Think Health Care Workers Are Tested Often For COVID-19? Think Again

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A nurse puts on personal protective equipment as she prepares to treat a COVID-19 patient at a rural Missouri hospital last month.

Jeff Roberson/AP

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Jeff Roberson/AP

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Nurses assist a COVID-19 patient at a Los Angeles hospital last month. The California Department of Health now «strongly recommends hospitals test all of their health care personnel for the coronavirus each week.

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A nurse holds a candle during a vigil in Los Angeles last month for health care workers who have died from COVID-19. The vigil was organized by California Nurses United.

Patrick T. Fallon/AFP via Getty Images

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A nurse holds a candle during a vigil in Los Angeles last month for health care workers who have died from COVID-19. The vigil was organized by California Nurses United.

Patrick T. Fallon/AFP via Getty Images

California’s state health department announced new guidance two weeks ago that strongly recommends hospitals do weekly testing of health care personnel — and suggests pooled testing might be a way to do it.

But Susan Butler-Wu, associate professor of clinical pathology at USC and director of the clinical microbiology lab at a large hospital in Los Angeles, says the state’s new recommendations are going to be very hard for most hospital labs to implement.

At her own hospital, she estimates that 10,000 people would need to be tested weekly. Without operational support from the state, she predicts the new protocols are going to cause problems — including further delays in testing.

«When you get some big mandate that, ‘Hey, test all the health care workers in your hospital,’ I don’t have a bunch of pixies with magic swabs and magic reagents that will just magically run this, Butler-Wu says.

The guidelines could also create staffing shortages, Butler-Wu says, if employees who recently had COVID-19 asymptomatically suddenly get positive PCR tests.

«They may not be infectious, but now what do we do? We tell them to isolate. Now we lose a whole bunch of stuff as a result of that, she says. «We’re asking people to stay home and not work when they’re truly essential and may not even be an infectious risk to anybody.

The larger problem is a systemic one, says Butler-Wu.

«As a country, because we don’t have a national plan or a national strategy, this is the situation we find ourselves: Football players can get tests, she says. «People choosing to socialize and wanting to feel safer doing so, even though it’s a pandemic, can get tests.

But a national program to regularly test the country’s health care workers? There isn’t one.

Anne Jackson is a nurse at the University of Michigan health system. She says it’s frustrating to read about how the university’s football players and coaches are tested daily, while hospital staff are only tested if they’re symptomatic or have a CDC-defined exposure. (The university also has a surveillance testing program that is open to staff who want to be tested.)

«Football makes them money, Jackson says. «The health system employees do as well, but not to the extent that the football players do, and the football players are more valuable to them than we are.

For Mina, the Harvard epidemiologist, the lack of regular testing of health care workers raises other questions.

«There’s a clear problem when we’re saying that the greatest-risk people, the people who are at the greatest risk to themselves and to their patients are the health care workers, Mina says. «And so that’s why we’re going to give them vaccines before anyone else. But then when we don’t have a vaccine and it’s just testing, we say, ‘Don’t worry about it, it’s not a big deal, you don’t need to be tested.’ «

It’s an approach, he says, that doesn’t make sense.