Close contact health staff exempted from restrictions if vaccinated - Hiqa

Healthcare workers who are close contacts of a confirmed Covid-19 case could, under new regulations, be exempted from restricting their movements if they are fully vaccinated.

In an advisory report published by the State’s health service regulator, the Health Information and Quality Authority has said that healthcare workers could be considered for derogation from restricting their movements as close contacts if they have completed the two doses of the vaccine.

In its report to the National Public Health Emergency Team, Hiqa said any decision should be in line with current derogation guidance and “may only be considered for healthcare workers who have been identified as essential to maintaining critical services and following a risk-based assessment by senior management.”

Staff shortages continue to put severe strain on hospitals and other services.

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Outbreaks in hospitals and nursing homes have resulted in large numbers of HSE and other healthcare staff being forced into self-isolation as close contacts of Covid-19 cases.

Healthcare workers currently identified as close contacts must restrict their movements and, if asymptomatic, can only return to work with a “not detected” Covid-19 test result after 10 days.

The administering of vaccines to healthcare workers will enable more staff to remain in work even if they are identified as close contacts of positive Covid-19 cases in light.

The two-dose Pfizer-BioNTech protects 95 per cent of people who receive it. It takes seven days after the second dose is administered for recipients to be fully protected. The doses are given 28 days apart.

Healthcare workers started receiving their second dose of the vaccine last week. So far, nearly 80,000 have received at least one dose.

Dr Máirín Ryan, Hiqa’s deputy chief executive and director of health technology assessment, said the derogation should, in the first instance, be limited to people who have completed vaccination within the previous two months given the current data available from research trials.

“Derogation should be accompanied by strict conditions of testing, active monitoring, and supervision by local management and occupational health,” said Dr Ryan.

“Consideration should also be given to providing guidance, training in processes such as risk assessment and support for appropriate implementation of derogation practices outside acute care settings where there may be limited access to occupational health services.”

Hiqa has said there was a need to communicate that vaccination does not lessen the requirement for infection prevention and control practices or the requirement to observe general public health guidance within and outside of hospitals and other healthcare settings.

The Hiqa report noted the view of the Covid-19 Expert Advisory Group that vaccination does not lead to sterilising immunity and that while the risk of transmission is lower in people who have completed the vaccination programme, it will be not fully eradicated.

“Some infections in vaccinated individuals will occur, but will likely be shorter in duration (as there will not be a lag time to mount an immune response) and associated with a lower viral load. Therefore, while the risk of transmission will be lower, it will not be zero,” the report states.

Hiqa advised Nphet that a “stratified or preferential approach to derogation” may need to be applied if there is more than one healthcare worker who can fulfill an essential role.

“This preferential derogation should take into consideration prior history of Covid-19, vaccination and the specific exposure risk that led to the identification of the healthcare worker as a close contact,” it said.

The report says current guidance specifies that healthcare workers who have had a confirmed infection within the last three months are exempt from close contact status.