An infection preventionist deals with COVID-19

Northern Montana Health Care Director of Infection Prevention Alysia Mosness said the COVID-19 pandemic has been an extremely stressful time for nearly everyone in the health care community and the upcoming holidays may bring a surge in cases in the Hill County area.

"I really worry going into the holidays what things are going to look like," she said. "... You know people are going to get together with family, and you know you're going to get that uptick after Thanksgiving and going right into Christmas after, that is worrying."

"We've had those conversations where it's like, 'It's looking better, but don't hold your breath,'" she added.

Mosness agreed to be interviewed on her experiences working with COVID-19 as part of a Havre Daily News ongoing series about the lives of health care workers and the work they do during this national crisis. See more in future editions of The Havre Daily News.

Prevention is a key

From a more top-down perspective, she said, the COVID-19 pandemic is especially difficult to deal with just because it's such a novel situation and understanding of the disease is still developing which makes policy making similarly difficult.

"COVID-19 has evolved from March until now, so we're constantly updating things based on the new research that's coming in," Mosness said.

She said changes have had to be made throughout the system at Northern Montana Hopsital, the entire flow of hospital floors having had to be altered to keep people safe.

Mosness said many people in the community are doing what they need to do to slow spread and she thanked them for their efforts, but still people are out there that need to be mindful of what they're doing.

"We know that people need to go to the grocery store and all these things that people need to do to live their lives, we have to have some degree of normalcy," she said. "But we have to be smart about what we're doing."

She said people getting together in groups can easily create outbreaks with just one positive person in attendance.

She said it's critically important that people keep their social circles small so if they do catch the virus they aren't giving the Hill County Health Department 50 contacts and stress the system further.

Mosness said she understands that people are mentally having a hard time with the isolation of social distance and she sympathizes with them, but the consequences of not being smart about going out became clear when the hospital started filling up a few weeks ago.

She said people need to realize how serious the situation is; the virus is remarkably contagious, it is absolutely not a normal flu, it is far more dangerous and the risk of the system becoming overwhelmed is very real if the public isn't careful.

Mosness said she still sees a lot of people who seem to think none of it is real or have made it an issue of politics and it's difficult for her and her colleagues to comprehend.

"It's hard for us to understand how some people can still believe it's not real when we're faced with it every day," she said. "... I promise you, it doesn't care if you're red or blue."

She said people need to stay quarantined for the full 14 days when asked.

It may seem like a long time, she said, but they see people on day 13 or 14 who start developing symptoms from their exposure.

She also said people need to understand that masks work and not wearing them can only make things worse.

"We've been wearing masks for years and years," she said. "You wouldn't want someone doing surgery without a mask on. They do something. There's a reason. They weren't invented purely because of COVID."

Mosness said she knows there are people who simply cannot be convinced and tries not to think about them too hard for the sake of her own stress levels.

"There are people you can't convince, and if you let all of that get to you your job becomes even more stressful," she said.

Mosness said on top of the coming holidays she and her colleagues also worry about the upcoming flu season and advised that everyone get the vaccine as soon as possible.

"Other sicknesses don't go away just because we have COVID," she said.

Most of all, people who feel sick, even if it's minor, need to stay home, Mosness said. The disease has many symptoms, and not everyone has major ones.

She said she thinks America's mentality when it comes to work is working against us during the pandemic and we need to break out of it for the sake of everyone's safety.

"I think the United States as whole operates in the mindset of, 'You work unless you can't make it,' and we've had to change that mindset," she said.

Pandemic changes the job of infection prevention

Normally, Mosness said, her job entails things like monitoring surgeries for post-operation infections, preventing hospital-wide infections and the spread of bloodborne illnesses, researching anti-biotic resistance and handling annual flu shots.

But since the surge of COVID-19 in Hill County, her work has been dominated by monitoring employee health and making decisions about how to keep everyone safe but keep the hospital functioning.

"It has really turned into monitoring employees for COVID, keeping track of all the employees that we've had out," she said.

Mosness said she regularly gets calls from various departments about employees who may have the disease, at which point she must examine the symptoms and decide what needs to be done, and whether they need to be tested for COVID.

If they test positive, contacts will need to be traced and arrangements made to make sure their department can keep functioning. If they're negative, the decision then becomes whether or not they can come to work, she said, which can be difficult in and of itself.

Stress on many levels

She said her fellow health care workers who have gotten COVID-19 have told her that there is significant emotional turmoil that comes with having to stay home, on top of whatever physical symptoms they may be experiencing.

She said people in the health care world have a tendency to take things home, and when people are out because of COVID-19 or are in quarantine they tend to take the weight of the world on their shoulders and feel guilty for not being there even though they shouldn't be.

"You're at home, and you know that all of your co-workers are here struggling because we're short on staff, and we're taking care of more people than we're used to," she said. "It's not just having COVID, it's also emotionally hard to deal with but there's nothing you can do."

Mosness also said the working conditions during the pandemic are difficult in general with the hospital having to serve more and more people, and consequently staff having to work harder and longer, often with less help.

She said this has meant staff have needed to shift departments and take on more work, especially during those times when COVID-19 has struck a department particularly hard.

"It's very stressful," she said. "You have people from different departments putting back on our clinical nursing hats. We've had moments where it was just, "All hands on deck.'"

She said virtually everyone has had to pick up more shifts, work late nights and doing that as they watch their co-workers get sick can be scary.

Mosness said it's also difficult to see the people who come in with COVID-19 as patients because they are often people the employees know.

"Being in a small community can be hard because you're taking care of people that you know, people that you care about," she said. "Your family members, friends, get really sick and it's very difficult for all of us. I don't think I know anybody here that says it's not stressful."

Surge strains the system

She said this stress was at it's worst a few weeks ago when the surge of COVID-19 in the county was at it's worst.

She said the situation at NMH has since stabilized, and they never exceeded capacity, but there was time not long ago when they were getting close, which she said was a nerve-wracking experience for just about everyone especially when so many other places were having the same issue.

"There were moments when we were down on ICU beds and those moments are kind of hit you differently now," she said. " ... We always had that backup where we could send someone to Billings or to Great Falls, and we're not living in that world right now. The places we would normally transfer people to are full, so you get this feeling of, 'Where do we go from here,' and those moments are scary, because there's nowhere to go, we just have to do the best we can."

Mosness said normally the hospital works very well with other facilities, and the thought of the entire system becoming overwhelmed weighs heavily on everyone.

"We haven't hit that breaking point, but even the thought of that becoming a possibility is very distressing," she said.

People doing their utmost

However, she said, even though it is a stressful situation, she has seen the best of her colleagues during the pandemic, with people volunteering to help out other departments because they know help is needed and doing as much as they can for their fellow workers regardless of familiarity.

"No one complains about it," she said. "They're all working with people they're not used to working with and coming together, so that's nice to see."

Mosness said workers at the hospital since March have developed a sort of camaraderie, and suspects this is because they had to lock their doors early on and have had to rely on each other for support more and more.

"When you're at work you're not really interacting with much of the public any more, we just have each other," she said.