How to Handle Common COVID Concerns in Your Office

If someone is being tested for coronavirus, we recommend keeping them out of work until their results come back. You can keep them out of work until they provide either a copy of their negative test results, or a doctor certification of their eligibility to return to work.

For more guidance on when to have an employee return to work, refer to the following CDC guidance:

• Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19
• When You Can be Around Others After You Had or Likely Had COVID-19
• Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19).

Please see this section for information on whether you need to pay an employee who is awaiting test results: “Paying Employees When They Are Not Working.”

For more on dealing with potential exposure in your office, including risk assessment protocol, see “Notifying Staff, Cancelling Patients, and Closing the Office.”

We recommend that you defer to the employee’s own healthcare provider for this decision. Their provider may or may not have the employee get a COVID-19 test, and ultimately that’s between the provider and the employee.

We do recommend getting something in writing that confirms they’re able to come back to work. Tell the employee that you will need either a doctor’s note clearing them to return to work, or documentation of a negative COVID-19 test.

Just note that you cannot require that they give you a copy of test results, as that is their private medical information. But they can certainly choose to supply it.

If the employee hasn’t sought out medical care, or doesn’t have a doctor’s note, but reports feeling healthy enough to return, we recommend that you refer to the following CDC guidance to determine if the employee is safe to return to work:

• Criteria for Return to Work for Healthcare Personnel with Suspected or Confirmed COVID-19 — This resource provides symptom-based, test-based, and time-based strategies for return-to-work protocol for employees who did and did not have symptoms.
• When You Can be Around Others After You Had or Likely Had COVID-19
• Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19).

Given that you have likely already been closed for a period of time and are currently trying to adapt to an ever-changing “new normal” with your ability to see patients, you certainly have a case for temporarily denying time-off requests. Especially when you know their requested time off may lead to needing them to stay out even longer to quarantine.

We know you never wanted to be “time-off travel police,” and you aren’t able to control what an employee does on their own time. But, if your employee is a provider and cannot work remotely upon returning from a trip, you may have to deny or un-approve a time off request.

Here are some things to consider while you try to protect your business:

Deny the requested time off.

• If an employee wants to take time off from work to go on a trip, you are able to deny that request. Requests for vacation have to be approved in advance, and you are able to deny requests that are unreasonable or create a staffing issue for your team.
• In particular if an employee’s travel would put them under a quarantine order upon their return based on your state or local law, you would have them out of the office even longer.
• That means a request for 3 days off could actually end up with them needing to take off over two weeks. You are certainly empowered to deny a time off request based on not being able to accommodate that length of an absence.

Talk to the employee about post-travel quarantine.

• Tell the employee that if they travel out of the area, they need to expect to stay out of the office for an additional 14 days of unpaid time.
• You may choose to have an across the board travel policy like this in place, or you might consider quarantine needs on a case by case basis. But, if the employee is making travel plans, they should consider the quarantine to be a given when making those plans.
• The status of the pandemic and recommendations for travel and public health are changing quickly, so you ultimately have to consider what’s going on at the time of the travel. That could look quite different than it did when you first considered the time off request.
• Even if a state travel quarantine order is not in place now, one could go into effect while the employee is away (We’ve already seen this happening!). You want to leave no doubt that a self-quarantine at home has to be part of any proposed travel plans.

Know that this can impact morale.

• Keep in mind that denying a time-off request for any reason is likely to lead to decreased employee morale and could even lead to the employee quitting their job. People are going to be upset when they can’t make their preferred plans.
• But, know that, as an owner or manager, only you can decide what is best for your business.
• Try to make your team understand that you don’t like denying requests, and are only doing it as a way to keep people healthy and safe and to be able to continue operating the business.
• Make sure they know that the pandemic won’t result in them losing any accrued paid time off. Their ability to use it may temporarily be on hold, but in time you’ll be able to approve requests. You may also want to consider allowing them to cash out unused time or have it roll over into the next year.

Exceptions can happen.

• Despite all your best efforts to prevent travel and inform employees that you can’t approve time off, there are likely still going to be instances where you approve time off. An employee may need to attend a funeral or have some other type of unexpected emergency occur.

According to the EEOC, employers may ask employees to submit to COVID-19 symptom screenings before they enter the workplace to determine if they might have the virus.

Employers should ensure that the tests are accurate and reliable. Testing should be done consistently and is not a substitute for social distancing or other precautions.

If you suspect that an employee might have the novel coronavirus, you can ask them to provide doctor certification of their eligibility to return to work.

Since you cannot ask them for their medical records, you should not ask to see their COVID test results, whether positive or negative.

If your area has a travel quarantine order in place, then you would want to follow those rules.

See “My state/city has a travel quarantine order. How does that affect me?” for guidance.

If there is no quarantine order in place for your area, then what to do is really up to you as a business owner.

You may choose to make anyone who traveled delay returning to work until they either test negative for COVID or are quarantined at home for a period of time. You are not required to do so unless your area has a travel quarantine order in place, however.

There’s no hard and fast rule about the length of time a quarantine should be. The prevailing quarantine standard is 14 days, but ultimately how to handle this is up to you.

We highly recommend considering this on a case-by-case basis rather than trying to have a one-size-fits-all policy. The prevalence of the virus in different locations continues to change, and some travel is much safer than others.

Here are some items to take into consideration when making a quarantine decision:

• Where are they travelling and what are public health experts saying about that location? If they’re travelling to a location that’s considered a “hot spot”, then it’s more risky to allow them to immediately return to work.

• State Department travel information
• CDC information for travel
• CDC travel health notices
• CDC guidance: COVID-19 and Cruise Ship Travel
• How are they travelling? Plane travel is much more risky than travelling by themselves in their car.What were they doing during the trip? Household family members staying in a vacation home for a few
• days is much different than someone visiting friends and going out to eat each day.
• Did they practice appropriate social distancing protocols?
• Are they aware of coming into contact with anyone who was symptomatic or who tested positive?
• Did the employee experience any symptoms during their trip, or are they now upon their return?

Encourage the employee to practice good hygiene on their trip (good advice really for all employees, traveling or not), and encourage them to self-report to you immediately if they find out they have been in close contact with anyone with the virus.

You can use your best judgment from there on whether to have them come back to work or stay at home for a period of time.

If your area has a travel quarantine order in place, then FFCRA pay likely applies.

See “My state/city has a travel quarantine order. How does that affect me?” for guidance.

Otherwise, if someone is not working because they are under self-quarantine post-travel, you are not required to pay them for this time off. If they have PTO, vacation, or sick time, you should make that available.

Otherwise, if this is a quarantine simply out of abundance of caution, then you are not required to pay for that time.

If the employee ends up being symptomatic, waiting for test results, or under a doctor’s orders to stay home, then FFCRA pay may apply.

See the next section: “Paying Employees When They Are Not Working.”

If you want help making a quick decision before working through the rest of the guidance in this section, we highly recommend you refer to these CDC resources, which have charts recommending what to do in response to specific situations:

• Healthcare employers: Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19
• Non-Healthcare settings: Public Health Guidance for Community-Related Exposure

CEDR Members can also download a COVID-19 “Investigation and Response Form” in the Members Area to help guide you through making decisions.

CEDR Members can download a COVID-19 “Investigation and Response Form” in the Members Area to help guide you through making decisions.

Note that we are providing the following in a numbered order, but this is just our recommended guidance based on currently known information.

You may want to take additional steps, and you may want to do things out of this proposed order, depending on your circumstances.

1. Gather all the details of what happened.

Make sure you are clear on what you are looking into.

Someone may be getting tested, may be symptomatic, may have concerns about exposure in their home, etc. Identify what the issue is and everything you know about it, including the dates of when the potential issue began and the dates on which the person was in the office after that initial incident.

Make a determination of the level of risk for the specific situation. Here are proposed considerations, though you should ensure you consider everything relevant to your situation and business:

2. Determine if others in the office are experiencing symptoms.

You’re likely already doing temperature and symptom checks for each employee, each day, and taking appropriate action. But be sure to take another look at those records, and be observant about those in the office.

3. Investigate the potential exposure to others in the office.

There’s no way to make a decision about whether anyone in the office was exposed, should be notified, or should be sent home, without evaluating what actually happened.

Take some time to essentially create a timeline of the potentially infected individual’s interaction with others in the office.

• Identify all dates and times when the individual was in the office during the potential exposure period.

• Identify each person that they were in contact with
• How long they were in contact
• Distance they were from each other
• Level of PPE each person was wearing

Be sure to do this in a realistic, practical way.

You may be requiring that employees wear masks and eye protection at all times but, if you know that they regularly take that protection off and sit at a table to have lunch together, they were likely unprotected during the workday and potentially exposed.

4. Investigate the impact of the person’s presence in the office.

Current studies show that the coronavirus can be present on surfaces, though the risk of infection from surfaces is currently believed to be low.

However, you do want to take a look at what areas and equipment this person was in contact with so you can determine any cleaning and sanitation needs, as well as the level of risk that someone else had contact with those same surfaces.

Identify what the individual was doing in the office — what they came into contact with, the extent to which those items are used by others, what type of PPE was being used, and the extent to which those items are sanitized.

Potential Exposure of Patients, Customers, and Other Visitors to the Office

Remember that your state or national associations, and/or public health departments may have their own protocols around this, and you should defer to that information when it is available.

Otherwise, you need to be looking at the extent to which the patient, customer, or visitor was in direct contact or close proximity with the individual in question and the level of PPE and precautions being taken.

Most businesses are taking extra precautions to ensure that contact with a visitor is limited and PPE is being used. Therefore, in most cases there likely won’t be a need to cancel appointments or contact those who were previously in the office.

If you do need to inform someone of potential exposure, remember that you cannot disclose the identity of the infected/at risk individual(s) unless they give you permission to do so.

Potential Exposure of the Rest of Your Team

Remember that your state or national associations, and/or public health departments may have their own protocols around this, and you should defer to that information when it is available.

Otherwise, you need to consider all the facts of your investigation. If employees were covered up in PPE all day and did not share much equipment, then you likely don’t need to send them home.

If there isn’t a confirmed positive test, you may not need to let them know what’s going on with their coworker.

Be very careful and honest with yourself about this. If someone took off their mask, gloves, and gown and ate lunch sitting across from the individual who may be infected, you probably need to send that employee home, as well.

If you do need to inform someone of potential exposure, remember that you cannot disclose the identity of the infected/at risk individual(s) unless they give you permission to do so.

Closing the Office

We are not seeing many businesses needing to shut down their offices due to potential COVID-19 exposure.

Note that this is because the businesses are taking sufficient health and safety precautions, and are keeping people out of work when they are symptomatic, have been travelling, or if they came into contact with someone when they were not wearing PPE.

If you find a high-risk situation in your office based on patient or employee activity, you may have to make the unfortunate decision to close. If you feel this might be the case, a call to your county or state public health department is warranted.

For more on office closures, read the section of our Original Coronavirus Resource Page, called “What if My Office Needs to Close?”

Cleaning the Office

An extra cleaning is a good precaution to take if there was any risk of exposure.

Review the CDC’s guidance on Cleaning and Disinfection for Community Facilities for recommended protocols. Make sure you’ve inventoried where the person was in the office and what they were doing so you know what may be in real need of some extra cleaning.

The CDC has also provided specific time-based recommendations on cleaning the office:

In most cases, you do not need to shut down your facility. If it has been less than 7 days since the sick employee has been in the facility, close off any areas used for prolonged periods of time by the sick person:

• Wait 24 hours before cleaning and disinfecting to minimize potential for other employees being exposed to respiratory droplets. If waiting 24 hours is not feasible, wait as long as possible.
• During this waiting period, open outside doors and windows to increase air circulation in these areas.

If it has been 7 days or more since the sick employee used the facility, additional cleaning and disinfection is not necessary. Continue routinely cleaning and disinfecting all high-touch surfaces in the facility.

Incident Reporting

If applicable to your business, follow the appropriate OSHA recordkeeping requirements.

If there is any reason to believe that someone was infected due to workplace exposure, notify your workers’ compensation carrier.

Some states are already requiring worker’s compensation carriers to provide coverage related to COVID-19, and other states will likely pass legislation that could force them to cover under certain circumstances.

With that in mind, we are advising everyone to report potential exposure events to their carriers and then, if something changes or becomes retroactive, you and the employee will be in the best possible position.

Ultimately, if the employee did try to make a claim that they were exposed to the virus in your office, you would need to run it through your worker’s comp insurance. You will therefore simply want to put them on notice of the possibility of a claim should an incident occur.

Note that your report just puts the carrier on notice — it does not create a claim.

But, if you were to terminate someone or take some action against an employee who wanted to file a claim, they could claim that action was a form of retaliation due to them having a potential work injury claim. The fact that you went ahead and self-reported the incident to your carrier is great evidence in your defense.