We advise against requiring a negative test or two consecutive negative tests to return to work. It isn’t clinically necessary and getting testing can be very challenging due to testing shortages and unreliable results.
Here’s the science behind it: the viral load is highest on two days prior to onset of symptoms and first day of symptoms and then drops each consecutive day. By day 10, the viral load has dropped to below a level that will infect others (although it may still be detectable which could still produce a positive result). Although clinically insignificant, some people are testing positive 80-100 days later, while there is no reason to keep them out of work that long .
Yes, even though CDC guidelines now say “symptoms improved,” we are still strongly recommending that respiratory and gastrointestinal symptoms are fully resolved before someone returns to work. This is more about optics of having a person coughing at work in front of co-workers and customers, for example, than about the science of their ability to infect others (very unlikely after 10 days).
We’re generally excluding in three day increments. There isn’t great guidance here and we’ve already discussed our concerns with returning employees who are coughing or having diarrhea.
Well - that is without the doubt, the issue of the last few days (and probably the next several weeks). The guidance on this one isn’t clear, and not every situation is the same. Here’s how we generally would handle it: If the sick person tests positive, then the answer is clearly yes, the employees will need to be excluded. But if the person who is sick has not been seen by a medical professional who gave them a presumptive COVID diagnosis, or if that person hasn’t tested positive, we would only exclude a coworker if they live with, care for, or are intimate with the person who is sick. If later the sick person tests positive, then we would go back and exclude folks who had close contact that meets the criteria (6ft, 15+ straight minutes while the sick person was symptomatic, or in the 2 days before they became symptomatic or tested positive).
Well, we can’t give legal advice but we also can’t communicate with a minor whose parents have specifically not provided consent. We would exclude the employee indefinitely until parental consent is obtained (or get HR and legal advice).
Although they didn’t provide a specific explanation, we believe it is because they have clearly documented that someone is no longer infectious ten days after onset of symptoms (or an initial positive test if asymptomatic). Working to help you get employees back to work, we now have a better feel for how many employees regularly take Tylenol or Advil (for back pain, old sports injuries and other chronic medical conditions). So getting someone to go three days without that pain relief can be difficult. This is a welcome change that will help get some people back to work sooner.
Symptoms always trump exposure. So if the employee was excluded for 14 days and on day 10 they develop symptoms, their new exclusion is 10 days from the symptom onset date (yes we know,,.that’s a long time).
In most of these situations, the transaction would not have resulted in close contact within six feet for 15+ straight minutes. Except in specific situations where the employee knows that they were definitely in close proximity for 15+ consecutive minutes, or they are contacted by an actual contract tracer from a local department of health, we generally don’t need to exclude for casual contact in a retail environment.
We’re still all looking for COVID immunity. Even with the incredible case counts, we’re not yet near herd immunity. This really excellent read addresses what we know and don’t about COVID-19 immunity.