Dr Muiris Houston: Doctors travelling from high Covid-19 areas should self-isolate

While exact details remain to be confirmed, it seems one of the four cases diagnosed with novel coronavirus illness (Covid-19) in the west of Ireland is a healthcare professional. The individual is one of a family of four who became unwell after returning from a skiing holiday in northern Italy. Reports suggest the professional worked one shift in an emergency department following his return and before he developed any symptoms.

While doctors and nurses are subject to the same public health advice as the general population, the Health Protection Surveillance Centre (HPSC) has issued some specific advice for health professionals. That advice was strengthened on Thursday.

For healthcare workers returning from an area with presumed ongoing community transmission the probability of infection is considered moderate to high, the HPSC says.

“If Covid-19 is acquired by a health care worker the potential impact on a vulnerable patient population could be extremely serious. In addition, onward transmission of Covid-19 and subsequent outbreaks may be more likely in health care facilities,” the advisory states.

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A healthcare professional returning from areas with presumed ongoing community transmission of Covid-19 in the preceding 14 days is asked to contact their local Department of Public Health prior to returning to work.

“If the health care worker is well (and) their only exposure is travel to an area of ongoing community transmission outside the areas of higher community transmission they are informed and advised about symptoms, and can return to work,” the guideline states.

They will be monitored by their local occupational health service or line manager for 14 days after their last exposure and “can continue to practice or work as normal as long as they are asymptomatic”.

However, if they have been in areas with higher community transmission, they must remain off work for 14 days after their last exposure. The professional is asked to self-monitor; if they develop symptoms during this period they should self-isolate and contact their local public health department for further advice.

Meanwhile, those who were a close contact of an infected person while abroad will be actively monitored for the 14-day period before return to work.

In a highly fluid situation, this advice will likely change. And as we move closer to a mitigation phase in this outbreak, we can expect the tone of public health messages to alter significantly.