HEALTH ADVISORY

SUMMARY

• As rapid at-home COVID-19 testing continues to increase in our community, the Fairfax County Health Department (FCHD) wanted to highlight that current Virginia Department of Health (VDH) guidance directs patients to report positive results to their healthcare provider.
• Healthcare providers who receive a report of a positive in-home COVID-19 test result should provide the patient current guidance on isolation and direct them to notify their close contacts (further details listed in Suggested Actions section below).
• Healthcare providers should also report positive results electronically through the VDH Point-Of-Care (POC) portal or via Epi-1.
• Patients can also self-report their positive at-home result via this FCHD reporting portal and will be referred to a website with isolation guidance and information on notifying close contacts.
   

SUGGESTED ACTIONS

• Educate COVID-19 positive patients and provide updated isolation & quarantine guidance (general public)
  • The Centers for Disease Control and Prevention (CDC) updated isolation and quarantine guidance for the general population. People with COVID-19 may end isolation after 5 days if asymptomatic or if symptoms are resolving. They should continue to wear a mask when around others for an additional 5 days.  
  • If an individual has access to a test and wants to test, the best approach is to use an antigen test towards the end of the 5-day isolation period. Testing should be done only if fever-free for 24 hours without the use of fever-reducing medication and other symptoms have improved (loss of taste and smell may persist for weeks or months and need not delay the end of isolation). If the test result is positive, one should continue to isolate until day 10. 
  • These recommendations apply regardless of vaccination status.  
  • The isolation period was shortened from 10 days because current evidence shows that most SARS-CoV-2 transmission occurs closer to the onset of illness, generally in the 1–2 days before and the 2–3 days after symptoms begin.
  • Current FCHD public health guidance and a toolkit for identifying and notifying close contacts can be found here: www.fairfaxcounty.gov/health/novel-coronavirus/toolkit-slow-spread.
• Healthcare providers should report positive results electronically through the VDH Point-Of-Care (POC) portal or via Epi-1. 
  • If the at-home test has an app or portal that allows a patient to report test results to the manufacturer, the patient should be encouraged to complete the reporting process. For at-home kits that include CLIA-certified laboratory oversight, completing the manufacturer’s reporting process will ensure that results are electronically reported to VDH through the Association of Public Health Laboratories Informatics Messaging Services platform.

ADDITIONAL INFORMATION

• New CDC guidance for shortened isolation and quarantine applies to the general public and does not include residents of long-term care facilities or other congregate settings where 10 days of isolation are still required, or healthcare personnel who should follow the guidance, below. 

Updated Guidance for the Management of Healthcare Personnel with SARS-CoV-2 Infection or Exposure

• CDC released updated guidance for isolation and quarantine of healthcare personnel (HCP), decreasing their isolation time after infection with COVID-19. CDC also updated guidance for contingency and crisis management in the setting of significant HCP shortages. Healthcare facilities should implement the following guidance for HCP:
  • Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2
  • Strategies to Mitigate Healthcare Personnel Staffing Shortages            
  • Health Alert Network (HAN) Health Advisory
• Healthcare facilities including nursing homes may implement new CDC guidance for contingency and crisis conditions to shorten duration of work restrictions for HCP when needed to alleviate healthcare staffing shortages. 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. 
• Return to work for HCP with SARS-CoV-2 infection: Under conventional conditions, HCP with SARS-CoV-2 infection who are asymptomatic or mildly symptomatic with improving symptoms can return to work after 7 days with a negative test, and the isolation period can be further shortened if there are staffing shortages.