A Panic-Free Guide to an Employee Diagnosis

Employers worldwide dread receiving the call that an employee has been positively diagnosed with SARS-CoV-2, or even reported symptoms consistent with the virus. These concerns are only magnified if the employee was recently on-site.

Perhaps you have already faced this situation, or perhaps you are preparing for the possibility. Either way, making sure your team is prepared to address all angles of the situation is the foundation of an effective response. Your team should have plans in place to accomplish three primary things: care, sanitize, and communicate.

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Care:

Your first focus should be caring for the ill employee. Depending on their situation, they may be quite sick or possibly panicked, so approach any conversation with empathy and understanding. Throughout, maintain a focus on protecting the employee’s privacy and the confidential nature of their health condition.

If the employee arrived on-site before informing anyone of their condition, they should immediately leave the facility. Be as discreet as possible in order to protect the confidentiality of the employee; for example, rather than broadcasting that the individual tested positive or is exhibiting symptoms, consider calmly asking if you can talk to them elsewhere (maintaining appropriate social distance at all times). Ideally, you should have a spacious private area cordoned off near the facility entrance where you can discuss further and let them wait for transportation if they need a family member to pick them up.

Regardless of whether the employee is on-site or off-site when you learn the news, you should gather some information from them to help you respond, ideally through an HR representative. This information should include:

• Condition: Have they been positively diagnosed with SARS-CoV-2, or are they simply experiencing symptoms of the virus? While this information should not change your response (you should always respond as if the employee has SARS-CoV-2), it may change whether you are required to report the incident to relevant authorities.

• Affected areas: What areas of the facility has the individual accessed in the last 7 days*? Ask the employee to walk through each day, starting from the entrance they used for the facility, and inquiring about workstation, restrooms, break rooms / cafeterias, any shared equipment, etc. 

*As of the date of publication, the CDC uses 7 days as the cut-off for requiring additional disinfection.

• Affected individuals: What “close work contacts” may have been exposed to this individual? Fisher Philips defines close work contacts as “all individuals who worked in close proximity (whing six feet) for a prolonged period of time (10 minutes or more to 30 minutes or more) with them during the 48-hour period before the onset of symptoms.” In addition to asking about other employees, inquire about any work-related third parties they may have contacted (e.g., vendors, customers, delivery personnel, etc.).

• Contact information: Make sure you have a way to stay in contact with the employee (e.g., a personal phone number, possibly an emergency contact).
  

Note that any health information you gather must be “maintained on separate forms and in separate medical files and be treated as a confidential medical record” that is stored apart from an individual’s personnel records in order to comply with the Americans with Disabilities Act (ADA).

Next, your HR representative should calmly and patiently walk the ill individual through next steps based on your company’s policy, answering any questions they might have. Some questions you may want to answer include:

• What is your quarantine and isolation policy?
  
  *Note that “quarantine” and “isolation” are not the same. A state of quarantine is applied to those who might have been exposed to the virus, whereas isolation is applied to those who are infected, experiencing symptoms, or waiting for test results. In the case of quarantine, the CDC instructs such individuals to stay home until 14 days after the last possible exposure; in the case of isolation, the individual should stay home until they have been deemed safe by meeting several conditions. See CDC guidance for quarantine and isolation. Note that the CDC has made several allowances regarding quarantine (NOT isolation) procedures for “essential critical workers.”
  

• What is your current sick leave and payment policy? If the employee’s sick leave will not cover a full quarantine, will any accrued vacation be applied?
  
  *The CDC advises employers to be as flexible as possible regarding sick leave, in order to encourage employees to honestly self-identify if they are feeling ill. Make sure your leave policy is consistent with relevant regulations like the Families First Coronavirus Response Act (FFCRA), which, among other things, requires employers with fewer than 500 employees to provide two weeks of paid sick leave at regular wages if an employee is “unable to work because the employee is quarantined...and/or experiencing COVID-19 symptoms and seeking a medical diagnosis.” It also expands unpaid leave provisions under the Family and Medical Leave Act (FMLA). The Department of Labor has provided posters summarizing the current regulation in multiple languages for employees here.
  

• What is the approval process for returning to work?
  
  *Note that the CDC currently advises that “employers should not require a COVID-19 test result or a healthcare provider’s note for employees who are sick to validate their illness, qualify for sick leave, or to return to work.” While it is legal within the ADA for you to require a doctor’s note to return to work if you apply the policy consistently, it places additional burden on healthcare providers that may be overwhelmed. Consider instead applying the CDC guidelines for discontinuing isolation or quarantine.
  

• What health benefits might apply to this employee?‍

• How should the employee stay in contact with the organization? Is there any particular information you would want to be informed of (e.g., perhaps you would want to know if there is a change in the employee’s condition requiring hospitalization)?
  

If you have not already done so, your HR team should prepare a one-pager with answers to these kinds of questions, which you can readily provide to an infected employee.

Sanitize:

As soon as the employee has identified all areas they have accessed within the last 7 days, immediately notify your EHS team or sanitation staff. While you may be wondering whether you should completely shut down your facility to clean, the CDC notes that “in most cases, you do not need to shut down your facility.” However, your EHS or sanitation team should act quickly to cordon off all areas identified by the employee. The CDC advises opening doors and windows to ventilate the area, and waiting as long as possible before cleaning and disinfecting (24 hours is best).

Apply the CDC guidelines for cleaning and disinfecting, including the use of appropriate PPE (the CDC recommends gloves and gowns with additional PPE as needed) and the use of an EPA-approved disinfectant. If you are low on supplies of disinfectant, the CDC also recommends the use of a bleach solution of sufficient concentration. Pay attention to easily-forgotten items or surfaces like pens or tools in their workspace, or any shared screens, keyboards, or equipment. In the case of equipment or electronics, you should likely use an alcohol-based solution, which is less corrosive than typical disinfectants; in such cases the CDC notes that the solutions should be at least 70% alcohol.

You may wonder if you have to wait for a period of time before re-opening affected areas, but the CDC states that “once area has been appropriately disinfected, it can be opened for use,” and that “workers without close contact with the person who is sick can return to work immediately after disinfection.”

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Communicate:

While your EHS or sanitation team disinfects the pertinent areas, your team should be notifying any others who may have been exposed or otherwise affected by the news. In these communications, you should NOT identify the infected employee by name, nor say anything specific about their symptoms or condition. Parties you should consider include the following:

• Close work contacts: As soon as the employee has identified close work contacts, HR should begin immediately notifying each of them privately and individually. If there are more than a handful, consider using a team of HR representatives so you can communicate in parallel and reach contacts more quickly. Ideally you can reach the employees by phone or even in-person if they are in the facility (always maintaining appropriate social distancing).
  
  As with the sick employee, keep the tone of the conversation calm and empathetic. An article in Harvard Business Review recommends sharing a message like the following: “Someone in our workplace has tested positive for Covid-19, and they have identified you as a close contact according to the CDC definition. We are here to support you. If you are at work, please prepare to leave as quickly as you can.” You should be prepared to answer the same questions you answered for the ill employee regarding your quarantine policy, leave policies, benefits, and the process for returning to work. Make sure you have a way to stay in contact with them during the quarantine process.
  

• Third parties (contractors, temporary workers, vendors, delivery personnel, customers, etc.): If you had any third parties that were exposed to the sick employee in work-related activities, you should contact them to notify them of the exposure. According to the CDC, “the timeframe for having contact with an individual includes the period of time of 48 hours before the individual became symptomatic.”
  
  Note that if it is necessary to facilitate contact tracing, the EEOC currently allows you to share the employees identity to a “staffing agency or contractor that places an employee in an employer’s workplace.”
  
  

• The employee’s manager or supervisor: If the employee has not already informed their supervisor, make sure the supervisor is aware of the situation so they can plan accordingly. In this case, you will need to share the employee’s identity and the process for the individual to return to work, but refrain from sharing details about their health condition.

Similarly, if you notified any close work contacts, you will also want to make sure their managers are aware that those individuals will be out of the facility, and explain the return-to-work process to them.

In both cases, stress to these supervisors that they must protect the confidentiality of these employees, and not to identify any of them by name nor share anything about their health condition.

• Other employees: If you choose to broadly notify other employees, again, do not identify the infected employee by name, nor say anything specific about their symptoms or condition. An example of an employee notification letter by Fisher Phillips is here. Reassure other employees that you have already notified any exposed contacts, so they know that if they haven’t had a conversation with HR, then they are not considered a close contact of the sick individual.
  

• Building management: If you don’t own your facility, make sure you inform your landlord that you have had a possible or confirmed case of SARS-CoV-2 on the premises. If you have not done so already, make sure your sanitization response is well-aligned with their policies and expectations and coordinate with them on any next steps.
  

• State and/or local health authorities: Depending on your location, you may be required to report confirmed cases of SARS-CoV-2 to city, county, or state health authorities for tracking purposes. Such organizations also may provide guidance on how to respond. In advance of an employee falling ill, you should investigate who you would be required to contact and store that contact information so that it is readily accessible whether you are on-site or off-site.
  
  

Note that if necessary, the EEOC currently allows you to share the employee’s identity with a public health agency. Note also that you do not need to report cases to the CDC.

• OSHA record-keeping: The Occupational Safety & Health Administration (OSHA) requires employers to record cases of SARS-CoV-2 if it meets three criteria:

1. the case is a confirmed case of COVID-19, as defined by Centers for Disease Control and Prevention (CDC)
2. the case is work-related as defined by 29 CFR § 1904.5
3. the case involves one or more of the general recording criteria set forth in 29 CFR § 1904.7
   

However, OSHA has recognized that it may be difficult to establish whether or not a case of SARS-CoV-2 is work-related, and therefore has announced that it will not enforce OSHA record-keeping standards unless “there is objective evidence that a COVID-19 case may be work-related” and “the evidence was reasonably available to the employer.”

As you consider these activities (Care, Sanitize, and Communicate), think through all the team members that would be involved in responding - whether line managers, HR business partners, the EHS team, or others. Make sure each player is well-versed in their role in the process and is prepared to calmly and efficiently respond. You may even want to practice with drills, similar to how you perform fire drills at regular intervals - pose a scenario to a group and ask them to walk through the response in a step-wise fashion.

Throughout the process, remember your focus on safety and empathy - and continue that in the subsequent days and weeks after a possible diagnosis. Consider having someone from HR follow up with infected or quarantined employees at defined intervals to check in, voice support, and continue to answer questions as the employee has them. Your response to a possible or confirmed case of SARS-CoV-2 is a unique opportunity to protect and care for your teams. Be prepared to respond to keep your team safe, calm, and cared for.