On August 10, the Centers for Disease Control and Prevention (CDC) updated the return to work criteria for healthcare professionals (HCP) with the COVID-19 infection. A test-based strategy is no longer recommended (except as noted below) because, in the majority of cases, it results in excluding from work HCP who continue to shed detectable COVID-19 virus but are no longer infectious.
Return to work criteria for HCP with COVID-19 infection are broken down into two categories: symptom-based strategy and test-based strategy.
Symptom-based strategy for determining when HCP can return to work.
- HCP with mild to moderate illness who are not severely immunocompromised:
- At least 10-day shave passed since symptoms first appeared and
- At least 24 hours have passed since last fever without the use of fever-reducing medications and
- Symptoms (e.g., cough, shortness of breath) have improved
Note: HCP who are not severely immunocompromised and were asymptomatic throughout their infection may return to work when at least 10 days have passed since the date of their first positive viral diagnostic test.
- HCP with severe to critical illness or who are severely immunocompromised:
- At least 10 days and up to 20 days have passed since symptoms first appeared and
- At least 24 hours have passed since last fever without the use of fever-reducing medications and
- Symptoms (e.g., cough, shortness of breath) have improved
- Consider consultation with infection control experts
Notes: HCP who are severely immunocompromised but who were asymptomatic throughout their infection may return to work when at least 10 days and up to 20 days have passed since the date of their first positive viral diagnostic test.
Test-based strategy for determining when HCP can return to work. In some instances, test-based strategy could be considered to allow HCP to return to work earlier than if the symptom-based strategy were used. Many individuals will have prolonged viral shedding which limits the utility of test-based strategies. A test-based strategy could be considered for HCP (e.g., those who are severely immunocompromised) in consultation with local infectious disease experts if concerns exist for the HCP being infectious for more than 20 days.
Criteria for test-based strategy are:
- HCP who are symptomatic:
- Resolution of fever without the use of fever-reducing medications and
- Improvement of symptoms, and
- Results are negative from at least two consecutive respiratory specimens collected ≥24 hours apart.
- HCP who are not symptomatic:
- Results are negative from at least two consecutive respiratory specimens collected ≥24 hours apart.