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A physician in Rhode Island was given a by the state's medical board for performing a procedure after testing positive for COVID-19.

According to the letter, Malcolm Kirk, MD, found out he was positive for COVID-19 the evening before the scheduled procedure. "Despite the positive test results, Respondent proceeded to conduct the procedure on the following morning of January 12, 2023, at Rhode Island Hospital," the consent order states.

The Rhode Island Department of Health license database lists Kirk's specialties as cardiac electrophysiology and cardiovascular disease.

Kirk admitted that he conducted a procedure on that day while COVID-19 positive, the letter said. An investigation was conducted after a complaint was filed, and it determined Kirk had engaged in "unprofessional conduct" by violating "both federal and state quarantine guidelines applicable to COVID-19." The board also fined Kirk $1,100.

Kirk and Rhode Island Hospital in Providence (the facility where the procedure took place), did not return requests for comment from 番茄社区.

"I'm a big believer that hospital spread is a big deal," said Jeremy Faust, MD, of Brigham and Women's Hospital and Harvard Medical School in Boston, who is also the editor-in-chief of 番茄社区. "There are people who say hospitals are no worse for spread than schools or other places, but the implications are different."

"If I spread it to a group of school kids, they lose a week of school; if I spread it to a group of people in the hospital, they die," he said.

Yet there hasn't been strong endorsement from medical leadership on COVID-19 infection control policies for the healthcare workforce.

A representative from the American Medical Association said in an email to 番茄社区: "The AMA is not the author of clinical guidelines. The AMA defers to the national medical specialty societies to establish clinical guidelines and best practices." The representative referred MedPage to the American College of Surgeons, which declined to comment on clinical guidelines or the reprimand. The American Hospital Association also declined to comment.

The Rhode Island Department of Health website's "Information For Healthcare Professionals" related to COVID-19 links out to the CDC interim guidance.

According to that (last updated in September 2022), healthcare workers with mild-to-moderate COVID-19 may return to work 7 days after symptoms appeared, as long as they obtain a negative COVID test result within 48 hours of work, that it's been at least 24 hours since they had a fever, and that their symptoms have improved.

For asymptomatic COVID-19 infection, healthcare workers can return to work after it has been at least 7 days since their first positive test and if they have a negative test within 48 hours of returning to work (or 10 days if testing is not performed or if they had a positive test at day 5-7).

The CDC is currently in the process of updating its 2007 , which many healthcare facilities follow; COVID-19 specific precautions have not yet been drafted.

Rhode Island regulations for healthcare workers under which Kirk would have been operating also require either or wearing an N95 mask when working in a healthcare facility during times when the COVID-19 prevalence rate is at or above 50 cases per 100,000 people.

However, Rhode Island Department of Health's says that it is not currently tracking prevalence. "Community Levels have been replaced by Hospital Admission Levels because the widespread change in testing, such as the use of at-home tests, has made Community Levels less reliable," it noted. There were 248 reported COVID-19 hospital admissions in the state in October, less than half what was seen in October of last year.

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