COVID Exposure or Infection? Next Steps

Determining the next steps when a worker has symptoms or has been exposed to COVD-19 can be tricky. First let’s review the definition of exposure: Being within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period.

An individual can spread the infection for 48 hours prior to becoming symptomatic or may be infected and show no symptoms at all. In the workplace, you would not fall under this definition of exposure IF you were wearing appropriate personal protective equipment (PPE) including the use of an N95 respirator or higher and eye protection.

TMC frequently receives questions on the following three scenarios.

A worker is experiencing Symptoms of COVID-19 with no known exposure.

Workers should either self-monitor or be screened at the beginning of each workday or shift. If they are exhibiting indicators of illness, they should not enter the workplace and if they become symptomatic during the workday, they should leave immediately. While symptoms of COVID-19 may mimic other respiratory illnesses, based on our current situation, COVID-19 infection should be ruled out. The best process to allow the individual to return to work is to have a COVID-19 PCR test. This test is highly accurate, and the results are reliable. If the worker is still experiencing symptoms after the negative test there is a possibility that the test was obtained too early, or it is a false negative. Follow-up with a healthcare provider about symptoms, especially if they worsen, about follow-up testing, and how long to isolate.

A worker who is not vaccinated and has been exposed to COVID- 19.

This individual should quarantine, regardless of whether they are exhibiting symptoms of the illness. The CDC recommends a 14-day quarantine period as the safest process but also has provided direction on reduced quarantine times which can be considered. Local and state health departments will have the final say on the length of the quarantine process. With the alternate process, workers may return to the workplace when meeting one of the following:

After day 10 without testing.
After day 7 if a test result is negative on day 5 or later.

If the test is positive, the return-to-work criteria must be met.

A worker who IS vaccinated and has been exposed to COVID-19.

Quarantine is not required if fully vaccinated unless symptoms appear. A COVD-19 test should be obtained on days 3 – 5. If the test is negative self-monitoring should occur for 14 days after the exposure, as symptoms may appear up to 14 days after exposure. If the test is positive, return-to-work criteria must be met.

Return to Work Criteria for Symptomatic and Asymptomatic Employees

Employees who have been removed from the workplace due to COVID-19 infection may return to work in accordance with guidance from a licensed healthcare provider or in accordance with CDC guidelines.

Symptomatic employees may return to work after all the following are true:

At least 10 days have passed since symptoms first appeared, and
At least 24 hours have passed with no fever without fever-reducing medication, and
Other symptoms of COVID-19 are improving. (Loss of taste and smell may persist for weeks or months and need not delay the end of isolation.)

Asymptomatic employees may return to work after at least 10 days have passed since a positive COVID-19 test. If an employer receives guidance from a healthcare provider that the employee may not return to work, they must follow that guidance.

Without a doubt, healthcare is facing challenging times and questions abound, such as how to maintain adequate staffing to deliver patient care. It does seem that guidance changes frequently which can lead to confusion. The goal for any employer is to protect their workers. Ensuring that workers understand the process if they are experiencing symptoms of COVID or if they have been exposed is the first step in reducing the risk of the spread of infection.