The California Department of Public Health has recommended that all general acute-care hospitals in the state test healthcare staff weekly and test and monitor all patients being admitted.
In a letter sent to hospitals Nov. 25, Deputy Director Heidi Steinecker said hospitals should start weekly testing on Dec. 7 of healthcare workers who have risk of unknown exposure to COVID-19, such as those who work in emergency departments or intensive care units, and including environmental services employees. Weekly testing of other healthcare workers should begin Dec. 14. Any symptomatic workers should be tested immediately.
In an emailed statement, the health department said that all general acute-care hospitals are required to submit a testing plan to their local licensing district by Dec. 7 but did not address if there would be penalties for those that do not.
Hospitals should use virus nucleic acid tests for all patients. Antigen tests should only be used for symptomatic patients, unless there is a limited supply of virus nucleic acid tests. In that case, antigen tests can be used for asymptomatic patients and should be repeated every three days, the state health department said.
Hospitals also should develop a plan for how results will be used, the department said. That includes how results will be explained to workers; how results will be tracked and reported to local authorities; how to notify patients and workers with potential exposure; what to do about workers who refuse to be tested or can't be tested; and how to handle potential staffing shortages. The health department said workers generally should not work while in an isolation period and deferred to CDC guidelines on staffing shortages.
Jan Emerson-Shea, a spokesperson for the California Hospital Association, said the association is waiting for clarification from the state health department on what the recommendations mean and if there will be any kind of prioritizations for testing because resources are strained.
"If you had to test a half a million people every week, that's a very large strain on hospital resources at the very same time that we are experiencing a surge in patients." Emerson-Shea said.
People who would be doing the testing, nurses or those in clinical labs, are needed for clinical care of COVID-19 and non-COVID-19 patients, she said.
"There are just a lot of stresses on the healthcare workforce," she said.
The California Nurses Association called the new recommendations a "huge win" for nurses.
"This is an amazing and welcome move," said Zenei Triunfo-Cortez, a Bay Area nurse and a president of California Nurses Association and National Nurses United, a nationwide nurses union of which the California Nurses Association is a part. "We applaud California for being a leader in requiring this type of testing program because it is desperately needed to fight this virus. There are simply too many asymptomatic people with COVID, and without robust testing, our hospitals will remain centers for spreading the disease instead of centers of healing as they should be."
Cathy Kennedy, a Sacramento-area nurse, a president of California Nurses Association and executive vice president of National Nurses United, said the testing "was a long time coming.
"We nurses knew this was needed and fought together to make it happen. Now hospitals in the rest of the country just need to do the same to get this virus under control," Kennedy said.
As of Nov. 29, California had recorded 1.2 million COVID-19 cases and 19,141 deaths, according to the state COVID-19 dashboard.