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.

Do I need to shut down my facility if the employee was at the facility while contagious?Not necessarily. You should quarantine close contacts of the contagious employee. The number of employees who need to quarantine and the number you need to operate your business will determine if you need to shut down.

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

  • Make sure the employee who tests positive and other employees who are close contacts do not come to work.
  • Consider improving ventilation using these Tools for Ventilation from the CDC to bring in more fresh air.
  • Follow CDC guidelines for cleaning your facility. When possible, do not reopen until cleaning has been completed.

 

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. 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.

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) while they are contagious (2 days before symptoms started.) The 15 minutes does not need to be continuous (e.g., 3, 5-minute periods would count). Wearing a mask reduces the risk, but employee would still count as a close contact.

When can an employee with a positive COVID-19 test who had symptoms return to work?Employees with a positive test who had symptoms may return to work when they meet the following criteria:

  • It has been at least 10 days since their symptom onset, AND
  • They have been fever-free for the last 24 hours on the 10th day, AND
  • Their symptoms are improving.

They do NOT need 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.

When can an employee with a positive COVID-19 test who has no symptoms return to work?Employees who are asymptomatic but had a positive test for COVID-19 should remain in isolation for at least 10 days from the date they were tested. 

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.

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) during the infectious period (including 2 days before symptom onset). Employees that have been exposed to a COVID-19 positive person may return to work when they meet the following criteria. Pick the situation that applies to your employee below:

My employee is unvaccinated or partially vaccinated

  • They must quarantine.
  • It is safest for them to quarantine for 14 days after their last exposure. No test is required to end quarantine.
  • They do have other options for quarantine. These options are to:
    • Quarantine for 10 days after their last exposure. No test is required to end quarantine. They should monitor themselves for symptoms until 14 days after their last exposure.
    • Quarantine and get tested for COVID 6 or 7 days after their last exposure. If their test is negative, they could end quarantine after 7 days of quarantine. They must have their negative test result before ending quarantine and the test cannot be before day 6. This test needs to be performed at a clinic or community test site, they cannot use an at-home test to end quarantine on day 7. They should monitor themselves for symptoms until 14 days after their last exposure.

My employee is fully vaccinated and does not have symptoms

Fully vaccinated means it has been at least two weeks since their dose of a 1-dose vaccine—such as Johnson & Johnson—or since their second dose of a 2-dose vaccine—such as Moderna and Pfizer. A fully vaccinated employee with no symptoms does not need to quarantine.

  • They should monitor themselves for symptoms for 14 days from the exposure.
  • They should get tested 3-5 days after exposure.
  • They should wear a mask in indoor settings for 14 days following the exposure or until they receive a negative test result (keep in mind everyone should follow current local mask guidance regardless of exposure or vaccination status).
  • See our guidance for more information.

My employee is fully vaccinated and has symptoms

Employees must isolate at home and get tested.

  • If they test negative, they can return to their activities and should continue to monitor for symptoms for 14 days after their exposure.
  • If they test positive, they must stay home and avoid others until:
    • It has been 10 days since their first symptom, AND
    • They are fever-free for the last 24 hours on the 10th day (without the use of fever-reducing medications), AND
    • Their symptoms have improved.

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?

  • Yes, if they had a close contact and are following the shortened 7-day quarantine (with a test on day 6).
  • No, if they tested positive and finished their 10-day isolation. They do not need a negative test to return to work. 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?

  • 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
  • Wear masks indoors
  • Have policies for hygiene, cleaning, and protective measures
  • Improve ventilation
  • 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, wearing masks, physical distancing, and cleaning and sanitizing protocols
    • 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?

  • Cough
  • Shortness of breath or difficulty breathing
  • Fever >=100.4F
  • Chills
  • Muscle pain
  • Sore throat
  • New loss of taste or smell
  • Nasal congestion or runny nose

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

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

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

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 many 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-monitor 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-monitor symptoms daily.

N/A

I. Employee is partially vaccinated or unvaccinated and 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. It has been at least 10 days since their symptom onset
  2. They have been fever-free for the last 24 hours of the 10th day (without the use of fever reducing medications)
  3. Their other symptoms have improved

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

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 partially vaccinated or unvaccinated and 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. It has been at least 10 days since their symptom onset
  2. They have been fever-free for the last 24 hours of the 10th day (without the use of fever reducing medications)
  3. Their other symptoms have improved

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-monitor 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-monitor 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-monitor symptoms daily.

N/A

O. Vaccinated employee had close contact with someone who has tested positive.

Employee can continue to work and self-monitor 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.

Contagious Period: Includes the two days before symptom start plus the 10 days after symptom start (12 days total)

Fully Vaccinated: Fully vaccinated means it has been at least two weeks since their dose of a 1-dose vaccine—such as Johnson & Johnson—or since their second dose of a 2-dose vaccine—such as Moderna and Pfizer.

Isolation: To separate a sick person with COVID-19 from people who are not sick.

Self-monitor: An employee shall monitor for symptoms daily prior to reporting to work. If an employee has any of these symptoms, they should stay home,

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. If someone has been vaccinated, see our guidance for more information.

Notification Procedures: Due to HIPAA rules and regulations, the employer should not disclose a positive case to the entire staff. After public health has interviewed the employee who tested positive, the employer will determine if any other employees 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 the workplace has an 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 there are workplace exposures and if there is a workplace outbreak. We will follow the health department’s guidance and recommendations for our workers safety.

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