Testing strategy for coronavirus (COVID-19) in high-density critical infrastructure workplaces after a COVID-19 case is identified
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Testing strategy for coronavirus (COVID-19) in high-density critical infrastructure workplaces after a COVID-19 case is identified

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      Workers in critical infrastructure sectors may be permitted to work if asymptomatic after potential exposure to a confirmed case of coronavirus disease 2019 (COVID-19), provided that worker infection prevention recommendations and controls are implemented. Outbreaks of illness among workers in food-producing facilities and surrounding communities have raised unique questions that identified the need for testing for COVID-19 to supplement existing guidance. This document presents different testing strategy options for exposed co-workers when public health organizations and employers determine testing is needed to help support existing disease control measures. Such strategies can aid in identifying infectious individuals with the goal of reducing transmission of SARS-CoV-2 in the workplace. These strategies augment and do not replace existing guidance.

      SARS-CoV-2, the virus that causes COVID-19, is primarily spread from person to person through respiratory droplets. Workers in high-density settings in which workers are in the workplace for long time periods (e.g., for 8-12 hours per shift), and have prolonged close contact (within 6 feet for 15 minutes or more) with coworkers may be at increased risk for exposure to SARS-CoV-2. A close contact is defined in existing Public Health Recommendations for Community-Related Exposure. Other distinctive factors that may increase risk for transmission among these workers include: sharing transportation such as ride-share vans or shuttle vehicles, car-pools, and public transportation; frequent contact with fellow workers in community settings in areas where there is ongoing community transmission; and shared or congregate housing such as dormitories. Workers include, but are not limited to, all employees, contractors, and others who perform work at the facility or worksite. Early experience from COVID-19 outbreaks in a variety of settings suggests that when symptomatic workers with COVID-19 are identified, there are often asymptomatic or pre-symptomatic workers with SARS-CoV-2 present at the workplace. Testing is important to identify such individuals, as they may not know they are infected. SARS-CoV-2 transmission from asymptomatic or pre-symptomatic persons can result in additional cases and potentially outbreaks of COVID-19. Implementing screening for symptoms of COVID-19, testing, and contact tracingpdf icon may be used to detect infected workers earlier and exclude them from the workplace, thus preventing disease transmission and subsequent outbreaks.

      Critical infrastructure employers have an obligation to manage the continuation of work in a way that best protects the health of their workers and the general public. Appropriate workplace protections, such as engineering and administrative controls, for those present in the workplace should remain in place. Examples of these controls can be found in existing guidance for Meat and Poultry Processing Workers and Employers, and for Manufacturing Workers and Employers and other critical infrastructure guidance. Screening workers and others entering the workplace for symptoms of COVID-19 and body temperature is a critical component of preventing transmission and protecting workers. Workplaces should review and follow existing guidance. Workers who are symptomatic upon arrival at work, or who become sick during the day, should immediately be separated from others. They should be sent to their home or a health care facility, as appropriate, and referred for further evaluation and testing in consultation with the state, territorial, or local health departments or through occupational health providers.

      After a COVID-19 case is identified, testing strategies of exposed co-workers may be considered to help prevent disease spread, to identify the scope and magnitude of SARS-CoV-2 infection, and to inform additional prevention and control efforts that might be needed.

    • Content Notes:
      Recommendations for Viral Testing, Specimen Collection, and Reporting -- Recommendations for Antibody Testing -- Categories for SARS-CoV-2 Testing -- Recommended testing for individuals with signs or symptoms consistent with COVID-19 -- Recommended testing for asymptomatic individuals with known or suspected exposure to SARS-CoV-2 to control transmission -- Recommended testing for asymptomatic individuals without known or suspected SARS-CoV-2 exposure for early identification in special settings -- Recommended testing to determine resolution of infection with SARS-CoV-2 -- Public health surveillance for SARS-CoV-2 -- Additional Resources -- Summary of Changes to Retired Document, “Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19)”.
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