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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

Pandemic Presenteeism: CA Says HCWs with COVID Can Skip Isolation and Go to Work

By Gary Evans, Medical Writer

A California public health policy allowing asymptomatic healthcare workers with COVID-19 to remain on duty sparked outrage among some nurses, who say it threatens their prime mission to protect and care for patients.

“We have enough COVID in our hospitals, so having COVID-positive workers come to work is very dangerous,” says Sandy Reding, RN, president of the California Nurses Association (CNA). “It can spread between coworkers and patients. The transmission rates are high, our numbers are climbing, our hospitals are full — so this seems absurd.”

The California Department of Public Health (CDPH) said due to “the critical staffing shortages currently being experienced across the health care continuum because of the rise in the Omicron variant, there is a change in return-to-work policy thorough Feb. 1, 2022.”

“Healthcare personnel (HCP) who test positive for SARS-CoV-2 and are asymptomatic may return to work immediately without isolation and without testing, and HCPs who have been exposed and are asymptomatic may return to work immediately without quarantine and without testing,” the CDPH stated in an All Facilities Letter. “These HCPs must wear an N95 respirator for source control.”

Although the health department set a sundown date and it issued a policy — not a regulation — opponents were wary of the move setting a precedent and increasing the level of presenteeism among workers. The CNA called for state health officials to rescind the policy, starting an online petition to rally support against the measure. Addressed to CA Gov. Gavin Newsom, the petition states that “eliminating the isolation time and sending asymptomatic or exposed health care workers to work will guarantee more preventable transmission, infections, hospitalizations, and death.

Reding says, “We will stand very strong against this, and we certainly don’t want it to be precedent setting.”

In a contrasting view, the policy will work as long as the healthcare workers abide by the outlined conditions, says Monica Gandhi, MD, an HIV clinician at San Francisco General Hospital.

“All health care workers in the state of California are required to be vaccinated,” she says. “Moreover, wearing an N95 mask at work will further minimize any chance of transmission, however miniscule.”

For more on this story, see the next issue of Hospital Employee Health.

Gary Evans, BA, MA, has written numerous articles on infectious disease threats to both patients and healthcare workers. These include stories on HIV, SARS, SARS-CoV-2, pandemic influenza, MERS, and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.