entry
  • Temperature checks
  • Mandatory hand-washing or sanitizing on entry
  • Mandatory mask wear

As an MA, you’ll more than likely be the person responsible for this gatekeeping. You’ll want to:

  • Familiarize yourself with temperature guns
  • Put together a symptom question checklist
  • Put together stocks of sanitizer and masks
  • Learn how to instruct patients in proper mask donning and doffing procedures
  • Be ready to dispose of contaminated masks appropriately

Protecting Providers With Personal Protective Equipment

You’ll also need to master PPE procedures for yourself and other providers. MAs are often responsible for maintaining inventory of PPE and distributing it. During a pandemic, that also means both instructing other providers on proper donning and doffing protocol, and occasionally acting as a spotter to ensure they are following those procedures safely.

Facility Layout and Cleaning

Because there is also some evidence that SARS-CoV-2 can survive in droplets on various surfaces for several days, it’s also possible to get infected by touching a surface and then accidentally touching your face. The CDC recommends regular cleaning with EPA-approved disinfectants.

MAs may do some of that cleaning, but more likely they’ll be responsible for monitoring and tracking how often it’s performed.

The process can be made easier by making some physical changes to the facility and the flow of patients through it. This can include:

  • Restricting patients to certain paths through the building to reduce areas requiring frequent cleaning.
  • Putting physical barriers up between staff (such as in reception areas) and patients.
  • Arranging furniture and providing visual cues (such as tape marks for queueing areas) to help maintain distancing.

Ongoing Monitoring of Healthcare Staff

Although patients are a big threat vector, the real nightmare is when healthcare providers become infected. During an asymptomatic period, they can spread the virus to every patient they come in contact with.

That makes monitoring of staff enormously important. MAs are likely going to be responsible for not only tracking themselves, but also other staff, regularly checking temperatures, asking about symptoms, and possibly administering tests directly.

Staying Informed About SARS-CoV-2 Infection Control Procedures

One of the most frightening things about COVID-19 is how little concrete information is actually available about how the disease is transmitted and progresses. That’s normal for a new disease, but it demands constant vigilance. What we think we know about it today could change dramatically tomorrow.

That’s why you can’t just take these infection control procedures and run with them. Part of infection control is keeping up with best practices as new evidence changes them.

You should regularly consult the updated CDC guidance for healthcare infection control, as well as the series of guides produced by WHO on the topic.

There are a whole class of medical professionals who are specializing in this subject too, and it’s worth seeing what their advice looks like. The Society for Healthcare Epidemiology of America has a dedicated COVID-19 resource website, and the Association for Professional in Infection Control and Epidemiology is making their reference materials on the topic available for free.

If you work for a large healthcare organization or in a hospital, it’s quite likely that you already have an infection control committee coming up with procedures, and their guidance will be the most important to follow as you get back to a full patient schedule in the coming months.