Virginia Department of Health Interim Guidance on Screening, Monitoring and Testing Employees Returning to Work: Critical Infrastructure Employees (Non-Healthcare)

Last Updated: May 22, 2020

Businesses and employers can help prevent the spread of COVID-19 by following the CDC’s Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 and guidelines developed specifically for the essential/critical setting.  

Screening, monitoring and testing are necessary for limiting the spread of COVID-19 in Virginia.  An important part of keeping workers safe is actively encouraging sick employees to stay home if they are ill and emphasizing to all employees the importance of knowing the symptoms of COVID-19.  Employers should also emphasize to employees the importance of notifying their supervisor(s) if they become ill at work and following the CDC guidelines for what to do if they are sick with symptoms of COVID-19.

Certain essential business operations may employ workers from other countries or states (e.g., migrant laborers working in agriculture or construction of critical physical infrastructure). These operations vary in size, location (urban vs. rural), and occupational health program capacity. In addition to the below guidelines for all critical infrastructure employees, additional COVID-19 guidance for migrant labor camp operators and employees is available here

Screening

Prior to a shift and on days employees are scheduled to work, employers should screen employees for COVID-19 symptoms. Employees should also self-monitor their symptoms by self-taking of temperature to check for fever and using the questions provided in this guidance (below) before reporting to work.  

For employers with established occupational health programs, employers can consider measuring temperature and assessing symptoms of employees prior to starting work/before each shift. Temperature and symptoms (or absence of symptoms) may be documented each day. The form provided as Attachment 1 (Daily Employee Screening Form) can be used to collect this information, if necessary. 

People with these symptoms or combinations of these symptoms may have COVID-19: 

  • Cough
  • Shortness of breath or difficulty breathing
  • Fever (CDC considers a person to have a fever when he or she has a measured temperature of 100.4oF or greater, feels warm to the touch, or gives a history of feeling feverish) 
  • Chills
  • Muscle pain
  • Sore throat
  • New loss of taste or smell

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

COVID-19 Screening Protocol: Employee self-check of health
Employees should assess themselves for symptoms of COVID-19 before reporting to work for each shift. Employees should ask themselves: “YES or NO since my last day of work, have I had any of the following:”

  • A new fever (100.4°F or higher) or a sense of having a fever?
  • A new cough that cannot be attributed to another health condition?
  • New shortness of breath that cannot be attributed to another health condition?

COVID-19 Screening Protocol: Employee self-check of health (continued)

  • New chills that cannot be attributed to another health condition?
  • A new sore throat that cannot be attributed to another health condition?
  • New muscle aches (myalgia) that cannot be attributed to another health condition or specific activity (such as physical exercise)?

If an employee answers YES to any of the screening questions before reporting to work, the employee should stay home and not report to work. 

If an employee reports COVID-19 symptoms upon arrival to work, the employer should activate the emergency protocol for COVID-19.

  • Immediately isolate the ill person from others and ask that person to wear a facemask or cloth face covering.
  • Determine if the person needs medical care.
  • Contact your company’s occupational health program (if available) or supervisor (if applicable).
  • Most cases of COVID-19 are mild and do not require medical care. In these situations, the ill person can self-isolate at home. If the person is not severely ill, but medical care seems indicated, a healthcare facility OTHER THAN a hospital emergency room should be used (if possible) and contacted prior to arrival.
  • If the person is experiencing any medical emergency or emergency warning signs of COVID-19, including, but not limited to trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, or bluish lips or face, call 911 and notify the operator that the person might have COVID-19.
  • Establish procedures for safely transporting anyone sick to their home or to a healthcare facility.

Additional Resources

VDH Interim Guidance for Daily COVID-19 Screening of Employees and Visitors

CDC FAQs: Reducing the Spread of COVID-19 in Workplaces

Monitoring

  • Employees with symptoms of COVID-19 at home should not come into work.
  • Sick employees should follow CDC recommendations for what to do when illness occurs.   
  • Sick employees (positive or negative for COVID-19) should not return to work until they have met CDC’s criteria to discontinue home isolation, using either a symptom- or test-based strategy.
    • Symptom-based strategy to discontinue isolation:
      • 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.
    • Test-based strategy to discontinue isolation:
      • 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).
  • Current best practices include quarantining asymptomatic contacts of a known COVID-19 case at home until 14 days have passed since last contact with the COVID-19 case (or, if contact is ongoing, 14 days after the COVID-19 patient has been released from isolation). However, it may be necessary for critical infrastructure employees who are asymptomatic contacts to remain in the workplace in order to provide essential services. These situations must be reviewed on a case-by-case basis, with home quarantine being the preferred method of addressing exposures.
    • Inform critical infrastructure employees who have had close contact with a person diagnosed with COVID-19 to self-monitor for symptoms, and to follow CDC guidance if symptoms develop. If the employee becomes sick, then symptomatic procedures for ending isolation (listed above) should be followed.
    • If a critical infrastructure employee does not have symptoms, they should follow appropriate CDC guidance for exposures. If a business is unable to operate without the critical infrastructure employee, the employee may return to work (not undergo quarantine) as long as: 
      • Employers pre-screen the employee (temperature checks)
      • Employers conduct regular monitoring of employee
      • Employee wears a face mask at all times for 14 days after last exposure
      • Employee maintains 6 feet of social distancing
      • Employer ensures work space is routinely cleaned and disinfected
  • Close off areas used by a sick person and do not use them until after cleaning and disinfection. Wait 24 hours before cleaning and disinfecting. If it is not possible to wait 24 hours, wait as long as possible. Ensure safe and correct application of disinfectants and keep disinfectant products away from children.
  • Employers should not require sick employees to provide a COVID-19 test result or healthcare provider’s note to validate their illness, qualify for sick leave, or return to work. Healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely manner. 

Additional Resources

VDH Daily Symptom Monitoring Log

Identification of Essential Critical Infrastructure Workers During COVID-19 Response

Testing

  • All employees who have symptoms should be referred to a healthcare provider for diagnostic testing for COVID-19.
  • Testing may be available at your doctor’s office, urgent care center, pharmacy, or other healthcare clinic. To find testing sites in your area, please visit the Virginia COVID-19 Testing Sites website.

Please visit VDH COVID-19 Testing for more information.