The Centers for Disease Control and Prevention stunned many disease experts last month when it announced healthcare workers could return to work seven days after testing positive for COVID-19, instead of its previous 10-day recommendation.
The policy applies to people who are asymptomatic, or whose mild or moderate symptoms are improving, and test negative within 48 hours of returning to work. But the CDC said the isolation period could be cut even more — down to five days — in the event of staffing shortages. In that case, healthcare workers wouldn’t need to test out of isolation. And in a crisis scenario, when there’s no longer enough staff to provide safe patient care, there would be no work restrictions at all, the CDC said.
Nearly one-quarter of US hospitals are reporting critical staffing shortages, according to the latest data from the US Department of Health and Human Services (HHS). Often, that means having to choose between treating sick patients and allowing infected employees to return to work (though hospitals can decide for themselves what constitutes a critical shortage, NPR reported).
But disease experts fear the CDC policy is fueling in-hospital transmission since research shows that some people with COVID-19 can still be infectious for up to 10 days.
“It’s a little bit of pandemic theater. You’re making the decision to bring healthcare workers back when they’re sick,” Susan Butler-Wu, an associate professor of clinical pathology at the University of Southern California, told Insider last month. “I don’t think the data support that.”
A week after the CDC’s announcement on December 23, the total number of hospitalized patients who contracted COVID-19 at least two weeks into their hospital stay went up 80% — from around 1,200 to 2,200 patients — according to HHS data.
Those patients “initially came into the hospital for something other than COVID and then were found to be positive,” Dr. Jorge Caballero, a data scientist with the nonprofit Coders Against COVID, told Insider. “The only place that they can possibly get COVID is in the hospital because that’s where they’ve been and they didn’t have it to begin with.”
Dr. Jeremy Faust, an emergency medicine physician at Brigham and Women’s Hospital, said many hospitals are implementing the CDC’s recommendations before they reach critical staffing shortages.
“If it’s choice between nothing and somebody who came back to work a little sooner than they should and wears PPE, I would take the latter,” he said. “But we should not do that unless it’s absolutely necessary because bringing people back to work sooner does increase the risk of spread. You have to decide if that increased risk is worth it. In a lot of cases, it’s not.”