On 23rd July a framework was issued facilitating the return of fully vaccinated health and social care staff to work in exceptional circumstances following close contact with a person with COVID-19, HSSMD(49) 2021 https://www.health-ni.gov.uk/sites/default/files/publications/health/doh-hss-md-49-2021.pdf. This was within the context of the advice for the general population in respect of self-isolation for close contacts which applied at that time.
As of August 16th the advice to the general population has changed. In Northern Ireland individuals who have been fully vaccinated (more than 14 days since they received the second dose of an approved COVID-19 vaccine) and have been in contact with someone who has tested positive for COVID 19 are exempt from the requirement to self-isolate. In addition contacts are advised to get a PCR test on day two and day eight of the 10 day period following last contact with the positive person.
https://www.nidirect.gov.uk/articles/coronavirus-covid-19-self-isolating
It is important to ensure appropriate safeguards and protections for patients who may be more vulnerable to COVID-19. Hence this communication outlines a process of risk assessment and mitigation for Health and Social Care staff, particularly those working with immunosuppressed and clinically extremely vulnerable (CEV) patients.
As of the date of this letter, fully vaccinated Health and Social Care workers will be permitted to attend work under the new measures pertaining to the general population as outlined above. Employers no longer need to demonstrate that the service is in extreme circumstances to ask employees to return to work.
Fully vaccinated staff who are identified as a contact of a positive COVID-19 case will no longer be expected to isolate and can to return to work in most circumstances. However, it is important the following safeguards are implemented for them do so safely:
- The staff member has had two doses of an approved vaccine, and is at least two weeks (14 days) post their second vaccination at the point of exposure.
- A negative PCR test prior to returning to their workplace. Staff should not attend work while awaiting the PCR test result. A subsequent PCR test should also be undertaken at day 8 following exposure to the case of COVID-19.
- Provision of subsequent, daily negative LFD antigen tests for a minimum of 10 days following their last contact with the case each day before commencing a shift.
- LFD test results should be reported to Test and Trace via the web portal and to their duty manager or an identified senior staff member). Any close contact who has a positive LFD test should self-isolate and arrange a PCR test.
- If a staff member has had a SARS-CoV-2 infection in the past 90 days, they should not have a PCR test and should only undertake daily LFD antigen tests (as above).
- The staff member is and remains asymptomatic.
- Continued use of IPC measures, in line with the current UK IPC guidance and appropriate to the service setting to which the staff member is returning.
- The staff member does not have ongoing contact with the person who tested positive for COVID-19, for example, they do not live with them. The staff member should remain off until 10 days have elapsed following exposure to a household contact.
- The staff member should be given information about COVID-19 symptoms and asked to self-check for symptoms every day. If the staff member develops any COVID-19 symptoms they should stay at home and immediately arrange a PCR test.
