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