GNYHA is pleased to share the New York State Department of Health’s (DOH) revision of the May 18 “Health Advisory: Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic” (attached) to allow for hospital discretion in devising a testing protocol for patients prior to elective procedures. GNYHA strongly advocated for these revisions, sharing expert input from members on key concerns impacting patient and staff safety and hospital operations. We thank DOH for responding to hospital feedback and aligning with the national standards set by the Centers for Disease Control and Prevention (CDC) while prioritizing COVID-19 safety.
The revisions specifically address the elective surgery pre-procedure testing components and align with recommendations from the CDC. The effective date for the new pre-procedure testing guidance is June 24, 2022. Facilities should continue to follow the May 12, 2021 guidance regarding pre-procedure testing until the revised guidance can be implemented.
Summary of Revisions
Pre-elective procedure SARS-CoV-2 viral testing before elective surgery or procedures by hospitals, ambulatory surgery centers, office-based surgery practices, and diagnostic and treatment centers is at the discretion of the facility.
Testing Policy Accounting for Community Transmission Rates
However, the guidance notes that while facilities have discretion, facilities must have a testing policy in place, and policies should require testing of all patients when community transmission rates are moderate, substantial, or high in the facility’s community and service area.
Community transmission rates are defined by the CDC for health care facilities and differ from the patient-oriented metric of COVID-19 community levels. At the time of this DOH bulletin’s issuance, community transmission rates are high throughout New York State.
Tests Permitted for Use
The guidance notes that facilities’ testing policies should maximize detection of infected patients accounting for local laboratory capabilities, turnaround time, and availability. Testing can be done using any nucleic acid amplification test (NAAT) or antigen test authorized by the US Food and Drug Administration. Acceptable test sites include the surgical facility, laboratory, local health department, pharmacy, home, local health care provider, or other testing site. This may include the use of at-home test kits.
Patients Recovered from COVID-19
Should providers test patients who have recovered from SARS-CoV-2 infection in the prior 90 days, an antigen test is recommended over the NAAT because some people may remain NAAT positive but not be infectious during this period. There is no need to test patients who are asymptomatic and recently recovered to prove they are now negative.
GNYHA encourages members to carefully review the revised guidance for requirements on pre-procedure testing. Notably, the revised guidance includes requirements for visitor distancing and visitation restrictions, which remain from the May 18 document. Facilities also should review these and the June 7 guidance on visitation to note the parameters for special populations, which remain in effect.