1. Immediately report the confirmed case to local public health officials

Upon confirmation of a positive case of COVID-19, a critical step is to notify your local public health department. These officials can help guide you through the process of managing a positive case, and in many cases, will direct necessary actions that must be taken to notify others who may have been exposed and make decisions about closure and reopening. Depending on the facility or type of work being performed where a confirmed case is reported, local public health departments may take a more hands on approach and conduct an inspection of the facility to better understand safety measures in place.

It is also critical to report any confirmed positive cases, as public health officials are tracking case counts, monitoring for new outbreaks, conducting contact tracing, and referring people to testing and self-quarantining. They are also in constant communications with healthcare providers to ensure that health systems and hospitals have the capacity to treat all patients in need of care.

2. Conduct contact tracing with employees that have been in close contact with the confirmed individual

Following a confirmed positive case, you may need to provide contact information to public health officials, or support and conduct contact tracing on your own. Individuals that have been exposed to a positive case, meaning they’ve had direct and close contact (less than 6 feet) for greater than 15 minutes, will need to be contacted and provided with guidance on how to proceed.

Some cities have designated personnel to support contact tracing efforts. Contact tracing training and resources are available from CDC and other organizations.

3. Prepare a communications plan for staff and the public

Another important and immediate step is to inform staff and potentially the public that a confirmed positive case has been reported and exposure is possible. Transparency is crucial to maintaining trust with your staff and community members. A best practice is to prepare drafts and create templates for these communications and have them reviewed by health department officials. A template that can be used as a starting place has been attached to this guide. Key information to communicate and guiding principles are outlined below:

• If an employee has COVID-19: Keep it confidential. This is required by the Americans with Disabilities Act (ADA). Direct employees to the Department of Health webpage or the Coronavirus assessment tool.
• Communication should be clear, straightforward and ensure the privacy of the individual(s) that tested positive in accordance with HIPAA, ADA and other applicable federal and local laws.
• Communication should be provided in a formal capacity (official letter, email, statement, etc.) documenting the case and actions taken. If possible, use multiple modes of communication to help ensure the message is received. You may also consider posting signs at the location where the positive case occurred if it is a location frequented by people for whom you may not have contact information (although, note below, that keeping an accurate record of people who visit your facilities is a key part of management during the COVID-19 pandemic).
• Communication should identify the actions you have taken – referring the individual(s) to seek appropriate medical attention, contacting local and state public health officials, self-isolation, enhanced cleaning and disinfection of facility, new health screening protocols, etc.
• Communication should document if others may have had potential exposure, if contact tracing is occurring, and recommendations on what those who may have been exposed should do.
  • CDC recommends that individuals who have had close contact (<6 feet) for greater than 15 minutes should be notified of exposure and take the following preventative actions:
    • Stay home until 14 days after last exposure and maintain social distance (at least 6 feet) from others at all times
    • Self-monitor for symptoms
      • Check temperature twice a day
      • Watch for fever, cough, or shortness of breath, or other symptoms of COVID-19
    • Avoid contact with people at higher risk for severe illness from COVID-19
    • Follow CDC guidance if symptoms develop
• Communication should reiterate the preventative and protective measures in place including physical distancing, wearing face coverings, cleaning and disinfection, hand washing, health screenings, etc.

Reminder: Reiterate how staff and public can prevent exposure
Following a positive case, reinforce the preventative measures that staff and the public should take while at home, while using facilities, and while in the workplace:

• Wash your hands often
• Avoid close contact
• Cover your mouth and nose with a cloth face cover when around others
• Cover coughs and sneezes
• Clean and disinfect
• Monitor your health daily

There is no need to have everyone tested, but you should let those employees who worked in the same area or otherwise interacted directly with the employee know that they may have had direct contact with someone who tested positive (do not name the employee). A general notice should be sent out to all employees that work in the building, that someone has tested positive for COVID-19.

You do not need to give a specific notice to all employees if they were not identified as coming into direct contact with the employee. Advise them that the office has been cleaned, employee is quarantining, and that management has addressed the issue. Invite them to contact management with any questions.

4. Clean and disinfect areas that may have been contaminated or contacted by confirmed positive individual(s)

While it is critical to have cleaning and disinfection practices in place to prevent the spread of COVID-19, additional deep cleaning and disinfection may be warranted following a confirmed positive case. Professionals should follow CDC’s guidance for cleaning and disinfection after a suspected or confirmed case of COVID-19 has been in your facility:

• Close off areas visited by the infected person. Open outside doors and windows and use ventilating fans to increase air circulation in the area. Wait 24 hours or as long as practical before beginning cleaning and disinfection.
• Cleaning staff should clean and disinfect all areas such as offices, bathrooms, common areas, shared electronic equipment (like tablets, touch screens, keyboards, remote controls, and ATM machines) used by the infected person, focusing especially on frequently touched surfaces.
• If it has been more than 7 days since the person with suspected/confirmed COVID-19 visited or used the facility, additional cleaning and disinfection is not necessary.

5. Ensure that the employee(s) have a leave plan in place

Labor & Industries recently changed how COVID-19 claims are processed. The change covers compensation benefits paid to employees exposed to a COVID-positive first responder. Under workers’ comp, first responders who have contracted the virus and tested positive will continue to receive medical treatment and time loss pay for their quarantine period. Learn more about what has changed and how to file a claim.

FFCRA paid sick leave is available to self-quarantine only when:

• An employee is instructed to quarantine by a health care provider; or
• An employee has COVID-19 symptoms AND is seeking a diagnosis.

FFCRA qualifying uses:

• Are subject to a federal, state, or local quarantine or isolation order related to COVID-19;
• Have been advised by a health care provider to self-quarantine due to COVID-19 concerns;
• Are experiencing COVID-19 symptoms and seeking medical diagnosis;
• Are caring for an individual subject to a federal, state, or local quarantine or isolation order or advised by a health care provider to self-quarantine due to COVID-19 concerns; or
• Are caring for the employee’s child if the child’s school or place of care is closed or the child’s care provider is unavailable due to public health emergency.

Resources

WA State Dept. of Labor and Industries: Paid sick leave and Coronavirus (COVID-19) common questions

U.S. Dept. of Labor Q&A

FFCRA regulations

FFCRA required poster

Bonus tip!

Employees could be hesitant to return to work in the same areas that have potentially been contaminated. If an employee approaches her/his supervisor and says that they are afraid to return to the office due to the risk of contracting COVID-19, there are four things you need to keep in mind.

• Evaluate the reason for the individual’s fear of returning
• Account for FFCRA obligations
• Account for ADA obligations
• Evaluate the risk of imminent danger in the workplace

Side note: Employers may wish to revise their employee handbooks or other policy statements, in view of these new requirements. Employees can and should further be required to acknowledge obligations as they may have individually to contribute to a healthy and safe workplace, and the consequences they can expect if they unreasonably fail to do so. That said, note that generally employees cannot waive their right to workers' compensation benefits should they sustain an occupational illness or injury in the course and scope of their employment, which – despite the employer’s best efforts – can potentially include contracting coronavirus in the workplace.

More RMSA COVID-19 resources

As staff return to the workplace, RMSA recommends requiring your employees and visitors to complete a COVID-19 health questionnaire before being admitted to the workplace. Use RMSA’s sample COVID-19 health screening template.