The California Department of Public Health has provided a COVID-19 outbreak guide for employers in conjunction with the guidance for reopening that the State of California has already provided.
The guidance is not intended for healthcare, congregate living settings and other such workplaces where the Cal/OSHA Aerosol Transmission Disease (ADT) standard applied.
Preparations for Identification of a COVID-19 Outbreaks in Their Workplace
Designating a person to be a workplace prevention coordinator is important to make sure there is someone responsible for implementing COVID-19 preventative measures and procedures to manage any outbreaks or COVID-19 related issues with employees.
Although Employers have been told numerous times to provide posters and instruct employees to stay home if they feel ill or have symptoms of COVID-19, it is crucial to keep reminding employers and employees about this. Some employees are facing the loss of income and a paycheck if they miss work or feel they will lose their job. That is why open communication about the employee’s health and contact with family members with COVID-19 immensely critical to preventing an outbreak.
- Remind employees to stay home is they have symptoms of COVID-19 include fever, chills, shaking chills, cough, difficulty breathing, sore throat, body or muscle aches, loss of taste or smell, loss of appetite, diarrhea, or loss of appetite.
- Have employees report to the coordinator if they have symptoms, were diagnosed with COVID-19, or are awaiting test results for COVID-19.
- Develop mechanisms for tracking suspected and confirmed cases among employees.
- Ensure that employees are informed and have access to sick leave policies that are sufficiently generous and flexible to enable employees to stay home if needed without penalty. There are additional services for employees such as supplemental paid sick leave for food sector employees with 500 or more employees nationwide and under the Families First Coronavirus Response Act.
- Identify contact information for the local health department (LHD) in the area where the workplace is located and where employees reside, if they reside in another county.
Employers Should be Prepared to Share Information with the Local Health Department and other Stakeholders
Notify the local health department where the workplace is located if there is a known or reasonable suspected outbreak in the workplace or if there are laboratory confirmed cases of COVID-19 in the workplace.
When there is an outbreak in a workplace, employers should contact the local health department in the jurisdiction where a COVID-19 positive employee resides and let them know about the outbreak.
Find out from the local health department on how frequently they expect the employer to provide updates to them about newly identified cases and any symptomatic employees.
The department further recommends that if the employees are unionized, identify in the union contract to clarify the role the union can assist in communication with employees. If the employer uses a contract, agency or temporary employees, the coordinator should identify who should communicate information and instructions on the outbreak to the contracted/temporary individuals.
Testing for Additional Employee Cases and Research Close Contacts to Control Further Spread in the Workplace
The guidance indicates that when an outbreak is suspected or known, testing all employees should be the first strategy considered for identification of all cases in the workplace. Employers should receive guidance from the local health department on how the testing can be arranged and how to prioritize testing. Employers can offer on-site COVID-19 testing of employees or otherwise arrange for testing through the company’s occupational or general medical services provider. Employers should notify the employees that they can contact their medical provider if they prefer them to do the testing.
If for some reason testing all employees is not available or recommended by the local health department, there are other alternative measures for controlling an outbreak. Some methods include tracing all close contacts of confirmed cases through interviews/shift records and instructing those individuals to quarantine or temporarily closing the workplace and quarantining all employees.
The guidance defines close contact as someone who spent 15 minutes or more within 6 feet of an individual with COVID-19 during their infectious period, which is the 48 hours before the individual developed symptoms. Close contacts should be instructed to quarantine at home for 14 days from their last known contact with the employee with COVID-19. Close contacts should be tested for COVID-19 when possible.
Remember that employers have to maintain confidentiality of employees suspected of or confirmed with having COVID-19 when talking to other employees at the worksite. Employers can only notify employees that were potentially exposed and provide information on home quarantine and symptom monitoring.
As part of the outbreak management, a strategy for when employees can return to work should be implemented. The CDC has recommended the following strategy and the local health department may recommend the following depending on the jurisdiction and outbreak:
| Symptomatic Positive
Employees with symptoms who are laboratory confirmed to have COVID-19 |
At least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and, at least 10 days have passed since symptoms first appeared. |
| Asymptomatic Positive
Employees who never had symptoms and are laboratory confirmed to have COVID-19 |
A minimum of 10 days has passed since the date of their first positive COVID-19 test. If they develop symptoms, then the criteria for laboratory-confirmed cases with symptoms apply. |
| Symptomatic Negative
Employees who had symptoms of COVID-19, but test result returned negative |
Same as laboratory confirmed cases. At least 3 days (72 hours) have passed since recovery, defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and, at least 10 days have passed since symptoms first appeared. |
| Asymptomatic Negative
Employees who never had symptoms, but were tested due to close contact with a laboratory-confirmed case-patient and were negative |
Employees should quarantine at home for 14 days after the last known close contact with the case-patient. Symptoms can develop even after testing negative within 14 days after exposure. |
| Symptomatic Untested
Employees who had symptoms of COVID-19 but were not tested |
Testing is highly recommended. If the employee cannot be tested, use the same criteria for return to work as laboratory-confirmed cases. |
| Asymptomatic Untested But Close Contact with Laboratory Confirmed COVID-19 Patient | Employees should be quarantined at home for 14 days after the last known close contact with the case patient
Employees who develop symptoms of COVID-19 while in quarantine should contact their healthcare provider. Even if they are not tested, the same criteria for return to work should be used as laboratory-confirmed cases. |
The Guidance warns that employers must be aware that testing reflects an employee’s status at a single point in time only. Even if an employee tests negative, they may still develop COVID-19 from a recent or subsequent exposure and should be quarantine at home. If a workplace outbreak is ongoing, testing may be needed at repeated intervals to capture all positive cases.
Lastly, the Guidance emphasizes that after a workplace outbreak, work areas of infected workers should not be entered by employees until they have been cleaned and disinfected with products approved by the EPA for COVID-19. Ongoing enhanced cleaning/disinfection of work areas when an employee with COVID-19 is identified is essential. Upon return, make sure employees use cleaners to disinfect their work areas regularly along with using provided necessary protective equipment.
Of course, in addition to Public Health guidance, Employers should review: Cal/OSHA Guidance for complying with the legal requirements to protect workers and reporting employee cases, including COVID-19 inpatient hospitalizations and deaths among employees; and the CDC website, at least weekly, for additional information on preventing outbreaks.