July 28, 2020
The Centers for Disease Control and Prevention (CDC) updated its guidance on July 20th related to the discontinuation of home isolation after a positive COVID-19 test. This updated guidance impacts employers who are returning non-healthcare employees to work after they test positive.
Previously, the CDC recommended the use of either a testing-based strategy or a symptom-based strategy to discontinue home isolation. Under the testing-based strategy, quarantining could be discontinued after two negative tests taken more than 24 hours apart. Many employers were using the testing-based strategy, rather than the symptom-based strategy, to return employees to work. However, the new CDC guidelines no longer recommend use of the test-based strategy to discontinue home isolation, except for persons who are severely immunocompromised.
Additionally, the CDC has changed the guidance for the symptom-based criteria. For employees who tested positive but never developed symptoms, the CDC now recommends that isolation and other precautions can be discontinued 10 days after the date of the employee’s first positive test. Employees who exhibited symptoms can discontinue home isolation if at least 10 days have passed since the onset of symptoms, and at least 24 hours have passed since the resolution of fever without the use of fever reducing medication, and all other symptoms have improved. Previous guidance required at least 72 hours since the resolution of fever and improvement of respiratory symptoms. The CDC warns, however, that some individuals with severe illness may produce replication-competent virus beyond 10 days, which warrants extending the person’s isolation for up to 20 days in consultation with an infection control expert.
This updated guidance is good news for employers who were having a difficult time returning recovered COVID-19 employees to work due to limited access to testing and the lag time related to receiving test results. However, there is no prohibition under the law that prevents employers from using stricter guidelines than those recommended by the CDC to return employees to work. An employer can continue to require an employee to obtain two negative tests, if the employer complies with applicable law, or require employees to wait 14 days instead of 10, before returning an employee to work. Additionally, because employers are unlikely to know how severe the employee’s illness was, it is recommended employers consider requiring employees to obtain a medical certification, or letter from their local health department, authorizing them to discontinue home isolation and return to work.
CDC guidance is a general recommendation that can, and may, be superseded by state mandate. States may implement stricter quarantine requirements for employees who test positive. Employers should ensure compliance with state law, in addition to CDC guidance, before returning an employee to work.
Additionally, employers should note that the quarantine method for a workplace exposure differs from quarantine obligations mandated by states when an employee travels out-of-state and is required to quarantine before returning to work.
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