Interim Recommendations for the Management of Healthcare Personnel Exposed to or Infected
with COVID-19 or Seasonal Influenza
September 30, 2025
Dear Colleague,
The Virginia Department of Health (VDH) is providing updated recommendations for the management of healthcare personnel (HCP) exposed to or infected with COVID-19 or seasonal influenza.
VDH worked with stakeholders to create Virginia’s recommendations based on the work proposed by the former Infection Control in Healthcare Personnel Workgroup of the Healthcare Infection Control Practices Advisory Committee. Healthcare facilities should evaluate VDH recommendations and consider updating HCP return to work and management guidance. The summary of recommendations includes:
- HCP who are infected with COVID-19 or seasonal influenza can return to work when at least 3 days have passed since symptom onset (or first positive test if asymptomatic), and they are 24 hours fever free without the use of fever-reducing medication and other symptoms improving.
- This is a change from prior guidance as it allows these persons to return to work sooner than previous CDC COVID-19 guidance and recommendations and brings seasonal influenza guidance into alignment.
- After return-to-work, HCP should wear a facemask for source control in all patient care and common areas of the facility for at least 7 days after symptom onset (or first positive test if asymptomatic).
- This is not a change from prior CDC COVID-19 guidance.
- Testing is not required for return-to-work.
- This is a change from prior COVID-19 guidance.
- HCP who are exposed to COVID-19 or seasonal influenza and are asymptomatic should wear a facemask for source control for at least 5 days after last exposure and monitor for symptoms.
- This change from previous guidance allows these persons to shorten the duration of source control compared to previous CDC COVID-19 guidance and recommendations.
These recommendations are intended to supersede CDC’s Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 and the section on the management of ill HCP contained within the CDC guidance document, Infection Prevention and Control Strategies for Seasonal Influenza in Healthcare Settings.
HCP should be encouraged to stay up to date on influenza and COVID-19 immunizations and follow healthcare facility policies for source control masking. Facilities can monitor trends for respiratory illnesses by reviewing local emergency visit data to inform broad source control recommendations.
If you have questions about the recommendations, please contact the VDH Healthcare-Associated Infections and Antimicrobial Resistance team at hai@vdh.virginia.gov.
Sincerely,
Karen Shelton, MD
State Health Commissioner