Facing understaffed hospitals, California temporarily allows asymptomatic workers to return after positive COVID test, exposure

A female nurse is shown wearing an N95 mask in a hospital room
SEIU-UHW and the California Nurses Association quickly condemned the emergency guidance they say removes "common-sense" safety requirements and will lead to additional COVID-19 cases. (Getty/JohnnyGreig)

Healthcare labor groups are pushing back against an emergency decision by the California Department of Public Health to permit healthcare personnel who tested positive for COVID-19 to return to work if asymptomatic, foregoing both an isolation period and follow-up testing.

The temporary guidance, published Saturday, is in effect through Feb. 1 for general acute care hospitals, acute psychiatric hospitals and skilled nursing facilities.

It aims to address “critical staffing shortages currently being experienced across the healthcare continuum because of the rise in the omicron variant,” according to the notice.

In addition to the update for asymptomatic healthcare personnel who initially tested positive, the guidance also permits workers who were exposed but do not have symptoms to resume work “immediately without quarantine and without testing.”

Both the exposed and test-positive healthcare workers should be assigned to work with COVID-19 patients when possible, according to the guidance.

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Additionally, these workers “must wear an N95 respirator for source control. Facilities implementing this change must have made every attempt to bring in the additional registry or contract staff and must have considered modifications to non-essential procedures,” according to the guidance.

Hospital employers in California are not bound to the public health department’s guidance and may choose to implement stricter return-to-work requirements.

Still, healthcare worker groups within the state released statements the same day condemning the California Department of Public Health’s temporary guidance.

SEIU-United Healthcare Workers West (SEIU-UHW), a healthcare union claiming more than 100,000 participants, said the state health department’s decision to drop “common-sense” testing and isolation requirements would only serve to increase workplace outbreaks and endanger patients.

“Our union will fight for safe working conditions for hospital workers who have continuously put their lives on the line during this pandemic,” Dave Regan, president of SEIU-UHW.  “We intend to expose any hospital employer who knowingly puts patients at risk by forcing COVID positive caregivers back to work.” 

The California Nurses Association (CNA) agreed that the new guidelines were “in effect guaranteeing more transmission” and suggested that the state had caved to the requests of private industry.

“Governor Newsom and our state’s public health leaders are putting the needs of healthcare corporations before the safety of patients and workers,” CNA President Cathy Kennedy said in a statement Saturday. “We want to care for our patients and see them get better—not potentially infect them. Sending nurses and other healthcare workers back to work while infected is dangerous. If we get sick, who will be left to care for our patients and community?”

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More than 35% of California hospitals reported experiencing critical staffing shortages, well over the national average of roughly 1 in 5, according to Department of Health and Human Services data.

California also isn’t the only area where workforce shortages are driving a faster return to work for healthcare workers. Per a Sunday report from the Associated Press, Dignity Health has told its Arizona hospital employees that they may request clearance to return to work if they had a positive COVID-19 test but are either asymptomatic or have improving mild symptoms.

These decisions come just a couple of weeks after the Centers for Disease Control and Prevention shortened its nationwide isolation guidance for healthcare workers and the general public alike. Those decisions were similarly panned by labor groups, prominent public health experts and the American Medical Association for, among other things, not requiring a negative test after a five-day isolation.