AFL 21-08.8, Updated Guidance on Quarantine for HCP Exposed to SARS-CoV-2 and Return to Work for HCP with COVID-19

This supersedes AFL 21-08.7 and provides updated guidance on:

· exposure risk assessment and work restriction for asymptomatic HCP with SARS-CoV-2 exposures (quarantine)

· work restrictions for HCP diagnosed with SARS-CoV-2 infection (isolation)

· incorporates updated CDC guidance for managing HCP with SARS-CoV-2 infection or exposure to SARS-CoV-2 (1/21/22), and updated CDC guidance for contingency and crisis management strategies to mitigate HCP staffing shortages (1/21/22).

This AFL removes the temporarily adjusted return-to-work criteria in place from 1/8-2/1/22. SNFs must use the work restrictions tables to guide decisions for HCP with SARS-CoV2 infection and for asymptomatic HCP with exposures based upon HCP vaccination status and facility staffing levels.

Asymptomatic boosted HCP or vaccinated but not booster-eligible do not need work restrictions for an exposure with a negative diagnostic test upon identification and at 5-7 days. This increases to 7 days for unvaccinated or vaccinated and booster-eligible but not received a booster dose and again within 48 hours prior to return. HCP who have recovered from SARS-CoV-2 infection in the prior 90 days don’t require work restrictions. In a critical staffing shortage, there are no work restrictions with diagnostic test upon identification and at 5-7 days.

HCP with SARS-CoV-2 infection would be isolated and restricted from work for 5-7 days if asymptomatic or mildly symptomatic with improving symptoms with negative diagnosis test same day or within 24 hours prior to return or 10 days without a viral test. The amount of time depends on vaccination status. This decreases with a critical staffing shortage and the ability to have HCP with a positive test care for positive residents may not apply for staff types or in settings where practically infeasible and for staff who don’t have resident care roles.

The CDPH work restrictions and negative test criteria for routine and critical staffing shortage scenarios are recommendations. SNFs always have the option to implement more protective procedures and have a longer quarantine or isolation period for HCP.

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