Staff coverage planning still a challenge during the COVID-19 pandemic

Jan. 19, 2022

Given Omicron’s transmissibility and resulting surge in COVID-19 cases, the Centers for Disease Control and Prevention (CDC) issued emergency guidance to help healthcare facilities, including laboratories, provide the staff necessary to ensure safe patient care.

During an Omicron-driven surge, the challenge of caring for patients would be complicated by the lack of access to employees in quarantine or isolation from SARS-CoV-2 combined with ongoing vacancies in healthcare positions.

Labs already feel the pain of staffing shortages. Of respondents to Medical Laboratory Observer’s 2021 salary survey, 80.5% said the current shortage of medical personnel has had a “moderate/large” impact on lab operations, up from 72.7% in 2020.

The CDC’s guidance on staffing is contained in two electronic documents: a first webpage addressing isolation after a confirmed infection and quarantine after exposure to the virus; a second webpage discussing contingency- and crisis-management strategies. Among the main points the CDC addressed:

  • Healthcare workers with COVID-19 who are asymptomatic can return to work after seven days with a negative test result, and isolation time can be cut further to address staffing shortages.
  • Healthcare workers who have received all COVID-19 vaccine doses, including boosters, do not need to quarantine at home following a high-risk exposure to the virus. The CDC defines high risk as an incident in which a healthcare worker’s eyes, nose, or mouth were exposed to material that may contain SARS-CoV-2.
  • Healthcare workers who have not received all vaccine doses and are exposed to the virus may return to work earlier than 14 days if they do not develop symptoms or test positive for COVID-19.

As far as contingency strategies, the CDC recommends canceling elective procedures; addressing social factors that might prevent employees from reporting to work, such as transportation issues; asking staff to postpone time off; and hiring temporary staff. Crisis strategies include transferring patients to other facilities or allowing fully vaccinated, asymptomatic staff who have been exposed to SARS-CoV-2 to work throughout their 14-day quarantine period. These staff members would need to wear a respirator or well-fitting mask. They also would have to report their temperature and symptoms (or lack thereof) before each shift.

“If shortages continue despite other mitigation strategies, as a last resort consider allowing HCP to work even if they have suspected or confirmed SARS-CoV-2 infection, if they are well enough and willing to work, even if they have not met all return-to-work criteria,” the CDC said. The agency added that such an option should be implemented only after considering such factors as where workers are in the course of their illness, the types of symptoms they have, and how much patient interaction they will have.

One thing is clear from the CDC’s discussion of staffing strategies: As the COVID-19 pandemic rolls into its 3rd year, laboratorians will need to approach staffing strategies with flexibility. They’d also be wise to recognize and reward the ongoing efforts of their exhausted staff members.

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