One State Urges Weekly Covid Testing for Hospital Workers

A respiratory therapist talks on the phone next to hospital beds while taking a break in the COVID-19 unit at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles, Thursday, Nov. 19, 2020.

A respiratory therapist talks on the phone next to hospital beds while taking a break in the COVID-19 unit at Providence Holy Cross Medical Center in the Mission Hills section of Los Angeles, Thursday, Nov. 19, 2020. Associated Press

 

Connecting state and local government leaders

The California state health department increased its guidelines for hospitals, saying weekly testing of employees should begin by Dec. 14.

After months of complaints from health care workers about insufficient protections during the coronavirus pandemic, the California Department of Public Health last week strengthened its Covid testing guidelines to spell out that hospitals should begin testing employees weekly. 

The department “strongly recommends” that acute-care hospitals—facilities that provide short-term, rather than residential care—implement weekly testing of all health care personnel “to maximize the strategy for prevention of outbreaks,” according to a letter dated Nov. 25.

Hospitals should begin weekly tests on Dec. 14, with facilities required to provide their plan for how they will test certain “high-risk” personnel—including nurses, doctors and support staff who work in emergency departments and intensive care units—by Dec. 7. The new protocol includes testing both symptomatic and asymptomatic workers, the department said, though anyone with symptoms of Covid-19 “should be tested immediately” rather than during scheduled weekly screenings. 

The policy update defines health care personnel as both paid and unpaid people working in health care settings “who have the potential for direct or indirect exposure to patients or infectious materials,” including EMTs, therapists, nurses, nursing assistants and doctors, as well as non-medical workers in administration, food services or cleaning.

Exemptions include only employees who “had a positive viral test in the past three months and are now asymptomatic,” unless they’ve had a possible exposure or begin exhibiting new symptoms, the department said.

It’s the state’s first official testing policy for health care workers, according to the California Nurses Association, the state chapter of National Nurses United, a union and professional organization.

“This is an amazing and welcome move,” Zenei Triunfo-Cortez, a registered nurse in the Bay Area and the organization’s president, said in a statement. “We applaud California for being a leader in requiring this type of testing program because it is desperately needed to fight this virus. There are simply too many asymptomatic people with Covid, and without robust testing, our hospitals will remain centers for spreading the disease instead of centers of healing as they should be.”

In addition to expanded screenings, hospitals’ testing programs must include policies that address how results will be explained to staff, how to communicate information about positive cases, procedures to deal with staff who decline to be tested and plans to address staffing shortages in the event of large outbreaks.

Testing protocols for health care workers vary by state and also by health system, and are often vague and hard to find. The Centers for Disease Control and Prevention recommends that hospitals and other care facilities prioritize testing for workers with symptoms and also test employees who have had “known exposure” to patients with the virus, but does not mandate action.

The update comes as health care workers brace for a surge of Covid-19 cases in the wake of Thanksgiving, when millions of Americans traveled and gathered with relatives despite public health guidelines that urged caution and continued isolation. 

In California, 59% of hospital beds are currently in use, Gov. Gavin Newsom said at a briefing Monday, and that number could rise to 78% by Christmas Eve.

“Without any additional interventions, change of behavior or fundamental shifts in the way we are conducting ourselves as individuals in this state, we could see an increase in hospitalizations two to three times greater than the current census in just one calendar month,” Newsom said.

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