CEOC: Implementation of contingency staffing

CEOC & COVID-19

TO: Ballad Health All

FROM: Ballad Health Corporate Emergency Operations Center

DATE: Tuesday, July 26, 2022

TITLE: Implementation of contingency staffing

ACTION: Please post and cascade to all team members.

Click here to view this memo as a PDF file.

COVID-19 inpatient cases: 132

COVID-19 patients in ICU: 27

COVID-19 patients on ventilators: 10

Pediatric inpatients with COVID-19: 5

Due to an increase in community transmission of COVID-19, and to the ongoing clinical staffing resource limitations, Ballad Health will upgrade to contingency staffing for team members who test positive for COVID-19, effective Tuesday, July 26. Ballad Health continues to remain in contingency staffing for all team members who have a high-risk exposure.

Contingency staffing is applied when increased clinical staffing needs are occurring or are expected due to quarantine measures. High-risk areas, such as cancer centers and oncology units will follow conventional guidelines when determining if COVID-exposed team members can return to work. Team members working with the Ballad Health Niswonger Children’s Network, inclusive of Niswonger Children’s Hospital, must contact their manager for an appropriate low-risk assignment before returning to work during contingency staffing.

Our systemwide COVID-19 inpatient census has risen to 132, as of Tuesday, July 26, and more than 230 team members have COVID-19, which has led us to make this change.

Key points to know about contingency staffing

  • All team members who test positive for COVID-19 must isolate for 5 days.
  • Team members may return to work between Days 6-10 if they are asymptomatic or having improving symptoms, regardless of vaccine status.
  • If the team member performs an antigen test on Day 5 and is still positive, they must isolate through Day 10.
  • Team members who have an exposure to COVID-19 will follow contingency guidelines and can work during the incubation period, and will be monitored for symptoms, regardless of vaccine status.
  • All team members will continue to consult with Team Member Health for clearance to return to work.

Contacts with COVID-19

  • High-risk contacts who are up-to-date with their COVID-19 vaccinations (primary series and booster) do not need to quarantine but must monitor for symptoms.
  • High-risk contacts who are NOT up to date with their vaccination can work and should be tested on Day 2 and on Day 6, and monitor for symptoms.

Guidelines for team members returning to work

Team members who have tested positive for COVID-19:

Team members who were asymptomatic throughout their infection and are not moderately to severely immunocompromised will be cleared to return to work if:

  • At least 5 days have passed since the date of their first positive test (Day 0), and a negative antigen test, if an antigen test is done on Day 5.

Team members with mild to moderate illness who are not moderately to severely immunocompromised will be cleared to return to work if:

  • At least 5 days have passed since symptoms first appeared (Day 0), AND
  • At least 24 hours have passed since last fever without the use of fever-reducing medications, AND
  • Symptoms (cough, shortness of breath, etc.) have improved, and
  • If the team member chooses to do an antigen test on Day 5, the antigen test is negative.

For team members who have had high-risk exposure to COVID-19, but were not known to be infected:

  • Team members identified as having a high-risk exposure in the workplace will be notified via their Ballad Health email, which will contain instructions for next steps.
  • If the team member is vaccinated and received all recommended boosters, no work restrictions are required for contingency staffing.
  • If the team member has not received all COVID-19 vaccine doses, including all recommended booster doses, as recommended by CDC, they may continue to work onsite throughout their 10-day post-exposure period if:
    • They are tested on Day 2 after the exposure, and if negative, again on Day 6. Date of exposure is considered Day 0.

All team members working in contingency staffing must adhere to all prevention measures listed below:

  • The team member will always use a respirator or well-fitting face mask in the facility. The team member must be alone when removing their respirator to eat or drink.
  • The team member will self-monitor temperature and symptoms daily. If the team member develops even mild symptoms consistent with COVID-19, they will either not report to work, or stop working and notify their supervisor and Team Member Health before leaving work.
  • If team members are tested and found to be infected with SARS-CoV-2, they will be excluded from work until they meet all Return-to-Work Criteria

Defining high-risk exposure

High-risk exposure is defined by the CDC as a team member having prolonged contact (closer than 6 feet for a cumulative time of 15 minutes) with a patient, visitor or team member who has confirmed COVID-19 infection and was not wearing a respirator (N95), OR if wearing a facemask, the person with SARS-CoV-2 infection was not wearing a face mask.

In an effort to reduce high-risk exposures, it is imperative that all team members advise the patient to don their face mask before each team member entry into the room. Any issue with visitors who are noncompliant with mask-wearing or personal protective equipment (PPE) will be escalated through the appropriate chain of command.

Questions

Have a question about vaccines, the BA.5 variant or other COVID-related topics? Contact the Ballad Health Corporate Emergency Operations Center at BalladHealthCorporateEOC@balladhealth.org.