Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2

Return to Work Criteria for HCP with SARS-CoV-2 Infection

The Centers for Disease Control and Prevention (CDC) has issued interim guidance for managing healthcare personnel (HCP) who have been infected with or exposed to SARS-CoV-2, the virus that causes COVID-19. The guidance provides criteria for determining when HCP with SARS-CoV-2 infection can safely return to work based on the severity of their symptoms and the presence of immunocompromising conditions.

Mild to Moderate Illness

HCP with mild to moderate illness and who are not moderately to severely immunocompromised may return to work if the following criteria have been met:

• At least 7 days have passed since symptoms first appeared, and a negative viral test* is obtained within 48 hours prior to returning to work (or 10 days if testing is not performed or if a positive test occurred between day 5-7).
• At least 24 hours have passed since the last fever without the use of fever-reducing medications.
• Symptoms such as cough and shortness of breath have improved.

*Either a NAAT (molecular) or antigen test may be used. If an antigen test is used, HCP should have a negative test obtained on day 5 and again 48 hours later.

Asymptomatic HCP

HCP who were asymptomatic throughout their infection and are not moderately to severely immunocompromised may return to work if the following criteria have been met:

• At least 7 days have passed since the date of their first positive viral test, and a negative viral test* is obtained within 48 hours prior to returning to work (or 10 days if testing is not performed or if a positive test occurred between day 5-7).

*Either a NAAT (molecular) or antigen test may be used. If an antigen test is used, HCP should have a negative test obtained on day 5 and again 48 hours later.

Severe to Critical Illness

HCP with severe to critical illness who are not moderately to severely immunocompromised may return to work if the following criteria have been met:

• At least 10 days and up to 20 days have passed since symptoms first appeared.
• At least 24 hours have passed since the last fever without the use of fever-reducing medications.
• Symptoms such as cough and shortness of breath have improved.
• The test-based strategy, as described below, can be used to determine the duration of work restriction for moderately to severely immunocompromised HCP.

The exact criteria for determining the duration of viral shedding in HCP are not known. Factors such as disease severity and the presence of immunocompromising conditions should be considered when determining the appropriate duration for specific HCP. For more information, refer to the CDC’s Ending Isolation and Precautions for People with COVID-19 Interim Guidance.

Moderately to Severely Immunocompromised HCP

HCP who are moderately to severely immunocompromised may produce replication-competent virus beyond 20 days after symptom onset or the date of their first positive viral test if they were asymptomatic throughout their infection. In these cases, consultation with an infectious disease specialist or other expert, as well as an occupational health specialist, is recommended to determine when these HCP can safely return to work. The use of a test-based strategy is advised.

Test-Based Strategy

HCP who are symptomatic could return to work if the following criteria are met:

• Resolution of fever without the use of fever-reducing medications.
• Improvement in symptoms such as cough and shortness of breath.
• Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) and tested using an antigen test or NAAT.

HCP who are asymptomatic could return to work if the following criteria are met:

• Results are negative from at least two consecutive respiratory specimens collected 48 hours apart (total of two negative specimens) and tested using an antigen test or NAAT.

FAQs

1. When can healthcare personnel with mild to moderate illness return to work?

• HCP with mild to moderate illness and who are not moderately to severely immunocompromised can return to work after meeting specific criteria, including the passage of at least 7 days since symptoms first appeared, a negative viral test result, and the improvement of symptoms.

2. What are the return to work criteria for asymptomatic healthcare personnel?

• Asymptomatic HCP can return to work after at least 7 days have passed since their first positive viral test and obtaining a negative viral test result.

3. How can healthcare personnel with severe to critical illness return to work?

• HCP with severe to critical illness and who are not moderately to severely immunocompromised can return to work after meeting criteria such as the passage of at least 10 days since symptoms first appeared, the absence of fever for 24 hours, and the improvement of symptoms.

Conclusion

The CDC has provided interim guidance for managing healthcare personnel with SARS-CoV-2 infection or exposure to SARS-CoV-2. The guidance outlines return to work criteria based on the severity of symptoms and the presence of immunocompromising conditions. Following these criteria will help ensure the safety of both HCP and their patients. For more information and detailed guidance, visit News Explorer Today.