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

Last Updated: September 2, 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, employees should 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. Because OSHA’s Access to Employee Exposure and Medical Records standard (29 CFR § 1910.1020) requires that covered employers retain medical records for the duration of employment plus 30 years, consider the burdens and benefits of documenting individually identifiable results of entry screenings.

The checklist provided in the VDH Interim Guidance for Daily COVID-19 Screening of Employees (Non-healthcare Workers) can be used to collect this information, if necessary.

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

  • Fever**
  • Cough
  • Shortness of breath or difficulty breathing
  • Chills
  • Fatigue
  • Muscle or body aches
  • Sore throat 
  • Headache
  • New loss of taste or smell
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

*This list does not include all possible symptoms.
**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.

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 or difficulty breathing that cannot be attributed to another health condition?
  • 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)?
  • A new loss of taste or smell?

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 (Non-healthcare Workers)
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 and employees who test positive for the virus that causes COVID-19 should not return to work until they have met CDC’s criteria to discontinue home isolation.
    • Persons who never develop symptoms may discontinue isolation and other precautions 10 days after the date of their first positive diagnostic COVID-19 test.
    • Persons with COVID-19 symptoms may discontinue isolation under the following conditions:
      • At least 10 days§ have passed since symptom onset and
      • At least 24 hours have passed since resolution of fever without the use of fever-reducing medications and
      • Other symptoms are improving (loss of taste or smell may persist for weeks or months after recovery and need not delay the end of isolation).

§A limited number of persons with severe illness may produce replication-competent virus beyond 10 days, which may warrant extending the duration of isolation for up to 20 days after symptom onset. Consider consultation with infection control experts.

  • 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 personnel filling essential critical infrastructure roles (except for education sector workers) 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 or tests positive for SARS-CoV-2, then appropriate 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 (except for education sector workers) 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

Education sector workers should continue to follow the standard public health quarantine guidance for non-essential workers as outlined here.

  • 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 EPA-approved 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
  • For high-density critical infrastructure workplaces in which a COVID-19 case is identified, an optional testing strategy is available for consideration. This strategy can be used to aid in identification of other potentially infectious individuals with the goal of reducing further transmission in the workplace. This testing strategy provides a tiered, risk-based approach to testing and implementing restrictions from work for co-workers of a person with confirmed COVID-19 in a high-density work environment. An algorithm outlining this strategy is available here. Some facilities may already have testing and work restriction plans in place that this strategy may augment.
  • Please visit VDH COVID-19 Testing for more information.