Return-to-work recommendations for healthcare workers

Most employers have questions about when to send employees exhibiting COVID-19 symptoms home, when to allow them back to work, and how to handle their return to work. Hospitals are no exception—and understanding when healthcare workers can and should return to work after a confirmed or suspected COVID-19 illness is key to flattening the curve on the virus’ spread.

When can the healthcare worker return?

The nationwide shortage of COVID-19 tests has affected healthcare workers like everyone else, meaning that not every healthcare worker who exhibits symptoms of COVID-19 will be tested nor can every healthcare worker with confirmed COVID-19 obtain subsequent tests. Because of that, the Centers for Disease Control and Prevention (CDC) has released separate return-to-work recommendations for healthcare workers who have confirmed or suspected COVID-19: a “test-based strategy” and a “non-test-based strategy.”

Test-based strategy:

If the worker has a positive COVID-19 test, they should not return to work until—

1. Fever has resolved (without fever reducing medications),
2. Respiratory symptoms have improved, and
3. They have received two "final" negative tests (24 hours apart).

Non-test-based strategy:

If workers are exhibiting symptoms of COVID-19, but has not had a test, they should not return to work until—

1. They have been fever-free (without fever reducing medications) for 3 full days, and
2. It has been at least 7 days since the symptoms first began.

These guidelines should not be confused with the CDC’s guidelines regarding healthcare workers who have had exposure to a patient with COVID-19, but are asymptomatic. The CDC’s guidelines for those healthcare workers was updated on March 7, 2020, to allow the workers to continue to work while asymptomatic.

Further, if a healthcare worker exhibited symptoms of COVID-19, did not receive a test, but was diagnosed with another illness (i.e., positive flu test), the worker’s return to work should be based on that diagnosis and not the COVID-19 recommendations.

What happens once the healthcare worker returns?

After the healthcare worker returns to work under the above guidelines, he or she should—

• Always use a facemask while in the facility until symptoms are fully resolved, or until 14 days after onset of symptoms (whichever is longer).
• Restrict contact with any severely immunocompromised patients until 14 days after onset of symptoms.
• Use proper hygiene and etiquette as outlined by the CDC: wash hands, cover nose and mouth when coughing or sneezing, and dispose of tissues appropriately.
• Self-monitor for any symptom recurrence or worsening and get reevaluated by occupational health if this occurs.

What if staffing shortages make the above guidelines impossible to follow?

The CDC has advised that if appropriate health authorities determine that the recommended guidelines are impossible to follow due to staffing shortages, the healthcare worker should be evaluated by occupational health to decide whether the worker should return earlier than recommended. If workers do return earlier than recommended, they should follow the same guidelines discussed above for healthcare workers who return to work.

These recommendations can serve as a basis for occupational health programs to determine when and how healthcare workers who have confirmed or suspected COVID-19 should return to work. However, because the COVID-19 public health emergency is a fluid situation, occupational health programs should be aware that state and local agencies may adapt these guidelines to better align with issues faced at the local level.

For more information about this subject and related COVID-19 issues, contact This email address is being protected from spambots. You need JavaScript enabled to view it..

Items on this web page are general in nature. They cannot—and should not—replace consultation with a competent legal professional. Nothing on this web page should be considered rendering legal advice.

© 2020