COVID-19 Screening Update – What has Changed and What you Need to Know

We have all heard the phrase “We are getting tired but the virus is not”. This couldn’t be more true for everyone from children to adults, employers and business owners, as well as those that need to be more careful as they are immunocompromised or care for those that are. We are tired; tired of being socially distant, tired of wearing masks, tired of working remotely, and overall just plain tired. The virus is not tired; its spreading like a wildfire, it has mutated, and it is taking loved ones from us.

As I prepare this article I noticed New Hampshire was listed as having an increase in cases again. The low numbers for a couple weeks make us think we are out of danger but all those numbers did was to make people think they don’t need to be careful. Now more than ever we need to be careful.

On July 22^nd the NH Division of Public Health Services a Department of Health and Human Services and the Bureau of Infectious Disease Control released “New Hampshire COVID 19 General Travel and Quarantine Guidance, & Employer Screening and Exclusion Criteria”. This document has changes in the screening question employers are asked to review with employees when they come in to work. The new recommendations are as follows.

Employee Illness and Risk Screening

Facilities and businesses should ask screening questions to assess risk for COVID–19 every day before an employee is allowed to work.

Questions include:

• Do you have any symptoms of COVID-19 or fever of 100.4 degrees Fahrenheit or higher? The symptoms of COVID–19 can include:
  • Fever, or feeling feverish;
  • Respiratory symptoms such as runny nose, nasal congestion, sore throat, cough, or shortness of breath;
  • General body symptoms such as muscle aches, chills, and severe fatigue;
  • Gastrointestinal symptoms such as nausea, vomiting, or diarrhea, and
  • Changes in a person’s sense of taste or smell

• Have you had close contact with someone who is suspected or confirmed to have
  COVID-19 in the prior 14 days?
• Have you traveled in the prior 14 days outside of New Hampshire, Vermont, Maine, Massachusetts, Connecticut, or Rhode Island?

After the Screening: What’s Next?

Employee Exclusion

Person(s) with any new or unexplained COVID–19 symptoms (even if only mild symptoms), those who report close contact with someone suspected or confirmed with COVID–19 , or those reporting travel risk factors should not be allowed in the facility:

• Symptomatic persons should be instructed to contact their health care provider to be tested for COVID–19 and self isolate at home following the instructions below.
  
  
• Asymptomatic persons reporting close contact with someone suspected or confirmed with COVID–19, or who report one of the travel-related factors should self quarantine for 14 days from their last exposure or return from travel.
  
  
• Person(s) with suspected or confirmed COVID–19 must isolate at home until symptom-based criteria are met for discontinuation of isolation:
  • At least 10 days have passed since symptoms first started *,
    AND
  • At least 24 hours have passed since last fever (off any fever reducing medications),
    AND
  • Symptoms have improved.
    
    
  • *Also – patients with severe to critical illness or who are severely immunocompromised must isolate for 20 days this also goes for asymptomatic severely immunocompromised patients who test positive 

Businesses have been doing a great job screening their employees and customers but the screening will not be thorough enough if they are not aware of the changes. What do these changes mean for businesses as we screen our staff? How can we keep them informed?

• Consider sending an email or memo to your staff explaining the changes: Your employees may not be aware of the new changes to the screening questions.
  
  
• Implement a remote working plan for those who need to isolate for 14 days after travel: The travel questions may come as a surprise to some and despite the location of their summer vacation they may not understand the need to self isolate if they have traveled outside New England.
  
  
• Recommend that your employees follow up with a health care provider: The addition of gastrointestinal symptoms and aches may seem general but in those that seem asymptomatic and have mild symptoms may in fact be positive for COVID–19. If they answer yes to any of the questions they cannot enter the facility and should follow up with their health care provider.

We are at a crucial crossroads with the virus right now; it has gained strength with experts commenting on the contagiousness is increasing so we need to “not be tired”. Businesses need to adhere to the guidelines for screening employees and customers; it's what we can do to help fight this.

Marta J. Silakka RN, BSN, CCM, COHN-S

NHADA – WCT

The NH Department of Health and Human Services, Division of Public Health Services, Bureau of Infectious Disease Control – COVID–19 Employee Guidance July 22, 2020 bulletin was used as a resource for this article.