The COVID-19 pandemic has had a profound impact on healthcare systems worldwide. Managing healthcare personnel (HCP) with SARS-CoV-2 infection or exposure is crucial to ensure the safety of both patients and staff. In this article, we will discuss the interim guidance for managing HCP with SARS-CoV-2 infection or exposure, including the criteria for their return to work.
Return to Work Criteria for HCP with SARS-CoV-2 Infection
The return to work criteria for HCP with SARS-CoV-2 infection vary depending on the severity of symptoms and the presence of immunocompromising conditions. It is important for HCP to self-monitor for symptoms and seek re-evaluation if symptoms recur or worsen. Let’s explore the criteria in detail:
HCP with mild to moderate illness who are not moderately to severely immunocompromised
HCP with mild to moderate illness who are not moderately to severely immunocompromised can return to work if the following criteria are met:
- At least 7 days have passed since symptoms first appeared if a negative viral test is obtained within 48 hours prior to returning to work (or 10 days if testing is not performed or if a positive test at day 5-7), and
- At least 24 hours have passed since the last fever without the use of fever-reducing medications, and
- Symptoms (e.g., cough, shortness of breath) have improved.
HCP who were asymptomatic throughout their infection and are not moderately to severely immunocompromised
HCP who were asymptomatic throughout their infection and are not moderately to severely immunocompromised can return to work if the following criteria are met:
- At least 7 days have passed since the date of their first positive viral test if a negative viral test is obtained within 48 hours prior to returning to work (or 10 days if testing is not performed or if a positive test at day 5-7).
HCP with severe to critical illness who are not moderately to severely immunocompromised
HCP with severe to critical illness who are not moderately to severely immunocompromised can return to work if the following criteria are met:
- At least 10 days and up to 20 days have passed since symptoms first appeared, and
- At least 24 hours have passed since the last fever without the use of fever-reducing medications, and
- Symptoms (e.g., cough, shortness of breath) have improved.
- The test-based strategy as described below for moderately to severely immunocompromised HCP can be used to inform the duration of work restriction.
Please note that the exact criteria for determining the duration of shedding replication-competent virus in HCP are not known. Factors such as disease severity and the presence of immunocompromising conditions should be considered when determining the appropriate duration for specific HCP.
HCP who are moderately to severely immunocompromised
HCP who are moderately to severely immunocompromised may produce replication-competent virus beyond 20 days after symptom onset or the date of their first positive viral test if they were asymptomatic throughout their infection. For these HCP, a test-based strategy and consultation with infectious disease and occupational health specialists are recommended to determine when they may return to work.
Test-based strategy for symptomatic HCP
Symptomatic HCP may return to work if the following criteria are met:
- Resolution of fever without the use of fever-reducing medications, and
- Improvement in symptoms (e.g., cough, shortness of breath), and
- Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) tested using an antigen test or NAAT.
Test-based strategy for asymptomatic HCP
Asymptomatic HCP may return to work if the following criteria are met:
- Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) tested using an antigen test or NAAT.
FAQs
Q: What are the criteria for HCP with mild to moderate illness to return to work?
A: HCP with mild to moderate illness who are not moderately to severely immunocompromised can return to work if at least 7 days have passed since symptoms first appeared, a negative viral test is obtained within 48 hours prior to returning to work, at least 24 hours have passed since the last fever without the use of fever-reducing medications, and symptoms have improved.
Q: How long should HCP with severe to critical illness stay away from work?
A: HCP with severe to critical illness who are not moderately to severely immunocompromised can return to work if at least 10 days and up to 20 days have passed since symptoms first appeared, at least 24 hours have passed since the last fever without the use of fever-reducing medications, and symptoms have improved.
Conclusion
Managing healthcare personnel with SARS-CoV-2 infection or exposure is crucial in maintaining the safety of healthcare settings. The interim guidance provides criteria for the return to work of HCP based on the severity of illness and immunocompromising conditions. Adhering to these guidelines is essential to protect both the healthcare workforce and the patients they care for. For more information and updates, visit Instant Global News.
