Episode 3: Understanding COVID Terminology
“Episode #3 – Understanding COVID Terminology” by Sue Lanza and Shawn Carty. Released: 2021. Track 3. Genre: podcast.
Transcription
Sue Lanza:
Hi everyone and welcome to another episode of House Guests, the podcast about all things related to The House of the Good Shepherd, a retirement community in Hackettstown, New Jersey. I’m Sue Lanza the CEO and I’m joined today by my co-host, the Reverend Shawn Carty, who is our chaplain. Please enjoy.
Well. Hi Shawn.
Rev. Shawn Carty:
Hello, Sue.
Sue Lanza:
How are you today?
Rev. Shawn Carty:
I’m well, here we are again.
Sue Lanza:
Here we are again. They can’t get rid of us somehow. So today, I know we wanted to talk about a very fascinating subject called the language of healthcare.
Rev. Shawn Carty:
Oh, one of my favorite subjects.
Sue Lanza:
Now, what do you mean by that?
Rev. Shawn Carty:
Well, as you know, I started here a year and a half, almost two years ago now and quickly decided or noticed that there was a whole language that I did not speak when I got here.
Sue Lanza:
Oh, you poor thing.
Rev. Shawn Carty:
I know. I, well and I will tell you that as a priest in the Episcopal Church, we have our own language which is befuddling to people but when I started working here, my first experience of working in healthcare, suddenly there was this whole list of acronyms and terms and sort of code language that I realized I was not understanding and so I’m curious to learn about more of it today.
Sue Lanza:
Well, you know we like to keep it our own language so that no one else knows about it. You know how, when kids are little and they have their own secret language and their own secret friends, well, that’s kind of what we’re talking about here so.
Rev. Shawn Carty:
And one example I can give you from the church is I remember at one point hearing somebody say, I saw the junior warden talking with the sexton in the undercroft.
Sue Lanza:
Oh my goodness. That sounds like the game of Clue.
Rev. Shawn Carty:
What it means is somebody was talking to the custodian in the basement.
Sue Lanza:
Oh my gosh.
Rev. Shawn Carty:
But churches have their own terms for these things, just as healthcare has its own set.
Sue Lanza:
Sure, sure. So kind of what we talk about this is saying, how do you navigate through all the jargon, all the abbreviations that poor people who have to encounter healthcare out of nowhere and under often times of stress, you know, someone’s in the hospital and they need to go to a healthcare facility and then they bombard them with all these terms and nobody knows what we’re talking about. They really feel it but I even know, as you coming in as a new employee, we’ve had other people come in and weren’t familiar with healthcare at all and it is like literally speaking some foreign language. So the first topic I thought of was we should talk about COVID a little bit.
Rev. Shawn Carty:
Mm, indeed. Yeah, well, and so we’re, in this podcast, we’re actually turning the tables a little bit. I’m asking the questions and you’re the one who’s providing us the expertise.
Sue Lanza:
Well, yes, I know I’m a little bit nervous about that because I don’t know, do I know the answers? What will happen if I don’t? Will the podcast just blow up or something?
Rev. Shawn Carty:
I suspect you will.
Sue Lanza:
So starting with COVID any thoughts that you have Shawn?
Rev. Shawn Carty:
Well, what is the one acronym that everybody in the world now knows as a result of COVID?
Sue Lanza:
Oh, come on. You’re going to make this that hard for me? No, I think I know this one. Well, no one before this, some of us in healthcare already knew this one, but the one that everybody seems to know now is PPE.
Rev. Shawn Carty:
Mm-hmm (affirmative).
Sue Lanza:
And that stands for Personal Protective Equipment and the reason we know it is if you try to go any place, you know that some places, depending on where you are in the world, are requiring masks and that’s a part of personal protective equipment, but there are lots of other things that fit into that category, depending on how much you need to protect and that could be a gown, it could be gloves, it could be eyewear, it could be even booties on your shoes, any number of things, sometimes a face shield and there’s a whole process that we didn’t even talk about at all.
But donning and doffing. Now who knew what the heck that was, but donning and doffing means how you put on all your PPE and there’s a certain methodology of how you doff it or take it off and it’s very important because how you do that means how you’re controlling the potential exposure to an infection. So we have our own methodology. We have little diagrams and ways that we show everybody how to do this because it’s very important to know, but the most important thing that people know PPE is face masks and they do vary in the types that they are.
There’s what they call the N95, that is the one that healthcare workers often use that has certain protective properties and there are cloth masks which are probably on the lower level. And then in between, it’s kind of a surgical mask, the blue things that everybody sees that people have used for years and years but now everybody has a bunch of them in their car ready to go at any given moment.
Rev. Shawn Carty:
Mm-hmm (affirmative) and we now see them as trash, all sorts of places, which breaks my heart, but.
Sue Lanza:
I know we’ve even seen them down by our river and I’m like, ooh.
Rev. Shawn Carty:
Yeah.
Sue Lanza:
So it means somebody lost one somewhere and they’re running around exposing people, I guess.
Rev. Shawn Carty:
I guess, yeah.
Sue Lanza:
So.
Rev. Shawn Carty:
Now the other thing with COVID of course, is that we’ve learned a lot about testing in the last year and a half, and there are different kinds of tests, as I understand it, because as the employees here know, we get tested with some frequency and it depends of course, on whether we’re in a situation where somebody has tested positive recently or not and whether we’re getting a particular kind of test. So what can you tell us about those tests?
Sue Lanza:
Well, it’s so funny because sometimes the family members will ask me and I think, oh my gosh, how do I even have any of this information? How did I learn these things? But there really are two types of tests and the school of thought is that one maybe is a little bit better than the other, but there’s a debate about that even as well. So the first one, the one that we do usually once a week here for our employees and our residents is called the PCR test and I even had to look this up to make sure I had the right words. PCR stands for Polymerase Chain Reaction, which is the type of test and it’s not just of the type of test for COVID, this methodology is used for many other types of tests and basically what they’re testing for here is genetic material in the sample that comes from the virus.
So they’re looking to see if that is present. The other one that we use a lot, and this is the spot test that we do, we call the rapid swab that we might do for people and it’s called a POC and the government sends us a lot of these. They sent them out when we were first doing some initial testing and we have supplies, we get regularly for this and we also use it if vendors or other healthcare professionals have to come in the building. So this is an antigen rapid test and this detects the presence or absence of viral protein and both of these cases, you know the infectious disease people could go back and forth a million times on this to say which is more effective? Sometimes we’ve had situations where somebody tests negative for a POC, you know the rapid test, but then a day later has symptoms and goes to the doctor, gets the PCR test and it tests positive so there’s still a lot of controversy about false positives, false negatives so we just do the best we can and hope it all comes out in the wash.
Rev. Shawn Carty:
Well, my understanding is that the PCR test is the more sensitive of the two.
Sue Lanza:
Yes.
Rev. Shawn Carty:
And I know that from personal experience as you know well, because I did test positive.
Sue Lanza:
I know you poor thing.
Rev. Shawn Carty:
Right in time for Christmas, which for a priest is not the best time to do that.
Sue Lanza:
No, we were very upset that you weren’t here.
Rev. Shawn Carty:
But my experience with this is both from being here, but also just, you know, personally.
Sue Lanza:
And who would know that we would be such quote, unquote “experts” on all this testing stuff but we were literally testing, doing something every week and we’re tabulating numbers, we’re reporting numbers, we’re reporting everything it seems, so this has become part of our normal life here.
Rev. Shawn Carty:
Yeah. So let’s say that someone does test positive, whether it’s the PCR or the POC test, what does that mean, and what does that set in motion for us?
Sue Lanza:
Yes, that sets a whole chain of events in motion. So it goes into what we call outbreak and an outbreak is really defined as one or more people who test positive and there’s certain criteria for it but basically what it means is that we have to send that employee home, or if it’s a resident, we have to do some isolation and set some other things in motion with what they call transmission based precautions. So we have to make sure that there’s no way that this is transmitting to other people so we set up barriers and isolation techniques and we put some different PPE, remember personal protective equipment in place and the outbreak means that we have certain reporting requirements.
We now have to stop certain activities in the facility. We have to notify different people, all the family members have to be notified, all the residents. There’s a whole chain of events that takes place, but it’s considered under the guise of an outbreak and you don’t come out of an outbreak until every resident and staff member, we go 28 days without a positive test so sometimes that can be challenging. Thankfully, we’ve been lucky here, we haven’t had many, if any, resident positive tests, but the staff you see comes and goes so there’s more chances for exposure so thankfully it’s been confined to that, but that is what an outbreak is.
Rev. Shawn Carty:
And an outbreak, I think most people would be surprised to find out, is just one person.
Sue Lanza:
I know it’s really hard.
Rev. Shawn Carty:
We think of an outbreak as you know, dozens of people have been, you know gotten food poisoning-
Sue Lanza:
Yes.
Rev. Shawn Carty:
Or something like that.
Sue Lanza:
Exactly.
Rev. Shawn Carty:
But in this case, because we’re being so careful, the requirements are that way. Just one person.
Sue Lanza:
Sure. Sure.
Rev. Shawn Carty: [inaudible].
Sue Lanza:
Yeah. I know it is, it’s a very low threshold, but because of the transmisibility of COVID and other diseases, this is why. It’s because it can just go like wildfire if we don’t deal with it right away.
Rev. Shawn Carty:
So when we are in an outbreak, even if it’s just one person, what does that change for us? What do we have to do?
Sue Lanza:
Well, we do all the notifications that I mentioned. We have, there’s daily reports that go to the Department of Health, with numbers of tests, people who are waiting for test results, who tested positive, didn’t test positive, whatever it may be and we break it up by the licenses that we have here and we happen to have three licenses, skilled, assisted living and CPC so we have to report everything separately. But one of the most important things that we do, and we did this for each of the outbreaks, we had two other outbreaks, as many other facilities did, and you know you have to go 28 days before where it concludes.
But one of the things that we do that we must do is we do what’s called a line listing. This is very typical in infection control methodologies. You basically are keeping a listing of when someone tested positive, what is their name, their age, where do they work? Are they a staff member or are they a resident? What area do they live in? Did they… And now we have new reporting requirements, where we first started, we didn’t have this, of course, where now we say, were they vaccinated? When were they vaccinated? You know, did it just happen? Or was it far from that? And if they’re not vaccinated that has some implications as well.
And it also talks about their symptoms that they have. There’s a whole list of possible symptoms from a sore throat to feeling just tired, to hospitalized, including death is listed there, if that happens and also any kind of comments that are made so in the case of us here, some people, if they’ve tested positive, we have to write down they tested positive, this is their third time. We’ve had a couple of employees who’ve had this exposure different times. So the county gets sent this information, the health department county office and then they have reporting requirements up to the New Jersey State Department of Health and everything has to match up what we’re sending in.
We had one positive case. They match it up with that and then from there, we start doing what they call contact tracing. And the contact tracing is trying to trace backwards 48 hours, let’s say in the case of an employee testing positive, who were they potentially exposed to? Was it someone here? Was it a group of people? They were up on a floor serving people. So we need to know, because we need to know what to do for those potentially exposed parties. In some cases it’s simple, the person and wasn’t anywhere in a resident area and that makes life a lot simpler and then we often find out, oh, they have a family member at home who tested positive for COVID so we know the origin and then we know that they didn’t expose anyone else so then that gives us our guidelines for how we have to craft the exposure level and potential situations within the building to make sure everybody stays safe.
Rev. Shawn Carty:
Well, and again, I know this from personal experience because when I did test positive, it had an effect on family members of mine who work in healthcare. Suddenly they were in a position of having been exposed, because I had tested positive.
Sue Lanza:
Sure.
Rev. Shawn Carty:
Which brings us to the question of some terms that we use in this, one of which is quarantine and the other is isolation. Can you help clarify what those mean?
Sue Lanza:
Sure. So let’s say we have someone who comes in from the hospital as a new admission and they are someone who is not vaccinated. They would be put in what we would call isolation, meaning that we’re going to put them in isolation where we’re going to treat them as if they potentially could have this don and doff the personal protective equipment and we’re going to make sure that they stay isolated from the rest of the population for a certain period of time and our infectious disease guidelines tell us how much, depending on their situation.
Quarantine is a bit different. So the case I mentioned where a potential employee came up and maybe was on the wing or was in close interaction with a lot of the residents, then we would quarantine a whole unit of people and we would have to treat everybody as if they had the potential for the disease and use transmission based precautions again where we’re making sure we’re donning and doffing, we have, outside every room so that we can change out of things, going in and out, making sure that everybody’s safe so that’s a little bit different. That means the residents really can’t go off their unit. They can’t go to group programs. They can’t go down to church.
Rev. Shawn Carty:
That’s right. [crosstalk]. I know.
Sue Lanza:
I know you’re thinking about church. I realize.
Rev. Shawn Carty:
And typically those, how long do those last? What’s, and is there a difference between them?
Sue Lanza:
There are. It can last usually 14 days, but it depends, there’s cases where depending on how the exposure goes, it could be 10 days. So we… You know, everything changes so frequently, even when I’m saying now, by the time somebody listens to this, there could be differences so-
Rev. Shawn Carty:
Right.
Sue Lanza:
… you have to take that into account. Forget to mention one thing. If somebody comes in from the hospital and we’re not sure, we have to treat them as if they potentially have COVID, that’s called a PUI. This is another one of those funny ones-
Rev. Shawn Carty:
Yeah, another acronym.
Sue Lanza:
Another acronym. Woo hoo!
Rev. Shawn Carty:
What does PUI stand for?
Sue Lanza:
Well, I keep thinking it’s person under the influence, but that’s not correct.
Rev. Shawn Carty:
Like a DUI, right, oh.
Sue Lanza:
Yeah. I know. I keep thinking that and I’m think no. No it’s Person Under Observation or they’re actually looking at them and…
Rev. Shawn Carty:
Or is it investigation?
Sue Lanza:
Investigation. See, I’m so glad you’re here. Thank goodness for that.
Rev. Shawn Carty:
Person under investigation. [crosstalk]
Sue Lanza:
Investigation. So same thing, observation. So we’re making sure that we just don’t randomly bring somebody into the building and then just have them mixing around and then we find out oops, a few days later, because there’s incubation periods and who knows where they could be in that period, so.
Rev. Shawn Carty:
And that’s the thing that’s so scary about the coronavirus is that you can be spreading it without having any symptoms and that’s why I think, as I understand it, it’s been such a devastating disease because-
Sue Lanza:
Yes.
Rev. Shawn Carty:
… other diseases you have symptoms and you realize you want to keep yourself outside of a group and not… You could feel perfectly fine, as I did, when I tested positive, I felt just fine.
Sue Lanza:
Right. I know it’s so deceiving. You just don’t know when it’s happening. Every time we have somebody come up positive, everybody’s in the state of shock like, well I was just, I just saw her, how could she be? And she doesn’t have any symptoms and, so yeah, it’s difficult.
Rev. Shawn Carty:
So if you were to sort of boil things down and pick the most important thing that people need to do in terms of COVID and preventing, just in spread of infectious disease generally, and I think I know the answer to this question.
Sue Lanza:
Let’s hope you do, yeah.
Rev. Shawn Carty:
What would you say?
Sue Lanza:
It’s hand washing, hand washing, hand washing.
Rev. Shawn Carty:
Yeah.
Sue Lanza:
Yeah and we call it hand hygiene because it’s just making sure that you’re washing your hands with soap and water and it’s for 20 seconds according to the CDC, there’s a whole lathering and process and turning off the faucets with a paper towel. There’s a whole process to it and we do go over this with observation, with our employees over and over and over again.
Rev. Shawn Carty:
And I can tell you from my own experience that we take it very seriously and I hope the listeners know that because it-
Sue Lanza:
Yes.
Rev. Shawn Carty:
… it really is important, it’s the thing, it’s a single thing we can do to really prevent and not just COVID, all sorts of other things.
Sue Lanza:
Right.
Rev. Shawn Carty:
It’s so important.
Sue Lanza:
It’s true and we can… And we also call it hand hygiene because it’s not just hand washing, although hand washing is the preferred method and there’s certain times when you can’t use the alcohol based, you have use hand sanitizer so, but that also counts as well if you can’t get to something, that’s what you should use.
Rev. Shawn Carty:
Right and as we know, there’s little stations all up and down the hallways here and there’s-
Sue Lanza:
Right.
Rev. Shawn Carty:
… even one right outside the chapel [crosstalk].
Sue Lanza:
See.
Rev. Shawn Carty:
[inaudible] so.
Sue Lanza:
We’re making sure you’re safe.
Rev. Shawn Carty:
That’s right. Well, anything else about COVID that we should talk about?
Sue Lanza:
Oh my goodness, I hope not. [crosstalk].
Rev. Shawn Carty:
It’s a long list.
Sue Lanza:
I hope not. That’s just an overview of some of the terms, but I bet a lot of our listeners know these terms already. They read them, see them all the time in the news.
Rev. Shawn Carty:
That’s right, yeah.
Sue Lanza:
Thanks for listening to this episode of House Guest, the podcast, which is dedicated to all great things about The House of the Good Shepherd, a retirement community in Hackettstown, New Jersey. To learn more about us, please visit our website hotgs.org. Thanks for listening. See you next time.
