JOHNSON CITY, Tenn. (WJHL) – Ballad Health employees who are positive for COVID-19 but asymptomatic or have gone at least 24 hours without a fever will be able to work at Ballad hospitals and facilities, CEO Alan Levine said Thursday.

Citing a staffing crisis that has more than 800 people out with COVID and a record COVID inpatient census, Levine said the system was declaring “crisis staffing,” according to the Centers for Disease Control and Prevention (CDC) updated guidelines.

“If they’re tested positive with COVID but they’re asymptomatic, our expectation is that they will come back,” Levine said at a news conference where he also outlined the crisis’s impact on emergency room wait times and ability to both admit and discharge patients from inpatient rooms.

One thing those guidelines say, however, is that systems must progress through the “contingency” phase prior to entering the crisis phase — and the contingency phase says hospital systems should “cancel all non-essential procedures and visits.”

Levine said Thursday that Ballad has decided not to cancel elective procedures. The guidelines for contingency phase call for systems to “(s)hift HCP (staff) who work in these areas to support other patient care activities in the facility. Facilities will need to ensure these HCP have received appropriate orientation and training to work in these areas that are new to them.”

Levine didn’t mention that part of the guidelines.

“All of the things we’re putting in place are guided by the CDC in terms of best practice for how to bring people back who might have COVID or who have had it and are on the route to recovery, because we need their help,” Levine said.

A CDC rubric spelling out how hospitals can let COVID-positive staff work under certain crisis circumstances.

“As a hospital system who has to care for patients who are very sick, there’s a point beyond which it becomes more risky to keep these people at home and not take care of the people that need help, and that’s the point we’re at.”

Ballad had a record 436 COVID-19 inpatients Thursday. Levine said about two-thirds of the 834 employees currently out with COVID work in clinical positions.

Levine said understaffing both at Ballad and at other post-acute facilities where some patients go after discharge has created a “cascading effect” that’s filling emergency rooms to overflowing as the system lacks inpatient beds to put patients needing hospitalization in.

CDC guidance updated Jan. 21 under the title “Strategies to Mitigate Healthcare Personnel Staffing Shortages” lists work restrictions due to COVID under conventional standards as well as “contingency” and then “crisis” standards. The CDC website says those strategies are supposed to be considered and implemented in order with crisis care being last.

Levine said Ballad wants to avoid a third round of stopping elective procedures. He said COVID-positive employees will be restricted from working in several departments, including oncology and Niswonger Children’s Hospital.

“If they’re clinical, it’s possible they can come back and work in a COVID unit,” Levine said. “It’s possible they can work in the emergency department as a sitter when we have mental health holds.”