Process for Reporting Symptoms/Positive Test for COVID-19

When symptoms are reported by:

1. Patient within 2 days following visit – continue to "If Patient Reports Symptoms."
2. Employee – skip to "If Employee Reports Symptoms."

If Patient Reports Symptoms

1. Record on Patient Tracking Form:
   • Date of reporting and date patient was last seen
   • Information provided by patient, including if testing has been done
2. If there is a positive diagnosis:
   • Assess employee "close contact" exposure.
   • Follow Process for Employee Exposure.
   • Send Notice of Potential Exposure to all employees who were at worksite during the high-risk exposure period. Notification must be made within one day of learning of positive test, diagnosis or quarantine. (required as of 1/1/2021)

If Employee Reports Symptoms

1. Record on Employee Tracking Form:
   • Date of reporting
   • Symptoms
2. Instruct employee to return home immediately, if not already home, and to keep employer updated on status.
3. Review Cal/OSHA return-to-work requirements.
4. Determine if there are other employees who should be included in the "exposed group."
5. Offer nonvaccinated employee COVID-19 testing at no cost to them.
6. If there is a positive diagnosis:
   • Assess if "close contact" exposures occurred at the worksite.
     • If yes, follow Process for Employee Exposure.
   • If there are three or more infected employees within 14 days, report outbreak to local health department.
   • Employers of >5 must report to workers’ comp carrier an employee’s positive COVID-19 test within 3 days.

Process for Employee Exposure

Follow if an employee reports exposure or is determined to have had exposure to symptomatic or COVID-19 case.

1. Determine: Is the employee fully vaccinated or was a confirmed case of COVID-19 and has been asymptomatic for 90 days after?
   • If yes, proceed to Employee May Continue to Work.
   • If no, continue to next step in process.
2. Record on Employee Tracking Form
   • Details of exposure, including date
   • Determine if it was a "close contact"
     • If yes, continue to Employee May Not Continue to Work.
     • If no, continue to Employee May Continue to Work.

Employee May Continue to Work

• Employee can continue to work and should actively self-monitor for 10 days.
• If employee becomes symptomatic in that time, instruct them to return home immediately.
• Review Cal/OSHA return-to-work requirements with employee.

Employee May Not Continue to Work

• Instruct employee to return home immediately and to keep employer updated on status. See COVID-19 Prevention Plan for more information.
• Review Cal/OSHA return-to-work requirements.
• Determine if there are other employees who should be included in "exposed group."
• Offer nonvaccinated employee COVID-19 testing at no cost to them.

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Glossary of terms:

• Close contact – Within 6 feet of a COVID-19 case for a cumulative total 15 minutes or more over a 24-hour period within or overlapping with the “high-risk exposure period” without respirator worn in accordance with a respiratory protection program.

• COVID-19 case – A person who has a positive COVID-19 test, has a positive COVID-19 diagnosis from a licensed health care provider or is subject to a COVID-19 related order to isolate issued by a local or state health official.

• Exposed group – Means all persons in a work location, working area or a common area at work where a COVID-19 case was present at any time during the high-risk exposure period, without wearing face coverings.

• Screening and symptoms guidance – Employee Screening Form.

• Face covering – A surgical mask, a medical procedure mask, a respirator worn voluntarily or a tightly woven or non-woven fabric of at least two layers.

• Fully vaccinated – Employer has documentation showing that person received, at least 14 days prior, either the second dose in a two-dose COVID-19 vaccine or a single-dose COVID-19 vaccine.

• High-risk exposure period – COVID-19 cases who develop symptoms from two days before they first develop symptoms until ALL of the following are true: It has been 10 days since symptoms first appeared, 24 hours have passed with no fever without the use of fever-reducing medications and symptoms have improved. For COVID-19 cases who never develop symptoms, from two days before until 10 days after the test specimen was collected.

• Worksite – Building, store or facility or other location where a COVID-19 case was present during the high-risk exposure period. It does not apply to buildings, floors or other locations that a COVID-19 case did not enter.

• Contact tracing – Identifying patients and employees in the office in close contact with the infected or symptomatic patient or employee. Advise person to seek medical evaluation.

Required Reporting:

Local health department:

• Whenever there are three or more employees who test positive or are diagnosed with COVID-19 within 14 days.

Division of Occupational Safety and Health (Cal/OSHA):

• To report any serious illness or injury or death of an employee that occurred at work or in connection with work.
• Reporting needs to occur within eight hours of when they knew or should have known of the illness, injury or death. This includes a COVID-19 illness if it meets the definition of serious illness. “Serious injury or illness” is defined in Title 8 Section 330(h) and includes inpatient hospitalization for a reason other than medical observation or diagnostic testing.

Workers’ compensation carrier:

• Employers of > 5 employees must notify workers’ comp carrier of employee with positive test regardless of where employee became infected.
  1. Have until Oct. 29, 2021, to report employees who tested positive between July 6 and Sept. 17, 2020.
  2. From Sept. 18, 2020, until Jan. 1, 2023, report within three business days of learning or reasonable knowing that an employee tested positive for COVID-19.
  3. An employee who believes they became ill with COVID-19 due to an exposure at work can file a claim and must be given a claim form.

Cal/OSHA Requirements:

• Employers must make COVID-19 testing available to employees who are not fully vaccinated and are exhibiting COVID-19 symptoms. The testing must be made available at no cost and during employees’ paid time.
• Employers may not require a negative COVID-19 test as a condition for an employee returning to work if employee has satisfied the return-to-work requirements.
• When an employee is not permitted to work because of a close contact exposure at work, the employer is required to maintain the employee’s earnings and other employee rights and benefits during that time. This may be done by using employer-provided sick leave benefits and other benefit payments from public sources if available.
• An employee’s earning and other employee rights and benefits also must be maintained during the time they are quarantined if they test positive or are diagnosed with COVID-19 due to an exposure at work. An employer must make up the difference for what workers’ compensation does not cover.
• Refer to a separate chart, “How to Pay Staff During a COVID-19 Related Absence.”

Cal/OSHA Return to Work Requirements:

COVID-19 cases, vaccinated and nonvaccinated persons with close contact who developed symptoms may return to work when they have met all of the following criteria:

• At least 10 days have passed since symptom onset or date of positive test;
• At least 24 hours have passed since resolution of fever (100.4 F) without the use of fever-reducing medications; and
• COVID-19 symptoms have improved.

Unless all of the following is true for the employee who had close contact:

• A negative COVID-19 test result with a specimen taken soon after symptoms onset.
• At least 10 days have passed since the last known close contact.
• Has been symptom-free for at least 24 hours without use of fever-reducing medication.

A COVID-19 positive person who did not develop symptoms may return to work after a minimum of 10 days since the date the test specimen was collected.

A nonvaccinated person with close contact who did not develop symptoms may return to work after a minimum of 10 days has passed since the last known close contact.