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 HCPs’ 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 here.
3. 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.
4. 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 here.
The CDC Testing Healthcare Personal website can be accessed here.
Compliance Perspective
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 facility’s 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 employee’s 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.
