The South Carolina Department of Health and Environmental Control (DHEC) has issued interim guidelines for employers to trust when responding to various scenarios involving COVID-19 in the workplace. Among others, the scenarios covered by DHEC involve those in which an employee’s test is positive, lives or has close contact with someone with a positive test, or is a customer of a restaurant where a team member is positive.
The new guidance from DHEC largely reflects that currently provided to companies by the Centers for Disease Control and Prevention (CDC) in relation to the periods required for the home isolation of employees, although a period has been extended by DHEC to a minimum of 17 days in cases involving employees living with a person who tested positive for COVID-19. Other return to work scenarios may also require additional consultation with DHEC.
Below are the DHEC guidelines. South Carolina employers should consider implementing the following best practices when responding to suspected or confirmed cases of COVID-19 in the workplace.
Best practices for when an employee has a positive test for COVID-19
When an employee’s test is positive for COVID-19, you must first tell that employee to stay home and recommend that they contact their doctor. You must then have Human Resources, Employee Relations, or a supervisor collect important positive employee documentation (ie, symptom onset date, date of receipt of test results, recent exposure to co-workers or customers , etc.).
In addition, employers must conduct a co-worker exposure assessment after becoming aware of a positive COVID-19 case in the workplace. While maintaining the confidentiality of the employee whose test was positive as required by the Americans with Disabilities Act (ADA), you must also notify the employee’s coworkers of their possible exposure to COVID-19 at work.
Employers will also need to consider the criteria issued by DHEC related to the release of home insulation:
- Residential isolation criteria for the positive employee: Like the CDC, DHEC also instructs employees with a positive test to stay out of work until they have recovered and: (1) 10 days have passed since the onset of symptoms; (2) the employee is without a fever (that is, less than 100.4 degrees Fahrenheit) for three days without using medication to reduce the fever; and (3) the employee’s other symptoms improved. On the other hand, in cases where an employee’s test is positive, but never shows any symptoms, the employee must be out of work and quarantined on their own for up to 10 days after the sample collection for testing. DHEC uses the CDC as to what symptoms employers and employees should watch for.
- Residential isolation criteria for absent co-workers: No additional steps need to be taken for co-workers who were not at work during the positive employee’s contagious period (ie, 48 hours before the positive employee’s symptoms start (or taking a test sample if there are no symptoms) until the release of domestic insulation)
- Residential insulation criteria for “Close contacts”: Like the CDC, DHEC also instructs that anyone who is a “close contact” must also quarantine up to 14) days after their last contact with the positive employee. “Close contact” means being within two meters of someone for a period of 15 minutes or more. If a co-worker is not a close contact, you should notify them of the potential exposure and advise them to self-monitor for signs or symptoms of COVID-19 for 14 days. However, these employees do not need to be quarantined or tested, unless they develop symptoms.
Given the above criteria, DHEC appears to be advocating for employers to implement a symptom-based strategy to determine when an employee should return to work after the test is positive. DHEC did not address in its guidance whether employers can also rely on a test-based strategy, such as the one currently offered as an option to employers under the recent guidance of the CDC. According to the CDC’s test-based strategy, employees with a positive test and with symptoms can return to work when the employee does not have a fever, respiratory symptoms have improved and the employee receives two consecutive negative test results, with at least 24 hours apart. Employees who test positive but have no symptoms can return to work after meeting the latter requirement.
Best practices for when an employee is sick but has not taken a COVID-19 test
Employees should be sent home and given incentives to test for COVID-19 when they have not yet done so and have experienced symptoms consistent with COVID-19. After sending the sick employee home, you must follow the protocol below:
- Sick employee tests negative for COVID-19: Sick employees who are negative for COVID-19 can return to work when they no longer have symptoms.
- Sick employee tests positive for COVID-19 or is not tested for COVID-19: Sick employees who test positive for COVID-19 must remain out of work until they have recovered and meet the criteria for release from home isolation described in the section above for best practices for when an employee tests positive for COVID-19. Notably, this same guideline also applies to any employee who is ill and does not take the COVID-19 test – the employer must respond in the same way as he would with any other positive case.
You should also notify those who came into contact with the sick employee while the employee had symptoms and two days before the symptoms appear. You must then implement additional precautions for these employees, as described in our complete and updated FAQ for employers on COVID-19 Coronavirus.
Best practices for when an employee is close to a positive COVID-19 case
You should also send an employee home if they live or have close contact with someone who has tested positive for COVID-19. In this scenario, employees cannot return to work unless the following criteria are met:
- Criteria when the employee does not live with the close contact: The employee must be quarantined for 14 days after their last contact with the positive person, if they do not live with the positive person. This guideline reflects the 14-day self-quarantine period currently recommended by the CDC in cases of close contact.
- Extended isolation period if the employee lives with close contact: The employee must be quarantined for another seven days beyond the date the positive person met the criteria for release from isolation if the employee lives with the positive person. DHEC did not limit this instruction to family members. Employers should be aware that this means that the employee must be quarantined for one year. Minimum 17 days, which exceeds the 14 day period currently recommended by the CDC in cases of close contact.
- Certain cases may involve additional DHEC consultation: In cases where the employee is released to return to work sooner than the employee would do in the applicable quarantine period above, the employee must contact the Human Resources Director or Supervisor and a return to work decision can then be made. made in consultation with DHEC.
Significantly, DHEC clarified that the negative test not shorten any of the two required quarantine periods listed above.
Best practices for when an employee is a close contact with someone who is sick but not tested
When an employee lives or has been in close contact with someone who has symptoms of COVID-19 but has not yet been tested, the employee can stay on the job as long as he or she does not exhibit COVID-19 symptoms while the contact is being tested and is waiting for their results.
However, in cases where the contact test is positive for COVID-19, you must send the employee home and follow the guidance for releasing the home insulation provided above regarding best practices for when an employee is a close contact with a positive COVID-19 case.
Best practices for when an employee is a “contact for a contact”
DHEC provided different considerations for employees who are a “contact of a contact”, which means that the employee lives or was in close contact with a person who was in close contact with another person who tested positive for COVID-19 or who displays symptoms of COVID -19. The CDC guidance does not seem to address what actions employers should take when an employee is a “contact for a contact”. According to DHEC, you must follow these steps:
- Step 1: The employee can remain at work as long as they have no symptoms. These employees do not need to be tested unless they develop symptoms and no further action needs to be taken unless the person with whom the employee has had contact develops symptoms or a positive test.
- Step 2: If the person with whom the employee had contact develops symptoms, send the employee home until it is possible to determine whether the symptoms are due to COVID-19. You must then follow the protocol listed directly below.
- Steps 3 and 4: If the person with whom the employee has come in contact with negative tests or his health care provider does not consider the illness to be COVID-19, the employee can return to work. However, if the person the employee has been in contact with is positive for COVID-19, you should follow the guidance on releasing home insulation provided in the section above regarding best practices for when an employee is positive for COVID-19 .
In line with the CDC, DHEC notes that a person can be qualified as a close contact, regardless of whether the person is wearing a face cloth cover or personal respiratory protective equipment (PPE).
Employers must also have a protocol to respond to cases where it is determined that an employee was a restaurant customer who subsequently announces that a restaurant employee has tested positive for COVID-19.
Under the guidance of DHEC, an employee who falls into this category can remain on the job as long as he or she does not have symptoms. However, if an employee begins to experience symptoms consistent with COVID-19, employers are instructed to follow the same procedure with regard to releasing the home isolation provided in the section above on best practices for when an employee is ill but has not taken a COVID-19 test.
Critical infrastructure workers
DHEC recognizes that its guidance is not directed at critical infrastructure workers and refers companies to the CDC’s recently relaxed guidelines on this point. These guidelines now allow critical infrastructure workers potentially exposed to COVID-19 to continue to work after exposure, as long as they remain symptom-free and employers implement additional precautions to protect the employee and the community. Employers in critical infrastructure sectors must continue to rely on CDC guidelines.