But CDC’s critical infrastructure worker guidance is seen limiting infected employees’ return to work.
The Centers for Disease Control and Prevention (CDC) has reduced the amount of time it recommends for employees to stay away from work after they have become exposed to someone who has tested positive for COVID-19.
Up until the CDC’s Dec. 2 announcement, the agency had advised that employers impose a blanket 14-day quarantine for those individuals who came into close contact with other individuals who tested positive or were presumed-positive.
While the agency continues to hold that the original 14-day quarantine period is best after a close contact, the revised guidelines now allow for quarantine periods it deems acceptable, if the individual remains symptom-free.
The new periods are: 10 days after close contact with the positive person; and seven days following close contact if the returning employee has a negative result for a test within 48 hours of the final day of the seven-day quarantine (that is, at least five days following close contact).
For both the 10- and seven-day alternatives, the CDC calls for daily symptom monitoring and mitigation strategies, including correct and consistent mask use, social distancing, hand and cough hygiene, environmental cleaning and disinfection, avoidance of crowds, and adequate indoor ventilation.
The CDC also says the seven-day alternative should be available only when the use of tests to discontinue a quarantine will not have an impact on community diagnostic testing. It also makes the point of emphasizing that testing for infection-evaluation should be the priority.
According to the CDC, if an individual develops symptoms during either the 14-, 10- or seven-day quarantine period, the person should be treated as a positive/presumed-positive, isolated and be subject to the associated guidelines, says Stephen R. Woods, an attorney with the law firm of Ogletree Deakins.
Generally, symptomatic individuals are able to return to work (discontinue home isolation) only after the following have occurred:
• Ten days have passed since the onset of symptoms.
• COVID-19 symptoms have ceased (except for the loss of taste or smell, which may last for some time and should not preclude the end of isolation/return to work).
• The individual is fever free for at least 24 hours without the use of fever-reducing medication.
Isolation periods may be longer for individuals who are severely immuno-compromised, as determined by medical providers, Woods points out.
“Given the CDC’s continued emphasis that a 14-day quarantine period is best, employers may decide to leave that quarantine time period in place,” he suggests. “Other employers needing or desiring more operational and staffing flexibility may opt to use the 10- or seven-day quarantine periods, taking into account the availability of testing for end-of-quarantine purposes in their communities.”
As is usual when it comes to these kinds of COVID-19 recommendations, employers should watch for agency guidance, state and local public health, which can vary significantly.
Critical Worker Changes
Just before Thanksgiving the CDC issued a separate guidance dealing with when critical infrastructure workers should return to their workplaces after they have experienced symptoms or have tested positive for COVID-19, which the agency says should only be done as a last resort and in limited circumstances.
In contrast with the above guidance, which deals with being exposed to someone who has tested positive for the virus, this one applies to workers who instead have tested positive or suffered from the disease.
“Bringing exposed workers back should not be the first or most appropriate option to pursue in managing critical work tasks,” the CDC said in its latest guidance. “Quarantine for 14 days is still the safest approach to limit the spread of COVID-19 and reduce the chance of an outbreak among the workforce.”
The agency guidance added that “reintegrating exposed critical infrastructure workers who are not experiencing any symptoms and have not tested positive back into onsite operations should be used as a last resort and only in limited circumstances, such as when cessation of operation of a facility may cause serious harm or danger to public health or safety.”
Recent news reports have said that the CDC is considering reducing its quarantine time limit for those who return to work after being exposed to the virus as well as having suffered from symptoms of the disease, but so far no official statement has been issued.
Much of the CDC’s previous guidance addressing returning critical employees back to work after a bout with the disease remains unchanged since it was issued last spring. Employers are still expected to implement the following mitigation precautions for returning workers:
• Encourage employees to screen for symptoms prior to reporting to work.
• Symptom screen employees, including temperature checks, upon their arrival at work.
• Regularly monitor employees for symptoms while at work.
• Require employees to wear face coverings while at work.
• As job duties permit, require employees to maintain social distance while at work.
• Routinely clean and disinfect the areas accessed by employees.
The recent change discouraging routine return to work for those who have been infected was based on research that has been conducted since the previous guidance, the CDC explains. This includes increased evidence that infected people pose a transmission risk when they don’t exhibit symptoms or before the onset of recognized symptoms.
The new guidance states, “Reintegrating exposed workers who are not experiencing any symptoms and who have not tested positive back into onsite operations carries considerable risk to other workers because many people with COVID-19 are asymptomatic but can still spread disease, and tests are imperfect.”
Taking note of the ongoing community transmission in many parts of the country which has led to surging infection rates, the CDC officials said that a continued need exists for communicating effectively to the general public and for a continued focus on reducing transmission through social distancing and personal prevention strategies.
State and Local Policies Vary
The new guidance also encourages all critical infrastructure employers to work with local health officials on any reintegration of exposed workers and reiterates the additional risk mitigation precautions required, including pre-screening, on-site screening with temperature checks, ongoing health monitoring, cleaning and disinfecting, social distancing, and ensuring all employees wear cloth masks.
“This new guidance follows a trend we have seen in some states,” note attorneys Francis Alvarez, Cressinda Schlag and Tara Burke of the Jackson Lewis law firm. “Since the initial CDC critical infrastructure worker guidance was issued in April, several states have adopted rules narrowing the circumstances under which critical infrastructure employers can allow asymptomatic exposed employees to continue to work.”
New York: Employees who are exposed to COVID-19 but remain asymptomatic can continue to work if deemed essential and critical for the operation or safety of the workplace, upon a documented determination by their supervisor and a human resources representative in consultation with appropriate state and local health authorities.
California: Critical infrastructure employers have been instructed to contact local health departments to determine if exposed asymptomatic workers can be allowed to continue working.
Wisconsin: The state Department of Health has not endorsed exposed, asymptomatic workers returning to work before a 14-day quarantine period. However, local health departments in Wisconsin are allowed to grant case-by-case exceptions.
New Mexico: If an essential business would be forced to cease operations due to the quarantine of exposed, asymptomatic workers, then such workers may continue working if they test negative for COVID-19 and certain safety measures are met. This option should be used as a last resort and only in limited circumstances, such as when cessation of operation of a facility may cause serious harm or danger to public health or safety, the CDC stresses.
In light of the new CDC guidance, critical infrastructure employers should consider reviewing their policies and procedures for returning asymptomatic exposed employees back to work, the lawyers urge. At the same time, they should keep in mind that state and local orders, and guidance from state, tribal, local and territorial health departments and safety agencies, may impose different and more restrictive requirements.
Among other things, the Jackson Lewis attorneys recommend that employers consider:
• Articulating and documenting the impact on operations such as how and why business operations might cease and, if applicable, the potential impact on health and safety if exposed, asymptomatic employees are held out of work for a 14-day quarantine period.
• Consulting with the local health departments on the reintegration of exposed workers.
• Developing plans and protocols to implement additional safety precautions, including pre-screening, health monitoring, and preventive measures.
They emphasize, “As always, employers must also continue to comply with all applicable federal OSHA and state OSHA equivalent workplace safety requirements.”
Attorney Michael Oliver Eckard of the Ogletree Deakins law firm added, “Because there may be a delay between the time a person is exposed to the virus and the time that virus can be detected by testing, early testing after exposure at a single time point may miss many infections. Thus, employers may wish to consider conducting serial testing (i.e., repeated tests at different points in time) to detect infections among exposed workers more accurately.”