In This Article
- For health care workers who have been infected with COVID-19, the test-based return-to-work approach involves repeat testing after the resolution of symptoms until two consecutive negative tests are obtained 24 hours apart
- A "time-plus-symptoms" approach involves health care workers returning to work after a set period of time since their symptom onset has elapsed and after symptoms, if present, have resolved
- Massachusetts General Hospital researchers assessed both approaches and report that the "time-and-symptoms" approach avoids more lost worktime and is the optimal system
If health care workers become infected with COVID-19, it is important to determine when it is safe and appropriate for them to return to work. The Centers for Disease Control and Prevention (CDC) issued guidance in April (updated last on September 11) that advised either repeat testing or a "time-plus-symptoms" approach to qualify workers for return to work.
The test-based approach involves repeat testing after the resolution of symptoms until two consecutive negative tests are obtained 24 hours apart. In the alternative time-plus-symptoms approach, health care workers can return to work after a set period of time since their symptom onset (or in the case of asymptomatic infection, the date of their positive test) has elapsed and symptoms have resolved.
Between March 7 and April 22, 2020, Erica S. Shenoy, MD, PhD, associate chief of the Infection Control Unit at Massachusetts General Hospital, and colleagues assessed both approaches by analyzing data from employees across the Mass General Brigham (MGB) system who had shown symptoms of COVID-19 infection. They found that using a resolution of symptoms and passage of time approach would have averted more than 4,000 days of lost work time, or a mean of 7.2 additional days of work lost per employee, compared to using a test-based approach.
The time-plus-symptom approach is now the preferred strategy per the CDC and has replaced the test-based approach at MGB. Not only has the approach reduced strain on testing capacity in the system, but it also allowed employees to anticipate when they will be allowed to go back to work.
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