COVID-positive employees can work after Eleanor Slater Hospital declares staffing 'crisis'

PROVIDENCE — The state-run Eleanor Slater Hospital has declared a staffing crisis and put employees with "mild symptoms" of the virus that causes COVID-19 back to work. .

A memo obtained by The Journal on Monday advised employees that "We have officially notified [the Rhode Island Department of Health] that we are in such a staffing situation."

The memo went out on New Year's Day, at a point when the Department of Health was publicly stating that no hospital in the state had declared the need to bring back infected employees.

"No, no facility has reported to us yet that they are in a position that requires COVID-19 positive health-care providers to be working. If a facility does reach that point, that information would be posted publicly so patients and families would be aware," Health Department spokesman Joseph Wendelken told The Journal over the weekend.

On Monday, Wendelken told The Journal that information was accurate then, but fluid.

When Monday began, for example, he reported the Respiratory and Rehabilitation Center of Rhode Island, a nursing home in Coventry, was "using asymptomatic staff that recently tested positive." By mid-morning, he said, the nursing home was no longer in “crisis."

Elaborating, Lori Mayer, a spokeswoman for the 134-resident nursing home, said the facility had "one asymptomatic COVID+ employee working on the center's COVID+ Unit" over the weekend, at a point "a number of staff members were out with COVID." They have since returned to work, she said.

Wendelken initially told The JournaL "Eleanor Slater Hospital had one asymptomatic staff person who recently tested positive on site on Saturday, and one worker on site on Sunday." He said none were there Monday.

On Tuesday, however, a spokesman for the state agency that runs the Slater hospital reported the hospitals actually "utilized two asymptomatic COVID-positive staff members on Saturday, Jan. 1, and three on Monday, Jan. 3. This corrects earlier numbers that were shared with the Department of Health.

"As of 12:30 p.m., there are no covid-positive staff working today,'' the spokesman Randal Edgar said.

"These people on Saturday and Sunday were masked,'' Wendelken said, "and facility administrators communicated that they would try to have them only caring for COVID-19 positive patients."

Despite that assurance, Pam Costello, the mother of one long-term patient on the Zambarano campus, was upset that she was not notified of the new policy and deeply concerned for her son, Jason Gagnon.

"What a dangerous situation to expose patients who are already compromised," she told The Journal. "I know in my son Jason’s case, who is very prone to severe lung infections, if he was to contract COVID from one of these workers, it could KILL him."

"Not only are patients in danger, but the workers who are healthy are being put in danger of contracting COVID and possible bringing it home to their families," she said. . "I was not allowed to even visit my son...over the holidays because I was exposed to a friend who may have been exposed to COVID but tested negative."

Lynn Blais, president of the United Nurses and Allied Professionals (UNAP), representing more than 7,000 nurses and health professionals, said her union "is unequivocally opposed" to the state’s decision to allow COVID-19 positive health-care workers to work.

"First and foremost, we believe that it's critically important to ensure a healthy workforce in which health-care workers are not spreading the virus to other workers and, more importantly, to at-risk patients who are susceptible to the most harmful effects of the virus."

"Second, this policy will likely come with the unintended consequence of exacerbating staffing shortages when more workers in hospitals become infected with COVID-19, get sick, and are forced to quarantine."

"The UNAP believes that only health care workers who are asymptomatic, have a negative test, and continue to wear a mask should be returning to the workforce after 5 days." .

More: RI Health Dept. opens door for COVID-infected staff to work at hospitals, nursing homes

Eleanor Slater Hospital, with 200 medical and psychiatric patients on two campuses in Cranston and Burrillville, has been on the verge of a staffing crisis for some time.

It had not, as of Monday morning, posted the required notice on its website that it had any COVID-infected employees taking care of any patients over the weekend.

The state agency that runs Eleanor Slater Hospital has not responded to inquiries.

The new crisis-staffing policy was posted quietly by health officials late last week.

Mirroring guidance from the CDC, the new Rhode Island policy allows hospitals and nursing homes to bring asymptomatic and "mildly symptomatic" employees back to work – without any waiting period – if they reach a point where the facilities are in a staffing crisis.

Wendelken, the Health Department spokesman, said the new CDC guidance "is reflective of science that indicates that most SARS-CoV-2 transmission occurs early in the course of illness."

"For healthcare providers, the CDC is recognizing that states across the country are experiencing healthcare worker shortages. If a facility is experiencing a significant staffing challenge, facility administrations may make a determination on the need to have ... COVID-19 positive healthcare providers work.

"However, asymptomatic or mildly symptomatic workers should be considered first in these instances, and of course masks are required."

"Also, facility administrators should be using their clinical judgement in making staffing decisions. For example, a facility may opt for a COVID-19 positive worker to only care for COVID-19 positive patients."

After The Journal brought the Health Department posting to light over the weekend, Twitter lit up with questions, statements of concern and in some cases condemnation.

Republican state Sen. Jessica de la Cruz tweeted: "RIDOH will allow health-care staff who test positive w/COVID to work but not unvaxxed health-care staff who test negative?! Its time for the state to admit its mistake. We need all hands on deck to address the health-care crisis. Rehire these qualified & experienced professionals."

Why not bring back "healthy, unvaccinated workers" before employees with known COVID infections?

Wendelken's answer: "An unvaccinated health-care worker is at greater individual risk, given how many COVID-19 positive patients are in facilities.

"Additionally, someone who is vaccinated and who tested positive for COVID-19 has a much lower viral load, compared to someone who is COVID positive and unvaccinated. This means that the likelihood of transmission is much less."

A spokeswoman for Care New England said its hospitals, which include Butler, Kent and Women & Infants Hospitals, are not using COVID positive workers at this time.

But "this may change in the future, due to the rising number of COVID infections and hospitalizations throughout the state of Rhode Island,'' spokeswoman Raina Smith said.

A spokeswoman for the Lifespan network spelled out tiered rules, none of which allow an infected employee, symptomatic or asymptomatic, to return to work for at least five days.

Tier One: "Lifespan employees who test positive for COVID-19 and are asymptomatic must stay home for five days and then can return to work." Tier Two: "If they have symptoms they must home for the five days'' and only return "if their symptoms have improved and they have been [without a fever] for 24 hours."

"Lifespan employees who have been exposed to COVID-19 but are asymptomatic may continue to work," spokeswoman Kathleen Hart said.

John Gage of the Rhode Island Health Care Association, which represents the majority of nursing homes in the state, said he was unaware of any using COVID infected staff.

"That said, RI nursing homes are in the midst of a critical staff shortage,'' he said. "There simply are not enough applicants to fill vacant positions.

"Facilities have quadrupled their use of staffing agencies ... [Many] charge exorbitant rates that, in some cases, amounts to price gouging – i.e. charging a $30/hour premium if staffing a facility with any covid cases for the duration of the 'outbreak” or else they will pull their staff altogether to send them elsewhere for the premium.

"It is out of control."

This article originally appeared on The Providence Journal: RI hospital COVID-positive employees can return due to staff shortage