One might think that dealing with Covid-positive patients is the most dangerous part of a doctor’s work day, but emerging evidence from across the country has indicated a far more insidious source as the vector for disease spread: the staff break room.
“Transmission in the workplace in hospitals is not related to patient care,” a specialist at a New York City hospital said in an interview with ClearHealthCosts. “It is related to employees eating meals together. They relax, they take off their masks, in a relatively small space. They let their guard down…Meals are the killer.”
Hospital places limits on break rooms
In late October, MedPage Today reported that a Covid outbreak at Mount Holyoke Medical Center in western Massachusetts, in which 15 hospital staff members tested positive, could probably be traced back to the employee break room.
“We think we traced it back to employees eating a meal together in a break room, and obviously when you are eating a meal, you take your mask off and they contracted it from one employee who was positive,” the Mount Holyoke CEO, Spiro Hatiras, told Western Mass News. The hospital has since put capacity limits on break rooms.
Similarly, the Wall Street Journal reported that, at the Mayo Clinic in Rochester, Minn., over 900 staff members were infected with Covid in November. Contact tracers were able to determine that the majority of work-related Covid exposures had happened in break rooms and lunch rooms.
“When the staff are together in a lunch room or break room, there’s a tendency to feel like you’re in a safe spot,” Clay Dunagan, chief clinical officer at BJC HealthCare in St. Louis, told the Wall Street Journal. “You’re with colleagues whom you believe are taking precautions, too. But just like the rest of the community, those people get sick when they’re outside the hospital.”
In August, a study by researchers in Turkey determined that “staying in the same personnel break room as other healthcare workers without wearing a medical mask for more than 15 minutes was found to be statistically significant risk factors for SARS-CoV-2 transmission.” The researchers had several recommendations for hospitals, including forbidding both consumption of food in break rooms and sitting face-to-face while dining in designated eating areas, and retraining of hospital staff in safety procedures.
Not only a hospital issue
Of course, this is not solely a hospital issue — the risk of employee Covid infection exists in any workplace where staff members regularly congregate without adequate social distancing or personal protective equipment (PPE).
As of October, the Center for Disease Control and Prevention (CDC) directly addresses the issue of break rooms in its employer guidelines. Among other things, the guidelines ask employers to identify common areas where employees might have close contact (less than six feet apart), and to use various methods to physically separate employees as much as possible, as well as replacing communal, high-touch items with pre-packaged, single-serving items.
“One of the good things we’ve learned so far is that PPE works,” the specialist at the New York City hospital said. However, break rooms are often a place where PPE and pre-established safety measures are foregone — people must remove their masks to eat, and strict social distancing can be forgotten as employees hang out with their coworkers.
Why skipping the break room is hard, and the role of pandemic fatigue
Part of the issue is that most people look forward to break times as a time to socialize, relax and eat with friends — an important, if not necessary, part of the workday. It is hard to ask people to go without or to modify what feels to many to be an integral part of their job.
“It’s hard not to have those social interactions…it’s human nature,” the specialist said. “In some cases it’s hard to find a space to eat those meals. You want to hang out with your colleagues and relax…People are sick of this.”
Pandemic fatigue is a very real phenomenon, defined by the World Health Organization (WHO) as “demotivation to follow recommended protective behaviors, emerging gradually over time and affected by a number of emotions, experiences and perceptions.” People are tired and frustrated with the massive changes to everyday life that they have had to maintain for far longer than most expected.
Pandemic fatigue is universal, seen in countries all over the world. “Citizens have made huge sacrifices,” Dr. Hans Kluge, the WHO’s regional director for Europe, told the New York Times. “It has come at an extraordinary cost, which has exhausted all of us, regardless of where we live, or what we do.”
While the WHO says pandemic fatigue is “an expected and natural response to a prolonged public health crisis,” it also warns that it “poses a serious threat to efforts to control the spread of the virus.”
It is universally acknowledged that a failure to follow safety guidelines is directly tied to the spread of infection. With the distribution of the first doses of vaccine, though, there is hope that the era of masking and distancing may eventually be behind us. Meanwhile, safety measures are still directly tied to stopping the spread of infection.