Updated guidance for self-isolation and return to work following COVID-19 contact in England

NHS England and Improvement have issued updated guidance on the 24 February 2022.

UKHSA have also made minor amendments to their guidance.

The relevant points for primary care optical staff are as follows:

• Self-isolation for those with a positive test is no longer a legal requirement but it is still expected from an NHS perspective as such you should continue to follow the steps below
• IPC requirements are unchanged
• Access to testing is to continue as previously until the 31 March with ongoing discussions about what will happen after that
• Staff should test twice weekly and report both positive and negative tests

The UK Health Security Agency has now also updated its COVID-19: management of staff and exposed patients or residents in health and social care guidance to reflect self-isolation changes when in contact with a confirmed or suspected Omicron variant case.

In updated guidance published on the gov.uk website on the 17 January 2022 further changes have been announced to the self-isolation requirements. The guidelines apply to all staff including substantive clinical and non-clinical roles, bank staff, contractors, and suppliers; students working in all facilities, settings and organisations delivering NHS care and volunteers working in settings with patients.

We have updated our guidance to reflect the latest developments below.

Updated guidance

In summary

• If you develop any symptoms of COVID-19, even if mild, you should stay at home and arrange a PCR test as soon as is possible. If the test is positive you must isolate, if the test is negative you can return to work
• If you have received a positive LFD test, you do not need to take a PCR test unless:
  
  • You wish to claim the Test and Trace support payment
  • You have received a letter from the NHS due to specific health conditions which may be suitable for new COVID-19 treatments
  • You are taking LFD tests as part of a research program that has requested it
  • You have a positive day two LFD test after returning from another country
• If you have a positive PCR test or LFD and no symptoms you must still self-isolate for 10 days, however you may be able to end your self-isolation period sooner in certain circumstances

You may return to work after five days of isolation on the conditions that:

• You should not have any COVID-19 symptoms other than cough or loss of smell
• You must continue to take an LFD test on the remaining days of the isolation period, even if you have returned to work
• If the LFD test is negative on day five, and a second test on day six is also negative, then you can return to work, but should continue to take tests on days seven, eight, nine and 10.
• If the LFD test is positive on day five, but negative on days six and seven then you can return to work, but should continue to take tests on days eight, nine and 10
• If any of these tests are positive you should isolate and wait 24 hours before taking another LFD test
• Tests must be taken before attending work
• PPE must be worn as per current IPC guidance
• The likelihood of a positive test after 10 days is low in the absence of a high temperature. If you still test positive on day 10, you should continue to take daily LFD tests and may return to work after a single negative test
• The likelihood of a positive test after 14 days is lower still. If you test positive on the day 14, you can stop testing and return to work on day 15 

Staff who are contacts of someone confirmed with COVID-19 must self-isolate if not fully vaccinated*.

You do not need to self-isolate if you are a close contact of someone with COVID-19, even if you live in the same household, as long as:

• You do not have the main COVID-19 symptoms
• You do not have any travel related isolation requirements
• You have a negative PCR result
• You can perform LFD tests for 10 days from the last contact with the COVID-19 case, if any of these are positive you must isolate as above
• Tests must be taken before attending work
• PPE must be worn throughout the day as per current IPC guidance
• If you have had COVID-19 in the last 90 days you should not have a PCR test and should only undertake daily LFD tests
• If you work with especially vulnerable people a risk assessment should be conducted and consideration to redeployment for 10 days following the last contact may be appropriate 

If you cannot meet the above requirements, you must self-isolate.

*The definition of fully vaccinated is currently that, you are fully vaccinated 14 days after having received two doses of an approved vaccine (such as Pfizer/BioNTech, AstraZeneca or Moderna/Spikevax) or one dose of the single-dose Janssen vaccine.

The guidance stresses that this definition may change in the coming days and as such we recommend that if you have not also received a booster vaccination and if this is less than 14 days ago, then you should consider self-isolating. We note that if you choose not to, that you will not be breaking any rules at this point, but we strongly encourage you to self-isolate in these circumstances.