By J. Darrel Hicks

I challenge environmental services (EVS) managers to prepare for the next surge by learning lessons from the past 30 months. To prepare for whatever is around the corner, managers must remember the recent COVID-19 challenges, which include but aren’t limited to the following: 

• Confusing and, at times, frustrating COVID-19 rules of engagement from the U.S. Centers for Disease Control and Prevention (CDC), the World Health Organization (WHO) and facility leaders 
• EVS team members who were refused entrance into a locked down hospital because they weren’t essential 
• Shortages of personal protective equipment (PPE), resulting in EVS staff who had to wear a single mask for 10- or 12-hour shifts for a week because they weren’t patient care givers. When N-95 masks became available, only doctors and nurses got them. It was a two-tier system. One EVS manager was told to go to the store and buy ponchos for the workers who cleaned isolation rooms so they could wipe them down with disinfectant and reuse them. Only the essential caregivers got isolation gowns. 
• The EVS workforce, like most sectors of first responders, often buckled under the strain of the pandemic. The influx of patients created unprecedented demand for their work, while the virus caused many workers to be out sick. EVS workers helped hospitals navigate the shortages by taking on new responsibilities and working overtime. 
• The problem of not having enough cloth privacy curtains to comply with the terminal cleaning of respiratory and droplet isolation rooms. If the curtains were available, quickly turning a room from dirty to clean and ready status was a challenge. One example of privacy curtain problems during the height of COVID19 was an EVS manager who was eight months pregnant climbing a 6-foot step ladder to take down privacy curtains and re-hang them in the clean patient room or emergency department. 
• The morale of EVS departments was at an all-time low. Many team members were unpaid due to hospital policies that did not provide additional sick time in cases of reinfection. In the early days of the pandemic, it was frantic. Nothing prepared EVS workers to see patients who went from just fine to intubated in an instant. 
• There wasn’t enough time to perform hygienic cleaning, and departments had to implement “trash and dash” instead. 
• Shortages of hospital disinfectants approved by the U.S. Environmental Protection Agency (EPA) on List N. 
• The infection prevention and control competency of frontline cleaning professionals was woefully inadequate. Team members who normally cleaned offices and public spaces were thrust into performing the terminal cleaning of isolation rooms and were unprepared for the pace and demands of turning rooms in 25 minutes or less. 
• Finding, cleaning and transporting gurneys, patient beds, mattresses and furniture to accommodate the surge of patients was constant. 

While the pandemic might not have caused these challenges, it certainly exposed them. Like the heavyweight champion Mike Tyson famously said, “You have a game plan in your head going into a fight. That’s great, until you get punched in the mouth.” 

Winter is coming. Get your guard up. Prepare for the rising numbers of pediatric patients with respiratory syncytial virus (RSV), along with the likelihood of a heavy influenza season beginning right away. 

J. Darrel Hicks, BA, MESRE, CHESP, Certificate of Mastery in Infection Prevention is the Past President of the Healthcare Surfaces Institute. Hicks is nationally recognized as a subject matter expert in infection prevention and control as it relates to cleaning. He is the owner/principal of Safe, Clean and Disinfected. His enterprise specializes in B2B consulting, webinar presentations, seminars and facility consulting services related to cleaning and disinfection. He can be reached at darrel@darrelhicks.com or you can learn more at www.darrelhicks.com.