Implementing Changes to Your Return to Work Policy

 As the experts learn more about COVID-19, the CDC continues to update their guidance.  On August 10, 2020 the CDC published an update for the Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 infection.  As an employer you need to establish these guidelines so your employees know what to expect if they are suspected and even confirmed to be infected with COVID-19 and that includes when they can return to work. You also want to determine if your state has specific rules that you must follow regarding this issue.

If you have developed and implemented a Return to Work Policy, you may want to consider the latest recommendations made by the CDC, but as an employer you can establish the policy that you feel best protects your patients and employees.  The CDC Guidance published on August 10, 2020 provides updates to the Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection.

A significant change is regarding symptom-based strategies opposed to test-based strategies for returning to work. CDC states that a test-based strategy is no longer recommended (except as otherwise noted) because, in most cases, it results in excluding from work HCP who continue to shed detectable SARS-CoV-2 RNA but are no longer infectious.

The symptom-based strategies for determining when HCP can return to work are based on their condition being Mild to Moderate Illness or Severe to Critical Illness. The definitions for the following categories of illnesses are defined in this guidance document. The following criteria is stated in this guidance:

Mild to moderate illness:

• At least 10 days have passed since symptoms first appeared and
• At least 24 hours have passed since last fever without the use of fever-reducing medications, and
• Symptoms (e.g., cough, shortness of breath) have improved

Severe to critical illness:

• At least 10 days and up to 20 days have passed since symptoms first appeared
• At least 24 hours have passed since last fever without the use of fever-reducing medications and
• Symptoms (e.g., cough, shortness of breath) have improved
• Consider consultation with infection control experts

Severely immunocompromised and asymptomatic throughout the infection:

• At least 10 days and up to 20 days have passed since the date of their first positive viral diagnostic text

The test-based strategy could be considered to allow HCP to return to work earlier than if the symptom-based strategy were used. The concern is that many individuals will have prolonged viral shedding which limits the utility of this approach. A test-based strategy could also be considered for some HCP (e.g., those who are severely immunocompromised) in consultation with local infectious diseases experts if concerns exist for the HCP being infectious for more than 20 days. Criteria for test-based strategy:

HCP who are symptomatic:

• Resolution of fever without the use of fever-reducing medications and
• Improvement in symptoms (e.g., cough, shortness of breath), and
• Results are negative from at least two consecutive respiratory specimens collected at least 24 hours apart (total of two negative specimens) tested using an FDA-authorized molecular viral assay to detect SARS-CoV-2 RNA.

HCP who are not symptomatic:

• Results are negative from at least two consecutive respiratory specimens collected at least 24 hours apart (total of two negative specimens) tested using an FDA-authorized molecular viral assay to detect SARS-CoV-2 RNA.

Review your Return to Work policy to determine if it should be updated to follow the CDC’s guidance. If you need assistance with this, contact SafeLink Consulting.

Get an Expert - Having an expert assist in developing your  Safety Management Program is the best way to know if your business has a proper plan in place. Learn more at: info.safelinkconsulting.com/covid19-safety-management. Contact SafeLink Consulting today for assistance. Complete the info request form or call 800.330.6003 or 470.533.2581 or set up a meeting with Sandy to learn more.

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