As the world adapts to the ongoing challenges of COVID-19, the Centers for Disease Control and Prevention (CDC) have recently updated their guidance regarding the management of COVID-19 and flu. Their latest guidance suggests a new approach to managing these respiratory illnesses, emphasizing reducing transmission in the workplace rather than solely relying on testing and quarantining measures, particularly with people generally not testing anymore.
The CDC's acknowledgment that COVID-19 and flu (and the other four circulating coronaviruses) are comparable in terms of overall risk underscores the need for a nuanced approach to managing both illnesses. While COVID-19 continues to pose a significant threat, with approximately 1000 deaths attributed to it weekly, this number is roughly the same as deaths from flu.
In light of this, it is essential to prioritize policies that promote a healthy work environment while minimizing the risk of transmission. The following are recommendations based on the latest guidance:
Stay Home with Symptoms
Employees should not come to work with a fever, regardless of the cause.
Return Home for Fever at Work
Employees who develop a fever while at work should immediately leave the workplace.
Managing Respiratory Symptoms to Reduce Risk
If an employee develops symptoms of an upper respiratory infection, especially coughing or sneezing, they should:
- Work from home, if possible, particularly during the initial 3-4 days of illness.
- If working from home isn't feasible, they should wear a mask while symptomatic, maintain social distance, use hand sanitizer regularly, and minimize contact with shared surfaces.
Testing Considerations:
Employees with symptoms may opt to test if they are in higher-risk environments:
- Such as around anyone known to be at risk for more serious respiratory disease outcomes, including senior citizens and people with chronic illnesses
- Settings where early detection through a positive test could lead to better outcomes with earlier treatment, which would include those with personal higher risk factors
- Events where critical employees are in close proximity (e.g., board meetings, executive committee meetings, critical work teams, etc.)
Testing Procedures:
Prioritize COVID testing over Flu-testing due to its over-the-counter availability (flu tests are only available on a doctor’s order). If the COVID test is negative, consider seeking a flu test from a healthcare provider. Over-the-counter flu tests are likely available for the 2024-25 flu season but are not yet FDA-approved.
If tested positive:
- For flu: Employees should remain at home for as long as they have a fever. Once the fever has cleared for 24 hours and symptoms are reducing, it is reasonable to return to work, wearing a mask for an additional period until at least after day eight, after the symptoms start.
- For COVID: Employees should remain away from work as long as they have a fever plus 24 hours. Once they are fever-free for at least 24 hours and have a negative antigen test result, they may return to work. After eight days, assuming there has been no fever for at least 24 hours, it is OK to return to work without testing. Note that the test-to-return to work is over and above CDC guidelines, but still reasonable to minimize outbreaks in workplace environments. Some organizations may reasonably choose to forgo this test-to-return step if they have good workplace controls in place, including optimized air-handling, lower workplace personnel densities, and known high rates of vaccination or history of COVID in the workforce.
Respiratory Disease Immunization Programs
Continuing to facilitate appropriate vaccination programs for respiratory diseases is a productivity enhancer. While additional COVID vaccination, beyond the original series and one booster, remains controversial (except for high-risk individuals), there is little question about the worksite benefits of facilitated Flu vaccine programs and increasing evidence of the benefits of RSV vaccines (respiratory syncytial-virus vaccinations during pregnancy and for those over 60)
By implementing these policies, workplaces can prioritize employee health and safety while at the same time minimizing the risk of viral transmission. Adapting to the evolving COVID-19 and flu dynamics is crucial to fostering a resilient and healthy workforce. We can navigate these challenging times effectively by prioritizing prevention and promoting responsible management.
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