On June 25, 2020, the New York City Health Department updated its guidance on personal protective equipment (“PPE”) for health care personnel (“HCP”) and N95 respirators, in line with recent guidance from the Centers for Disease Control and Prevention (“CDC”). In addition, due to declining community transmission in New York City, the Department also revised its guidance on work restrictions for health care personnel following exposure to COVID-19. However, these guidelines may again need to be revised as the pandemic evolves.

HCP are now advised to use eye protection (goggles or face shield), in addition to face masks or higher level of respiratory protection, during all patient encounters, whether or not COVID-19 is suspected. CDC recommends this protection because most infections occur when the virus enters unprotected mouths, noses, or eyes, and pre-symptomatic and asymptomatic transmission of the virus has been demonstrated.

Due to shortages of N95 respirators, providers and facilities are encouraged to continue conservation measures, including extended use and reuse of N95 respirators, as appropriate. Moreover, providers and facilities should prioritize N95 respirators for aerosol-generating procedures or settings where such procedures are conducted frequently, such as intensive care units. For evaluation of patients with COVID-like illness, clinicians are still advised to use gloves, gown, face mask (or N95 respirator), and eye protection.

Asymptomatic health care personnel (“HCP”) exposed to individuals with COVID-19 in the healthcare setting (patient, visitor, other HCP) should be excluded from work for 14 days. Note, this is a departure from the Health Advisory issued by the New York State Department of Health on March 31, 2020, allowing asymptomatic HCP exposed to a suspected or confirmed case of COVID-19 to continue working if certain conditions were met, and excluding the HCP would result in staff shortages. Due to the current phase of the pandemic in New York City, exclusion of HCP from work has become more feasible.

Exposure is defined as any of the following:

    • HCP was not wearing a face mask or respirator and spent 15 minutes or more within 6 feet of a person with confirmed COVID-19;
    • HCP was not wearing eye protection and spent 15 minutes or more within 6 feet of a person with confirmed COVID-19 who was not wearing a face covering;
    • HCP did not wear all recommended PPE (gloves, gown, N95 respirator, and either goggles or face shield) when a procedure was performed that can generate aerosols (e.g., intubation, suctioning, high-flow oxygen, nebulizer).

HCP exposed to COVID-19 in the community are also recommended to self-quarantine for 14 days, unless directed otherwise by their employer. When excluded from work, asymptomatic HCP must self-quarantine for 14 days, and self-monitor for symptoms by taking their temperature twice daily. If they have a fever or other COVID-19 symptoms, HCP should contact their health care provider to arrange for assessment and COVID-19 testing. HCP should also notify their employer. If HCP is suspected or confirmed to have COVID-19, they should consult their facility’s policies and State requirements before returning to work. HCP may be eligible for a free hotel room through NYC’s COVID-19 Hotel Program, if unable to self-quarantine or isolate in their home.

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If you have any questions regarding this alert, please do not hesitate to contact us.

Putney, Twombly, Hall & Hirson LLP

 

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