Trumbull County Job & Family Services union employees said they want clear return-to-work guidelines for those who test positive for COVID-19.
Right now, they said they’re getting mixed messages from county commissioners who don’t want workers to bear the unfair burden of finding tests and waiting for results and from department heads who said they’re responsible for keeping other employees safe.
“We’re getting two different stories and we’re caught in the middle,” said JFS case worker and union President Marcelle Raphtis during a Jan. 5 commissioners meeting.
Agency employees who test positive for COVID-19 have been required to show their infection has resolved with a negative PCR test result before they can come back to the office.
“I have to have something that indicates they are OK. I cannot mandate masks, but I highly recommend they have masks. I also recommend they sanitize,” JFS Director John Gargano said during the meeting.
“Now the [U.S. Centers for Disease Control and Prevention] is saying COVID testing before ending isolation is the ‘best approach.’”
As CBS News reported last week, the CDC at the end of December updated its COVID isolation guidelines, shortening the period to five days for those who aren’t exhibiting COVID-like symptoms, and recommended those in quarantine receive a negative result from an at-home rapid test before ending isolation — but it didn’t make those tests a requirement.
Under CDC guidelines, businesses are not required to have employees show a negative COVID-19 test to return to work, though the CDC recommends testing negative before leaving isolation.
But the national testing infrastructure is currently outstripped amid the coronavirus’ extremely contagious omicron variant and a nationwide shortage of materials reported Wednesday by the Ohio Department of Health. Test samples are taking longer to be analyzed, appointments are harder to book and at-home tests are flying off shelves.
Meanwhile, JFS employees are burning through their personal sick leave while waiting to be cleared for work.
Tests are at a premium
The data reported on the state’s coronavirus testing dashboard is now several days behind due to “unprecedented” levels of testing.
About 60,000 Ohioans took coronavirus tests each day this past week, Dr. Bruce Vanderhoff, ODH director, told reporters Wednesday. There were nearly 90,000 tests performed Jan. 5 — the most in a single day since the pandemic began.
Though the Ohio Department of Health has distributed 5.6 million free, over-the-counter COVID-19 rapid tests since the pandemic began — including 1.4 million just in December — a nationwide shortage of testing supplies has slowed future distributions, according to a Wednesday news release.
The department is now waiting on more than two-thirds of the 1.2 million kits it ordered for January. The tests it’s distributing now will be prioritized for K-12 schools and colleges and universities until statewide inventory stabilizes, meaning fewer for local health departments and library distribution sites, at least for now.
“In Cincinnati, I don’t think you can find a rapid test in any pharmacy. Libraries are out of them all the time now,” Dr. Jennifer Forrester of University of Cincinnati College of Medicine said during a Thursday media briefing on COVID-19, hosted by the Ohio Department of Health.
She recommended Ohioans who are seeking a test reach out to their primary care providers.
“I know that may be more difficult for people in the more rural areas. The mass testing sites are in more urban areas,” she said. “Touching base with your health care provider may [offer] a way to get tested. … They may not be as quick as the antigen test, but again, a piece of the information you need.”
Trumbull’s policy confusing
A Jan. 5 resolution approved by commissioners Niki Frenchko and Frank Fuda appeared to settle the testing dispute by striking down the JFS requirement, but county administrators are still confused about what was actually passed and whether the policy still stands.
Though Fuda opted to table the resolution for further discussion, he made no formal motion to do so. Frenchko then pushed for a vote on the official action on the floor, which would set quarantine and return-to-work guidelines for employees under the board of commissioners in accordance with existing CDC guidelines.
It further stated: “No additional guidelines shall be required to return to work, as the board of commissioners [does] not have the statutory authority to create health guidelines.”
Fuda voted in favor of the measure but afterward told Raphtis that JFS employees should continue following the testing policy. Fuda told Mahoning Matters on Wednesday he likely voted in error during that meeting.
A JFS representative on Wednesday declined to comment for this report, because agency heads aren’t sure what policy is in place. Fuda said he intended to meet with JFS employees Thursday, but told Mahoning Matters that day he hadn’t had time to arrange the meeting.
Caught in the middle
Richard Jackson, the county’s human resources director, told commissioners on Jan. 5 he recommended the testing requirement for all county departments.
“At no time was it a CDC guideline, but I advised all departments to require tests to return to work — the reason being that in addition to health guidelines, as an employer, we also have a responsibility to protect the employees here,” he said.
Frenchko said the policy was “unacceptable” for county employees and sought alternatives, like a doctor’s note.
“You’re making people do PCR tests to return to work, and it’s exhausting their sick leave,” she said. “If someone doesn’t have any symptoms and they’re under quarantine due to exposure reasons and they still don’t exhibit symptoms, that should be adequate, instead of making them wait to get into a doctor’s appointment, wait to get a test result and then exhaust even more sick time.
“It’s unfair to employees, and that’s why I put this [resolution] in place.”
Under the Americans with Disabilities Act, employers can require their workers to deliver a health care provider’s note “to verify that employees are healthy and able to return to work,” but the CDC recognizes “extremely busy” medical facilities “may not be able to provide such documentation in a timely manner.”
In those cases, the CDC urges businesses to consider not requiring them, and instead follow the CDC’s guidelines for isolating after a positive test. Those guidelines were updated late last month to recommend a five-day isolation period, down from 10 days, for those who haven’t had a fever for at least 24 hours.
What’s the best approach?
The American Medical Association in a Jan. 5 letter questioned the CDC’s decision to shorten the recommended isolation period, noting about 31% of people with COVID-19 remain infectious after five days of testing positive for COVID-19. The association called the new guidelines “confusing and counterproductive,” despite being near the end of the pandemic’s second year.
“A negative test should be required for ending isolation after one tests positive for COVID-19. Re-emerging without knowing one’s status unnecessarily risks further transmission of the virus,” association President Dr. Gerald Harmon said in the letter.
But the CDC notes those who recover from COVID-19 may still have detectable levels of the coronavirus in their noses for up to three months after their symptoms began, though they’re unlikely to still be contagious.
“These findings strengthen the justification for relying on a symptom-based rather than test-based strategy for ending isolation of most patients,” according to CDC guidance from Dec. 28.
Mercy Health letting COVID-positive workers come back
Bon Secours Mercy Health last week joined other hospitals nationwide now updating return-to-work guidelines to allow COVID-positive employees to return to work, so long as they have mild or no symptoms.
The hospital system is now seeing its highest volume of COVID-19 hospitalizations since the pandemic began, putting “severe strain” on its staff and facilities, according to a statement issued Monday.
“If those employees feel well enough to fulfill their role, they can now return to work as soon as they choose to do so,” it reads. “While we are taking extraordinary steps to best serve our patients during this crisis period, the health and safety of our patients and employees remains our priority to ensure we can continue to care for all patients, while maintaining our commitment to quality.”
Employees who choose to return must wear N95-rated masks at all times, at least for 10 days after their symptoms began, and can’t interact with coworkers or patients without one, spokesperson Kara Carter said.
They won’t work with immunocompromised patients and must also take breaks or meals off-premises, she said.
Coming to terms
Trumbull JFS administrators and employee union heads said they’ll work together to clarify the department’s return-to-work policy, but they doubt they can make everyone happy.
“Commissioner Frenchko’s suggestion not to return with a negative PCR test — that will send employees over the roof because they will not feel comfortable taking someone’s word for it,” said Anthony Tedesco, a JFS case worker and union vice president, speaking to commissioners by phone, since he was at home due to illness.
“I feel it’s unfair to place this on the union or the administration because it’s a difficult thing to balance. Every recommendation that comes out is going to upset another employee,” he said. “This is what we deal with daily. We’re trying to keep everybody calm while Director Gargano gets this straightened out.”
Gargano offered to allow JFS employees to return to remote working, as the department did during the height of the pandemic in 2020. Frenchko said she expects that solution would alleviate some of the problem.
“Some of the employees want to go home, and I totally understand that,” Tedesco said. “Some people are scared. I understand that. We had a death in our agency, which has really lit a fire under this.
“We’re trying to come to an agreement here that everybody will be satisfied with, because no matter what, somebody’s not going to be satisfied. … We’re going to have this constant back and forth.”
This story was originally published January 14, 2022 4:00 AM.