What are the Covid-19 (Coronavirus disease 2019) quarantine guidelines and return to work protocols for healthcare providers?

COVID-19 Quarantine and Return to Work Guidelines for Healthcare Providers

Healthcare providers should not return to work until they have completed at least 10 days of isolation after symptom onset, have been fever-free for at least 24 hours without antipyretics, and have experienced improvement in other symptoms. 1, 2

Core Return-to-Work Criteria

Healthcare providers must meet ALL of the following conditions before returning to work:

• Minimum 10 days of isolation from symptom onset (or from first positive test if asymptomatic) 1, 2
• Fever-free for at least 24 hours without using fever-reducing medications 1, 2
• Improvement in respiratory and other symptoms (cough, shortness of breath, fatigue) 1, 2

This symptom-based approach is the standard for most healthcare workers and prioritizes both worker safety and preventing workplace transmission 1.

Special Considerations for Healthcare Providers

Severely Ill or Immunocompromised Providers

For healthcare workers with severe COVID-19 or those on immunosuppressive medications, a case-by-case approach is required with potentially longer isolation periods 2:

• Viral shedding continues beyond 10 days in severe cases 2
• Consider requiring negative RT-PCR testing before return to work in high-risk settings 2
• Surgical healthcare workers should remain isolated for at least 2 weeks until negative RT-PCR is obtained 2

Early Return-to-Work Programs

Some healthcare systems have implemented early return-to-work protocols for asymptomatic exposed workers (not infected workers) to address staffing shortages 3:

• Asymptomatic healthcare workers with higher-risk exposure can return to work 8 days after exposure if they remain asymptomatic through day 7 with negative testing on days 5-7 3
• This applies only to exposed but not infected workers, not those with confirmed COVID-19 3

Mandatory Workplace Safety Protocols Upon Return

Once healthcare providers meet return-to-work criteria, the following measures must be implemented:

Daily Screening

• Verbal screening and temperature checks at the start of each shift to identify potential COVID-19 carriers 4, 1
• Screen for fever, chills, cough, and difficulty breathing in the past 24 hours 4
• Screen for contact with known COVID-19 cases in the past 14 days 4

Personal Protective Equipment

• Change out of work clothing, scrubs, or uniforms at the worksite before going home to prevent family exposure 4, 1
• Wear appropriate PPE based on exposure risk level 4
• Use face masks in all patient care areas 4, 1

Infection Control Measures

• Maintain physical distance of at least 2 meters from others when possible 4, 1
• Clean hands frequently with soap and water for at least 20 seconds or use alcohol-based hand sanitizer with >60% ethanol 4, 1
• Avoid touching eyes, nose, or mouth with unwashed hands 4, 1
• Wipe down shared equipment and surfaces with disinfectant 4, 1

Critical Pitfalls to Avoid

Do Not Return to Work If:

• Still febrile (even if 10 days have passed) 1, 2
• Symptoms are worsening rather than improving 1, 2
• Less than 10 days have elapsed since symptom onset, regardless of symptom improvement 1, 2

Common Mistakes:

• Relying solely on temperature checks without verbal symptom screening is insufficient 1
• Returning too soon can lead to workplace outbreaks and put vulnerable patients at risk 1
• Assuming negative rapid tests mean immediate return is safe—the 10-day minimum still applies for symptomatic cases 2

Occupational Health Recognition

COVID-19 should be recognized as an occupational disease for healthcare workers 4:

• Any healthcare worker who develops COVID-19 after workplace exposure should be presumed to have an occupationally acquired disease 4
• Workers required to self-isolate must continue to maintain wages and benefits 4
• Contacts of infected workers must be traced, tested, and isolated 4