By Olivia Wann, BS, JD
Give it fourteen if you must quarantine. Centers for Disease Control and Prevention (CDC) provides guidance for the general public and health care settings.
CDC published Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19 https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html. The following guidance applies to healthcare personnel with potential exposure in a healthcare setting to patients, visitors, or other healthcare personnel with confirmed COVID-19.
A prolonged exposure to a COVID-19 individual warrants quarantine. The revised guidance indicates that the definition of “prolonged” was extended to refer to a time period of a total of 15 or more minutes. This represents cumulative minutes, not consecutive minutes. In other words, you may have only been exposed for 5 minutes three times in one day. According to this refined definition, we have 15 minutes.
Any duration of exposure is considered prolonged if the exposure occurred during the performance of an aerosol-generating procedure.
If exposure occurred, we evaluate the personal protective equipment that was in use by the healthcare worker. If the worker was not wearing a respirator or facemask, not wearing eye protection if the COVID-19 individual was not wearing a cloth face covering or facemask, or if the worker was not wearing all the recommended personal protective equipment (i.e., gown, gloves, eye protection, respirator) while performing an aerosol-generating procedure, then work restrictions would apply.
CDC indicates the worker would be excluded from work for 14 days after last exposure. The worker would be advised to monitor themselves for fever or symptoms consistent with COVID-19.
Any worker who develops fever or symptoms consistent with COVID-19 should immediately contact their established point of contact (e.g., occupational health program) to arrange for medical evaluation and testing.
What happens if the exposure occurred outside of working hours when our routine PPE is not in place?
CDC provides guidance entitled When to Quarantine at https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html. Once again, we assess whether there has been close contact with someone who has COVID-19. In addition to close contact within six feet of someone who has COVID-19 for a total of 15 minutes or more, did you provide care at home to someone who is sick with COVID-19? Did you have direct physical contact with the person (hugged or kissed them)? Did you share eating or drinking utensils with them? Did they sneeze, cough, or somehow get respiratory droplets on you?
Stay home for 14 days after your last contact with a person who has COVID-19. Watch for fever (100.4◦F), cough, shortness of breath, or other symptoms of COVID-19. If possible, stay away from others, especially people who are at higher risk for getting very sick from COVID-19.
People who have tested positive for COVID-19 do not need to quarantine or get tested again for up to 3 months as long as they do not develop symptoms again. People who develop symptoms again within 3 months of their first bout of COVID-19 may need to be tested again if there is no other cause identified for their symptoms.
By following CDC’s recommendations, we can do our part in preventing the transmission of COVID-19.