ALBANY, Ga. — Amid the Coronavirus pandemic, hospitals have been wrestling with a life or death question: should much-needed health care workers continue to work if they test positive for the coronavirus but don’t show symptoms?
With so many state and federal agencies involved in policies and guidelines, it has become confusing. 11Alive has learned at least hospital told workers this week that they can work even after testing positive for COVID-19 as long as they aren't showing any symptoms. The hospital has since reversed course after backlash to the original memo by employees and loves-ones.
The concern is due to the fact that some medical experts have said COVID-19 carriers can spread the virus even while they themselves are not showing symptoms.
“We had a very long, animated conversations with the local health department and the state health department, asking them to reconsider, discussing what position this would put us in and any healthcare organization. And, unfortunately, they felt like they were under a federal mandate to do that,” said Scott Steiner, the CEO of Phoebe Health.
He says the conversations happened Sunday after the hospital learned the Department of Public Health (DPH) was starting a new initiative.
The memo to the healthcare workers said as a condition of federal resources, they would now be eligible to be tested for COVID-19 even if they are not showing symptoms for the virus.
The Phoebe Health message to the employees went on to say, “if you test positive for COVID-19, you should come to work unless you are experiencing symptoms of the Coronavirus and you will be required to wear a mask at all times.”
DPH Commissioner Dr. Kathleen Toomey signed off on the original memo that Phoebe sent its employees requiring them to keep working even if they test positive for COVID-19.
On Wednesday, the department told 11Alive's investigative program, "The Reveal," that, "it was a mistake that unfortunately was not caught in the approval process."
Steiner says the reaction among staff and the public was understandably swift.
"If we don't have nurses and doctors tell me who's going to care for our patients?" Steiner asked rhetorically. "It's not a perfect situation. That's the other piece of this: everybody's looking for the exact right answer. And there isn't one. I'd love to be able to say, ‘hey, if you've tested positive go home, you know, take, whatever it is seven days or two weeks. But again, remember we have to run a hospital here, otherwise, we would have to shut down and most organizations are in that same position."
Phoebe Health says they have now made changes to the policy after conversations with DPC and the CDC Wednesday afternoon.
DPH says the CDC is giving local authorities some flexibility in order to avoid staffing shortages during the pandemic. They went on to say “once confirmed as positive, any staff member must be excluded from the hospital and remain in isolation as per routine protocol.”
Health care workers will now only work if they are asymptomatic, waiting for their COVID-19 test results and wear proper protective gear.
“Am I an asymptomatic carrier of the virus being told to work? What we’re being told is if we’re not showing symptoms of the infection, we should still work and that’s regardless of how great our exposure has been,” a nurse who asked to remain anonymous told 11Alive.
But what about other hospital systems?
At Piedmont Health, Chief Nursing Officer Kelly Hulsey said, “we are abiding by the CDC guidelines […] We are operating by the best information that we have from the CDC, other agencies. And, just again, trying to make sure that our staff is safe, that we're taking care of them and that we're able to take care of all our patients.”
Piedmont Health says asymptomatic employees can still work but they are not being tested until they show symptoms.
Emory and Grady hospitals also say they are not testing healthcare workers who are not showing symptoms.
Children's Healthcare and Wellstar say employees can stay home if they show symptoms.
In a sea of muddled messages, all the healthcare workers 11Alive talked to say, they are still doing the best they can in a growing pandemic. At Phoebe, once a staff member is exposed to the virus, they can only work with COVID positive and suspected patients.
“What we tell our patients is that their safety and their health care is our most important item, and that we would never put them intentionally at risk. That the measures that we have put into place to protect them and to protect our staff, to protect our doctors, are what the CDC and the experts have recommended,” Steiner said.
He also added that several hundred Phoebe Health employees, who were not showing symptoms for the coronavirus, asked for the test when the memo went out Sunday. They are still waiting for results. He hopes none comes back positive.
Department of Public Health Statement:
Monday afternoon, a notice was written by the hospital to inform hospital staff of testing guidelines for healthcare workers.
When that notice was written, the word “positive” was inadvertently inserted when referring to healthcare workers being able to return to work after testing positive for COVID-19. It was a mistake that unfortunately was not caught in the approval process. The message was distributed to staff and posted on Facebook, which is actually where the error was identified by Dr. Ruis. He immediately notified the hospital and asked them to make the correction.
It has now, however, come to our attention that the hospital as recently as yesterday was continuing to message staff that employees who have tested positive for COVID-19 but are asymptomatic can continue to work with proper PPE. That is not correct and that has been communicated to the hospital on numerous occasions by Dr. Toomey and Dr. Ruis. Here is the message sent by Dr. Toomey to the hospital CEO 30 minutes ago:
“I have been informed that infected healthcare workers are continuing to work. They cannot be permitted to work if they test positive. As I discussed with your team over the weekend, if staff are exposed to an infected patient, they can continue to work with patients until their test comes back, while using appropriate PPE as long as they remain asymptomatic. Once confirmed as positive, any staff member must be excluded from the hospital and remain in isolation as per routine protocol. Please ensure this message is transmitted to staff immediately. Guidance can be confusing. Please call me directly if you have questions.”
PHOEBE PUTNEY HEALTH SYSTEM RESPONSE:
The safety of our patients, team members and community is, and always will be, Phoebe’s top priority. Throughout the COVID-19 public health crisis, we have made every effort to follow evolving guidance issued by the Centers for Disease Control and Prevention (CDC) and the Georgia Department of Public Health (DPH).
During a call today with representatives from the CDC and DPH, we were informed their guidance is changing again, and we will once again change our course to follow those guidelines, specifically in reference to return-to-work guidelines for Phoebe employees who test positive for COVID-19 despite showing no symptoms. The CDC admitted the guidance they are asking Phoebe to follow is not a current written policy, as the agency does have official guidelines for how to deal with asymptomatic healthcare workers who are tested for COVID-19.
There are multiple inaccuracies in the statement WXIA received from DPH, but now is not the time to adjudicate those inaccuracies. As the individual hospital most severely impacted by this crisis in the state of Georgia, we must continue to focus on our patients and the Phoebe Family and ensuring we have the staffing and personal protective equipment to meet the healthcare needs of our community.
We have spent far too much time over the last few days dealing with the unintended consequences of the state’s decision to test asymptomatic healthcare workers in Dougherty County, while not doing so in 157 of Georgia’s other 158 counties. We are ready to move beyond these issues and once again dedicate all our energy and resources toward protecting our patients and employees and defeating COVID-19.
We look forward to working closely with the CDC, DPH and other partners as we navigate through this unprecedented public health emergency.
DPH Guidance for Asymptomatic Health Care Workers, Pending Test Results
The CDC does give some flexibility to healthcare systems, healthcare facilities to avoid staffing shortages. In consultation with Public Health, the hospital is allowing staff who are asymptomatic to work with appropriate PPE until test results are processed. If the test comes back positive, then the employee must remain out of work for seven days from the date of the test. If they remain symptom-free after seven days, they may return to work but must follow the CDC guidance below:
The guidance from CDC for returning to work is listed below.
Exclude from work until:
- Symptomatic and test positive for COVID-19:
- At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
- At least 7 days have passed since symptoms first appeared
- Asymptomatic and test positive for COVID-19
- 7 days have passed since positive test.
Once they meet the above criteria, the must follow these return to work practices and work restrictions
After returning to work, healthcare providers should:
- Wear a facemask at all times while in the healthcare facility until all symptoms are completely resolved or until 14 days after illness onset, whichever is longer
- Be restricted from contact with severely immunocompromised patients (e.g., transplant, hematology-oncology) until 14 days after illness onset
- Adhere to hand hygiene, respiratory hygiene, and cough etiquette in CDC’s interim infection control guidance (e.g., cover nose and mouth when coughing or sneezing, dispose of tissues in waste receptacles)
- Self-monitor for symptoms, and seek re-evaluation from occupational health if respiratory symptoms recur or worsen
11Alive is focusing our news coverage on the facts and not the fear around the virus. We want to keep you informed about the latest developments while ensuring that we deliver confirmed, factual information.
We will track the most important coronavirus elements relating to Georgia on this page. Refresh often for new information.