PROVIDENCE, R.I. (WPRI) — At least two Rhode Island health care facilities have begun allowing workers who have tested positive for the coronavirus to continue treating patients, amid the ongoing pandemic and a medical staffing crisis.
The R.I. Department of Health on Monday confirmed the state has aligned its quarantine and isolation policies for health care workers with the U.S. Centers for Disease Control and Prevention.
The policy allows health care facilities, such as hospitals and nursing homes, to call employees into work, even if they have tested positive for the coronavirus, and — in certain circumstances — are experiencing mild symptoms.
“According to the CDC, if a hospital or nursing home is experiencing a significant staffing challenge, facility administrations may make a determination on the need to have a COVID-19 positive health care provider work,” Health Department spokesperson Joseph Wendelken said. “However, asymptomatic or mildly symptomatic workers should be considered first in these instances, and of course masks are required.”
As a result, at least two organizations so far have opted to staff operations with coronavirus-positive workers: Eleanor Slater Hospital and Respiratory and Rehabilitation of Rhode Island. The decision on whether to enact the policy is being left up to individual health care facility administrators.
Respiratory and Rehabilitation — a Coventry nursing home — is currently using asymptomatic staff who “recently tested positive,” according to the Health Department. Wendelken said the facility is no longer considered in a “crisis” level of care, but that “the status of the facility is fluid.”
Eleanor Slater, a state-run hospital with campuses in Cranston and Burrillville, used asymptomatic staff on Saturday and Sunday — but not Monday, according to Wendelken.
“These people on Saturday and Sunday were masked, and facility administrators communicated that they would try to have them only caring for COVID-19 positive patients,” he added.
Eleanor Slater employees were first notified on New Year’s Eve that workers who tested positive and were asymptomatic could come into work. A day later, the policy was updated to say that “staff who are exposed or positive and mildly symptomatic may continue to work,” according to a memo reviewed by Target 12.
The state’s policy shift — first reported by The Providence Journal — reflects an ongoing staffing crisis in Rhode Island that has been worsening in recent months. Hospital leaders have warned about an outflow of employees who have decided to leave because of burnout after nearly two years working through a pandemic.
Dr. Megan Ranney, a local emergency physician and professor at Brown University, told 12 News last week: “I have never seen it so bad as it is right now.”
“We have been short-staffed for months, and I want to be clear – it’s not because of the vaccine mandates,” Ranney said in an interview for last weekend’s edition of Newsmakers. “The hospital systems in Rhode Island kept workers. It’s really because people are burnt out, and tired, and because some of our nurses and other staff can make more money going to other states.”
The health care worker policy change also comes as COVID-19 hospitalizations have increased 64% to 323 people as of Dec. 28 compared to the same time a month earlier. Daily infections, meanwhile, have hit new record highs multiple times in recent weeks, and daily deaths have increased to levels not seen in nearly a year. (The state is not releasing updated COVID data until Tuesday.)
Dr. Jay Schuur, who heads the Rhode Island Hospital emergency department, said the latest surge of infections has fueled a rising number of sick callouts. As a result, he said it’s been challenging to staff operations in a way that ensures there are enough beds to meet patient demand at the hospital.
Schuur said his department is reviewing the updated CDC guidelines to see if there’s any way for asymptomatic employees to safely return to work earlier than before. But he called it a “last resort.”
“We may get to that point if there’s significant further spread, but we’re not at that point right now,” he told Target 12 on Monday.
A spokesperson for Rhode Island Hospital parent Lifespan, Kathleen Hart, said in a follow-up email that the organization has required all employees to get vaccinated and is now “strongly encouraging” them to get boosters shots, as well. There are currently no plans to have employees work after testing positive.
“Lifespan employees who test positive for COVID-19 and are asymptomatic must stay home for five days and then can return to work,” Hart said. “If they have symptoms they must isolate while at home for the five days and may return to work if their symptoms have improved and they have been afebrile for 24 hours.”
“Lifespan employees who have been exposed to COVID-19 but are asymptomatic, may continue to work,” she continued. “If there is someone living in their household with COVID the employee must get tested at the direction of Lifespan’s Employee Health Services.”
Care New England, the state’s No. 2 hospital group, is also continuing to tell employees to stay home after testing positive, according to spokesperson Jessica McCarthy.
Lynn Blais, president of the United Nurses and Allied Professionals union, said her organization is “unequivocally opposed to the state’s decision” on bringing back COVID positive workers. UNAP represents more than 7,000 nurses and other health workers.
“First and foremost, we believe that it’s critically important to ensure a healthy workforce in which health care workers are not spreading the virus to other workers and, more importantly, to at-risk patients who are susceptible to the most harmful effects of the virus,” Blais said. “Second, this policy will likely come with the unintended consequence of exacerbating staffing shortages when more workers in hospitals become infected with COVID-19, get sick, and are forced to quarantine.”
Blais said employees who test positive should only return to work after five days if they are asymptomatic, have a negative test result, and wear a mask when they come back.
News of the state’s shift in policy also evoked criticism from some state lawmakers, including state Rep. David Place. The Burrillville Republican argued the new staffing policy shows the state’s decision last year to mandate vaccines among health care workers was a mistake.
“Why not admit we made a mistake,” he tweeted Monday.
Wendelken pushed back on the criticism, arguing the risk associated with a COVID-19 positive health care worker in protective gear is still far less than the alternative.
“An unvaccinated health care worker working in an acute care setting is at high-risk of being infected with COVID-19 themselves (especially given the high case rates right now), and transmitting during the pre-symptomatic stages,” he wrote in an email.
Rhode Island does not track internally how many people hospitals ultimately fired because of their vaccination status, but Wendelken cited Lifespan — the state’s largest hospital system — reporting publicly that it lost about 1% of its workforce as a result.
At Care New England, the second-largest hospital system, Wendelken quoted executive Dr. Raymond Powrie as saying the “vaccine requirements have actually helped stabilize the workforce because less illness among staff means fewer people having to miss work because of quarantining.”
“The hospitals actually came to the state and requested a vaccine requirement,” he added.
Wendelken did not immediately respond to a question about how many state workers have been laid off because of the vaccine requirement.