# Updated Quarantine AFL Offers Flexibility During Critical Staffing Shortages

Also on Sept. 9, CDPH revised its quarantine guidance for health care workers with the release of AFL 21-08.4. The guidance now includes a section titled “Return to Work for Hospital HCP diagnosed with COVID-19.” This section specifies that during critical staffing shortages, as a last resort, hospitals may consider allowing HCP with suspected or confirmed SARS-CoV-2 infection to work if they are well enough and willing to work, even if they have not met all return to work criteria.

This recommendation is consistent with the Centers for Disease Control and Prevention Guidance on Mitigating Staffing Shortages, which identifies that such a strategy might be considered when, despite efforts to mitigate, staffing shortages persist.

This new section in the AFL also notes:

• Considerations for determining which suspected or confirmed HCP should work
• Positive HCP may not care for patients who have not tested positive for COVID-19 until at least 10 days from the date of their positive test.
• If hospital HCP are allowed to work before meeting all criteria, they should be restricted from contact with severely immunocompromised patients (e.g., transplant, hematology-oncology) and hospitals should consider prioritizing their duties as described in the AFL.
• Positive HCP must maintain separation from other HCP as much as possible (for example, use a separate breakroom and restroom) and wear a N95 respirator for source control at all times while in the facility.
• Health care facilities should inform patients and HCP when the facility is operating under critical staffing shortages, that changes in practice should be expected, and that — if HCP with suspected or confirmed SARS-CoV-2 infection are allowed to work — actions will be taken to protect patients and HCP from exposure.

See the “Return to Work for Hospital HCP diagnosed with COVID-19” section of the AFL for additional details.