TCMS and Austin Public Health is advising the medical community that the CDC Guidance for Return-to-Work for Healthcare Personnel was revised April 30, 2020.




As the CDC continues to compile and analyze the infectivity and transmission of the COVID-19 virus, new Criteria for Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19 (Interim Guidance) have been released.

 

The significant changes relate to the change to a “symptom-based strategy” for those with symptoms and a “time-based strategy” for those without symptoms.

 

Additionally, this guidance extends the duration of exclusion from work to at least 10 days since symptoms first appeared. This change was driven by evidence suggesting a longer duration of viral shedding and hence the concern for possible continued infectivity.

 

Criteria for Return to Work is based on the confirmed COVID -19 provider being symptomatic or asymptomatic.




Symptom-based strategy

Exclude from work until

  • At least 3 days (72 hours) have passed since recovery:
    • Defined as resolution of fever without the use of fever-reducing medications and
    • Improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
    • At least 10 days have passed since symptoms first appeared

Test-based strategy

Exclude from work until:

  • Resolution of fever without the use of fever-reducing medications and
  • Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens).



Time-based strategy

Exclude 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.
  • If they develop symptoms, then the symptom-based or test-based strategy should be used.

Test-based strategy

Exclude from work until:

  • Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens).



Regardless of the strategy employed by a provider, all should continue to self-monitor for symptoms, and seek re-evaluation from occupational health if respiratory symptoms recur or worsen.

 

The guidance for non-health care providers to return to work is still seven (7) days from symptom onset, but must continue to wear cloth face covering or a facemask.

 

The full documentation can be found at the CDC Website link below:

https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhealthcare-facilities%2Fhcp-return-work.html

John Abikhaled, MD

TCMS President