04/15/2020
The below links should provide some information regarding an employer’s obligation with respect to employees with COVID-19 or similar symptoms:
Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html
Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19)
Plan, Prepare and Respond to Coronavirus Disease 2019
Summary of Changes to the Guidance:
Below are changes as of March 21, 2020
Updated cleaning and disinfection guidance
Updated best practices for conducting social distancing
Updated strategies and recommendations that can be implemented now to respond to
COVID-19
Purpose
This interim guidance is based on what is currently known about the coronavirus disease 2019 (COVID-19). COVID-19 is a respiratory illness that can spread from person to person. The outbreak first started in China, but the virus continues to spread internationally and in the United States. The Centers for Disease Control and Prevention (CDC) will update this interim guidance as additional information becomes available.
The following interim guidance may help prevent workplace exposures to COVID-19, in non-healthcare settings. (CDC has provided separate guidance for healthcare settings.) This guidance also provides planning considerations for community spread of COVID-19.
To prevent stigma and discrimination in the workplace, use only the guidance described below to determine risk of COVID-19 infection. Do not make determinations of risk based on race or country of origin and be sure to maintain confidentiality of people with confirmed coronavirus infection. There is much more to learn about the transmissibility, severity, and other features of COVID-19 and investigations are ongoing. Updates are available on CDC’s web page.
Preparing Workplaces for a COVID-19 Outbreak
Businesses and employers can prevent and slow the spread of COVID-19. Employers should plan to respond in a flexible way to varying levels of disease transmission in the community and be prepared to refine their business response plans as needed. According to the Occupational Safety and Health Administration (OSHA), most American workers will likely experience low (caution) or medium exposure risk levels at their job or place of employment (see OSHA guidance for employers for more information about job risk classifications). https://www.osha.gov/Publications/OSHA3990.pdf
Businesses are strongly encouraged to coordinate with state [https://www.cste.org/page/StateEpi] and local [https://www.naccho.org/membership/lhd-directory] health officials so timely and accurate information can guide appropriate responses. Local conditions will influence the decisions that public health officials make regarding community-level strategies. CDC has guidance for mitigation strategies according to the level of community transmission or impact of COVID-19 [ [https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf]
All employers need to consider how best to decrease the spread of COVID-19 and lower the impact in their workplace. This may include activities in one or more of the following areas:
reduce transmission among employees,
maintain healthy business operations, and
maintain a healthy work environment.
Reduce Transmission Among Employees
Actively encourage sick employees to stay home:
• Employees who have symptoms (i.e., fever, cough, or shortness of breath) should
notify their supervisor and stay home.
• Sick employees should follow CDC-recommended steps. Employees should not return
to work until the criteria to discontinue home isolation are met, in consultation with
healthcare providers and state and local health departments.
• Employees who are well but who have a sick family member at home with COVID-19
should notify their supervisor and follow CDC recommended precautions.
Identify where and how workers might be exposed to COVID-19 at work:
• See OSHA COVID-19 webpage [https://www.osha.gov/SLTC/covid-19/] for more
information on how to protect workers from potential exposures and guidance for
employers [https://www.osha.gov/Publications/OSHA3990.pdf], including steps to
take for jobs according to exposure risk.
• Be aware that some employees may be at higher risk for serious illness, such as older
adults and those with chronic medical conditions. Consider minimizing face-to-face
contact between these employees or assign work tasks that allow them to maintain a
distance of six feet from other workers, customers and visitors, or to telework if
possible.
Separate sick employees:
• Employees who appear to have symptoms (i.e., fever, cough, or shortness of breath)
upon arrival at work or who become sick during the day should immediately be
separated from other employees, customers, and visitors and sent home.
• If an employee is confirmed to have COVID-19 infection, employers should inform
fellow employees of their possible exposure to COVID-19 in the workplace but
maintain confidentiality as required by the Americans with Disabilities Act (ADA).
The employer should instruct fellow employees about how to proceed based on the
CDC Public Health Recommendations for Community-Related Exposure.
Educate employees about how they can reduce the spread of COVID-19:
• Employees can take steps to protect themselves at work and at home. Older people and
people with serious chronic medical conditions are at higher risk for complications.
• Follow the policies and procedures of your employer related to illness, cleaning and
disinfecting, and work meetings and travel.
• Stay home if you are sick, except to get medical care. Learn what to do if you are sick.
• Inform your supervisor if you have a sick family member at home with COVID-19. Learn what to do if someone in your house is sick.
• Wash your hands often with soap and water for at least 20 seconds. Use hand sanitizer
with at least 60% alcohol if soap and water are not available.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Cover your mouth and nose with a tissue when you cough or sneeze or use the inside
of your elbow. Throw used tissues in the trash and immediately wash hands with soap
and water for at least 20 seconds. If soap and water are not available, use hand sanitizer
containing at least 60% alcohol. Learn more about coughing and sneezing etiquette on
the CDC website.
• Clean AND disinfect frequently touched objects and surfaces such as workstations,
keyboards, telephones, handrails, and doork***s. Dirty surfaces can be cleaned with
soap and water prior to disinfection. To disinfect, use products that meet EPA’s criteria
for use against SARS-CoV-2external icon, the cause of COVID-19, and are appropriate
for the surface.
• Avoid using other employees’ phones, desks, offices, or other work tools and
equipment, when possible. If necessary, clean and disinfect them before and after use.
• Practice social distancing by avoiding large gatherings and maintaining distance
(approximately 6 feet or 2 meters) from others when possible.
Maintain Healthy Business Operations
Identify a workplace coordinator who will be responsible for COVID-19 issues and their impact at the workplace.
Implement flexible sick leave and supportive policies and practices.
• Ensure that sick leave policies are flexible and consistent with public health guidance
and that employees are aware of and understand these policies.
• Maintain flexible policies that permit employees to stay home to care for a sick family
member or take care of children due to school and childcare closures. Additional
flexibilities might include giving advances on future sick leave and allowing
employees to donate sick leave to each other.
• Employers that do not currently offer sick leave to some or all of their employees may
want to draft non-punitive “emergency sick leave” policies.
• Employers should not require a positive COVID-19 test result or a healthcare
provider’s note for employees who are sick to validate their illness, qualify for sick
leave, or to return to work. Healthcare provider offices and medical facilities may be
extremely busy and not able to provide such documentation in a timely manner.
• Review human resources policies to make sure that policies and practices are
consistent with public health recommendations and are consistent with existing state
and federal workplace laws (for more information on employer responsibilities, visit
the Department of Labor’s [https://www.dol.gov/] and the Equal Employment
Opportunity Commission’s [https://www.eeoc.gov/] websites).
• Connect employees to employee assistance program (EAP) resources (if available) and
community resources as needed. Employees may need additional social, behavioral,
and other services, for example, to cope with the death of a loved one.
Assess your essential functions and the reliance that others and the community have on your services or products.
• Be prepared to change your business practices if needed to maintain critical operations
(e.g., identify alternative suppliers, prioritize existing customers, or temporarily
suspend some of your operations if needed).
• Identify alternate supply chains for critical goods and services. Some good and services
may be in higher demand or unavailable.
• Talk with companies that provide your business with contract or temporary employees
about the importance of sick employees staying home and encourage them to develop
non-punitive leave policies.
• Talk with business partners about your response plans. Share best practices with other
businesses in your communities (especially those in your supply chain), chambers of
commerce, and associations to improve community response efforts.
Determine how you will operate if absenteeism spikes from increases in sick employees, those who stay home to care for sick family members, and those who must stay home to watch their children if dismissed from childcare programs and K-12 schools.
• Plan to monitor and respond to absenteeism at the workplace.
• Implement plans to continue your essential business functions in case you experience
higher than usual absenteeism.
• Prepare to institute flexible workplace and leave policies.
• Cross-train employees to perform essential functions so the workplace can operate
even if key employees are absent.
Consider establishing policies and practices for social distancing. Social distancing should be implemented if recommended by state and local health authorities. Social distancing means avoiding large gatherings and maintaining distance (approximately 6 feet or 2 meters) from others when possible (e.g., breakrooms and cafeterias). Strategies that business could use include:
• Implementing flexible worksites (e.g., telework)
• Implementing flexible work hours (e.g., staggered shifts)
• Increasing physical space between employees at the worksite
• Increasing physical space between employees and customers (e.g., drive through,
partitions)
• Implementing flexible meeting and travel options (e.g., postpone non-essential
meetings or events)
• Downsizing operations
• Delivering services remotely (e.g. phone, video, or web)
• Delivering products through curbside pick-up or delivery
Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions outlined in their COVID-19 response plan based on local conditions.
Maintain a healthy work environment
Consider improving the engineering controls using the building ventilation system. This may include some or all of the following activities:
• Increase ventilation rates.
• Increase the percentage of outdoor air that circulates into the system.
Support respiratory etiquette and hand hygiene for employees, customers, and worksite visitors:
• Provide tissues and no-touch disposal receptacles.
• Provide soap and water in the workplace. If soap and water are not readily available,
use alcohol-based hand sanitizer that is at least 60% alcohol. If hands are visibly dirty,
soap and water should be chosen over hand sanitizer. Ensure that adequate supplies are
maintained.
• Place hand sanitizers in multiple locations to encourage hand hygiene.
• Place posters that encourage hand hygiene to help stop the spread at the entrance to
your workplace and in other workplace areas where they are likely to be seen.
• Discourage handshaking – encourage the use of other noncontact methods of greeting.
• Direct employees to visit the coughing and sneezing etiquette [https://www.cdc.gov/healthywater/hygiene/etiquette/coughing_sneezing.html] and clean hands
[https://www.cdc.gov/handwashing/index.html] webpage for more information.
Perform routine environmental cleaning and disinfection:
• Routinely clean and disinfect all frequently touched surfaces in the workplace, such as
workstations, keyboards, telephones, handrails, and doork***s.
• If surfaces are dirty, they should be cleaned using a detergent or soap and water
prior to disinfection.
• For disinfection, most common EPA-registered household disinfectants should
be effective. A list of products that are EPA-approved for use against the virus
that causes COVID-19 is available here:
[https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2]. Follow the manufacturer’s instructions for all cleaning and disinfection
products (e.g., concentration, application method and contact time, etc.).
• Discourage workers from using other workers’ phones, desks, offices, or other work
tools and equipment, when possible. If necessary, clean and disinfect them before and
after use.
• Provide disposable wipes so that commonly used surfaces (for example, doork***s,
keyboards, remote controls, desks, other work tools and equipment) can be wiped
down by employees before each use. To disinfect, use products that meet EPA’s
criteria for use against SARS-Cov-2
[https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2],
the cause of COVID-19, and are appropriate for the surface.
Perform enhanced cleaning and disinfection after persons suspected/confirmed to have
COVID-19 have been in the facility:
• If a sick employee is suspected or confirmed to have COVID-19, follow the CDC
cleaning and disinfection recommendations:
https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning-disinfection.html
Advise employees before traveling to take additional preparations:
• Check the CDC’s Traveler’s Health Notices for the latest guidance and
recommendations for each country to which you will travel. Specific travel information
for travelers going to and returning from countries with travel advisories, and
information for aircrew, can be found on the CDC website.
• Advise employees to check themselves for symptoms of COVID-19 (i.e., fever, cough,
or shortness of breath) before starting travel and notify their supervisor and stay home
if they are sick.
• Ensure employees who become sick while traveling or on temporary assignment
understand that they should notify their supervisor and promptly call a healthcare
provider for advice if needed.
• If outside the United States, sick employees should follow company policy for
obtaining medical care or contact a healthcare provider or overseas medical assistance
company to assist them with finding an appropriate healthcare provider in that country.
A U.S. consular officer can help locate healthcare services. However, U.S. embassies,
consulates, and military facilities do not have the legal authority, capability, and
resources to evacuate or give medicines, vaccines, or medical care to private U.S.
citizens overseas.
Take care when attending meetings and gatherings:
• Carefully consider whether travel is necessary.
• Consider using videoconferencing or teleconferencing when possible for work-related
meetings and gatherings.
• Consider canceling, adjusting, or postponing large work-related meetings or gatherings
that can only occur in-person.
• When videoconferencing or teleconferencing is not possible, hold meetings in open,
well-ventilated spaces.
Resources for more information:
• COVID-19 Website
https://www.cdc.gov/coronavirus/2019-ncov/index.html
• What You Need to Know About COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/downloads/2019-ncov-factsheet.pdf
• What to Do If You Are Sick With COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/downloads/sick-with-2019-nCoV-fact-sheet.pdf
• Interim US Guidance for Risk Assessment and Public Health Management of Persons
with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated
or Community Settings
https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html
• Health Alert Network
https://emergency.cdc.gov/HAN/
• Travelers’ Health Website
https://wwwnc.cdc.gov/travel
• National Institute for Occupational Safety and Health’s Small Business International
Travel Resource Travel Planner
https://www.cdc.gov/niosh/docs/2019-165/pdfs/2019-165.pdf?id=10.26616/NIOSHPUB2019165
• Coronavirus Disease 2019 Recommendations for Ships
https://www.cdc.gov/quarantine/maritime/index.html
• Coronavirus Disease 2019 Recommendations for Airlines and Airline crew
https://www.cdc.gov/quarantine/air/managing-sick-travelers/ncov-airlines.html
• Persons at Higher Risk of Severe Illness
https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher-risk.html
Other Federal Agencies and Partners
• OSHA COVID-19 Website
https://www.osha.gov/SLTC/covid-19/
• OSHA Guidance for Preparing Workplaces for COVID-19
https://www.osha.gov/Publications/OSHA3990.pdf
Criteria for Return to Work for Healthcare Personnel with Confirmed or
Suspected COVID-19 (Interim Guidance)
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
Summary of Recent Changes as of April 13, 2020
• Indicates a preference for use of the Test-based strategy to determine when HCP may
return to work in healthcare settings
• Adds return to work criteria for HCP with laboratory-confirmed COVID-19 who have
not had any symptoms
• Aligns with recommendations for universal source control for everyone in a healthcare
facility during the pandemic.
CDC guidance for COVID-19 may be adapted by state and local health departments to respond to rapidly changing local circumstances.
Who this is for: Occupational health programs and public health officials making decisions about return to work for healthcare personnel (HCP) with confirmed COVID-19, or who have suspected COVID-19 (e.g., developed symptoms of a respiratory infection [e.g., cough, sore throat, shortness of breath, fever] but did not get tested for COVID-19).
Decisions about return to work for HCP with confirmed or suspected COVID-19 should be made in the context of local circumstances. Options include a test-based strategy or a non-test-based strategy (i.e., time-since-illness-onset and time-since-recovery strategy).
Return to Work Criteria for HCP with Confirmed or Suspected COVID-19
Use the Test-based strategy as the preferred method for determining when HCP may return to work in healthcare settings:
1. 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 molecular assay for
COVID-19 from at least two consecutive nasopharyngeal swab specimens collected
≥24 hours apart (total of two negative specimens) [1]. See Interim Guidelines for
Collecting, Handling, and Testing Clinical Specimens for 2019 Novel Coronavirus
(2019-nCoV)
[https://www.cdc.gov/coronavirus/2019-ncov/lab/guidelines-clinical-specimens.html].
If the Test-based strategy cannot be used, the Non-test-based strategy may be used for determining when HCP may return to work in healthcare settings:
2. Non-test-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 7 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.
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.
Return to Work Practices and Work Restrictions
After returning to work, HCP should:
• Wear a facemask for source control at all times while in the healthcare facility until all
symptoms are completely resolved or until 14 days after illness onset, whichever is
longer. A facemask instead of a cloth face covering should be used by these HCP for
source control during this time period while in the facility. After this time period,
these 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 (or other recommended PPE) when indicated, including
when caring for patients with suspected or confirmed COVID-19.
• Of note, N95 or other respirators with an exhaust valve might not provide
source control.
• Be restricted from contact with severely immunocompromised patients (e.g.,
transplant, hematology-oncology) until 14 days after illness onset
• Self-monitor for symptoms, and seek re-evaluation from occupational health if
respiratory symptoms recur or worsen
Strategies to Mitigate Healthcare Personnel Staffing Shortages
Maintaining appropriate staffing in healthcare facilities is essential to providing a safe work environment for healthcare personnel (HCP) and safe patient care. As the COVID-19 pandemic progresses, staffing shortages will likely occur due to HCP exposures, illness, or need to care for family members at home. Healthcare facilities must be prepared for potential staffing shortages and have plans and processes in place to mitigate them, including considerations for permitting HCP to return to work without meeting all return to work criteria above. Refer to the Strategies to Mitigate Healthcare Personnel Staffing Shortages document for information.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/mitigating-staff-shortages.html
Footnotes
1. All test results should be final before isolation is ended. Testing guidance is based upon limited information and is subject to change as more information becomes available. In persons with a persistent productive cough, SARS-CoV-2-RNA might be detected for longer periods in sputum specimens than in upper respiratory tract (nasopharyngeal swab) specimens.
Definitions
• Cloth face covering: Textile (cloth) cover that are intended to keep the person wearing
one from spreading respiratory secretions when talking, sneezing, or coughing. They
are not PPE and it is uncertain whether cloth face coverings protect the wearer.
Guidance on design, use, and maintenance of cloth face coverings is available.
• Facemask: Facemasks are PPE and are often referred to as surgical masks or procedure
masks. Use facemasks according to product labeling and local, state, and federal
requirements. FDA-cleared surgical masks are designed to protect against splashes and
sprays and are prioritized for use when such exposures are anticipated, including
surgical procedures. Facemasks that are not regulated by FDA, such as some
procedure masks, which are typically used for isolation purposes, may not provide
protection against splashes and sprays.
• Respirator: A respirator is a personal protective device that is worn on the face, covers
at least the nose and mouth, and is used to reduce the wearer’s risk of inhaling
hazardous airborne particles (including dust particles and infectious agents), gases, or
vapors. Respirators are certified by the CDC/NIOSH, including those intended for use
in healthcare.
Further Guidance re self-quarantine an d sick leave:
• CDC guidelines require the exposed employees to self-quarantine due to their exposure
to a COVID-19 positive person (even if they don’t have symptoms), then depending
on the size of the employer and its location, either the expanded sick leave law under
FFCRA or City of LA’s emergency paid sick leave ordinance may apply (assuming the
job is the kind that cannot be done remotely).
Coronavirus disease 2019 (COVID-19) - Interim Guidance for Businesses and Employers