Wildfire smoke continues to complicate managing employee illness during the COVID pandemic. Sore throat, nasal congestion, cough, and nausea are some of the common symptoms our team is seeing in WA, OR, and CA over the past weeks in fire-affected areas.
The CDC is walking back it's recommendation of temperature checks. They removed the health screening for international travellers coming to the US and is now saying that daily employee temp checks are an “optional strategy that employers may use” rather than a requirement, although many jurisdictions continue to require them (New York just made guest temp checks a requirement for indoor dining). But experts question the value of temp checks since so many carriers of the virus are asymptomatic.
We’re hearing more and more daily on the risks we face with flu season approaching. The WSJ does a good job of identifying symptoms and differences, but for those that don’t subscribe, the CDC page on the differences and similarities is helpful, as well.
Along those lines, Dr. Fauci says that “about 40%-45% of infections are asymptomatic” which makes infection control very difficult, and increases the importance of close contact exclusions even for asymptomatic people.
New reports are a stark reminder that complications and deaths do occur in younger people. And the US has seen a 15% rise in pediatric cases in the past two weeks likely tied to return to school.
Best questions:
What happens when someone truly can’t isolate from a sick person in their home?
Unfortunately, when an employee truly can’t self-isolate from a sick person in their home, they must stay out for 24 days from the symptom onset for the sick person. 10 days for that person to recover from COVID and stop being infectious, plus 14 days to make sure the employee doesn’t develop COVID themselves.
When a child is sick and tests negative for strep and COVID, can we return the parent to work safely?
This depends on the child’s symptoms. As you’ve heard us say here before, there are still very high false negative rates for COVID testing. So if a child has COVID-like symptoms, we can’t return a parent based on a single negative COVID test. If that childs gets diagnosed with something else by a doctor and recovers, for example, they get diagnosed with an ear infection, take antibiotics which resolve their symptoms and feel better, then we would be able to return that parent. But if there’s no other diagnosis and the child is sick with COVID-like symptoms, we unfortunately have to assume it’s COVID and exclude accordingly.
What should we be watching for in college towns?
College towns are really struggling with the sudden outbreak of COVID as students return to school. Managers should be diligent about ensuring that every single person working has taken a symptom survey that day which includes questions about close contact with confirmed or possible COVID cases. Encourage employees to speak up if someone in their home, dorm, or social circle is sick and make sure they understand that it’s important to share that info even if the employees themselves aren’t showing symptoms.
Now that indoor dining, entertainment, and shopping are starting to reopen, how do we reassure our teams that serving guests indoors is being done as safely as possible?
We recommend super clear and regular communication with your teams. Show them everything you’re doing to ensure their and your guests safety, and don’t leave anything out. This should include everything you’ll tell your guests, of course (reduced capacity, health screenings, social distancing, online menus, etc.) but should also include your company policy for how employees should handle things like customers who refuse to wear a mask or who look visibly ill. Make sure employees know the policy, and consider an additional training to help them prepare for any situations that might be uncomfortable. Show them that you have their backs and that you’ll hold guests accountable for keeping employees safe just like you’ll hold them accountable for keeping your guests safe.
We have an employee who tested positive within the past 90 days, recovered and had two negative tests after that, and who now has a fever, fatigue, and shortness of breath. Do we exclude them again and for how long?
Yes, until they are 24-hours fever-free without fever-reducing medication and their shortness of breath is improving. COVID is a strange illness and relapses like this can occur. If it’s within 90 days, they may return once they are fever-free and their respiratory and GI symptoms are improved.
What if that same employee as above tested positive over 90 days ago?
If the employee tested positive over 90 days ago, they’ll need to be excluded for a full 10 days from symptom onset, just the same as if they’d never had COVID before.
Should we be requesting antibody testing for employees who tested positive?
No. Antibody tests are interesting, but they’re not very actionable. If someone had a confirmed COVID positive test result on a PCR or Antigen test when they were sick, there’s no need to see an antibody test afterward. They’ll be excluded for 10 days from their symptom onset (or positive test result if asymptomatic) and then they’re in the clear for 90 days. After 90 days, they can be excluded for close contact or new symptoms. Antibody tests won’t change that 90-day rule, because we don’t know enough yet about what they mean.
Some people are excluded while they’re waiting for COVID test results. Others are not. Why?
We consider three categories of testing here at ZHH and Zedic: “Symptoms or Exposure”, “Curiosity”, and “Routine” (we’ve made up these titles to describe the various situations).
“Symptoms or Exposure” - If someone is tested because they are experiencing symptoms or were exposed to someone sick, they’ll be excluded while they’re waiting for test results.
“Curiosity” - Many get tested just to feel better - we like to call this “Curiosity Testing.” Someone heard a rumor that someone at their kid’s school was COVID+ so they went to go get tested, or they’re going to go on a trip and wanted to be tested before they leave, or they know that my sister’s daughter’s best friend has it and I may have been second- or third-hand exposed (which doesn’t require a work exclusion). Since these reasons aren’t related to direct exposure or symptoms, we don’t exclude these employees while we wait for results.
“Routine” - Some people work other jobs in healthcare, assisted living facilities, schools, or other work that requires routine testing. If someone is getting regularly tested for something like that and doesn’t have symptoms, we don’t exclude these employees while we wait for results.
Best read (or graphic):
Understanding herd immunity is important to understanding where we go from here. Vaccinations alone will not get us where we need to go.
….we’ll save you a Google, Paul Rudd is 51 years old (and 5’10” tall)...
Disclaimer: This Executive Summary is meant for general information and educational purposes only and does not constitute, and is not intended as, any form of medical, legal or regulatory advice or a recommendation or suggestion regarding the same. No recipient of this information should act or refrain from acting on the basis of this information without first seeking legal advice from counsel in the relevant jurisdiction.
