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Reporting Symptoms/Positive Test for COVID-19

November 22, 2022 55110

When a Patient Reports Symptoms or a Positive COVID-19 Test

  1. Record on Patient Tracking Form: Reporting Symptoms or Positive Test for COVID-19: Patient Tracking Form.
    • Date of reporting and date patient was last seen.
    • Information provided by the patient, including if testing has been done.
  2. If there is a positive diagnosis:
    • Assess employee close contact exposure.
    • Follow steps below for When an Employee Has Close Contact Exposure.
    • Send Notice of Potential Exposure to all workers who were at the worksite during the infectious period. Notification must be made within one day of learning of a positive test, diagnosis or quarantine.

When an Employee Reports Symptoms or a Positive COVID-19 Test

  1. Record on Employee Tracking Form: Reporting Symptoms, Exposure or Positive Test for COVID-19: Employee Tracking Form.
    • Date of reporting
    • Symptoms
  2. Instruct employee to return home immediately, if not already home, and to keep the employer updated on status.
  3. Determine if there are other employees who should be included in the “exposed group.”
  4. Offer employee COVID-19 testing at no cost to them if employee tested positive or exhibited symptoms at the workplace.
  5. If there is a positive diagnosis:
    • Assess if close contact exposures occurred at the worksite.
    • If yes, notify affected individuals and follow steps below for When an Employee Has a Close Contact Exposure.
  6. If there are three or more infected employees within 14 days, report the outbreak to the local health department.
  7. Employers of > 5 must report to workers’ comp carrier an employee’s positive COVID-19 test within three days.

Cal/OSHA return-to-work requirements for confirmed COVID-19 cases and CDPH recommendations for symptomatic individuals. Employer must demonstrate requirements were met. Regardless of vaccination status or previous infection, employee may return to work after:

  1. Isolating for at least five days;
  2. Obtaining a negative result after testing on or after day five;*
  3. No symptoms or symptoms are resolving; and
  4. At least 24 hours have passed since a fever of 100.4 degrees Fahrenheit or higher has resolved without the use of fever-reducing medications.

Employee shall wear a mask at all times if they return to work before a full 10 days have passed since the first positive COVID-19 test.

If employee does not test or the employer chooses not to require a test, the employee may return to work after:

  1. Ten days have passed since the date of first positive COVID-19 test;
  2. No symptoms or symptoms are resolving; and
  3. At least 24 hours have passed since a fever of 100.4 degrees Fahrenheit or higher has resolved without the use of fever-reducing medications.

NOTE: More stringent local health department orders supersede the Cal/OSHA and CDPH requirements.

*CDPH recommends use of an antigen test. Employer must collect evidence of testing, for example a dated photo of the test and employee. The day the positive test was administered or symptoms start is Day 0.

When an Employee Has a Close Contact Exposure to COVID-19

Close contact – See below for the definition which was changed by CDPH on November 9, 2022.

  1. Record on Employee Tracking Form: Reporting Symptoms, Exposure or Positive Test for COVID-19: Employee Tracking Form
    • Date of reporting
    • Date of close contact exposure
  2. Offer employee testing at no cost to them if exposure occurred at the workplace.

Everyone, regardless of vaccination status:

  1. Does not need to be excluded from the workplace.
  2. Test as soon as possible and again between three to five days after exposure. Employee who had COVID-19 within the last 30 days does not need to test unless symptoms start.
  3. Wear surgical mask at work except when involved with aerosol-generating procedures where respirator use is required.
  4. If symptoms develop, stay at home and test.
  5. If testing positive, isolate and follow Cal/OSHA return-to-work requirements.

Cal/OSHA requires employers to review current CDPH guidance for persons who had close contacts, including any guidance regarding quarantine or other measures to reduce transmission. Dental practices are in the “high-risk settings” category of CDPH’s quarantine and isolation guidance. Employers must develop, implement and maintain effective policies to prevent transmission of COVID-19 by persons who had close contacts.

Glossary of Terms

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.

Close Contact

  • In indoor spaces, 400,000 or fewer cubic feet per, close contact is defined as sharing the same indoor airspace for a cumulative total of 15 minutes or more over a 24-hour period during an infected person's (confirmed by COVID-19 test or clinical diagnosis) infectious period. Rooms separated by floor-to-ceiling walls are considered distinct indoor spaces.
  • In large indoor spaces greater than 400,000 cubic feet per floor, close contact is defined as being within 6 feet of the infected person for a cumulative total of 15 minutes or more over a 24-hour period during the infected person's infectious period.
  • An employee does not have close contact when wearing a respirator in compliance with the Cal/OSHA respiratory protection program.

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

COVID-19 symptoms - Means a fever of 100.4 degrees Fahrenheit or higher, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea, unless a licensed health care professional determines the person's symptoms were caused by a known condition other than COVID-19.

COVID-19 test – This means a viral test for SARS-CoV-2 that is now:

  1. Cleared, approved or authorized, including in an Emergency Use Authorization (EUA), by the United States Food and Drug Administration (FDA) to detect current infection with the SARS-CoV-2 virus (e.g., a viral test).
  2. Administered in accordance with the authorized instructions.
  3. A COVID-19 test may be both self-administered and self-read only if another means of independent verification of the results can be provided (e.g., a time-stamped photograph of the results).

Exposed group – This means all employees at a work location, working area or a common area at work where an employee COVID-19 case was present at any time during the infectious period. A common area at work includes bathrooms, walkways, hallways, aisles, break or eating areas and waiting areas. The following exceptions apply:

  1. For the purpose of determining the exposed group, a place where persons momentarily pass through while everyone is wearing face coverings, without congregating, is not a work location, working area or common area at work.
  2. If the COVID-19 case was part of a distinct group of employees who are not present at the workplace at the same time as other employees, for instance, a work crew or shift that does not overlap with another work crew or shift, only employees within that distinct group are part of the exposed group.
  3. If the COVID-19 case visited a work location, working area or common area at work for less than 15 minutes during the infectious period, and the COVID-19 case was wearing a face covering during the entire visit, other people at the work location, working area or common area are not part of the exposed group. 

NOTE: An exposed group may include employees of more than one employer.

Face covering – A surgical mask, medical procedure mask, or respirator worn voluntarily or tightly woven or nonwoven fabric of at least two layers that completely covers the nose and mouth and is secured to the head with ties, ear loops or elastic bands that go behind the head. If gaiters are worn, they shall have two layers of fabric or be folded to make two layers. A face covering is a solid piece of material without slits, visible holes or punctures and must fit snugly over the nose, mouth and chin with no large gaps on the outside of the face. A face covering does not include a scarf, ski mask, balaclava, bandana, turtleneck, collar or a single layer of fabric. This definition includes clear face coverings or cloth face coverings with a clear plastic panel that otherwise meet this definition and which may be used to facilitate communication with people who are deaf or hard-of-hearing or others who need to see a speaker’s mouth or facial expressions to understand speech or sign language respectively.

Infectious period –

  • For symptomatic infected persons, it is 2 days before the infected person had any symptoms through Day 10 after symptoms first appeared (or through the first day they test negative if testing on Day 5 or later), and 24 hours have passed with no fever, without the use of fever-reducing medications, and symptoms have improved, OR
  • For asymptomatic infected persons, it is 2 days before the positive specimen collection date through Day 10 after positive specimen collection date (or through the first day they test negative if testing on Day 5 or later) after specimen collection date for their first positive COVID-19 test.
  • Infected persons who test negative on or after Day 5 and end isolation are no longer considered to be within their infectious period. Such persons should continue to follow CDPH isolation recommendations, including wearing a well-fitting face mask through Day 10.

Respirator – Means a respiratory protection device approved by the National Institute for Occupational Safety and Health (NIOSH) to protect the wearer from particulate matter, such as an N95 filtering facepiece respirator.

Returned case – Means a COVID-19 case who returned to work pursuant to subsection (c)(10) and did not develop any COVID-19 symptoms after returning. A person shall only be considered a returned case for 90 days after the initial onset of COVID-19 symptoms or, if the person never developed COVID-19 symptoms, for 90 days after the first positive test. If a period of other than 90 days is required by a CDPH regulation or order, that period shall apply.

Worksite – Building, store or facility or other location where a COVID-19 case was present during the infectious period. It does not apply to buildings, floors or other locations that a COVID-19 case did not enter, locations where the worker worked by themselves without exposure to other employees or to a worker’s personal residence or alternative work location chosen by the worker when working remotely

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: From Sept. 18, 2020, until Jan. 1, 2023, employers of > 5 employees must notify workers’ comp carrier of an employee with a positive test regardless of where employee became infected. Must report within three business days of learning or reasonable knowing that an employee tested positive for COVID-19. An employee who believes they became ill with COVID-19 due to 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 all employees who are exhibiting COVID-19 symptoms or who had “close contact” exposure to a COVID-19 case at the workplace. The testing must be made available at no cost and during employees’ paid time.
  • The employer is not required to make COVID-19 testing available to returned cases.
  • Employers may not require a negative COVID-19 test as a condition for an employee returning to work if the employee has satisfied the return-to-work requirements.
  • When an employee is not permitted to work because of 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 earnings 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 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.

Related Links:

CDPH- Guidance on Isolation and Quarantine for COVID-19 (ca.gov) Nov. 9, 2022

CDPH - Order of the State Public Health Officer Beyond Blueprint (ca.gov) Oct. 13, 2022

CDPH – Guidance on Isolation and Quarantine for COVID-19 (ca.gov)  June 9, 2022

Cal/OSHA ETS – COVID-19 Prevention Emergency Temporary Standards - Fact Sheets, Model Written Program and Other Resources (ca.gov)

 
 

 

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