The latest guidance says that critical workers, including health care providers, who may have been exposed to COVID-19 may continue to work under very controlled circumstances that include mask use (but must leave if they begin experiencing symptoms).
As the COVID-19 pandemic continues to grow, discussions are expanding beyond how to avoid exposure to the virus and toward what should happen after potential exposure occurs. The U.S. Centers for Disease Control and Prevention says that for "critical infrastructure workers" including health care providers, that response should include consistent employer efforts to pre-screen, monitor, disinfect, and support the use of masks and other PPE.
In a recently released interim guidance document, CDC says that while critical infrastructure workers may be allowed to work after potential exposure to COVID-19—provided they don't develop symptoms — it's important for the workers and their providers to take certain precautions. According to CDC, "potential exposure" is defined as "being a household contact or having a close contact within six feet of an individual with confirmed or suspected COVID-19," with a timeframe of 48 hours before the infected individual became symptomatic.
The CDC recommendations call for:
Pre-screening. "Employers should measure the employee’s temperature and assess symptoms prior to them starting work. Ideally, temperature checks should happen before the individual enters the facility."
Regular monitoring. "As long as the employee doesn’t have a temperature or symptoms, they should self-monitor under the supervision of their employer’s occupational health program."
Use of masks. "The employee should wear a face mask at all times while in the workplace for 14 days after last exposure. Employers can issue facemasks or can approve employees’ supplied cloth face coverings in the event of shortages."
Social distance. "The employee should maintain 6 feet and practice social distancing as work duties permit in the workplace."
Disinfection and cleaning. "Clean and disinfect all areas such as offices, bathrooms, common areas, shared electronic equipment routinely."
CDC also advises that employees who begin feeling sick during the day should be sent home immediately and their workspaces thoroughly cleaned. Employers should also collect information on the employee's activities for two days before the symptoms emerged, and consider others in a facility who were within six feet of the infected employee during that time to be exposed.
Bill Boissonnault, PT, DPT, DHSc, FAPTA, APTA's executive vice president of professional affairs, says that the CDC recommendations make it clear that providers and their employers shouldn't take chances — or cut corners — when it comes to responding to the COVID-19 emergency.
"These guidelines need to be taken seriously," Boissonnault said. "It's everyone's responsibility to take whatever precautions possible to limit the spread of the virus — including wearing PPE and making PPE available to workers."
he recommendations echo recent CMS guidelines for outpatient facilities that acknowledge the role employer discretion plays in minimizing risk of infection while providing necessary care — but strongly support the use of masks and other PPE when potential exposure has occurred. The U.S. Occupational Safety and Health Administration advises employers that they are "obligated to provide their workers with PPE needed to keep them safe while performing their jobs," leaving employers to decide the types of PPE to be issued "based on the risk of being infected with the SARS-CoV2 virus while performing job tasks that may lead to exposure."
The advisories from CDC and CMS are also consistent with guidance APTA provides on management of patients to minimize the risk of COVID-19 transmission.