The Centers for Disease Control and Prevention (CDC) has issued guidelines for healthcare personnel (HCP) to return to work after suspected or confirmed COVID-19 infection.1

Employee health professionals should consider their local situation with the coronavirus in using one of the two options recommended by the CDC: a test-based method or a non-test-based method

“Use the test-based strategy as the preferred method for determining when healthcare personnel may return to work in healthcare settings,” the CDC recommended.

Test, or No Test

However, since testing has been an issue since the pandemic began, the CDC includes a non-test method as well.

The test-based method calls for exclusion from work until these three conditions are met:

  • Fever resolves without use of fever-reducing medications;
  • Respiratory symptoms (e.g., cough, shortness of breath) improve;
  • Two negative results from at least two consecutive nasopharyngeal swab specimens collected 24 hours apart (total of two negative specimens).

The non-test-based method calls for exclusion from work until:

  • At least 72 hours have passed since resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms;
  • At least seven days have passed since symptoms first appeared.

“HCP with laboratory-confirmed COVID-19 who have not had any symptoms should be excluded from work until 10 days have passed since the date of their first positive COVID-19 diagnostic test, assuming they have not subsequently developed symptoms since their positive test,” the CDC recommended. “If HCP had COVID-19 ruled out and have an alternate diagnosis (e.g., tested positive for influenza), criteria for return to work should be based on that diagnosis.”

After returning to work, HCP should wear a medical facemask for source control at all times until all symptoms are completely resolved or until 14 days after illness onset — whichever is longer. Then, HCP should revert to their facility policy regarding universal source control during the pandemic.

A facemask for source control does not replace the need to wear an N95 or higher-level respirator when indicated. Of note, N95 or other respirators with an exhaust valve might not provide source control.

Workers returning to work from COVID-19 infection should be restricted from contact with severely immunocompromised patients until 14 days after onset. They should self-monitor for symptoms and seek re-evaluation from occupational health if respiratory symptoms recur or worsen, the CDC recommended.

REFERENCE

  1. Centers for Disease Control and Prevention. Return to work for healthcare personnel with confirmed or suspected COVID-19. Updated April 13, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html