Reversing course on employee quarantines, federal health officials now say that essential workers who've been exposed to the coronavirus can stay on the job while monitoring their symptoms.
The new guidance, released by the Centers for Disease Control and Prevention (CDC) on April 8, applies only to businesses deemed critical, such as hospitals, grocery stores and food processing plants.
Previous guidance called for all workers to isolate at home for 14 days after being close to anyone suspected of having the virus, in case they too became sick and infected others. Now employees can keep working as long as they don't have symptoms, but they should wear a facemask, avoid getting close to other people, and submit to a daily temperature check.
The changes came as many essential businesses such as Amazon ramped up hiring and worried about potential labor shortages. Employee quarantines hit health care institutions especially hard, and some hospitals had stopped requiring them in mid-March. CDC Director Robert Redfield acknowledged these concerns when he announced the changes at a White House briefing.
"One of the most important things we can do is keep our critical workforce working," he said. "We really looked at how to maintain that workforce particularly at this time as we begin to get ready to reopen."
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The guidelines also call for essential businesses to:
- Frequently clean and sanitize workspaces and shared surfaces
- Work with facility maintenance staff to increase air exchanges in rooms
- Stagger work breaks to reduce crowding
- Immediately send home anyone who becomes ill
Alka Ramchandani-Raj, an attorney specializing in workplace safety and health at Littler, said clients have been concerned about sending home exposed workers for 14-day quarantines since the practice was first recommended in February. The rush of hiring recently announced by essential companies such as Amazon is partly a response to the quarantines, she said.
"It starts with one person and anyone who's in close contact is taken out of the workplace and all of those people have further exposed people. It keeps on expanding." The CDC was "trying to ensure there was a way for companies to continue running."
[SHRM members-only memo: COVID-19 Memo to Employees: Essential Business Operations]
Ramchandani-Raj said 14-day quarantines for exposed employees became increasingly unmanageable in regions with large outbreaks of COVID-19, the illness caused by the virus, especially when there is no easy access to testing for the virus. "It is difficult to maintain the workforce when the virus is so spread out in the community and we really don't know when people have it or don't have it or it takes a significant period of time to find out," she said.
Melissa Camacho-Johnson, RN, an oncology nurse at the University of California, Davis and a nurse representative for the California Nurses Association (CNA), said hospitals were initially strict about requiring all exposed workers to stay home for 14 days. But as the virus spread, the rules changed until eventually, no one was quarantined. "For at least three weeks, that hasn't happened," she said.
Camacho-Johnson said that having exposed staff continue working puts other health care workers and vulnerable patients at risk, since the infection can spread to others before a fever or any other symptoms develop. In any case, she said, employers will have to deal with absences sooner or later—either when exposed workers are isolated for 14 days, or when they get sick and infect others. "Now would be the best time to do it," she said, noting that her hospital had not yet been overwhelmed by coronavirus cases. "We have shut down units (in anticipation of a surge) and nurses are looking for work."
The CNA has been critical of other CDC guidance changes, including its recommendation that surgical masks be used by healthcare workers in place of N95 masks, which are specifically designed to block viruses. "I like to follow the data, and all I can see are so many reasons why we shouldn't be coming to work after we're exposed," she said. "But we're not following the science models. We're following the business models."