According to the CDC the new definition of close contact is:
Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.
The key change is that the definition of “prolonged” was extended to refer to a time period of a total of 15 or more minutes, which aligns with the time period used in the guidance for community exposures and contact tracing.
If a HCP has prolonged close contact with a patient, visitor, or HCP with confirmed COVID-19 and the HCP not wearing a facemask (or eye protection if the person with COVID-19 was not wearing a cloth face covering or facemask), the HCP would have the following work restrictions:
- Exclude from work for 14 days after last exposure
- Monitor themselves for fever or symptoms consistent with COVID-19
- Any HCP who develop fever or symptoms consistent with COVID-19 should immediately get medical evaluation and testing.
If the HCP was properly using PPE there are basically no work restrictions, but the HCP should:
- Follow all recommended infection prevention and control practices, including wearing a facemask for source control while at work, monitoring themselves for fever or symptoms consistent with COVID-19 and not reporting to work when ill, and undergoing active screening for fever or symptoms consistent with COVID-19 at the beginning of their shift.
- Any HCP who develop fever or symptoms consistent with COVID-19 should immediately self-isolate and get medical evaluation and testing.
If the HCP does contract COVID, the CDC provides the following guidance on returning to work:
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 days have passed since symptoms first appeared and
- At least 24 hours since last fever (w/o use of fever-reducing medications) and
- Symptoms (e.g., cough, shortness of breath) have improved
* note there are stricter requirements for severe cases or immunocompromised HCP
Test-Based Strategy for Determining when HCP Can Return to Work.
In some instances, a test-based strategy could be considered to allow HCP to return to work earlier than if the symptom-based strategy were used. The criteria for the test-based strategy are:
HCP who are symptomatic:
- Resolution of fever without the use of fever-reducing medications and
- Improvement in symptoms (e.g., cough, shortness of breath), and
- Results are negative from at least two consecutive respiratory specimens collected ≥24 hours apart (total of two negative specimens) tested using an FDA-authorized molecular viral assay.
HCP who are not symptomatic:
- Results are negative from at least two consecutive respiratory specimens collected ≥24 hours apart (total of two negative specimens) tested using an FDA-authorized molecular viral assay.
