As North Dakota's hospitals fill up with COVID-19 patients, the state says medical workers can show up for work even if they contract the coronavirus as long as they do not show any symptoms.
Governor Doug Burgum issued an order last week allowing health care staff who test positive for the virus to keep caring for COVID-19 patients. The change was "requested by hospitals to address staffing," he said on Twitter.
Nursing groups blasted the decision, saying it could lead to hospitals forcing sick nurses to show up for work or retaliating against those who test positive and decline to work.
"Nearly 400 nurses in the United States have died as a result of COVID-19 and many others have been infected and hospitalized. This is unacceptable. Nurses and health care workers who are risking their lives and the health of their own families deserve better," the American Nurses Association (ANA) said in a statement.
Allowing sick nurses to treat patients also puts other medical workers and patients at risk of catching the virus, said Cheryl Peterson, ANA's vice president of nursing programs.
"We know that even asymptomatic people can still spread the virus, so while everybody's going to do the best they can, the reality is there is the potential they could spread it," she said. "You're still in common areas, you still have to walk the hallways, you still have to be in an elevator."
The North Dakota Nurses Association and the state's Emergency Nurses' Association also criticized Burgum's order while also calling for a statewide mandate that residents wear a mask in public. (Burgum issued a mask mandate as part of an executive order late Friday.)
"Excluding COVID-positive health care workers from quarantine and isolation requirements increases the risk of other health care workers being exposed to COVID-19," the emergency nurses' group said in a statement. It also called for hospitals to take other measures, including hiring additional staff, canceling non-essential medical care and assigning workers with COVID-19 to jobs that don't involve patient interaction, such as telemedicine visits.
Tessa Johnson, president of the North Dakota Nurses Association, called the order "a punch in the gut."
"We're all kind of at our breaking points, and now if we contract the virus, we're still going to work," Johnson told local news outlet Valley News Live in a video posted on the health care group's website.
She added that the order could damage health authorities' efforts to contain the virus. "As nurses, people really look to us — our friends look to us, our neighbors look to us," Johnson said. "We're telling these people in our community, 'If you're in close contact, if you're positive, we want you to stay home and quarantine and slow that spread.' But if we're doing the exact opposite and we're going to work [COVID-]positive, it really contraindicates what we're educating."
COVID-19 is surging in the state, with 1,400 new infections reported on Friday, according to the North Dakota Department of Health. Hospitals are at capacity, with 1 in 6 hospitalizations now attributed to the coronavirus, according to Burgum. Sanford Health, one of the largest health care systems in the state, last week transferred dozens of patients to a nearby nursing home to free up space, according to InForum.
Sanford has not asked sick health care workers to care for patients, a spokesperson told CBS MoneyWatch. "It's not needed right now, and it would be a last resort," the spokesperson said.
CHI St. Alexius Health, the largest health system in central and western North Dakota, "appreciates the extra option our governor has given, however we will not be utilizing this staffing option at this time," a spokesperson told CBS MoneyWatch.
Altru Health System, headquartered in Grand Forks, is "actively evaluating how we could safely bring our asymptomatic staff in to support our COVID unit," but it has not yet asked asymptomatic staff to work, a spokesperson said.
"Steps such as these are being considered as we face increased volumes of patients and a high number of staff requiring quarantine. In order to safely care for all patients who need us, we must consider this option to do so," Altru Health spokesperson Kenneth Harvey said in an email.
"If implemented, we would follow strict guidelines and protocols to ensure the rest of our workforce and patients remain safe. These staff would remain strictly in our COVID units and separate from other staff and patients during breaks and upon entry. Staff will be given the opportunity to work and can decline if they choose," Harvey said, noting that the Centers for Disease Control and Prevention has approved the practice as a way to deal with staffing shortages.