Return to Work Criteria for HCP with Confirmed or Suspected COVID-19

As of August 10, 2020, CDC recommends new criteria for return to work for HCP with confirmed or suspected COVID-19 which include a symptom-based (i.e., time-since-illness-onset and time-since-recovery strategy), time-based strategy or a test-based strategy (symptom-based preferred). Of note, there have been reports of prolonged detection of RNA without direct correlation to viral culture. Detecting viral RNA via PCR does not necessarily mean that infectious virus is present.

Symptomatic HCP with suspected or confirmed COVID-19:
  • Symptom-based strategy. Exclude from work until:
    • At least 1 days (24 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.
  • Test-based strategy. Exclude from work until (not recommended):
    • Resolution of fever without the use of fever-reducing medications and
    • Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
    • Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens). Of note, there have been reports of prolonged detection of RNA without direct correlation to viral culture.
HCP with laboratory-confirmed COVID-19 who have not had any symptoms:
  • Time-based strategy. Exclude from work until:
    • 10 days have passed since the date of their first positive COVID-19 diagnostic test assuming they have not subsequently developed symptoms since their positive test. If they develop symptoms, then the symptom-based or test-based strategy should be used.
      • Note, because symptoms cannot be used to gauge where these individuals are in the course of their illness, it is possible that the duration of viral shedding could be longer or shorter than 10 days after their first positive test.
  • Test-based strategy. Exclude from work until:
    • Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens).
      • Note, because of the absence of symptoms, it is not possible to gauge where these individuals are in the course of their illness. There have been reports of prolonged detection of RNA without direct correlation to viral culture.
Consider consulting with local infectious disease experts when making decisions about discontinuing Transmission-Based Precautions for individuals who might remain infectious longer than 10 days (e.g., severely immunocompromised).

COVID-19 Reporting

Where to submit cases to CDPH: