Updated April 13, 2020
* Fever is either a measured temperature >38.0°C (100.4°F) or a subjective fever. Note that fever may be intermittent or may not be present in some individuals, such as those who are elderly, immunosuppressed, or taking certain medications (eg, NSAIDs). Clinical judgement should be used to guide testing of individuals in such situations. Respiratory symptoms consistent with COVID-19 are cough, shortness of breath, and sore throat. Medical evaluation may be warranted for lower temperatures (<38.0°C [100.4°F]) or other symptoms (eg, muscle aches, nausea, vomiting, diarrhea, abdominal pain, headache, runny nose, fatigue) based on assessment by occupational health.
On April 8, 2020, the CDC updated guidance for “critical infrastructure workers” (which includes health care and public health workers) to “continue work following potential exposure to COVID-19,” if “they remain asymptomatic and additional precautions are implemented to protect them and the community.”
The CDC defines a potential exposure as a household contact or having close contact (within 6 feet) with 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 CDC recommends that workers who have had an exposure but remain asymptomatic adhere to the following practices prior to and during their work shift:
If an employee becomes sick during the day, the individual should be sent home immediately.
For additional information, see the CDC’s “Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person With Suspected or Confirmed COVID-19.”
* Factors to consider when defining close contact include proximity (closer distance likely increases exposure risk), the duration of exposure (longer exposure time likely increases exposure risk), whether the infected individual has symptoms (the period around onset of symptoms is associated with the highest levels of viral shedding), if the infected person was likely to generate respiratory aerosols (e.g., was coughing, singing, shouting), and other environmental factors (crowding, adequacy of ventilation, whether exposure was indoors or outdoors). Because the general public has not received training on proper selection and use of respiratory PPE, such as an N95, the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE. At this time, differential determination of close contact for those using fabric face coverings is not recommended.