Short staffed U.S. hospitals are asking workers with covid to return — even if they may be infectious

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Hospitals are increasingly asking staff who have the coronavirus to work while potentially infectious, underscoring how the hyper-transmissible omicron variant has sidelined employees, overwhelmed resources and upended nearly two years of strict protocols. Though vaccine requirements are common at hospitals, many health care workers are coming down with the virus, exacerbating staffing issues.

Ten-day isolation periods have given way to five-day ones under CDC guidelines updated late last month, with workers sometimes allowed back as long as symptoms are deemed mild and improving. Officials acknowledge even halving isolation may not be enough to keep hospitals staffed: The CDC says health care workers who test positive can keep working uninterrupted in a “crisis” — and one state, California, recently declared that hospitals could take that step for employees without symptoms.

Some in the health care industry call the changes dangerous to already-demoralized front line workers and their patients, especially those most vulnerable to covid-19. Research in a preprint study from the United Kingdom suggests that about 1 in 3 people who get the coronavirus remain infectious after five days.

thers call looser return-to-work standards necessary to keep crucial services running, as federal data shows more than a fifth of U.S. hospitals reporting a “critical staffing shortage” in the past week and about 30 percent anticipating one in the week to come. High-quality protective gear reduces the risks, they emphasize.

“The last thing you want is to say, well, we’re closing the hospital because we don’t have enough doctors and nurses,” said Carlos del Rio, president-elect of the Infectious Diseases Society of America.

At Holy Name Medical Center in Teaneck, N.J., 191 of 3,500 employees were out sick one day last month. Nursing director Michele Acito said hospital officials had to “become creative” in managing the high number of absences, shuffling nurses around.

“We were very happy when the CDC came out and said people could return to work after five days if they have mild to moderate symptoms or no fever,” she said.

Health care is hardly the only area where fears of an omicron-fueled breakdown in essential services have reshaped U.S. guidance. Days after the CDC changed its return-to-work advice for health care workers, the agency halved its recommended isolation time for the general public — telling infected but asymptomatic Americans they could go about their lives after five days, no negative test required. The shift was driven in part by worries that cases could sideline crippling numbers of police, firefighters, grocery store employees and more.

... the dilemma for health care workers could become especially acute as staff shortages collide with record nationwide coronavirus hospitalizations. About 160,000 people were hospitalized with the virus on Thursday — surpassing the pre-omicron record set last January, when vaccinations were just becoming available.

When the CDC changed its isolation guidance last month, it also said that isolation periods could be scrapped entirely if made necessary by staffing constraints, though facilities should turn to asymptomatic or mildly ill employees first.

Health care facilities around the country have implemented the relaxed guidance in recent weeks, despite some medical groups expressing serious concerns about even a five-day return-to-work protocol without testing. ...

 

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