Healthcare personnel (HCP) who are suspected or confirmed to have COVID-19 should meet the Centers for Disease Control and Prevention (CDC) Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 (Interim Guidance)[i]. Decisions about returning to work should be made in the context of local circumstances. Options include:
Symptomatic HCP with suspected or confirmed COVID-19 (Either strategy is acceptable depending on local circumstances):
- Symptom-based strategy. Exclude from work until:
- At least 3 days (72 hours) have passed since recoverydefined 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:
- 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 respiratory specimens collected ≥24 hours apart (total of two negative specimens)
- Symptom-based strategy. Exclude from work until:
HCP with laboratory-confirmed COVID-19 who have not had any symptoms (Either strategy is acceptable depending on local circumstances):
- 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-basedor test-based strategy should be used.
- 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 respiratory specimens collected ≥24 hours apart (total of two negative specimens).
COVID-19 Antibody Testing NOT Required
An antibody test is different from a viral test. Antibody tests help determine whether the individual being tested was ever infected, and according to the CDC Interim Guidelines for COVID-19 Antibody Testing[ii], antibody test results “should not be used to make decisions about returning persons to the workplace.” Additionally, the CDC’s Interim SARS-CoV-2 Testing Guidelines for Nursing Home Residents and Healthcare Personnel[iii] offers the following, “Antibody (serologic) test results should generally not be used as the sole basis to diagnose an active SARS-CoV-2 infection and should not be used to inform IPC [infection prevention and control].”
On June 17, 2020, the U.S. Equal Employment Opportunity Commission (EEOC) issued an updated COVID-19 technical assistance publication[iv] addressing antibody testing. At this time, the Americans with Disabilities Act (ADA) does not allow employers to require antibody testing before allowing employees to re-enter the workplace as an antibody test at this time does not meet the ADA’s “job related and consistent with business necessity” standard for medical examination or inquiries for current employees. A viral test can determine whether someone has an active case of COVID-19 and is permissible under the ADA.
The EEO laws, including the ADA and Rehabilitation Act, continue to apply during the time of the COVID-19 pandemic, but they do not interfere with or prevent employers from following the guidelines and suggestions made by the CDC or state/local public health authorities about steps employers should take regarding COVID-19[v].
Title I of the ADA applies to private employers with 15 or more employees. It also applies to state and local government employers, employment agencies, and labor unions. All nondiscrimination standards under Title I of the ADA also apply to federal agencies under Section 501 of the Rehabilitation Act.
References
[i] Centers for Disease Control and Prevention. Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 (Interim Guidance). https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html
[ii] Centers for Disease Control and Prevention. Interim Guidelines for COVID-19 Antibody Testing. https://www.cdc.gov/coronavirus/2019-ncov/lab/resources/antibody-tests-guidelines.html
[iii] Centers for Disease Control and Prevention. Interim SARS-CoV-2 Testing Guidelines for Nursing Home Residents and Healthcare Personnel. https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-testing.html
[iv] U.S. Equal Employment Opportunity Commission. COVID-19 Technical Assistance Publication. https://www.eeoc.gov/newsroom/eeoc-issues-updated-covid-19-technical-assistance-publication-addressing-antibody-testing
[v] U.S. Equal Employment Opportunity Commission. What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws. https://www.eeoc.gov/wysk/what-you-should-know-about-covid-19-and-ada-rehabilitation-act-and-other-eeo-laws
Blog by Eleisha Wilkes, RN, RAC-CTA, Proactive Medical Review
Learn more about Eleisha and the rest of the Proactive team.