Exemption from 14-day isolation period for health care workers causes confusion

As highlighted in recent media reports, health care workers and employers are continuing to receive mixed messages around the requirement for health care workers to self-isolate for 14 days following return for international travel.

BCCPA has previously issued a statement regarding the direction from the Provincial Health Officer (PHO) that essential health care workers are partially exempt from the 14-day isolation period.

To further clarify, health care workers returning from international travel should immediately physically and socially isolate themselves, as per the direction of the PHO and BC Centre for Disease Control. This means staying home and not going to work or school, and monitoring symptoms for 14 days after arrival in Canada.

Once physically isolated, health care workers are instructed to contact their employer(s) and report that they have returned from international travel. Only if the employer determines that the health care worker is essential to resident or client care, will the health care worker be permitted to return to work. When not at work, health care workers are directed to follow directions to socially isolate.

If a health care worker has returned from a high-risk area, they are still required to self-isolate regardless. High-risk areas currently include Iran, Italy and Hubei province in China. Additional regions may be added in the coming days.

Health care workers who are returning from international travel and have been determined by their employer to be essential to resident/client care are directed to take additional precautions to reduce the risk to their patients, colleagues, and the public should they become symptomatic, including:

  1. Self-monitor daily for signs and symptoms of illness;
  2. Wear a surgical mask at all times and in all areas of your workplace;
  3. Follow infection prevention and control protocols including diligent hand hygiene and the use of personal protective equipment when delivering patient care;
  4. Reduce close contact with other health care workers and avoid shared spaces where possible;
  5. Avoid close contact with others when traveling to and from work and between shifts; and
  6. Self-isolate at home on days when not required at their workplace.

Health care workers must also follow any directive from their employer to designate their one site of employment, if and when it is required by their local health authority.

For health care employers making critical decisions regarding staffing, the PHO has provided direction that “essential workers” are people who provide services that are considered critical to preserving life, health, public safety and basic societal functioning and who have been determined by the leadership of their organization, on an individual basis, to be critical to delivering these essential services.

Leadership teams are advised to establish thresholds beyond which the delivery of essential services becomes impossible and should only relieve a worker from the requirement to self-isolate if this threshold has been reached. The potential risk to the public, residents/clients and staff must be considered when relieving a health care worker of the 14-day isolation period requirement.

Other important information to take into consideration includes:

  • Where the person traveled, recognizing that many countries in the world are experiencing significant community transmission of the virus;
  • Duration and type of activity while away (family visit rather than attending an event involving a large gathering of people);
  • Whether the worker or any member of the worker’s household is displaying symptoms of illness. If a worker or any member of the worker’s household is displaying symptoms of illness, the worker or member of the household must be assessed by a health professional, and infection with SARS-CoV-2 ruled out before the worker may be considered for return to work; and
  • The work environment of the individual e.g. whether they work independently, outside or in a group setting, and the risk of the worker transmitting infection to co-workers.