Hospitals letting staff infected with Covid continue to work

[ffemt8978]

Health officials let COVID-infected staff stay on the job

Health authorities around the U.S. are increasingly taking the extraordinary step of allowing nurses and other workers infected with the coronavirus to stay on the job if they have mild symptoms or none at all.

apnews.com

This almost has a hypocritical feel to it. Covid is a pandemic worthy of costing people their jobs for not being vaccinated, yet asymptomatic people who test positive can continue to work around the sick?

 

[MMiz]

I’ve noticed similar policies across different critical fields as this variant spreads like wildfire.

The feeling I get is similar to the anthrax/bio terror training I got after 9/11. It’s a “these injections will keep you alive long enough to continue working.”

Whatever it takes to keep the country going, right?

 

[ffemt8978]

I’ve noticed similar policies across different critical fields as this variant spreads like wildfire.

The feeling I get is similar to the anthrax/bio terror training I got after 9/11. It’s a “these injections will keep you alive long enough to continue working.”

Whatever it takes to keep the country going, right?

Does make it a harder to sell to the public that drastic measures are still required to combat Covid, doesn't it?

 

[MEDicJohn]

We just got the notice from County EMS about this today. Long as you're asymptomatic you work with a mask on. Strange time we live in

 

[MMiz]

Does make it a harder to sell to the public that drastic measures are still required to combat Covid, doesn't it?

That’s not my take at all. My sense is that there is misguided optimism that we can simply push through this, no matter the cost, and come out the other side with herd immunity.

This wave of Covid has impacted more people I know, more severely, than any other.

 

[mgr22]

Health officials let COVID-infected staff stay on the job

Health authorities around the U.S. are increasingly taking the extraordinary step of allowing nurses and other workers infected with the coronavirus to stay on the job if they have mild symptoms or none at all.

apnews.com

This almost has a hypocritical feel to it. Covid is a pandemic worthy of costing people their jobs for not being vaccinated, yet asymptomatic people who test positive can continue to work around the sick?

I see room for compromise based on this line from the linked piece:

"Also, infected workers will be required to wear extra-protective N95 masks and should be assigned to treat other COVID-19-positive patients, the department said."

Unvaccinated workers could be assigned to COVID-positive patients, too, instead of being fired. It sounds punitive, but that wouldn't be the intent. The idea would be to accommodate subsets of unvaccinated workers who believe that they already have immunity or that COVID is no big deal. They'd get to keep their jobs and hospitals would be less shorthanded.

As long as we're living in bizarro world, we might as well consider whatever isn't intuitive.

 

[Carlos Danger]

You know that the pendulum has swung FULLY in the opposite direction when, at a time that the dominant variant is one that is said to be much more contagious than preview ones, asymptomatic transmission is a bigger concern than ever, and ICU's are once again at capacity in some areas, it is now OK to work when you are C19+, caring for healthy and sick patients alike, as long as you feel OK.

Sounds to me like this is, more than anything, a political calculation made amidst falling approval ratings, the widespread perception of a faltering economy, and looming midterm elections. But that's just my take.

What a time to be alive!

 

[DrParasite]

we have hospitals that are firing staffers who are refusing to get vaccinated, but allowing COVD+ staffers to continue to work.

 

[MEDicJohn]

we have hospitals that are firing staffers who are refusing to get vaccinated, but allowing COVD+ staffers to continue to work.

and the cases of vaccinated people becoming covd+ has blown up.

 

[DrParasite]

and the cases of vaccinated people becoming covd+ has blown up.

which torpedoes the justification for mandating the vaccine on all employees, because the data shows that being vaccinated does not prevent you from spreading or becoming infecting by COVID.

 

[MMiz]

which torpedoes the justification for mandating the vaccine on all employees, because the data shows that being vaccinated does not prevent you from spreading or becoming infecting by COVID.

*For the Omicon variant. It appears as though the vaccine was effective at keeping folks from getting infected with the Delta and previous variants.

 

[Summit]

The vaccine was never a guarantee against infection, and it is less so with Omicron, but still some protection against infection and it seems shorter duration of shedding replication competent virus. Further, sick staff are out for shorter periods as they aren't getting severe disease and long COVID is also reduced. Not many people got fired... vast majority of people got vaccinated or got exemptions. Losing 0-2% of the refuseniks isn't why there is crisis return to work protocols now.

What most of you probably don't know is this crisis standard of HCW isolation where you work while probably infectious is not new this last December. It was there for a LONG time. It is just nobody had to activate it before, or if they have, they've kept mum. Between the lower transmission rates and case doubling times of Wuhan-1 (original strain) combined with transmission controls in 2020, and then the high VEI of the vaccines against Alpha and Delta in 2021, there was not widespread sudden nationwide situations where 10% then 20% then 30% of staff was out on isolation like with Omicron.

So then you make the choice:

1. Have some patients die of Rona due to crisis return to work standards
2. Have more patients die of crisis standards of care / lack of care due to no staff available

 

[Carlos Danger]

The optics and messaging to the public are, once again, awful.

• Non HCW to me: So, healthcare workers actually got fired for not being vaccinated?
• Me to non HCW: Yes
• Non HCW to me: Why was it so important that you all get vaccinated?
• Me to non HCW: Well, they didn't want us coming to work with COVID and spreading it to our patients and colleagues, some of whom can't be vaccinated or for whom the vaccines don't work well.
• Non HCW: I mean that seems logical, right?
• Me to non-HCW: It does. I hate broad mandates but if I'm being totally honest, it makes sense.
• Non HCW: But now they are telling you guys that it's OK to come to work with COVID? Even though the dominant strain now is the most infectious one yet?
• Me to non HCW: Yes.

 

[Summit]

The optics and messaging to the public are, once again, awful.

I agree that your example conversation IS horrible messaging.

This pandemic is marked by complex decisions that cannot be summed up in a single simple sentence much less a mere yes/no. This pandemic is a complex situation with changing circumstances, evolving understanding, and varied response options.

I would hope someone with your understanding might conduct an explanation more like my post above. You might use words like "CRISIS" to explain why it is different right now. You might mentioned that Omicron's high transmission combined with newly reduced vaccine effectiveness against infection have created the crisis. You could discuss that such crisis measures are temporary and might pose a question of "what would happen if there were no doctors in the ER because they were all sick?"

 

[Carlos Danger]

I would hope someone with your understanding might conduct an explanation more like my post above. You might use words like "CRISIS" to explain why it is different right now. You might mentioned that Omicron's high transmission combined with newly reduced vaccine effectiveness against infection have created the crisis. You could discuss that such crisis measures are temporary and might pose a question of "what would happen if there were no doctors in the ER because they were all sick?"

Except that we're not in a crisis and all the ER doctors aren't out sick. We're not in a situation where "you either get treated by a doctor who is C19+ or you don't get treated at all". This is a false dilemma. If we ever were at that point, then sure, let's do whatever we have to do to take care of the people who need us. But all I've seen is business as usual - elective surgical cases; people showing up for normal clinic appointments - with the exception of some staff members coming to work in N95's.

I'm totally OK with that, of course, if that's what the science tells us makes sense. The problem is that it's completely inconsistent with much of the other things we are still being told.

The pandemic is no longer an emergency and even though the public health authorities definitely won't admit that because all their power is dependent on the public being fearful, it appears that they are finally to the point that they will at least balance their interests against the costs of the policies that they espouse. I'm sure it's totally coincidental that this is happening at a time that the approval ratings of the sitting administration are plummeting and midterms are only 10 months away.

 

[mgr22]

The pandemic is no longer an emergency and even though the public health authorities definitely won't admit that because all their power is dependent on the public being fearful, it appears that they are finally to the point that they will at least balance their interests against the costs of the policies that they espouse. I'm sure it's totally coincidental that this is happening at a time that the approval ratings of the sitting administration are plummeting and midterms are only 10 months away.

Lots of assumptions in that paragraph, wouldn't you say?

Here in Tennessee, we averaged 13.5K infections per day last week. About 2700 Tennesseans were hospitalized with COVID as of Sunday. My son transported some of them. Sounds pretty emergent to me.

 

[Summit]

Except that we're not in a crisis and all the ER doctors aren't out sick. We're not in a situation where "you either get treated by a doctor who is C19+ or you don't get treated at all". This is a false dilemma. If we ever were at that point, then sure, let's do whatever we have to do to take care of the people who need us.

Really? That's not happening? Are you certain?

I admittedly don't know what is happening in your hospital. Maybe you are in an area early in Omicron. If you have no staffing crisis and you wouldn't have one if you were on conventional RTW guidance, but you are doing crisis RTW, then that is some sketchy unjustified policy.

However, you shouldn't base your judgement on what is happening elsewhere based on what you see in your hospital. If you haven't seen what happens when the number of staff out doubles every two days and that goes on for 10+ days... well... all of a sudden 10 days of iso doesn't work and it can become a contingency situation or a crisis.

I work in two hospital systems and see the picture across CO KS and UT through them and my interfacing with other people in my position across multiple systems and independent hospitals.

CO went to crisis standards of care for EMS this last week. No biggie, right?

Some adaptation of the crisis and contingency return to work guidance lanes is absolutely a needed thing at many facilities depending on the department and the shift. I've seen an ED doctor go to work COVID+ 3 days post symptom onset because otherwise there literally would have been NO ED DOCTOR; a valid application of crisis. BTW, cancelling electives doesn't magically create ED docs or nurses. I have seen hospitals that had to go to contingency (5 day) in order to stay staffed and still struggle and they were cancelling electives.

The pandemic is no longer an emergency

So if you had enough staff sick at once that you couldn't staff the hospital... due to the pandemic... that they have to work while contagious... emergency or not?

The pandemic is not an emergency in terms of staffing or care standards in all places on all days. But it continues to cause emergencies in many places many days.

even though the public health authorities definitely won't admit that because all their power is dependent on the public being fearful

Maligning an entire profession... keepin' it classy bud. I don't think you hang out with a lot of PH folks. I do, so I take umbrage.

 

[Carlos Danger]

Lots of assumptions in that paragraph, wouldn't you say?

Here in Tennessee, we averaged 13.5K infections per day last week. About 2700 Tennesseans were hospitalized with COVID as of Sunday. My son transported some of them. Sounds pretty emergent to me.

Am I making assumptions? Sure. So is everyone who believes that the policies being promoted by the feds aren't political.

 

[Carlos Danger]

However, you shouldn't base your judgement on what is happening elsewhere based on what you see in your hospital. If you haven't seen what happens when the number of staff out doubles every two days and that goes on for 10+ days... well... all of a sudden 10 days of iso doesn't work and it can become a contingency situation or a crisis.

Nowhere in my post did I make any judgment about what is happening anywhere else.

Some adaptation of the crisis and contingency return to work guidance lanes is absolutely a needed thing at many facilities depending on the department and the shift. I've seen an ED doctor go to work COVID+ 3 days post symptom onset because otherwise there literally would have been NO ED DOCTOR; a valid application of crisis.

You are missing the point entirely. The ability to modify isolation requirements in order to do what needs to be done in the face of a true emergency has always existed. We never needed the blessing of the CDC for that (kind of like when many places were using bandanas instead of real PPE in the early days of the pandemic because even after the experiences of SARS, MERS, and swine flu, etc., and billions upon billions of dollars in funding, our public health and emergency planning officials apparently never had the foresight to think about the preparing for the eventuality of a respiratory pandemic requiring massive levels of PPE, which resulted in not only forcing HCW's into an unsafe and unfair situation, but also lying to the public). The issue is the idea of simultaneously preaching about how the newest variant is the most contagious one yet and about to overwhelm the healthcare system like never before, while also allowing healthcare workers who are known positives to work even in places that aren't having serious staffing issues.

And also the contradiction of firing nurses and other healthcare workers - a majority of whom likely have at least some level of natural immunity to COVID - because it's too dangerous to allow unvaccinated people in the workplace because they MIGHT have COVID and transmit it - yet allowing people who DEFINITELY have COVID to come to work due to staffing shortages that were at least contributed to by firings. It's pretty darn inexplicable, if you ask me. Yes, I know vaccinated people transmit COVID at a lower rate than unvaccinated people. I also know that in every discussion about vaccination status the issue of natural immunity is completely ignored, as if it doesn't exist at all. Are you seriously saying that it's better to have staffing comprised of vaccinated but C19+ people than unvaccinated C19- people?

Maligning an entire profession... keepin' it classy bud. I don't think you hang out with a lot of PH folks. I do, so I take umbrage.

Not an entire profession; just the federal and state authorities who continue to capitalize on fear and keep managing to avoid consequences for their incompetence and refuse to release important data and intentionally suppress information and opinion that doesn't support their foregone conclusions.

If the shoe fits, wear it. If that's not you - and I don't suspect that it is and have never suggested that it is - then I'm not talking about you and you can stop being so sensitive every time I mention it.

 

[Summit]

allowing healthcare workers who are known positives to work even in places that aren't having serious staffing issues.

You are missing the point entirely. That is not what is supposed to be happening. If places are choosing to do crisis staffing without a crisis need, they are NOT following the intent of the guidance. Sounds like a hospital failure based on greed, not a public health guidance failure.

Are you seriously saying that it's better to have staffing comprised of vaccinated but C19+ people than unvaccinated C19- people?

Are you seriously putting those words in my mouth?

What the hell is wrong with you? I don't see how I can have a reasonable discussion with you at this point.

I'll just wait for some more of your conspiratorial thinking that this is all about power, politics, and control. You disappoint me.