Health Advisory

Summary

• The Virginia Department of Health issued updated recommendations for exclusion of healthcare personnel (HCP) who test positive or have symptoms consistent with COVID-19 or influenza.
  • HCP are those who provide direct healthcare services or who work in a location where healthcare is provided, including both clinical and support staff.
• The changes reduce the isolation period for COVID-19, remove return to work testing requirements, and align guidance for COVID-19 and influenza.
• The full recommendations can be found in the VDH health care provider guidelines (PDF).

Suggested Actions

• Healthcare providers and facilities should update HCP exclusion and return to work guidance for COVID-19 and influenza consistent with the new VDH recommendations (linked above and summarized in the ADDITIONAL INFORMATION section of this Advisory).
• Apply the updated guidance to HCP who test positive, HCP who have symptoms consistent with COVID-19 or seasonal influenza who have not been tested, and HCP with known exposures to either virus. 

Additional information

• Updated VDH guidance for exclusion of HCP with confirmed or suspected COVID-19 or influenza are provided below. Note that the day of symptom onset or of a positive test is defined as day 0.
  • Infected (test positive) and Asymptomatic:
    • Exclude for 3 days from the first positive test.
    • Can return on day 4 if a facemask is worn for source control in all patient care and common areas of the facility through day 7, if not already wearing a facemask as part of universal source control masking.
  • Infected (test positive or with compatible symptoms) with Mild to Moderate Illness:
    • Exclude for 3 days from symptom onset*
    • Can return on day 4 if ALL of the following criteria are met:
      • At least 24 hours have passed with no fever (without using fever-reducing meds)
      • Symptoms are improving
      • They feel well enough to return to work
      •  A facemask is worn for source control in all patient care and common areas of the facility for at least 7 days, if not already wearing a facemask as part of universal source control masking.
        *Facilities may consider temporary reassignment or exclusion of HCP from the care of patients/residents at highest risk of severe disease, including those with moderate or severe immunocompromising conditions. This reassignment is indicated for 7-10 days after symptom onset or until symptom resolution, whichever is longer.
• For HCP with severe or critical illness or who are moderately or severely immunocompromised, follow CDC guidance on COVID-19 risk assessment and infection control for healthcare personnel.
  • Exposed and Asymptomatic (who have not tested positive):
    • Wear a facemask for source control in all patient care and common areas of the facility for at least 5 days after the exposure. *
    • Monitor for symptoms for 5 days after last exposure. Any HCP who develops signs or symptoms of COVID-19 or influenza should be restricted from work as described above.
      *Work restrictions may be considered if HCP are unable to wear source control, are moderately to severely immunocompromised, care for or work on a unit with patients who are moderately to severely immunocompromised or work on a unit experiencing ongoing COVID-19 transmission that is not controlled with initial interventions.
• Current respiratory disease activity in Fairfax County, including COVID-19 and influenza diagnoses at emergency departments and urgent care centers, is displayed on the Fairfax County Health Department’s Respiratory Illness Dashboard. The dashboard is updated each week on Tuesdays.