The California Department of Public Health recently released updated Interim Work Exclusion Guidance that details when health care personnel with COVID-19, influenza, and other acute respiratory viral infections may return to work. 

The guidance, announced in an All Facilities Letter, applies regardless of whether diagnostic testing for viral pathogens is performed or the results of such testing is confirmed. Note: This guidance does not apply to novel viral pathogens, including avian influenza, for which other public health guidance is available.

Under the new guidance, health care personnel with suspected or confirmed respiratory viral infection, regardless of whether testing is performed, should: 

• Not return to work until at least 3 days have passed since symptom onset (or a positive test, if asymptomatic), at least 24 hours have passed with no fever (without use of fever-reducing medicines), symptoms are improving and they feel well enough to return to work. With symptom onset being day 0, the first possible day of return to work would be on day 4.
• Wear a facemask for at least 10 days after symptom onset or positive test in all patient care and common areas of the facility (if not already wearing a facemask as part of universal source control masking).
• Perform frequent hand hygiene, especially before and after each patient encounter or contact with respiratory secretions.

Under the guidance, facilities may also consider temporary reassignment or exclusion of personnel from care of patients at highest risk of severe disease, including those with moderate or severe immunocompromising conditions, for 7-10 days after symptom onset or until symptom resolution, whichever is longer. See the complete Interim Guidance for Healthcare Personnel with Acute Respiratory Viral Infections for additional considerations regarding personnel who are moderately to severely immunocompromised or are caring for patients at highest risk of severe disease. 

CDPH is also encouraging health care personnel to stay up to date on influenza and COVID-19 immunizations and follow health care facility policies for source control masking.