COVID-19 Eye on Provider Workforce: Bringing Exposed and Confirmed Staff Back to Work

March 31, 2020

By: Raul A. Tabora, Jr.

The NYS Department of Health (DOH) is issuing updates on COVID-19 requirements for providers nearly every day during this crisis. This will focus on an important update issued this past Saturday designed to replenish the health care workforce by setting standards on when providers may allow workers to return to work after exposure or confirmation with COVID-19. The update is available here.

It applies to all healthcare settings, including but not limited to hospitals, long term care facilities (LTCFs), adult care facilities (ACFs), end-stage renal disease (ESRD) facilities, emergency medical services (EMS), home care, outpatient clinics, and private practices issued by the DOH Bureau of Healthcare Associated Infections (BHAI), titled: Health Advisory: Updated Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure or Infection. 

The advisory distinguishes between healthcare personnel (HCP) who:

A. have been exposed to a confirmed case of COVID-19, or who have traveled internationally in the past 14 days, vs. 
B. those with confirmed or suspected COVID-19, whether healthcare providers or other facility staff. 

The following table provides a quick reference on the new DOH standards:

A. For those exposed to confirmed cases or traveled abroad in the past 14 days, the following must be met: B. Those with confirmed or suspected COVID-19, the following must be met:

1. Furloughing such HCP would result in staff shortages that would adversely impact operation of the healthcare entity.
2. HCP who have been contacts to confirmed or suspected cases are asymptomatic. 
3. HCP who are asymptomatic contacts of confirmed or suspected cases should self-monitor twice a day (e.g., temperature, symptoms), and undergo temperature monitoring and symptom checks at the beginning of each shift, and at least every 12 hours during a shift. 
4. HCP who are asymptomatic contacts of confirmed or suspected cases should wear a facemask while working, until 14 days after the last high-risk exposure.
5. To the extent possible, HCP working under these conditions should preferentially be assigned to patients at lower risk for severe complications (e.g., on units established for patients with confirmed COVID-19), as opposed to higher-risk patients (e.g., severely immunocompromised, elderly). As this outbreak grows, all staff will need to be assigned to treat all patients regardless of risk level. 
6. HCP allowed to return to work under these conditions should maintain self-quarantine when not at work. 
7. If the HCP who are asymptomatic contacts and working under these conditions develop symptoms consistent with COVID-19, they should immediately stop work and isolate at home. Testing should be prioritized for hospitalized healthcare workers. All staff with symptoms consistent with COVID-19 should be managed as if they have this infection regardless of the availability of test results. 

1. Furloughing such HCP would result in staff shortages that would adversely impact operation of the healthcare entity.
2. HCP with confirmed or suspected COVID-19 must have maintained isolation for at least seven days after illness onset, must have been fever-free for at least 72 hours without the use of fever reducing medications, and must have other symptoms improving. 
3. If HCP is asymptomatic but tested and found to be positive, they must maintain isolation for at least seven days after the date of the positive test and, if they develop symptoms during that time, they must maintain isolation for at least seven days after illness onset and must have been at least 72 hours fever-free without fever reducing medications and with other symptoms improving. 
4. Staff who are recovering from COVID-19 should wear a facemask while working until 14 days after onset of illness, if mild symptoms persist but are improving. 
5. To the extent possible, staff working under these conditions should preferentially be assigned to patients at lower risk for severe complications (e.g., on units established for patients with confirmed COVID-19), as opposed to higher-risk patients (e.g., severely immunocompromised, elderly). As this pandemic grows, all staff will need to be assigned to treat all patients regardless of risk level. 
6. HCP allowed to return to work under these conditions should maintain self-isolation when not at work. 

Guidance and directives are frequently changing. You should check frequently for updates.  

Should you have any questions on this guidance, please feel free to contact any of the attorneys in our Health Care Practice, or the attorney in the firm with whom you are regularly in contact.