MOH tackles staff shortage with reduced quarantine for Covid infected

 

The Health Ministry has again relaxed quarantine rules for healthcare workers in a bid to tackle staff shortages at its facilities, this time for personnel who have already tested positive for Covid-19.

Its director-general Dr Noor Hisham Abdullah (above) issued a circular, dated March 21, stipulating that in the event of a “human resource crisis”, healthcare workers down with Covid-19 may be required to return to work early.

For healthcare workers who are in Category 2 (symptomatic, no pneumonia) in terms of their Covid-19 severity, they may be required to return to work on the sixth day after the onset of symptoms, provided that they test negative using an RTK-Ag test on Day 5.

The symptoms must have substantially resolved by then and at least 24 hours have passed since the last fever, without the use of fever-reducing medications.

If they still test positive on Day 5, however, quarantine should be continued as usual.

As for healthcare workers without symptoms, they may be required to return to work on Day 6, after their first positive test, with no further testing required.

The protocol titled “Management of healthcare worker confirmed with Covid-19 in the event of a human resource crisis” was posted on the Health Ministry website yesterday.

Both categories of healthcare workers are required to follow return-to-work standard operating procedures (SOPs) spelt out in an earlier document.

Among others, the return-to-work SOPs stipulate that affected healthcare workers must wear a well-fitted three-ply surgical face mask when in close contact with other colleagues if physical distancing is not possible, and they should continue self-isolation at home after work.

No sharing of closed, confined spaces

They are explicitly forbidden from sharing closed, confined spaces with other colleagues, such as being unmasked in the pantry, the on-call room or the prayer room.

When it comes to patient care, they must wear ‘appropriate’ personal protective equipment in all clinical areas and strictly adhere to hand hygiene, respiratory hygiene and cough etiquette. They are also not allowed to care for immunocompromised patients.

For comparison, the isolation period of members of the public infected with Covid-19 is seven days for those who are vaccinated and 10 days if they are unvaccinated or partly vaccinated. There are no testing requirements for release or any return-to-work SOPs for the public.

Multiple studies have previously shown that Covid-19 patients are infectious beginning around two days before the onset of symptoms or the first positive test (for asymptomatic patients).

After developing symptoms or first testing positive, they gradually become less infectious over the next 10 days or so. Vaccinated individuals usually clear the infection several days earlier than their unvaccinated counterparts.

Widespread staff absences 

In the circular sighted by Malaysiakini, Noor Hisham cited widespread staff absences due to Covid-19 as the reason for introducing the new rules.

He said there were 3,343 healthcare workers infected with Covid-19 in the week beginning Feb 6, rising to 8,966 during the week beginning Feb 20, and 13,866 during the week beginning March 6.

“On March 15, it was found that 16,558 healthcare workers were unable to work because they needed to undergo isolation or receive hospital treatment due to Covid-19 infection.

“Such healthcare worker absences have caused disruption to the delivery of healthcare and medical services to patients,” he added.

Hospital directors and district health officers are in charge of assessing whether there is a human resource crisis to justify invoking the shortened quarantine period, based on an assessment of factors such as patient load and the number of available staff.

Other measures must also be taken to address the shortage, such as by adjusting staff schedules and mobilising staff from other facilities.

It is unclear whether such a crisis has already occurred during the Omicron variant wave or the new rules were introduced in anticipation of a future need.

Malaysiakini has contacted the Health Ministry for comment yesterday and has yet to receive a response.

Last month, the news portal reported that the ministry introduced new quarantine rules for healthcare workers who had close contact with Covid-19 patients, in a bid to address staff shortages.

Among others, healthcare workers with “low risk” close contact but have no symptoms are not required to quarantine or undergo testing at all and can return to work immediately, though they must monitor their symptoms for the next 14 days.

At the time, members of the public who become close contacts with those infected with Covid were required to quarantine between five and 10 days, depending on their vaccination status.

Asymptomatic close contacts who had their Covid-19 booster shots only become exempt from quarantine from March 1, though they must take a self-test on the first and third days after their exposure. - Mkini