On February 14, 2021, the Centers for Disease Control and Prevention (CDC) updated their guidance for testing healthcare personnel. The CDC recommendations for COVID-19 testing have been developed based on what is currently known about COVID-19 and are subject to change as additional information becomes available.
The update added a recommendation that asymptomatic people who have recovered from COVID-19 infection may not need to undergo repeat testing or quarantine in the case of another COVID-19 exposure within 3 months of their initial diagnosis.
Testing of healthcare personnel (HCP) can be considered in four situations:
- Testing HCP with signs of symptoms consistent with COVID-19: These individuals should have prompt consideration for testing.
- Testing asymptomatic HCP with known or suspected exposure to COVID-19: Testing is recommended for HCP who have had close contact with a person with COVID-19 infection in the community (including household contacts). In addition, due to HCPsā often extensive and close contact with vulnerable individuals, the CDC recommends managing occupationally exposed HCP conservatively:
- Exposures believed to pose a higher risk for transmission: Exposed HCP should be excluded from work for 14 days following the exposure.
- Lower risk exposures: HCP may continue to work; however, CDC recommends screening for symptoms prior to starting each workday and using source control measures.
The update added a recommendation that asymptomatic people who have recovered from COVID-19 infection may not need to undergo repeat testing or quarantine in the case of another COVID-19 exposure within 3 months of their initial diagnosis. Additional information can be accessed at: Interim Guidance on Duration of Isolation and Precautions for Adults with COVID-19 | CDC
- Testing asymptomatic HCP without known or suspected exposures to COVID-19 as part of expanded screening: Currently, testing is recommended for these HCP working in nursing homes.
- Testing HCP who have been diagnosed with COVID-19 infection to determine when they are no longer infectious: A test-based strategy, which requires serial tests and improvement in symptoms, can be considered to allow HCP with COVID-19 to return to work earlier than the symptom-based strategy. However, in most cases, the test-based strategy results in prolonged work exclusion of HCP who continue to shed detectable COVID-19 RNA but are no longer infectious. The CDC Return-to-Work Criteria can be accessed at: Return-to-Work Criteria for Healthcare Workers | CDC
The CDC Testing Healthcare Personal website can be accessed at: Interim Guidance on Testing Healthcare Personnel for SARS-CoV-2 | CDC
Issue:
It continues to be imperative that nursing facilities are informed of CDC and other reliable source updates on COVID-19. The updates should be provided to all staff timely. As leaders in nursing facilities, it is our role to be knowledgeable and up-to-date on all information from the CDC and other reliable sources.
Discussion Points:
- Review the facilityās Infection Control policies and procedures. Ensure that the most up-to-date COVID-19 information is incorporated into your policies. Update policies as needed.
- Educate all staff on the most recent updates from the CDC. Document that these trainings occurred and file the signed training documents in each employeeās education file.
- Periodically audit to ensure that staff are following infection control procedures, and that testing, work exclusion, and return-to-work occurs according to CDC and state guidelines.
