Health Care Personnel Working with Coronavirus Patients Have Guidance on Exposure

The health care law attorneys at Chapman Law Group discuss compliance and regulatory matters health care practitioners should know about in the wake of the Coronavirus.

With an influx of patients being tested daily for the Coronavirus (COVID-19), primary care doctors and urgent care facilities across the U.S. are putting themselves in the closest contact with it — and putting themselves at risk.

But are latex gloves and face masks enough to keep medical personnel protected?

What are the levels of exposure based on what health care personnel are or aren’t wearing?

And should doctors, nurses and medical assistants self-monitor after treating patients who could be carrying COVID-19, or should there be oversight from a higher authority?

We have answers now, as the Centers for Disease Control and Prevention (CDC) has issued interim guidance for health care personnel regarding potential COVID-19 exposure. The CDC’s memo helps with assessing risk, monitoring and work restriction decisions for those at medical practices who have frequent, close-contact, person-to-person exchanges with patients.

What is ‘Close Contact’?

The CDC is clarifying “close contact” for health care exposure as:

  • “a) being within approximately 6 feet (2 meters), of a person with COVID-19 for a prolonged period of time (such as caring for or visiting the patient; or sitting within 6 feet of the patient in a healthcare waiting area or room); or
  • “b) having unprotected direct contact with infectious secretions or excretions of the patient (e.g., being coughed on, touching used tissues with a bare hand).”

What is Considered a ‘Prolonged’ Period of Time for Exposure?

The CDC notes that it cannot “precisely define the duration of time that constitutes a prolonged exposure,” as more still needs to be known about transmission risks, but, “it is reasonable to consider an exposure greater than a few minutes as a prolonged exposure.”

The guidance memo adds that “[b]rief interactions are less likely to result in transmission; however, clinical symptoms of the patient and type of interaction (e.g., did the patient cough directly into the face of the HCP) remain important.”

What Are the Degrees of Risk?

Because each health care facility is different, the CDC advises that the facility “in consultation with public health authorities should use the concepts outlined in this guidance along with clinical judgement to assign risk and determine need for work restrictions.” [Emphasis added.]

For purposes of the CDC’s interim guidance, though, the risk levels for exposure are defined as:

  • High: Personnel “who have had prolonged close contact with patients with COVID-19 who were not wearing a facemask while HCP nose and mouth were exposed to material potentially infectious with the virus causing COVID-19.”
  • Medium: Personnel who wore a facemask when in prolonged close contact with a patient with Coronavirus.
  • Low: Personnel had “brief interactions with patients with COVID-19 or prolonged close contact with patients who were wearing a facemask for source control while [personnel] were wearing a facemask or respirator.” The CDC notes, however, that “[u]se of eye protection, in addition to a facemask or respirator would further lower the risk of exposure.”

What Kinds of Monitoring Will Be Needed?

The CDC has two methods of recommended monitoring for Coronavirus, which should be applied until 14 days after doctors’, nurses’ and other health care personnel’s last potential exposure:

  • Self-Monitoring with Delegated Supervision: Personnel “should monitor themselves for fever by taking their temperature twice a day and remain alert for respiratory symptoms (e.g., cough, shortness of breath, sore throat).” This should be done with “oversight by their healthcare facility’s occupational health or infection control program in coordination with the health department of jurisdiction, if both the health department and the facility are in agreement.”
  • Active Monitoring: Here, “the state or local public health authority assumes responsibility for establishing regular communication with potentially exposed people to assess for the presence of fever or respiratory symptoms (e.g., cough, shortness of breath, sore throat). For [personnel] with high- or medium-risk exposures, CDC recommends this communication occurs at least once each day.”

How Do All of These Factors Work Together?

The CDC has produced a table showing the epidemiologic risk classification for health care personnel who have been exposed to patients with coronavirus in a health care setting; recommendations for associated monitoring; and work restriction recommendations:

Who Should I Contact If I Need Assistance with Coronavirus-Related Compliance at My Practice?

As health law attorneys, we at Chapman Law Group want to make sure our clients — health care facilities, general practitioners, nurses and other licensed health care professionals — are following proper protocol as the Coronavirus situation continues. We have been watching the COVID-19 developments carefully, and we are here to help you maintain compliance while keeping you and your practice safe. Call us today so we may assist you during this crucial time in health care.

Need an Attorney? Contact us now!

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