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Damaris Reyes didn’t believe it when her sister told her she’d seen on Facebook that a doctor tested positive for the new coronavirus at St. Christopher’s Hospital for Children, where both sisters have been taking their children for primary care and the occasional sick visit since birth.
“You can’t believe everything you see on Facebook,” she said. Besides, “St. Christopher's would have let us know.”
But on Sunday, the 34-year-old mother of three saw the same news on television: St. Christopher’s closed its intensive care unit to new patients and shut down its level 1 trauma center two days earlier after a doctor tested positive for the new coronavirus. Tower Health and Drexel, which jointly own the hospital, notified patient families and staffers who had come into direct contact with the doctor. The rest of the community, including Reyes’ family, found out about the incident days later, when it was reported on the news.
“It’s just a scary feeling — not knowing, being worried,” she said. “It would make it less worrying to at least know someone is reaching out to show some type of concern. Just let us now you guys are trying.”
In the early weeks of the pandemic’s spread in the Philadelphia area, health systems have taken a need-to-know approach to alerting patients about an exposure — contacting only families and staffers who came in direct contact with the individual who tested positive. That’s the approach Children’s Hospital of Philadelphia took when a cardiologist at its King of Prussia office tested positive in March. And on Wednesday Penn Medicine said several health-care workers across its system had tested positive — but refused to say which facilities were affected.
CHOP, St. Christopher’s, and Penn all declined to explain the reasoning for their method. Notifying only those directly affected protects the privacy of health-care workers who have, overnight, become patients, and could be intended to keep families that are likely not at risk from panicking.
But at a time when anxiety is already high, learning about a coronavirus exposure at a hospital — the very places trusted to help people get healthy — is unnerving, especially when the information doesn’t come from hospital administration.
As the virus spreads and hits more health-care workers, health systems will need to consider how to respond to a growing number of families like the Reyes family, who have been left feeling in the dark.
“To the extent that you can play both roles, as a person and also a provider, empathy can go a long way… in establishing trust and credibility in health communications," said Amy Henderson Riley, a health communication specialist in Philadelphia.
Health communicators typically take guidance from the Centers for Disease Control and Prevention on how to disseminate information in a crisis, and empathy is top of the list of best practices, she said.
According to those guidelines, which are published in a crisis communication manual, health systems should also make sure people can easily understand the source of the information, such as by adding their logo. Crisis communications should be written in the language spoken in the patient community and use photos that look like the hospital’s patients.
“There is a responsibility that an institution of any kind, whether they are a health system, law practice, retail shop — if anyone learns about that exposure, there’s an ethical responsibility to tell anyone who might have been exposed so they can take action as they so wish," Henderson Riley said.
But how wide a net hospitals should cast when notifying patients about coronavirus exposures is unclear, she said. Should a health system tell only people who had direct contact with someone who has tested positive for the virus, or itsr entire patient base, or something in between?
Anne Falls, whose daughter sees doctors in the King of Prussia building where the CHOP cardiologist tested positive, wishes hospitals would err on the side of greater transparency.
Falls said her daughter, who is 17, had a physical therapy appointment in the week before the cardiologist tested positive on the same floor as the cardiology office.
CHOP notified about two dozen patient families and 17 employees about potential exposure and urged them to stay in place, but Falls was not among them.
She said she worries her daughter, who has asthma and a heart condition, could have been exposed to the virus if they shared an elevator with the doctor or one of his patients, or if another patient in the physical therapy office had a cardiology appointment earlier in the day.
“We haven’t gotten a notice or anything,” Falls said. “No one has contacted us, even to say, ‘Hey, we saw you were in the same building, but we don’t think there’s any issue.’ ”
CHOP did not respond to a request for comment. After the doctor was hospitalized with the new coronavirus, CHOP closed the cardiology office and an adjacent allergy clinic to disinfect; the offices reopened several days later.
Asked about its approach to notifying families, a spokesperson for Tower Health, which operates St. Christopher’s, said the hospital had since posted on its website a letter to families in English and Spanish, describing the incident and the steps the hospital has taken to ensure patients and staff are safe.
But that letter hadn’t yet appeared online on Sunday, when Reyes was grasping for information.
St. Christopher’s has played a positive role in Reyes’ life since she saw doctors there as a child, and for her children, ages 5, 9, and 15, the hospital is “all they’ve ever known.”
Yet the incident — and in particular St. Christopher’s lack of quick communication — has left her questioning whether she’ll take her kids back.