April 9, 2020

Surveillance key to monitoring exposed employees

Medical surveillance by the Occupational Health Clinic is essential to the COVID-19 response at Vanderbilt University Medical Center.


by Paul Govern

Medical surveillance by the Occupational Health Clinic is essential to the COVID-19 response at Vanderbilt University Medical Center.

“The reason we’re here is to protect our employees as they’re doing their job to protect everybody else,” said Lori Rolando, MD, MPH, the clinic’s director. “Our goal is to protect our employees and, by extension, protect their families and their patients as well.”

The clinic monitors employees who’ve had close contact with anyone positive for COVID-19: patients, co-workers, family members, roommates. Within 6 feet of a COVID-19 carrier for more than five minutes is considered close contact.

Tracking the health status of these employees takes diligence, coordination and health information technology. Clinic Instructor Tanicia Washington Haynes, NP, leads clinic staff and some 30 trained volunteers in the monitoring effort.

VUMC employees at the 21st Avenue campus who require assessment for COVID-19 might visit the assessment site in the MCE garage. (photo by Erin O. Smith)

It begins with an electronic patient registry: anyone who has tested positive for COVID-19 at any site across the VUMC network automatically goes into a COVID registry the moment the test is resulted.

“We reach out by email to all employees whose work would have put them in close contact with these patients. Also, we conduct phone interviews with any employees who have tested positive themselves, and if it turns out they were at work during their infectious period, we ask about any close contact with co-workers during that time,” Haynes said.

As of April 7, Occupational Health had sent out more than 2,300 COVID monitoring enrollment forms via email, asking employees about their exposure and providing instructions for self-monitoring. As of that date, the clinic had received over 1,500 responses (based on automated contact tracing, some employees will have received the enrollment form more than once), and 114 of VUMC’s approximately 24,000 employees had tested positive for COVID-19.

Required self-monitoring involves checking your temperature twice a day and completing a daily, two-question email survey regarding symptoms. To date, the bulk of the employees subject to monitoring work in COVID-19 outpatient assessment areas or in hospital units where COVID-19 patients have been admitted.

Any exposed employees who experience symptoms are required to stop work immediately and contact Occupational Health.

“If someone has had an exposure and they report symptoms — shortness of breath, cough, fever, loss of sense of smell — we’re going to refer them for testing and ask that they remain home until results are reported,” Rolando said.

If an employee doesn’t respond to the daily survey, Occupational Health follows up with emails and telephone calls.

“We absolutely understand that people have a lot of competing priorities, particularly right now, with everything that’s going on. But we’d like for everybody who gets one of these surveys to think of it really as an opportunity to take a moment for self-care, to take a moment to focus on how they’re feeling,” Rolando said.

Employees without easy internet access can complete the enrollment form and daily survey by telephone (615-936-0955).

“If employees have questions or concerns or anxiety around the monitoring process, we encourage them to reach out to us,” Rolando said.

Contact the Occupational Health Clinic at 615-936-0955. More information for employees and patients, including updated COVID-19 exposure guidelines, is available at