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
- Pre-procedural COVID-19 testing algorithm
- Addendum A - Isolation Duration Guidance Outpatient and Inpatient COVID-Flu
- Inpatient isolation guidance
- Ambulatory isolation guidance algorithm
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