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Helsinki orders asymptomatic Covid patients back to work and school

The city, however, recommends its own staff stay at home for five days if testing positive for the virus.

A positive at-home Covid test. Image: Heikki Saukkomaa / Lehtikuva

The City of Helsinki has instructed residents to return to work or school even in the event of a positive Covid test result, if they show no symptoms and it is not possible to organise remote work or studies.

Yle received the instructions given to staff of health centres and emergency services last week. In the documents, the city instructed staff to advise patients that they should return to work, school or daycare despite a positive test result, if they are suffering no symptoms.

The general guideline from the Finnish Institute for Health and Welfare (THL) is still that if a person tests positive for Covid, they should isolate for five days, regardless of symptoms.

On Thursday morning, the City of Helsinki added instructions to its own website, according to which an asymptomatic person who has tested positive for Covid can return to work if the employer agrees. The instructions also state that, in principle, sick leave is not granted if a person is asymptomatic.

Healthcare worker: Terrible advice

Yle was contacted by a nurse working at a health centre, who says the city’s new instructions have caused confusion among health centre staff.

The healthcare worker asked to remain anonymous because she fears she will run into problems in her workplace if her identity is revealed. Yle is aware of the worker's identity and profession.

According to the nurse, the new instructions have not been properly reviewed among employees.

"The most confusing thing is that the instructions suddenly changed so drastically," they said.

The nurse added that even if an asymptomatic client should be advised to return to work, school and daycare while infected with Covid, they would not want to do so and take responsibility for the spread of the disease.

"It would be really awful to recommend that," they said.

Symptoms hard to determine

If a patient has to assess their own symptoms, it may go amiss because the diverse symptoms of Covid range from stomach irregularities to a mild throat tickle.

"There are the clear flu-like symptoms, but then there may be stomach bug-like symptoms or symptoms so small that it is unclear," said the healthcare worker.

In children, it may be even more difficult to assess symptoms if they do not have a fever or other obvious symptoms.

The healthcare worker interviewed by Yle feels that the instructions given to healthcare professionals in patient care are in conflict with the overall restrictions within society. What are the benefits of restrictions if you can go to work with asymptomatic Covid, the worker asked, adding that workers feel the city has surrended to the pandemic.

Infectious Disease Physician: No obstacle to going to work

Sanna Isosomppi, Chief Physician of Helsinki's Epidemiological Operations, tells Yle that the new guidelines are based on the principle that anyone showing signs of a respiratory infection should stay home.

If there is Covid in the family or someone knows that they have been exposed and their test result is also positive, working remotely is still recommended, wherever possible.

"If the workplace can adhere to hygiene recommendations, such as the use of a mask and social distancing, there is no real obstacle to going to work," said Isosomppi.

The main principle in the current situation is that those with symptoms should stay at home and the hygiene recommendations, such as wearing masks, apply to everyone, even asymptomatic people, regardless of vaccination status.

"The mask recommendations have been made to prevent the spread of infection even when we do not know that we are infected," she said.

Sanna Isosomppi, Chief Physician of Helsinki's Epidemiological Operations. Image: Markku Pelkonen / Yle

"We haven't raised the white flag"

Isosomppi refutes the healthcare worker's criticism that Helsinki has surrendered to the pandemic, and no further efforts are being made to prevent the virus from spreading. According to Isosomppi, the situation has changed significantly and therefore the means to prevent the spread of the infection are different.

"In the early stages of the pandemic, the population did not have the protection provided by vaccinations against the disease. The virus was new and the repercussions of getting infected were different then. Even back then, the disease in children and adolescents was the same, but the situation in the adult population was considerably different and the risks of getting a more serious form of the disease were greater," Isosomppi said.

Additionally, in the early stages of Covid, no one had immunity provided by the disease they were suffering from.

"Extensive testing, isolation and contact tracing was a very meaningful strategy, at the time, but now the pandemic situation has changed, particularly with the Omicron mutation," she said.

Staying home with symptoms and effective protective gear implemented by everyone is essential now.

"I understand that this is confusing, but in [the Helsinki] region we are moving towards Covid becoming a virus that causes respiratory infections," Isosomppi said.

However, the pandemic is not over yet and Covid should continue to be taken seriously.

"By no means have we raised the white flag," she said.

Helsinki advised asymptomatic nurses to go to work

Some healthcare personnel diagnosed with Covid have also been advised to go to work if they show no symptoms, should they not be able to work remotely.

Yle is in possession of instructions emailed more than two weeks ago to staff working in health centres, emergency services and the internal medicine outpatient clinic.

According to the instructions, after a positive home test or PCR test result, the employee can return to the workplace, if asymptomatic, should working remotely not be possible.

The instructions have raised concerns among employees.

The healthcare worker who contacted Yle says she does not know if anyone working with patients has been asymptomatically suffering from Covid.

"I hope this hasn't been the case, and that it won't be," they said.

Now the City of Helsinki is advising its staff to stay home for five days if suffering from asymptomatic Covid. On Wednesday the city outlined new instructions for its staff on how to handle a positive test result.

"An asymptomatic employee who has received a positive test result should work remotely for five days," said Matti Heiskanen, a leading expert from the city's human resources department.

If it is not possible to do their work remotely, the employer must arrange alternative assignments for the employee.

Heiskanen said that the new instructions ought not to compromise service capacity, even if part of the workforce is working remotely because of them.

The new guidelines therefore repeal the instructions previously given to healthcare personnel, that they should go back to work if exhibiting no symptoms and the work cannot be done remotely.

Heiskanen does not know where the previous instructions for healthcare personnel have originated from, and Juha Jolkkonen, Helsinki City’s executive director for social services and health care, and Timo Lukkarinen, the City’s medical director, did not respond to Yle requests for comment.

Heiskanen could not say whether there have been any people suffering from asymptomatic Covid working with patients, as per the instructions issued a few weeks ago.