Postexposure Evaluation and Follow-up
Healthcare-associated Exposure to SARS-CoV-2 Virus

The COVID‑19 pandemic is caused by the novel SARS‑CoV‑2 virus. SARS‑CoV‑2 is transmitted from person-to-person primarily by inhalation of airborne droplets or nuclei generated by coughing or sneezing; less frequently by contact with freshly contaminated articles and environmental surfaces.¹⁴ There currently exist no vaccine or PEP for SARS‑CoV‑2. On April 30, 2020 the CDC updated interim guidance addressing return to work criteria for HCP with confirmed or suspected COVID‑19, summarized as follows:

For symptomatic HCP with suspected or confirmed COVID‑19, exclude from work until:

• At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
• At least 10 days have passed since symptoms first appeared.¹⁵
  
  

  OR

• Resolution of fever without the use of fever-reducing medications and
• Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
• Negative results of an FDA Emergency Use Authorized COVID‑19 molecular assay for detection of SARS‑CoV‑2 RNA from at least two consecutive respiratory specimens collected ≥24 hours apart (total of two negative specimens.¹⁵

For HCP with laboratory-confirmed COVID‑19 who have not had any symptoms, exclude from work until:

• 10 days have passed since the date of their first positive COVID‑19 diagnostic test assuming they have not subsequently developed symptoms since their positive test. If they develop symptoms, then the symptom-based or test-based strategy should be used. Note, because symptoms cannot be used to gauge where these individuals are in the course of their illness, it is possible that the duration of viral shedding could be longer or shorter than 10 days after their first positive test.¹⁵
  
  

  OR

• Negative results of an FDA Emergency Use Authorized COVID‑19 molecular assay for detection of SARS‑CoV‑2 RNA from at least two consecutive respiratory specimens collected ≥24 hours apart (total of two negative specimens). Note, because of the absence of symptoms, it is not possible to gauge where these individuals are in the course of their illness.¹⁵

An infectious disease expert should be consulted in when making return to work decisions for HCP who might remain infectious longer than 10 days (e.g., severely immunocompromised).