On June 1, the Pennsylvania Department of Health released the following update to their guidance on risk assessment and work restrictions for healthcare personnel with potential exposure to COVID-19:
This guidance has been updated to simplify the determination of risk exposures warranting work restriction. Highlights of the guidance include:
- Resume contact tracing and application of work restrictions in areas where spread of COVID-19 in the community has decreased
- Focus on exposures believed to result in higher risk for healthcare personnel (HCP) (i.e., prolonged exposure to patients with COVID-19 when HCP’s eyes, nose, or mouth are not adequately covered)
- The definition of “prolonged exposure” was extended to refer to a time period of 15 or more minutes of close contact (within ≤ 6 feet). However, any duration should be considered prolonged if the exposure occurs during performance of an aerosol-generating procedure.
- If you have additional questions about this guidance, please contact DOH at 1-877-PA-HEALTH (1-877-724-3258) or your local health department.
This updated guidance describes the process for resumption of contact tracing and application of work restrictions that should occur in areas where spread in the community has decreased and when capacity exists to perform these activities without compromising other critical infection prevention and control functions. Guidance has been simplified to focus on exposures that are believed to result in higher risk for HCP (i.e., prolonged exposure to patients with COVID-19 when HCP’s eyes, nose, or mouth are not adequately covered). Other exposures not included as higher risk, including having body contact with the patient (e.g., rolling the patient) without gown or gloves, may impart some risk for transmission, particularly if hand hygiene is not performed and HCP then touch their eyes, nose, or mouth. The specific factors associated with these exposures should be evaluated on a case by case basis; interventions, including restriction from work, can be applied if the risk for transmission is deemed substantial.
This guidance supersedes PA-HAN-484 and applies only to asymptomatic healthcare workers with potential exposure to patients, visitors, or other HCP with confirmed COVID-19 in a healthcare setting. For public health action for other situations, please refer to the following guidance:
- For HCP with any known exposure to COVID-19 who become symptomatic, exclude immediately from work, counsel them to seek testing. Follow PA-HAN-493 and PA-HAN-501.
- For HCP who are asymptomatic, but test positive for COVID-19, follow guidance in PA-HAN-509.
- For patients and visitors exposed to COVID-19 in a healthcare setting, refer to CDC Guidelines for community exposure. The guidance provided in this document does not apply to patients and visitors exposed in healthcare settings.
- For HCP with known exposure to COVID-19 in the community or with travel-associated exposure, including those who are a household contact of a case, follow CDC Guidelines for community exposure or CDC Guidelines for travel-related exposure, respectively. Exclude exposed HCP for 14 days following the last date of exposure, unless all of the following criteria are met in the healthcare facility:
- Exclusion of the exposed HCP would mean there would no longer be enough staff to provide safe patient care
- Other contingency capacity standards have been exhausted (see CDC strategies)
- The facility has met criteria for crisis capacity standards for staffing as defined in their emergency preparedness plan.
If the above criteria have been met, asymptomatic HCP exposed to COVID-19 in the community or via travel may continue to work in the healthcare setting under crisis capacity standards.