St. Mary’s Hospital in Lewiston has implemented a policy allowing employees who test positive for COVID-19 to come to work in some situations.
Personnel who have tested positive for COVID-19 will only be allowed to work when “absolutely necessary” and the policy applies to workers who have had exposure to, have tested positive for, or are under investigation for COVID-19. Those workers will work in COVID-positive units and will be required to wear full personal protective equipment, including an N95 mask, gloves, and a face shield, at all times.
According to a letter that was distributed to hospital staff and patients, the policy “will only be enacted when a work unit is truly in crisis status and has exhausted all other options for filling shifts with individuals who do not have work restrictions.”
Federal CDC guidelines allow workers who have tested positive for COVID-19 to remain on the job in crisis staffing situations. Crisis staffing, according to Stephen Costello, St. Mary’s Vice President of Business Development and Communication, refers to when the hospital “could have situations arise that would leave us without enough staff to properly take care of patients.”
What constitutes “crisis staffing” is different for each hospital and medical facility. St. Mary’s policy reflects changes that were made to the U.S. Centers for Disease Control and Prevention (CDC) guidance on December 23, 2021, which were adopted by the Maine CDC on December 27.
At a January 12 press conference, Maine CDC Director Dr. Nirav Shah and Maine Department of Health and Human Services (DHHS) Commissioner Jeanne Lambrew explained that the updated guidance is designed to allow facilities to set policies that reflect their staffing levels and needs without coordinating with the CDC.
Previous versions of Maine CDC guidance for hospitals and other types of medical facilities, such as nursing homes, required consultation with the agency about the implementation of crisis staffing policies.
But the latest guidance, which was updated to reflect concerns related to the increased transmissibility of the Omicron variant of COVID-19, gives healthcare facilities greater freedom to set staffing policies that ensure they have adequate personnel to deliver care.
“Facilities are best positioned to evaluate their own needs as to whether conventional, contingency, or crisis strategies are most appropriate at a given time,” Shah in the December 27 public health advisory notice that updated the state’s guidance.
The new guidance recommends different types of work restrictions depending on the level of staffing restriction a healthcare facility is facing and the vaccination status of an individual who has been either exposed to or tested positive for COVID-19.
According to Maine CDC’s December 27 public health advisory, for facilities operating under conventional conditions, asymptomatic individuals who have been infected with COVID-19 can return to work after 7 days and with a negative test, regardless of vaccination status. For facilities operating under contingency conditions, positive individuals can return to work after 5 days; facilities can opt to require a negative test.
Under crisis conditions, asymptomatic or mildly symptomatic individuals can return to work in less than five days. The guidance also advises that facilities should avoid allowing COVID-19 positive workers to treat immunocompromised and pregnant patients, if possible. The guidance also advises that work restrictions should not be shortened for moderately to severely immunocompromised workers.
The guidance also states that facilities operating under crisis conditions should inform patients and personnel they are operating under crisis standards, detail changes in practice, and describe actions that are being taken to protect patients and personnel.
In addition, on January 11, Gov. Janet Mills activated an additional 169 members of the National Guard to non-clinical support roles in Maine’s healthcare facilities. Like previous Guard members activated by the governor, they will open additional beds in nursing facilities, swing bed units, and “decompression sites” accepting patients who have been discharged from hospitals. Guard members will be deployed next week and serve in these capacities through the end of February.
Mills also announced the Federal Emergency Management Agency approved her request to send Federal COVID-19 Surge Response Teams to MaineHealth in Portland and Central Maine Medical Center (CMMC) in Lewiston. From two teams of seven nurses and pharmacists, three will go to Maine Health and four to CMMC. The teams, which are scheduled to remain through January 27, will administer COVID-19 vaccines, allowing Maine healthcare workers to focus on patient care.