The Centers for Disease Control and Prevention stunned many disease experts last month when it said healthcare workers could return to work seven days after testing positive for COVID-19.
The policy applies to people who are symptom free, and who have mild or moderate symptoms, and who test negative within 48 hours of returning to work. In the event of staffing shortages, the CDC said the isolation period could be shortened even more. In that case, healthcare workers wouldn't need to be isolated. In a crisis, there would be no work restrictions, according to the CDC.
According to the latest data from the US Department of Health and Human Services, 25% of US hospitals are reporting critical staffing shortages. Hospitals can decide for themselves what constitutes a critical shortage, but they often have to choose between treating sick patients and allowing employees to return to work.
Some people with COVID-19 can still be infectious for up to 10 days, and disease experts fear that the CDC policy is fueling in-hospital transmission.
It's a little bit of theater. "You're making the decision to bring healthcare workers back when they're sick," Susan Butler-Wu, an associate professor of clinical pathology at the University of Southern California, told Insider last month. I don't think the data supports that.
The number of hospitalized patients who contracted COVID-19 at least two weeks into their hospital stay went up 80% after the CDC's announcement on December 23, according to HHS data.
In-hospital COVID-19 transmission.
The US Department of Health and Human Services.
The patients came into the hospital for something other than COVID and were found to be positive, according to a data scientist with the nonprofit Coders Against COVID. The only place that they can get it is in the hospital, because they didn't have it before.
Many hospitals are implementing the CDC's recommendations before they reach critical staffing shortages, according to Dr. Jeremy Faust, an emergency medicine physician.
If it's choice between nothing and someone who came back to work a little sooner than they should and wears PPE, I would take the latter. Bringing people back to work sooner does increase the risk of spread, so we should not do that unless it's absolutely necessary. If that increased risk is worth it, you have to make a decision. It's not in a lot of cases.
The rise of COVID-19 in hospitals is not explained by Omicron's transmissibility.
Local in-hospital transmission is also rising.
The jump in implementation of the new CDC policies can be seen in large hospital systems.
Rhode Island's Department of Health updated its isolation guidance on December 31 to reflect the new CDC recommendations for hospital and nursing home workers. Within a few days, the number of people who contracted COVID-19 in the hospital skyrocketed.
Rhode Island has a COVID-19 transmission.
The US Department of Health and Human Services.
Omicron is more transmissible than other variants, so it could be driving some degree of in-hospital transmission on its own. The US saw a slight increase in the transmission of COVID-19 within hospitals in the month leading up to the new CDC rule.
There are few explanations for the rapid increase in patients who contracted COVID-19.
He said that the CDC's policy of shortening the isolation period was the reason for the change.
healthcare workers can spread COVID-19 even if they wear masks.
A nurse checks the fit of her mask before entering a patient's room in the COVID-19 unit of MedStar St. Mary's Hospital in Leonardtown, Maryland.
The images are Win McNamee.
Insider spoke with four nurses who were told to come into work with COVID-19, two in Kentucky and one in Florida. Many of them were worried about infecting patients and also worried about wearing thick, tight masks for long hours when they were already congested or short of breath.
Omicron leaves little room for mistakes in mask-wearing.
He said that even a fleeting exposure to Omicron is all it takes to get someone exposed and sick. The variant is more efficient than Delta at getting into our cells.
Even healthcare workers who wear protective masks like an N95 may still be exposed to infectious particles when they cough or sneeze. It's unrealistic to think that masks can be worn every second of a shift.
"When doctors, nurses need to eat, you take off your mask, and we know that this virus is airborne," said Caballero. It can linger in rooms for hours.
Faust said that in-hospital transmission could be caused by a few high contagious people.
He said that a patient could be in the hospital for a week and never leave. If a few of them were really, really contagious, the virus could be hanging out in the air and that's where you'd get it, if you take that patient to a radiology suite for an X-ray, and that suite has been occupied by 50 people throughout the day
The new CDC recommendation always carried the risk of more in-hospital transmission, experts said.
"We can't just look at the other way," he said. The patients, the patients' families, and the doctors and nurses need to be involved in the process.
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