Management of HCW with repeat positive tests
Current National Institute for Health and Care Excellence (NICE)
guidelines require a negative test prior to returning to work with
immunocompromised patients.6In accordance with UK national
guidance, individuals with repeat positive screens following a minimum
period of seven days self-isolation were advised to continue working if
they were not scheduled to come into close contact with heavily
immunocompromised patients, provided they remained
asymptomatic12. This approach to managing repeat
positive screens is further supported by recent data from the Korea
Centers for Disease Control & Prevention, which showed no clear
evidence of onward transmission to the contacts of 285 repeat-positive
individuals, 108 of whom had samples taken for attempted viral culture,
which was universally unsuccessful.13 Additional small
studies have also demonstrated inability to culture virus from clinical
samples obtained later than 8 days after symptom onset, suggesting
prolonged detection of viral RNA is unlikely to indicate ongoing risk of
transmission.14,15