Saturday, December 25, 2021

CDC HAN: Rapid Increase of Omicron Variant Infections in the United States: Management of Healthcare Personnel with SARS-CoV-2 Infection or Exposure


#16,553

Yesterday, in CDC Releases Emergency Guidance for Healthcare Facilities to Prepare for Potential Omicron Surge, we looked at newly revised guidance on quarantine and isolation durations for HCWs issued by the CDC in hopes of maintaining adequate staffing of healthcare facilities in the face of the expected Omicron  wave. 

Today the CDC has followed up this guidance with a HAN Advisory.
 
HAN messages (Alert, Advisory, Update, or Info) are designed to ensure that communities, agencies, health care professionals, and the general public are able to receive timely information on important public health issues.

I've reproduced the summary, and some excerpts, but follow the link to read it in its entirety. 


Rapid Increase of Omicron Variant Infections in the United States: Management of Healthcare Personnel with SARS-CoV-2 Infection or Exposure

Distributed via the CDC Health Alert Network
Friday, December 24, 2021, 7:00 PM ET
CDCHAN-00460

Summary

Due to the increased transmissibility of the SARS-CoV-2 Omicron variant and concerns about potential impacts on the healthcare system, the Centers for Disease Control and Prevention (CDC) is updating recommendations to enhance protection for healthcare personnel, patients, and visitors, and ensure adequate staffing in healthcare facilities. The guidance is based on the limited information currently available about the Omicron variant and will be updated as needed as new information becomes available.

Background

On November 24, 2021, a new variant of SARS-CoV-2, B.1.1.529 (Omicron), was reported to the World Health Organization(WHO). Current COVID-19 vaccines are expected to protect against severe illness, hospitalizations, and deaths from infection with the Omicron variant. Omicron might cause more breakthrough infections than prior variants, and some studies have found lower effectiveness of the primary series of vaccines against infection (1-3).

On December 1, 2021, the first case attributed to Omicron was reported in the United States. Omicron has now been reported in all 50 states. CDC has been working with state and local public health officials to monitor the spread of Omicron in the United States and has identified a rapid increase in infections consistent with what has been observed in other countries. Multiple large clusters of Omicron variant cases have demonstrated the rapid spread of the virus. Holiday-related travel and gatherings may further accelerate these trends. Plausible scenarios include steep epidemic trajectories that would require prompt public health action to prevent severe impacts on the health of individuals and healthcare systems.

The clinical severity profile of Omicron infection will strongly influence its impact on U.S. hospitalizations and deaths. Early data suggest Omicron infection might be less severe than infection with prior variants (3,4); however, reliable data on clinical severity remain limited (5). Even if the proportion of infections associated with severe outcomes is lower than with previous variants, a rapid, large increase in the number of infections could still result in many people with severe outcomes requiring medical care and hospitalization in a short period. Demand for ambulatory care, supportive care for treatment of mild cases, and staffing shortages resulting from work restriction of healthcare personnel with SARS-CoV-2 infection or with higher-risk exposures could also stress the healthcare system.

Maintaining appropriate staffing in healthcare facilities is essential to providing a safe work environment for healthcare personnel and safe patient care. CDC’s mitigation strategies offer a continuum of options for addressing healthcare staffing shortages and are meant to be implemented sequentially. These strategies were updated on December 23, 2021. If conventional strategies cannot be sustained during a surge in cases, facilities may consider implementing contingency strategies, then crisis strategies, in an incremental manner. Facilities are best positioned to evaluate their own needs as to whether conventional, contingency, or crisis strategies are most appropriate at a given time.

Consider options to address a healthcare surge by shortening the duration of work restrictions. When staffing shortages are anticipated, healthcare facilities and employers should plan and prepare to address these shortages in collaboration with staff leadership, human resources, and occupational health services. This can include adjusting staff schedules, hiring additional healthcare personnel, and rotating personnel to positions that support patient care activities. It can also include modifications in practices for work restrictions of healthcare personnel who have had higher-risk exposures to SARS-CoV-2 or who have been infected with SARS-CoV-2, as described below. Conventional, contingency, and crisis strategies to mitigate staffing shortages are described in CDC guidance and are intended to allow flexibility to maintain adequate staffing for safe and effective patient care while minimizing the risk of SARS-CoV-2 transmission in healthcare facilities. Protecting the health and safety of healthcare personnel remains critical and includes ensuring the recommended personal protective equipment (PPE) is available and that healthcare personnel are trained to use it properly.