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Since early September, mandate to test all Nursing Home staff based on county positivity rates have had an uptick in positive diagnoses of asymptomatic people.  Typically, when testing is done, there is roughly a 48-hour delay until results are known. This means that if someone is asymptomatic and providing direct patient care, the potential is there for an asymptomatic positive person to expose co-workers and/or patients to COVID. 

For this very reason it is imperative that you always continue to follow the known strategies to help reduce the spread of COVID.   If you observe a co-worker who is not following safe guidelines, it is time to speak up and hold each other accountable. The basic safety guidelines have not changed. 

  • Wear Your PPE Appropriately.  Not only when you are treating patients, but when you are present in the facility, maintain wearing your facemask and avoid removing it in presence of others. Healthcare personnel should wear a facemask at all times while they are in the facility, including in breakrooms or other spaces where they may encounter co-workers.  Because person-to-person transmission through respiratory droplets within a radius of six feet is currently thought to be the main way the virus spreads, everyone — including healthcare personnel — can reduce the risk to themselves and others by wearing a mask. Cloth face coverings should NOT be worn by healthcare personnel instead of a respirator or facemask if PPE is required.
  • Practicing Physical Distancing. For healthcare personnel, the potential for exposure to COVID-19 is not limited to direct patient care interactions. Transmission can also occur through unprotected exposures to asymptomatic or pre-symptomatic co-workers in breakrooms or co-workers or visitors in other common areas.
  • Emphasize the importance of source control and physical distancing in non-patient care areas.
  • Provide family meeting areas where all individuals (e.g., visitors, healthcare personnel) can remain at least six feet apart from each other.
  • Designate areas and staggered schedules for healthcare personnel to take breaks, eat, and drink that allow them to remain at least six feet apart from each other, especially when they must be unmasked.
  • When at all possible a six-foot barrier should always be maintained.
  •  Wash Hands Often.  Make sure there is adequate alcohol-based hand sanitizer available for use and sinks with soap and water are kept stocked with supplies.
  • Continue Taking Other Preventive Measures. Clean and disinfect frequently touched surfaces daily.  If you are sharing electronic devices make it a habit to disinfect with cleaning cloths between users.

The CDC has recently updated definition of exposure. The new definition includes exposures adding up to a total of 15 minutes spent six feet or closer to an infected person. Previously, the CDC defined a close contact as 15 minutes of continuous exposure to an infected individual, it has now changed to cumulative in a 24-hour period.  Generally speaking, a COVID+ individual must review everyone they have come in contact with for the previous 48-hours to evaluate whether they would fall into the “exposed” category.

This has been referred to as 6-15-48 analysis. Using the CDC’s updated definition would require identifying employees who worked within six feet of an infected person, for a cumulative total of 15 minutes during any 24-hour period in the 48-hours prior to when the sick individual showed symptoms. Or, if someone is asymptomatic, the evaluation should include the 48-hours before the COVID-19 test was administered. Properly wearing PPE will help prevent exposure.

Make sure you are adhering to these established safety practices to reduce the possibility of spreading this virus. Be a part of the solution and hold each other accountable to continue to focus on sound infection control principles, keeping everyone safer.