Dear Director Bazron:
While we are hopeful you are working hard to develop evidence-based and proactive plans for the prevention and management of COVID-19 at St. Elizabeths Hospital, I’m writing to share with you a list of critical issues that the ACLU-DC believes must be addressed to not only protect the health of the vulnerable populations you serve but to safeguard their civil rights and civil liberties.
As you know, people in these facilities are highly vulnerable to outbreaks of contagious illnesses. They are housed in close quarters and are often in poor health. Without the active engagement of the D.C. Department of Behavioral Health and hospital leadership, they have little ability to inform themselves about preventive measures, or to take such measures if they do manage to learn of them.
As you work with the D.C. Department of Health (DOH) to develop plans that will prevent an outbreak or minimize its impact if one does occur, please be sure to address the following issues:
- Education of the patients and their families: Patients at St. Elizabeths and any family members of patients need to be informed about the virus and the measures they can take to minimize their risk of contracting or spreading the virus. They must be educated on the importance of proper handwashing, coughing into their elbows, and social distancing to the extent they can. Information about the spread of the virus, the risks associated with it, and prevention and treatment measures must be based on the best available science
- Education of the staff: Medical, clinical, administrative, and custodial staff must all be educated about the virus to protect themselves and their families, as well as patients at St. Elizabeths.
- Staffing plans: DBH and St. Elizabeths’ leadership must review sick-leave policies for hospital staff who should be encouraged to stay home if they exhibit flu-like symptoms like fever and cough, so as not to spread the virus to residents. Regardless of how many staff stay home because they are sick, the treatment facilities will have to continue functioning in ways that do not reduce essential treatments and services for patients. There must be a plan for how necessary functions and services will continue if large numbers of staff are out with the virus.
- Provision of hygiene supplies: The most basic aspect of infection control is hygiene. There must be ready access to clean, warm water and adequate hygiene supplies like hand sanitizer for handwashing. As witnessed with the recent water crisis at the hospital, conditions can become dangerous for both patients and staff if supplies are not planned for in advance of any outbreak or shortage.
- Screening and testing of St. Elizabeths’ staff and patients: The plan must include guidance, based on the best science available, on how and when to screen and test people in your facilities for the virus.
- Quarantine and treatment of persons exposed to the virus: The plan must describe how and where patients of St. Elizabeths will be housed if they are exposed to the virus, are at high risk of serious illness if they become infected, or become sick with it. This should not result in patients being moved to the D.C. Jail or Central Treatment Facility. Treatment plans for those who test positive, including guidance on how to where to seek treatment, as well as arranged transfers to other area hospitals if necessary, must also be included. Furthermore, any interruptions in regular activities, such as exercise or visits and phone calls with families or attorneys, should be based solely on the best science available and should be as limited as possible in scope and duration.
- Treatment: Courses of treatment must be evidence-based, available immediately, and in compliance with scientifically based public health protocols.
- Vulnerable Populations: The plan must provide for additional precautions for those who are at high risk of serious illness if they are infected, such as pregnant women and people with chronic illnesses or compromised immune systems.
- Data collection: The collection of data regarding COVID-19 will be part of the public health response. As with any contagious disease, data collection is critical to understanding and fighting the virus. DBH and St. Elizabeths’ staff must be part of this process. The same information that is tracked in the community must be tracked in St. Elizabeths. Under no circumstances should data collection or reporting mechanisms lead to further involvement of law enforcement, ICE, or other federal agencies.
We ask that you share the specifics of your plan with the public as soon as possible to aid in speedier information sharing and give confidence to the public that these measures are in place.
We hope you find this input helpful, and please reach out if we can be a resource during this time.
Thank you for your attention to this urgent matter.
Executive Director, ACLU of the District of Columbia