During a recent webinar hosted by the Dialysis Patient Citizens Education Center, nephrology experts suggested ways, informed by guidance from the CDC, for patients on dialysis to safely approach COVID-19.
“This is an emerging situation,” Shannon Novosad, MD, MPH, medical officer with the Dialysis Safety Team in the Division of Healthcare Quality Promotion at the CDC, told the audience. “We’re still learning new information every day and, based on that, we adapt the measures we think are needed to keep everyone safe.”
Novosad argued that, although the CDC is in close contact with dialysis facilities to ensure adequate safety measures are in place, patients should also be informed as to what the dialysis facilities are doing and what efforts they can make to prevent themselves from becoming ill. Patients on dialysis, she said, are a uniquely vulnerable population due to their chronic condition (kidney disease) and their tendency to be older and to have multiple comorbidities.
According to Novosad, some basic, but critical, steps patients on dialysis can take to prevent the spread of COVID-19 include the following:
- hand hygiene (eg, washing hands with soap and water for at least 20 seconds);
- respiratory hygiene (eg, disposing of tissues immediately after use);
- clean and disinfect surfaces at home; and
- limit contact with others.
Novosad also said patients should preemptively plan what they will do in the event of illness, which consists of gathering information on important contacts (health care providers and family) and ensuring they have access to several weeks of medication and/or other supplies.
She stressed that patients should not postpone dialysis treatments.
“Your facilities are all working and planning on how they can provide you dialysis safely,” she said.
Novosad said patients should also be aware of what steps dialysis facilities are taking to protect them from infection. Noticing these precautionary measures can help patients assess how well their facility is responding to CDC recommendations. Some changes patients should be aware of include the following:
- more education and training sessions for dialysis facility staff (eg, on personal protective equipment and signs/symptoms);
- missing staff (some members may stay home if they are experiencing symptoms);
- waiting area changes (eg, signs at entrances indicating how to respond to patients who exhibit symptoms, separate space for patients who may be infected, additional tissues and hand sanitizer); and
- alterations to treatment schedule (due to staff illness or all patients suspected of illness being scheduled at same time).
Patients should call the facility ahead of treatment if they experience any symptoms of fever or respiratory infection, as they may be able to have a private room or be placed at the end of the treatment area. There should always be 6 feet between patients.
Novosad added it is crucial for patients to speak up and ask clinic-staff about specific preparations for COVID-19, how these changes may affect treatment and how patients can play a role in protecting themselves and others. Monitoring alerts from local health authorities, she said, is another key step to staying informed of how COVID-19 is affecting individual neighborhoods.
Concluding the webinar, Alan Kliger, MD, clinical professor of medicine at the Yale School of Medicine and chair of the Nephrologists Transforming Dialysis Safety initiative, told the audience, “We’re not in a sprint. It’s more like a marathon. We could be protecting ourselves in this way not just for a few days or weeks, but for months.”
Despite the gravity of the situation, he advised patients: “It’s important to keep calm. Most people with COVID-19 do fine.” – by Melissa J. Webb
To listen to a recording of the webinar visit: https://www.youtube.com/watch?v=lWXHlHp7wqs