DOH Clarifies Guidance on False Positive Antigen Tests and Work Exclusion
On an association call on Oct. 22nd, the Department of Health (DOH) responded to questions posed by LeadingAge NY related to the exclusion of staff from work in three different scenarios: after positive antigen tests, asymptomatic with community exposure, and presentation with common cold symptoms.
Positive Antigen Tests: Recognizing the potential for false positive test results using antigen tests, LeadingAge NY asked how the DOH antigen test algorithm relates to staff furlough and visitation requirements. DOH provided the following directions:
- The purpose of the algorithm for antigen tests is to minimize the impact of false results.
- If a staff member or resident in a nursing home or adult care facility (ACF) without an outbreak has a positive antigen test which is immediately contradicted by a negative PCR test (i.e., PCR test performed within 48 hours of antigen test and results returned within three days of POC test), DOH presumes the antigen test result is false.
- The facility should:
- Report the positive case on the daily Health Emergency Response Data System (HERDS) survey.
- Submit a specimen for PCR testing and exclude the staff member from work until a negative PCR result is obtained.
- If the PCR result is negative, the staff member may return to work upon receipt of the negative test result and does not need to be furloughed for 14 days.
- Suspend visitation until the PCR test result is received. If the PCR result is negative, visitation may be resumed.
Asymptomatic Staff Who Are COVID-Negative and Exposed in Nursing Homes: DOH acknowledged that there is a gap in its guidance with respect to nursing home staff who test negative, have no symptoms, but are notified that they have been exposed through contact in the community. While the July guidance for all other settings permitted organizations to exempt such employees from furlough if certain conditions are met, the April 29th nursing home guidance does not address this situation. DOH instructed facilities to refer to the first section of the March 31st guidance (this guidance was superseded by July 24th guidance for other settings), which provides that the employee may continue to work if furlough would create staffing shortages and other conditions are met. DOH noted that although this is the current guidance, they have significant concerns regarding staff who are exposed to COVID-19 continuing to work in a nursing home without a 14-day furlough.
Nursing Home Staff with Cold Symptoms: The nursing home work exclusion guidance issued on April 29th requires facilities to exclude workers who are symptomatic for 14 days. However, if a staff member has cold symptoms that mimic some COVID-19 symptoms, but tests negative, they may return to work once symptoms clear up and they are fever-free for three days without medication. There is no need to exclude them from work for 14 days. If a physician suspects that, notwithstanding a negative test result, the staff member has COVID-19 (e.g., staff member loses sense of smell), the physician can make them a suspect case, and the staff member should stay out of work for the full 14 days (with three days fever-free).
Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838