[MCOH-EH] COVID-19 symptom based strategy

[Abhijay Karandikar]

Now that the CDC has issued guidelines strongly in favor of using a symptom based strategy to RTW (https://www.cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html) for HCP with COVID-19, I am curious to know the following:

1. Are you using the mild-moderate-severe-critical illness definitions for determining duration of work exclusion (10 vs 20 days) or are you using the minimum (10 days only, with 24 hours of being afebrile, etc.) based on operating in crisis capacity?

2. Clinical judgement is of great importance when using the symptom based strategy. Who does the triaging - staff/OH-EH providers/IP?

3. Are you asking employees to use their ETO/PTO/sick time for time away due to symptoms irrespective of the duration?

4. Are you still offering testing? If so, who pays for the two tests needed 24 hours apart? What is the turnaround time for test results? Does testing result in returning employees much sooner than based on symptoms only, especially since symptoms need to significantly improve as well? 

In our institution, we (as guided by IP) have always used the symptom based strategy due to the issues associated with testing. However, there has been an increased demand for testing from employees lately.

Thanks,
Abhijay

Abhijay P. Karandikar, MD, MPH, FACOEM
Chief, Section of Employee Health
Reading Hospital, PA