AHCA Update: Updated CDC Guidance Released on Return to Work and Clinical Care
The Centers for Disease Control and Prevention (CDC) released two updated guidances on April 30, 2020, around criteria for returning to work for healthcare personnel (HCP) with confirmed or suspected COVID-19 and the discontinuation of transmission-based precautions and disposition of patients with COVID-19. 1. Updated Criteria for Return to Work for HCP with Confirmed or Suspected COVID-19 - Decisions about return to work for HCP with confirmed or suspected COVID-19 should be made in the context of local circumstances. This updated guidance includes the following:
Changed the name of the ‘non-test-based strategy’ to the ‘symptom-based strategy’ for those with symptoms and the ‘time-based strategy’ for those without symptoms
Updated these to extend the duration of exclusion from work to at least 10 days since symptoms first appeared.
The CDC specifically notes that after returning to work, HCP should:
Wear a facemask for source control at all times while in the healthcare facility until all symptoms are completely resolved or at baseline. After this time period, these HCP should revert to their facility policy regarding universal source control during the pandemic.
Self-monitor for symptoms, and seek re-evaluation from occupational health if respiratory symptoms recur or worsen.
CDC also has information focused around strategies to mitigate healthcare personnel staffing shortages you might be interested in reviewing. 2. Updated Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings - This updated guidance includes the following:
Changed the name of the ‘non-test-based strategy’ to the ‘symptom-based strategy’ for those with symptoms and the ‘time-based strategy’ for those without symptoms, and updated these to extend the duration of Transmission-Based Precautions to at least 10 days since symptoms first appeared.
Added criteria for discontinuing Transmission-Based Precautions for patients who have laboratory-confirmed COVID-19 but have not had any symptoms of COVID-19.
According to the CDC, if a patient is discharged to a nursing home or other long-term care facility (e.g., assisted living community), AND transmission-based precautions:
are still required, they should go to a facility with an ability to adhere to infection prevention and control recommendations for the care of COVID-19 patients. Preferably, the patient would be placed in a location designated to care for COVID-19 residents.
have been discontinued, but the patient has persistent symptoms from COVID-19 (e.g., persistent cough), they should be placed in a single room, be restricted to their room to the extent possible, and wear a facemask (if tolerated) during care activities until all symptoms are completely resolved or at baseline.
have been discontinued and the patient’s symptoms have resolved, they do not require further restrictions, based upon their history of COVID-19.