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COVID-19 Briefing - Friday, October 23rd

Everything you need to know heading into the weekend...

Today's Recap:

Best Questions:

Does the new CDC guidance on close contact mean we’re going to have more exclusions?

We don’t think so.  The good news here is that this is basically what our clinical team has been guiding our clients to do since back in August, when our contacts at the CDC started clarifying that they meant 15 cumulative minutes. This is just a clarification for the time period for us to count small interactions that add up to 15 mins. In most workplace cases, people either only see each other once per 24-hour period for a work shift, for example, or they live together, hang out outside of work, etc. in which case they often hit the 15-minute-mark clearly in a short period of time. In practice, this guidance doesn’t change much and we don’t expect it to add many exclusions.

If someone has an antibody test which is positive (they had COVID 5 months ago), do we still need to exclude them for new close contact or symptoms?

Unfortunately, positive antibody tests don’t tell us much that’s actionable. The only people who don’t need to be excluded when they have close contact are those who have had active COVID-19 in the past 90 days (confirmed by a PCR or antigen test). That same group doesn’t need to be excluded for a full 10 days if they experience COVID-like symptoms again within the 90 day window, but they do need to be fever-free and any respiratory or GI symptoms resolved before they can return to work.

For anyone who has had COVID more than 90 days ago, they’ll need a full, normal exclusion each new time they are exposed via close contact and/or each new time they experience COVID-like symptoms.  

There’s still so much we don’t know about COVID antibodies, COVID antibody testing and re-infection.  Once we do know more, there’s a chance this guidance will be revised. But for now, it stands.

Does an exclusion for close contact with a COVID positive start from the onset of the sick person’s symptoms or the last contact with the person who tested positive?

This is one of the most common questions we get.  And the answer is: An exclusion starts from the most recent contact with the person who tested positive, as long as that contact took place when they were infectious. Although they were infectious from two days before the onset of symptoms, they remain infectious for ten days from onset (or test date). So any contact during that 12-day period is considered a close contact with a COVID positive case.

An employee was within 6ft for 15+ total mins of someone who now has COVID-like symptoms, but hasn’t been tested yet. Do we need to exclude them?

This depends. If they were just in normal, everyday contact (hopefully masked) and the person isn’t yet confirmed COVID, we generally don’t recommend excluding them. Especially as we head into the winter cold and flu season, we want to be reasonable about excluding people who might have spent 20 mins around someone with a minor cold. But if they live together, are intimate with the sick person, act as caretaker for them, hugged or kissed, shared utensils/drink/vape/cigarettes, or somehow got respiratory droplets through being coughed or sneezed on, then we’d likely go ahead and exclude for COVID-like symptoms.

If an employee has a very minor symptom along with close contact to a confirmed COVID+, should they be excluded for 10 days due to symptoms or 14 days due to exposure?

Generally, we say that symptoms trump exposure. If someone has COVID-like symptoms that would result in a 10-day exclusion, and they were exposed to someone with COVID, the simplest explanation is that they already have COVID and just need to be out for 10 days from their symptom onset.

If they have a very minor symptom, like just a headache or just nausea, which wouldn’t normally result in a 10-day exclusion, then that’s a different story and we’ll stick with the 14-day exclusion for now. Most of the time, unfortunately, that person will develop other, clearer cut symptoms later on at which point we’ll switch them over to a 10-day exclusion.

Best Read:

We’re hearing an awful lot about potential and real drug shortages lately. This is a great read about the impact of COVID on drug supplies and how to ensure a resilient US supply.

The CIDRAP Viewpoint:  Ensuring a Resilient US Prescription Drug Supply

Best Laugh:

COVID has brought out the best and worst in us. Here’s some of the best. Click through the link to see some signs this restaurant has posted which will truly make you LOL.

This Austin Restaurant is Making the Wittiest Pandemic Signs Anywhere

Irreverence against Covid on the signboards of a tex-mex restaurant in  Austin - Domus

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Disclaimer: This post is meant for general information and educational purposes only and does not constitute, and is not intended as, any form of medical, legal or regulatory advice or a recommendation or suggestion regarding the same.  No recipient of this information should act or refrain from acting on the basis of this information without first seeking legal advice from counsel in the relevant jurisdiction.