Testing to Determine Resolution of Infection
The decision to end home isolation and return to work for employees with suspected or confirmed SARS-CoV-2 infection should be made in the context of clinical and local circumstances. Polymerase chain reaction (PCR) amplification tests have detected SARS-CoV-2 RNA in some people’s respiratory samples after they have recovered from COVID-19. Prolonged viral shedding has been demonstrated without direct evidence for virus capable of replicating or causing infection.
Consequently, in most cases, evidence supports a symptom-based strategy to determine when to discontinue home isolation or precautions.
For persons who are severely immunocompromised, a test-based strategy could be considered in consultation with infectious diseases experts.
For all others, a test-based strategy is no longer recommended except to discontinue isolation or precautions earlier than would occur under the symptom-based strategy.
Under the Americans with Disabilities Act, employers are permitted to require a healthcare provider’s note to verify that employees are healthy and able to return to work.
However, as a practical matter, employers should be aware that healthcare provider offices and medical facilities may be extremely busy during periods of community transmission of SARS-CoV-2 and may not be able to provide such documentation in a timely manner.
In such cases, employers should consider not requiring a healthcare provider’s note for employees who are sick to validate their illness, qualify for sick leave, or to return to work.
Most people with COVID-19 have mild illness, can recover at home without medical care, and can follow CDC recommendations to determine when to discontinue home isolation and return to work.