How Often Should Healthcare Workers Be Tested For Tb

How Often Should Healthcare Workers Be Tested For Tb – Amanda Foster spent three weeks in New York helping out as a crisis nurse because she saw it as an “opportunity to help not only those infected but also my colleagues across the country.”

She worked in long-term care and correctional facilities. The long-term care facility, in particular, showed her how quickly COVID-19 can kill.

How Often Should Healthcare Workers Be Tested For Tb

Foster tested positive for COVID-19 antibodies a few days after her return. She sought antibody testing because her husband is immunocompromised, but she herself has never had any symptoms.

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“The only symptoms I could have had would be fatigue, and I had a headache twice,” said Foster. things to which it could be attributed.”

These frontline workers face the high potential for COVID-19 infection, but strategies differ in how often they are tested for the disease and whether symptoms are needed before testing.

Several experts say healthcare workers need aggressive testing to protect patients and prevent the spread of the coronavirus among staff. But research at major hospitals shows that testing by Arizona health workers is inconsistent, with no regular, ongoing testing for workers.

Hospital systems across the Valley have different testing policies. Some test symptomatic workers. Some offer antibody tests for anyone who wants it.

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Some experts say more frequent testing of healthcare professionals can help protect these professionals and limit the spread in these settings, allowing them to continue to treat patients safely for longer.

Foster believes that all healthcare workers, and really anyone in a hospital setting, such as housekeeping or food service workers, should be tested regularly, especially as research has shown that people are spreading the virus before they show symptoms or if they ever have. show symptoms.

“The test is really just a snapshot of the infection status, and these healthcare workers are exposed daily when they work with these patients,” Foster said. “So, as a nurse caring for patients, and particularly known infected patients, I chose to be tested. I want to know if I am bringing this virus to my family and my community. I want to know if I’m possibly spreading this to my patients, and I know a lot of nurses feel that way.”

Among the White House’s reopening criteria is a “robust testing program for at-risk healthcare workers, including emerging antibody testing.”

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“Robust” is not defined in the guidelines, but the criteria suggest it is important to have some sort of strong testing program for healthcare workers, particularly those who interact with COVID-19 patients.

Governor Doug Ducey has moved Arizona to phase one of the White House reopening plan, meaning he believes Arizona has met all the necessary criteria. Because what constitutes a “robust” test is subjective, it’s unclear whether Arizona has reached this level.

The US Centers for Disease Control and Prevention says one of the “high priority” groups for COVID-19 testing is healthcare facility workers with symptoms. Some experts say frontline healthcare workers should be tested regularly, regardless of whether they have symptoms.

Banner Health, the state’s largest healthcare system, offers diagnostic tests for employees who are symptomatic or concerned about possible exposure. They can test drive-thru at any time. Asymptomatic employees can be tested for antibodies, according to spokeswoman Becky Armendariz.

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Dignity Health is testing staff members who have symptoms and meet the CDC’s testing criteria, said spokeswoman Carmelle Malkovich. Employees must complete an online screening survey and, if they meet the criteria, will be tested at an employee testing station. Team members are asked to self-isolate until their results return, usually within 24 hours. Employees who test positive for work-related exposure are quarantined until released to return to work, Malkovich said.

HonorHealth requires symptom screening for all staff, doctors and nurses when they enter an HonorHealth facility. Those with symptoms are recommended for testing according to CDC guidelines, according to the company. It is unclear from a written statement provided by HonorHealth whether any employee testing is actually taking place within HonorHealth or whether employees are being directed to be tested elsewhere.

At the Mayo Clinic in the Phoenix area, any employee who shows symptoms or has a “high-risk exposure” undergoes a diagnostic test. The clinic plans to begin a “regular cadence of general employee testing” in the coming weeks, spokeswoman Jennifer Ruble said. All employees also undergo a symptom check every day.

Foster was not tested at any time in New York, but said she would have if she had symptoms. Each shift included a temperature check and monitoring for any other symptoms, she said. Because of the shortage of testing and the intense spread in New York, she said it was probably the “best you can do in this situation.” Other nurses she worked with who were showing symptoms were automatically quarantined for 14 days, which she acknowledged could create staffing problems.

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Foster is finishing up a graduate nursing program and rotating clinically to do so in the Valley. She hopes to return to work next week and will have another test later this week to see if she tests positive again for IgM antibodies, those that indicate current or recent exposure, to ensure it is safe for her husband to return home.

“I look forward to hugging my loved ones and being in the same room with them,” she said.

Several public health experts say testing should be more comprehensive for healthcare workers because they are on the front lines, and positive infections — especially those without symptoms — would be harmful to patients, other staff and infection control in hospitals.

Joshua LaBaer, ​​director of the Biodesign Institute at Arizona State University, said he thinks all healthcare professionals should be tested regularly, regardless of whether they have symptoms.

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“They are at high risk of contracting it,” LaBaers said, pointing out the risks in their work environment, even when wearing PPE.

A mid-April article in the medical journal The Lancet called for “mass testing of symptomatic and asymptomatic healthcare workers.” This would mitigate numbers depletion due to unnecessary quarantine, reduce the spread of mild or asymptomatic individuals, and protect the workforce by reducing hospital transmission, the authors argued.

Thomas Tsai, associate professor at Harvard T.H. Chan School of Public Health, said he thinks “robust” testing means health care workers should undergo routine health surveillance.

“Hospitals need to develop their protocols. This is really a workplace safety issue,” Tsai said. “We really need to protect our frontline healthcare workers, and one way to do that is to do routine surveillance in terms of testing, but also make sure they have the personal protective equipment they need.”

Repeat Fit Testing Not Routinely Required

Anyone with symptoms — regardless of their job — should be tested now, said Jennifer Nuzzo, an epidemiologist and professor at the Johns Hopkins Bloomberg School of Public Health.

“First of all, anyone who is symptomatic should be tested, period. And doubly health professionals”, said Nuzzo.

Measures must be taken to understand how many health workers in the state have been infected, Nuzzo said, and whether they are being infected at work or in the community.

That would require some level of “surveillance testing” to understand the level of infection in hospitals, she said.

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“And if the answers to the question suggest there is a problem, that could lead to more regular testing by healthcare professionals,” she said.

It’s not yet clear how big the problem is for healthcare workers in Arizona, while it’s clear that long-term care facilities, for example, have high infection rates and high potential for dire outcomes, she said.

Claire Standley, a research assistant professor at Georgetown University’s Center for Global Health Science and Security, said there is a strong case for regular testing of healthcare workers, particularly those on the front lines. If these workers are in situations that aren’t ideal, such as limited personal protective equipment, the argument for testing them regularly is even stronger, she said.

Under ideal circumstances, Standley said a testing strategy would include testing people at high risk even if they are asymptomatic, especially if a positive test result changes their behavior.

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“Personally, I think there are benefits to having a proportionate strategy that broadens your testing algorithm to include those people who may be high-risk but asymptomatic contacts,” said Standley. “Now you’re catching them before they leave and about the possibility of spreading the disease and you can recommend self-isolation.”

Contact the reporter at [email protected] or 602-444-4282. Follow her on Twitter @alisteinbach.Reach reporter Rachel Leingang by email at [email protected] or by phone at 602-444-8157, or find her on Twitter and Facebook.For healthcare professionals, see Isolation and work restriction guidance. For strategies to mitigate healthcare staff shortages, see Contingency and Crisis Management. For healthcare professionals advising people in non-health settings about isolation for laboratory-confirmed COVID-19, see End isolation and precautions for people with COVID-19.

This interim guidance has been updated based on currently available information about COVID-19 and the current situation in the United States. Updates have been made to reflect the higher levels

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