Omicron Guidance Updates

COVID-19 Inpatient Isolation Guidance Update

January 12, 2022

Situation: COVID-19 units are nearing capacity

Background: Omicron variant of COVID-19 is spreading rapidly in the community resulting in increased numbers of patients requiring COVID-19 isolation precautions. Isolation practices at NMC have purposefully been conservative. Numerous organizations (CDC, ECDC, WHO) recommend shorter durations of isolation for certain patients.

Assessment: We are able to safely discontinue COVID-19 isolation in selected patients and thereby preserve capacity for isolation for patients at risk of transmitting disease. Shortening isolation for certain patients will allow us to continue to provide COVID-19 level precautions for those who must remain in isolation.

Recommendation: Adopt this revised COVID-19 inpatient isolation guidance.

All new COVID-19 infections will be assumed to be the result of the omicron variant. Because of the transmissibility of omicron, beginning Friday, Jan. 7, we will test patients who require a hospital admission or are scheduled for a procedure or a surgery, including those who experienced a COVID-19 infection within the last 90 days. There are no changes to the list of procedures that require changes.

Beginning Friday, Jan. 7:

  • All patients admitted to the hospital will continue to be tested for COVID-19, but we will now include those who experienced a COVID-19 infection within the last 90 days
  • Patients scheduled for a procedure or surgery on Monday, Jan. 10 or later, must be tested for COVID-19, including those who experienced a COVID-19 infection within the last 90 days. There are no changes in the list of procedures that require testing
  • Patients with acute COVID-19 infection occurring on or after Friday, Jan. 7, will be managed as previously with deferral of repeat testing for 90 days

Updated guidance due to omicron

Additional notes for health care teams:

  • All patients with elective procedures included in pre-procedure testing scheduled on Monday, Jan. 10 or later, will require COVID-19 testing
  • If there is any concern, clinically or with possible exposure to COVID-19, we strongly encourage repeat testing for COVID-19
  • Patients who have had COVID-19 in the last 90 days may test positive for a prolonged period of time. In this setting, if the procedure is urgent/emergent, it can proceed under COVID-19 precautions as per prior protocols. If the procedure can be delayed, a physician can defer for 21 days as per past protocols. Finally, if you would like to reschedule earlier than 21 days, please contact COVID ID and a decision can be made on the value of repeat testing to attempt to ascertain if this is persistent viral shedding from a past delta infection or a new infection with omicron.
  • For new admissions with a positive screening test, if concerns arise regarding if this is an old, or new infection, please contact COVID ID for further assessment
  • There are no changes to duration of isolation or exit of isolation policies for the inpatient setting. If a patient is within 21 days of a COVID-19 infection, they should be in COVID-19 precautions in the hospital (regardless of if they exited CDC home-based isolation). Earlier exit from isolation can occur through established protocols only

Please review this SBAR for more information.