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Process for Exposed or Potentially Exposed Health Care Workers

Kettering Health Network Employee Health and Infection Prevention Control have decided to discontinue the normal IPC practice of Contact Tracing (Universally) per the CDC additional considerations and recommendations below.

While contact tracing and risk assessment— with appropriate implementation of HCP work restrictions—of potentially exposed HCP remain the recommended strategy for identifying and reducing the risk of transmission of COVID-19 to HCP, patients, and others, it is not practical or achievable in all situations. Community transmission of COVID-19 in the United States has been reported in multiple areas. This development means some recommended actions (e.g., contact tracing and risk assessment of all potentially exposed HCP) are impractical for implementation by health care facilities. In the setting of community transmission, all HCP are at some risk for exposure to COVID-19, whether in the workplace or the community.

Devoting resources to contact tracing and retrospective risk assessment could divert resources from other important infection prevention and control activities. Facilities should shift emphasis to more routine practices, which include asking HCP to report recognized exposures, regularly monitor themselves for fever and symptoms of respiratory infection, and not report to work when ill. Facilities should develop a plan for how they will screen for symptoms and evaluate ill HCP. This could include having HCP report absence of fever and symptoms prior to starting work each day.

Facilities could consider allowing asymptomatic HCP who have had an exposure to a COVID-19 patient to continue to work after options to improve staffing have been exhausted and in consultation with their occupational health program. These HCP should still report their temperature and absence of symptoms each day before starting work. Facilities could have exposed HCP wear a facemask while at work for the 14 days after the exposure event if there is a sufficient supply of facemasks. If HCP develop even mild symptoms consistent with COVID-19, they must cease patient care activities, don a facemask (if not already wearing), and notify their supervisor or occupational health services prior to leaving work.

Kettering Health Network will use the following steps:

  1. IPC is notified of positive COVID Test results for patient/employee
  2. IPC notifies Unit Managers and alerts Employee Health
  3. Unit Managers will inform employees on the unit of specific date ranges of hospitalization of the patient and Employee Health protocol regarding exposure. Employees will self-determine need for wearing a mask if there was any exposure based upon below CDC guidelines

Employees with low-risk exposures after Employee Health investigation will continue to work with assigned PPE.

Employees with moderate-to-high risk patient/co-worker exposures (per CDC guidelines) will be allowed to continue to work if:

  • Employee performs self-monitor (temperatures twice a day)
  • Work while wearing a surgical mask (always) for 14 days post-confirmation date
  • The employee calls Employee Health at (937) 395-8900 with signs or symptoms of fever or upper respiratory disease (cough/congestion/shortness of breath)
  • They see their Primary Care Physician for evaluation and diagnosis after becoming symptomatic
  • Employee will be required to call Employee Health to update health status and prior to Return to Work. 
  • Employee Health will communicate with identified employees’ manager to notify of exposure and the need for employee to wear a mask for the next 14 days.
  • Unit Manager will inform employees on the unit and police compliance.

Employees who test positive should

  • Remain under home isolation precautions for a minimum of 7days from symptoms AND until they are symptom-free for 72 hours.
  • Notify Employee Health of positive test result
    • Employee Health will notify IPC and unit manager
      • Unit Manager to notify staff
  • Notify Employee Health prior to return
April 1, 2020