What to Do If an Employee is Sick or was Possibly Exposed

A barista wearing a mask serves coffee

This guidance is not intended for health care personnel.

I have an employee who tested positive for COVID-19

Do I need to contact Public Health Madison & Dane County about this employee?

No, you do not need to contact us unless you are required by law to report communicable diseases. You will need to follow the CDC guidelines under Reduce Transmission among Employees. This section discusses what to do with employees experiencing symptoms and those that have tested positive.


Do I need to shut down my facility if the employee was at the facility while contagious?

It depends. You do need to clean which might mean closing areas of the workplace for about 24 hours. You also need to ensure you have enough staff to operate, especially since you might have a number of employees who need to be quarantined. See “How do I need to clean my facility…” for more information.


What steps should I take after an employee of my facility tests positive for COVID-19?

  • Follow CDC guidelines for cleaning your facility. When possible, do not reopen until cleaning has been completed.
  • Do not allow employee testing positive or other employees with close contact to come to work.


Do I need to notify customers or clients?

If the employee with the positive test had close contact (defined below) with any customers or clients, those individuals should be notified. Public Health Madison & Dane County will work with you to do this. This is required under statute 252.03(1).


Does the business with an outbreak need to notify the general public?

In extreme cases where a large amount of people working in an establishment test positive and close contacts are not easily traceable, Public Health Madison & Dane County may need to notify the general public that an exposure at that business might have occurred.


How do I need to clean my facility after an employee tested positive for COVID-19 and was at work while contagious?

If an employee tested positive for COVID-19 and worked while contagious, it is recommended to thoroughly clean this space using EPA-approved disinfectants, a diluted bleach solution, or 70% alcohol solution. According to CDC, the following cleaning and disinfecting should be performed in your facility:

  • Close off areas used by the person who is sick. Companies do not necessarily need to close operations, if they can close off affected areas.
  • Open outside doors and windows to increase air circulation in the area.
  • Wait 24 hours before you clean or disinfect. If 24 hours is not feasible, wait as long as possible.
  • Clean and disinfect all areas used by the person who is sick, such as offices, bathrooms, common areas, shared electronic equipment like tablets, touch screens, keyboards, remote controls, and ATM machines.
  • Vacuum the space if needed. Use vacuum equipped with high-efficiency particular air (HEPA) filter, if available.
    • Do not vacuum a room or space that has people in it. Wait until the room or space is empty to vacuum, such as at night, for common spaces, or during the day for private rooms.
    • Wear disposable gloves to clean and disinfect. For soft (porous) surfaces such as carpeted floors or rugs, clean the surface with detergents or cleaners appropriate for use on these surfaces, according to the textile’s label. After cleaning, disinfect with an appropriate EPA-registered disinfectant on List N: Disinfectants for use against SARS-CoV-2external icon. Soft and porous materials, like carpet, are generally not as easy to disinfect as hard and non-porous surfaces. EPA has listed a limited number of products approved for disinfection for use on soft and porous materials on List N. Follow the disinfectant manufacturer’s safety instructions (such as wearing gloves and ensuring adequate ventilation), concentration level, application method and contact time. Allow sufficient drying time if vacuum is not intended for wet surfaces.
    • Temporarily turn off in-room, window-mounted, or on-wall recirculation HVAC to avoid contamination of the HVAC units.
    • Do NOT deactivate central HVAC systems. These systems tend to provide better filtration capabilities and introduce outdoor air into the areas that they serve.
    • Consider temporarily turning off room fans and the central HVAC system that services the room or space, so that particles that escape from vacuuming will not circulate throughout the facility.
  • Once area has been appropriately disinfected, it can be opened for use. Workers without close contact with the person who is sick can return to work immediately after disinfection.
  • If more than 7 days since the person who is sick visited or used the facility, additional cleaning and disinfection is not necessary.
  • Continue routine cleaning and disinfection. This includes everyday practices that businesses and communities normally use to maintain a healthy environment.


What is the definition of close contact?

Close contact is defined as being within 6 feet of an infected person for a prolonged period (15 minutes or more) starting from 2 days before illness onset. The 15 minutes does not need to be continuous (e.g., 3, 5-minute periods would count) and wearing a cloth face covering does not completely remove the exposure risk when in close contact.


When can an employee with a positive COVID-19 test return to work?

Employees with a positive test may return to work when they meet the following criteria:

  • They have been fever-free for 24 hours
  • Their respiratory symptoms are improving
  • It has been at least 10 days since their symptom onset
  • If the person had no symptoms, they may return 10 days after they were tested

We recommend against requiring employees to have a negative COVID-19 test before returning to work. People with COVID-19 may have positive test results for weeks after they recover but are not contagious after they meet the symptom criteria above. Requiring a negative test places an unnecessary burden on the employee and may prevent you from providing services due to extended employee absences.


Does an employee need a clearance letter from Public Health before they can return to work?

No, employees do not need a clearance letter before returning to work. Public Health Madison & Dane County can work with people who have a positive test to determine when they can return to work based on the criteria above and may provide this information in the work exclusion letter.


What if the employee diagnosed with COVID-19 is asymptomatic? When can they come back to work?

Employees that are asymptomatic but had a positive test or diagnosis for COVID-19 should:

  • Self-isolate and monitor their health for 10 days.
  • If they have no symptoms, they may return to work after 10 days from testing
  • If they develop symptoms during the 10 days, they should extend isolation precautions for at least 10 days from the date of symptom onset and must meet the following criteria before returning to work:
    • They have been fever-free for 24 hours.
    • Their other symptoms have improved.
    • It has been at least 10 days since their symptom onset.

I have an employee who had close contact to someone who tested positive for COVID-19

When can an employee who has had close contact to someone with COVID-19 return to work?

Close contact is defined as being within 6 feet of an infected person for a prolonged period (15 minutes or more) starting from 2 days before illness onset. Employees that have been exposed to a COVID-19 positive person may return to work when they meet the following criteria:

  • If they have no symptoms: Employee must quarantine. See our guidance on quarantining. See our guidance if they have been vaccinated.
  • If they have or develop symptoms: Employees must stay home and avoid others until:
    • they have been fever-free for 24 hours (without the use of fever-reducing medications),
    • their symptoms improve,
    • AND it has been 10 days since their first symptoms.

Employees do not need a clearance letter before returning to work. Public Health Madison & Dane County works with people who have been in contact with someone with COVID-19 to determine when they can return to work based on the criteria above and provides this information in the work exclusion letter.

Testing, Preventing Spread, and Symptoms

Should I require my employees to be tested for COVID-19 before they can work?

No, Public Health Madison & Dane County does not recommend requiring employees to be tested before being able to work. A test only tells us if a person has COVID-19 on the day they are tested. Furthermore, Public Health Madison & Dane County does NOT require negative COVID-19 test result(s) to return to work after testing positive. This is because people with COVID-19 may have positive test results for weeks after they recover but are not contagious after they meet the isolation criteria. Requiring documentation or proof of a test puts an unnecessary burden on staff and delays when an employee is able to start work. As always, any employee who is sick or has symptoms should not be at work.

Workplaces considering testing for their employees should follow CDC guidance when determining whether and how to test employees. Workplaces must follow all guidelines related to obtaining a CLIA waiver and reporting of test results.

What should an employer do to help prevent the spread of COVID-19 in their facility?

Employers should:

  • Allow employees to work remotely, communicate virtually, and limit in-person meetings and gatherings
  • Stagger work schedules and rearrange workspaces to allow physical distancing to be maintained
  • Provide employees proper PPE (gloves, masks, etc as defined by job duties and risk of exposure), handwashing supplies, and hand sanitizer
  • Have the policies required by the order written for hygiene, cleaning, and protective measures
  • Clean on a more frequent basis; clean high-touch surfaces every 2 hours or after every user when possible.
  • Train employees on:
    • Your employee illness policy
    • The symptoms of COVID-19
    • What to do if they test positive or were exposed
    • The importance of frequent hand washing or sanitizing, heightened cleaning and sanitizing protocols, and physical distancing
    • When to wear PPE and the proper way to wear PPE.

What are the symptoms of COVID-19 that I should have my employees self-monitor for prior to coming to work?

  1. Cough
  2. Shortness of breath or difficulty breathing
  3. Fever >=100.4F
  4. Chills
  5. Muscle pain
  6. Sore throat
  7. New loss of taste or smell

This list is not all-inclusive. Other less common symptoms have been reported, including gastrointestinal symptoms like nausea, vomiting, or diarrhea.

COVID-19 Scenarios at the Workplace

Policy and Requirements for Returning to Work

Employee Scenario

Policy

Return to Work Requirements
A. Employee has no symptoms (asymptomatic) and has tested positive for COVID-19

Do not allow employee to come to work. Arrange for delivering paycheck to employee.

Employee shall stay home and monitor for symptoms. If the employee has no symptoms, they can return 10 days after they were tested.

If during the 10 days the employee becomes symptomatic, then they must continue to stay home for at least 10 days from the date of the symptom onset and meet all the following before returning to work:

  1. They have been fever-free for 24 hours (without the use of fever reducing medications)
  2. Their other symptoms have improved
  3. It has been at least 10 days since their symptom onset

Doctor’s note or Public Health release NOT required to return to work.
B. Employee is sick with symptoms of COVID-19, but has not yet been tested

Do not allow employee to come to work. Arrange for delivering paycheck to employee.

Recommend employee be tested. Employee shall stay home until all of the following apply:

  1. They have been fever-free for 24 hours (without the use of fever reducing medications)
  2. Their other symptoms have improved
  3. It has been at least 10 days since their symptom onset

If employee is tested, stay home until test results return. Follow Scenario D or E, depending on test results.

Doctor’s note or Public Health release NOT required to return to work.
C. Employee is sick with symptoms of COVID-19, has been tested but not yet received the test results

Do not allow employee to work. Arrange for delivering paycheck to employee.

Stay home until test results return. Follow Scenario D or E, depending on test results.

Doctor’s note or Public Health release NOT required to return to work.
D. Employee is sick with symptoms of COVID-19, has been tested and test results came back negative

Employee does not have COVID-19. Follow standard employee illness protocols for returning to work. Example: 24 hours fever-free, or 2 days after last episode of vomiting or diarrhea, or when on antibiotics for at least 24 hours, or as approved to work by a doctor.

A negative lab result or copy of the negative lab result is not required to return to work.  A doctor’s note may be required to return to work based on medical condition and business illness policy.
E. Employee is sick with symptoms of COVID-19, has been tested and test results came back positive

Do not allow employee to work. Arrange for delivering paycheck to employee.

Employee shall stay home until all of the following apply:

  1. They have been fever-free for 24 hours (without the use of fever reducing medications)
  2. Their other symptoms have improved
  3. It has been at least 10 days since their symptom onset

Doctor’s note or Public Health release NOT required to return to work.
F. Employee had COVID-19 in the past and now has another positive test. If the new positive test is within 90 days of the first positive test, the employee may continue to work and does not need to isolate. Other employees are not at risk. People who have COVID-19 can test positive for may weeks after they recover and are no longer infectious. If the first positive test was more than 90 days ago, the employee is considered newly infected and you should follow A or E above.

N/A
G. Employee has been in close contact with someone who shows symptoms but has not been tested

Employee can continue to work and self-monitors symptoms daily.

N/A
H. Employee has been in close contact with someone who shows symptoms and is waiting on test results

Employee can continue to work and self-monitors symptoms daily.

N/A
I. Employee has been in close contact with someone who tested positive for COVID-19 (symptomatic or asymptomatic)

Do not allow employee to work. Arrange for delivering paycheck to employee.

Employee must quarantine. See our quarantine guidance for instructions.  

If symptoms appear, stay home until all of the following apply:

  1. They have been fever-free for 24 hours (without the use of fever reducing medications)
  2. Their other symptoms have improved
  3. It has been at least 10 days since their symptom onset

Employee may not return until the quarantine is complete.

Doctor’s note or Public Health release NOT required to return to work.
J. Employee is living with someone who tested positive for COVID-19

Do not allow employee to work. Arrange for delivering paycheck to employee.

If employee is unable to have complete separation from the person who had a positive COVID test: the employee must quarantine after the person who tested positive ends their isolation. See our quarantine guidance for instructions.

If employee is able to completely separate from the person who tested positive: the employee must quarantine after last contact with the person who tested positive. See our quarantine guidance for instructions. 

If symptoms appear, stay home until all of the following apply:

  1. They have been fever-free for 24 hours (without the use of fever reducing medications)
  2. Their other symptoms have improved
  3. It has been at least 10 days since their symptom onset
 Employee may not return until the quarantine is complete.

Doctor’s note or Public Health release NOT required to return to work.
K. Employee is a close contact to someone who tested positive for COVID-19 at work.

Do not allow employee to work. Arrange for delivering paycheck to employee.

Employee must quarantine after last contact with person and no symptoms arise. See our quarantine guidance for instructions.  

If symptoms appear, stay home until all of the following apply:

  1. They have been fever-free for 24 hours (without the use of fever reducing medications)
  2. Their other symptoms have improved
  3. It has been at least 10 days since their symptom onset

If employee is tested, stay home until test results return. Follow Scenario D or E, depending on test results.

 Employee may not return until the quarantine is complete.

If they become symptomatic, must follow the symptom criteria for returning to work. 

Doctor’s note or Public Health release NOT required to return to work.
L. Employee is a close contact to someone who has been exposed to another positive person

Employee can continue to work and self-monitors symptoms daily.

N/A
M. Employee lives with or cares for someone who is has been exposed to another positive person

Employee can continue to work and self-monitors symptoms daily.

N/A

N. Employee who has tested positive for COVID-10 within the past 90 days has been in close contact with someone who tested positive for COVID-19 (symptomatic or asymptomatic)

 Employee can continue to work and self-monitors symptoms daily.  

N/A
O. Employee had close contact with someone who has tested positive but is vaccinated. Employee can continue to work and self-monitors symptoms daily in most situations. See our guidance if they have been vaccinated for more information. N/A

Definitions and Reminders

Asymptomatic: A person showing no symptoms.

Close Contact:

  • Someone who was within 6 feet of a COVID-19 positive person (regardless of wearing a mask or other PPE) for at least 15 cumulative minutes
  • Keep in mind the minutes of close contact add up; being within six feet for three, 5-minute periods would make someone a close contact.
  • Can occur starting 2 days before positive test or illness onset, whichever occurred first

Isolation: To separate a sick person with COVID-19 from people who are not sick. People can end isolation when the following criteria are met:

  1. They have been fever-free for 24 hours (without the use of fever reducing medications)
  2. Their other symptoms have improved
  3. It has been at least 10 days since their symptom onset

Self-monitor: An employee shall monitor for the following symptoms daily prior to reporting to work.  If an employee has any of these symptoms, they shall stay home, and immediately report to employer:

1. Cough

2. Shortness of breath or difficulty breathing

3. Fever >=100.4F

4. Chills

5. Muscle pain

6. Sore throat

7. New loss of taste or smell

This list is not all-inclusive. Other less common symptoms have been reported, including gastrointestinal symptoms like nausea, vomiting, or diarrhea.Quarantine: To separate and restrict the movement of a person who was exposed to COVID-19 in case they become sick. See our quarantine guidance for instructions. See our guidance if someone has been vaccinated for more information.

Notification Procedures:

Due to HIPAA rules and regulations, we will not disclose a positive case to the entire staff.  After public health has interviewed the employee who tested positive, we will determine if any other employees that may have been exposed (close contact) and work with the health department to contact these individuals for quarantining.

If there are multiple positive employees within the workplace, this does not necessarily mean that we have a workplace outbreak.  Due to community spread of COVID-19, someone can be exposed in a variety of settings beyond work.  Most important to know is that every positive case is reported to the health department, and the health department will contact us if they determine through their tracing if there are workplace exposures and/or if this is a workplace outbreak. We will follow the health department’s guidance and recommendations for our workers safety.

Doctor’s note or Public Health release to work not needed

If an employee tests positive, public health recommends against requiring employees to have a doctor’s note or a Public Health release letter to return to work, as this is an unnecessary burden during an emergency response for a communicable disease like COVID-19. 

Public Health also recommends against requiring negative COVID-19 test results before returning to work. People with COVID-19 may have positive test results for weeks after they recover but are not contagious after they meet the symptom criteria above. Requiring negative tests for returning to work places an unnecessary burden on the employer and may prevent employees from providing services due to extended employee absences.

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