As hospitals are becoming overwhelmed with COVID-19 patients, North Dakota is permitting coronavirus-positive health care workers to continue assisting patients.
The guidance stipulates that the health care workers must remain asymptomatic and take enhanced precautions in order to stay on the job. This comes as travel nurses are stretched thin as dozens of states are reporting record hospitalizations.
Given the situation in North Dakota and elsewhere, it is possible more states will have to follow suit and continue using infected staff members in order to provide care. The CDC has spelled out guidance in these situations.
The CDC says hospitals must exhaust a number of other guidelines, including adding travel nurses, postponing elective medical procedures, and postpone elective time off, before going into a crisis staffing situation.
“If shortages continue despite other mitigation strategies, consider implementing criteria to allow HCP (health care personnel) with suspected or confirmed COVID-19 who are well enough and willing to work but have not met all Return to Work Criteria to work,” the CDC’s guidance states. “If HCP are allowed to work before meeting all criteria, they should be restricted from contact with severely immunocompromised patients (e.g., transplant, hematology-oncology) and facilities should consider prioritizing their duties in the following order:
1. If not already done, allow HCP with suspected or confirmed COVID-19 to perform job duties where they do not interact with others (e.g., patients or other HCP), such as in telemedicine services.
2. Allow HCP with confirmed COVID-19 to provide direct care only for patients with confirmed COVID-19, preferably in a cohort setting.
3. Allow HCP with confirmed COVID-19 to provide direct care for patients with suspected COVID-19.
4. As a last resort, allow HCP with confirmed COVID-19 to provide direct care for patients without suspected or confirmed COVID-19.”
North Dakota Gov. Doug Burgum spelled out the challenges facing his state.
“Our hospitals are under enormous pressure now,” Burgum said. “We can see the future two, three weeks out, and we know that we have severe constraints.”
Despite Burgum’s warning, his state is among the ones not to issue an order requiring masks in public places.
In update CDC guidance, the agency says that masks can reduce the viral load for the wearer, in addition to prevent the spread of the virus.
Steven Weiser, MD, president of Altru Health System in Grand Forks, North Dakota,, wrote in an op-ed about the toll the virus is having on workers.
"Your neighbors in healthcare are pleading with you – they are tired, they are covering shifts for their colleagues who cannot work, they are working in new areas and rallying together to ensure that our promise of providing care to our community is upheld," Weiser wrote. "I ask you, on behalf of our team of healthcare workers, to please take the recommendations... very seriously. This is about protecting our at-risk community members and friends. We need your partnership to stop the spread, now. Doing so will save lives."