Interpreter Safety During the COVID-19 Pandemic

Healthcare for patients with limited English proficiency 

OPEN LETTER TO GOVERNORS AND HOSPITALS  
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The Certification Commission for Healthcare Interpreters (CCHI) has issued an open letter to governors and hospital associations to raise awareness about the safety of healthcare interpreters and language access services for patients with limited English proficiency (LEP) and their families, as well as the safety of all healthcare workers during the current unprecedented COVID-19 pandemic. Healthcare interpreters work in close quarters and in close proximity to patients and the safety of all workers with direct patient contact must be the number one priority. This includes physicians, nurses, allied professionals, and face-to-face/on-site healthcare interpreters.
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​PERSONAL PROTECTIVE EQUIPMENT
The open letter reminds hospitals and healthcare systems that face-to-face/on-site healthcare interpreters should be provided the same level of protection and use of personal protective equipment (PPE) as any healthcare provider for whom they are interpreting while also recognizing that PPE shortages may necessitate certain limiting measures. It is extremely important for managers to have transparent and honest conversations with interpreters and collectively come to an understanding on when and to whom PPE is provided.​

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​ALTERNATIVES TO ON-SITE INTERPRETATION
When PPE is not available there are alternatives to face-to-face/on-site interpretation. Ultimately, if appropriate PPE is not available for an interpreter, then alternatives must be provided to both reduce the spread of the coronavirus by interpreters and ensure their personal safety. Unlike most healthcare providers, interpreters work in different departments, different facilities, and even different campuses throughout the day. Their inadequate protection will result in spreading the virus not only in the community and to their families but also to other healthcare workers and patients within and outside a specific facility.

REMOTE INTERPRETING
The CCHI recommends that all hospitals, health systems, clinics, and healthcare providers deploy remote interpreting for most of their interactions with LEP patients and their families, as the primary modality for delivery of language access services in the time of this pandemic. The implementation of remote interpreting may take time and require certain information technology solutions as well as evaluation for compliance with laws and regulations. However, the implementation of remote interpreting will allow facilities to reserve much needed PPE for healthcare professionals who must be in direct contact with patients. Furthermore, face-to-face interpreters have a higher risk of becoming a vector of infection even with the appropriate use of PPE due to the mobility of their job. When institutions utilize telemedicine and telehealth options for providing care, they must incorporate remote interpreting into these solutions to ensure equal access to healthcare for limited English proficiency patients.

HOW TO IMPLEMENT REMOTE INTERPRETING
Remote interpreting may be implemented in the following ways:

• Create in-house call centers. Current staff interpreters interpret remotely via video or

phone. Enforce proper distancing and cleaning protocols in the call centers to ensure interpreter safety.

• Tools for remote video/phone interpreting. Provide current staff interpreters with tools to interpret from home via a video application or phone.
• Equip rooms for limited English proficiency patients.  Provide patient rooms  that have access to a phone or video device (tablet, computer monitor, TV screen) connected to the internet.

These steps do not completely eradicate the need for the face-to-face interpreting modality, as this modality is crucial when interpreting for hard-of-hearing patients, patients with dementia, deaf and blind patients, and young children. All interpreters need to work closely with management to ensure the safety of everyone and to provide equal access to healthcare for limited English proficiency patients.

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A BRIEF NOTE ON CONFERENCE INTERPRETING
The International Association of Conference Interpreters (AIIC) has issued best practices for interpreters during the COVID-19 crisis. AIIC's Technical and Health Committee and Taskforce on Distance Interpreting specify rules on social distancing in interpreting booths, social distancing for sign language teams, disinfection, and the use of disposable gloves and personal headset covers.
  

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REFERENCES
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CCHI Open Letter on Ensuring Healthcare Interpreters’ Safety during the COVID-19 Pandemic. April 3, 2020. https://cchicertification.org/covid-19/covid-19-update/.

AIIC Taskforce on Distance Interpreting, Technical Committee. "AIIC best practices for interpreters during the Covid-19 crisis.” aiic.net March 17, 2020. http://aiic.net/p/8956.

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