Employee testing positive for Covid and protocol

Good afternoon. I practice in the West Coast where Covid is starting to ramp up! Just this week, I was informed that a pediatric practice and subspecialty pediatric practice each had an employee test positive. The pediatric practice closed its doors, mandated that all employees be tested for covid and the owner called all patients that were exposed. The subspecialty office called their exposed patients (how I found out due to mutual patient) but not sure of any other measures.

My question is: what steps have other private practices done once they are informed there has been an employee testing positive? If a medical practice is wearing appropriate PPE all day, what actions would private practice partners take with their employees and patients? I would appreciate everyone’s opinions. I live in Nevada, if that matters.

Thank you!

Please refer to the CDC GUIDELINES regarding HCP health care personnel “exposure and risk assessment” which has been recently updated as per the link copied below .
Depending on the local COVID 19 infection rates , the symptomatic or a symptomatic positive test employee will need to be excluded from work for the specified period. But I am not sure that “closing a practice” is either recommended by any authority or the most appropriate response for pediatric practices. We need to focus on exposure control and at the same time , continue providing services .

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adiqad20-Thank you so much! Agreed about focusing on exposure control at same time providing services. I wanted a good protocol if this scenario occurred in our office. Have a great day!

The CDC guidelines are very clear on this. You do not close your doors. The symptom based strategy for return is preferred since some will test positive for a long time.

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My gut instinct was this. I will share articles with my fellow local peds docs. The owner was very concerned as being blamed for spreading it. CDC info is very helpful! My PPP loan is about done and wanted action plans for this event in future. I am looking into the new aid for all of us to make sure I qualify too! Thank you too ssirota!

This just happened to me yesterday. I am in Texas and a small practice. One of my MAs tested positive. All staff are wearing masks all day, although some pull them down occasionally to “breathe” or drink. Mask and eye protection with every patient and everyone entering the building wears a mask except for those under 2. From the CDC website, I believe we can stay open and everyone continue to wear masks and report symptoms/check fever daily. We all are being tested too. Looking forward to the health department’s input when they open tomorrow.

Dr Tomberlin
We are also in Texas

  1. You stated “we are all being tested” What test are you doing? Covid PCR for all including asymptomatic employees?; IgG/IgM?
  2. What about all patients who came in contact with your employee? Patients who were in that day? Are you informing them? Are you testing them?
  3. What about the clinic and “deep” cleaning? Is the clinic open?
  4. What about sick leave for the employee who was positive?
    We have not had a case, but a local chick-fil-A had a positive employee and shut down.

Although testing has become more available, we are still not able to obtain the rapid COVID test. Where are practices getting the rapid test?

Just reiterating something that Dr. Tomberlin stated above, make sure you are staying close communication with your state and local health departments as you develop your plan of action and communications with staff and patients.

Would love the know the answers to these questions!

  1. We were all tested with the NAAT test through QUEST. Even asymptomatic employees. This was not mandated by the health department but my employees felt better seeing a negative test. Lots of teaching being done with them. We had 3 employees with mild symptoms who were held out of work until their tests came back negative. Everyone came back with a negative test and nobody is showing symptoms, now nearly 2 weeks later.
  2. The health department instructed us that we did NOT need to contact patients due to the very low risk of exposure with her wearing a mask, gloves and eye protection (mostly mask made the difference) and all patients and parents over 2 wearing a mask.
  3. Yes, we stayed open. We clean all surfaces between every patient, including chairs, table, counter, sink, door handles. We currently don’t have any toys in the rooms. With the latest data showing the low likelihood of transmission through surfaces, I felt comfortable with our current practices. The health department did not mention anything more to do either.
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Dr Tomberlin

Thank you for you response. What is the turnaround for the Quest test?

Mr. S. Ramchandra
Bay Colony Pediatrics
2251 Fm 646 Rd West, Ste 155
Dickinson, Texas 77539
281-614-2445

They quoted us 5-8 days. We got results in 4-5 days. We have gotten a little bit quicker turnaround time with LabCorp (usually 3 days). We are getting some of the Quidel tests for Sofia machines this week so will have immediate results soon

Do you take Texas Medicaid? What CPT are you going to use for Sofia Antigen tests? What ICD code will you use if patients has no symptoms but just wants test for exposure, or clearance, and the test is negative? Texas Medicaid is not paying for Z11.59, Z03.818, Z20.828.

I don’t take Medicaid. I am charging cash for the test right now, as the code given is not recognized by most payers since it is so new.

Have you been able to get an answer to what is the sensitivity and specificity of results from Sofia machine?