The Centers for Disease Control and Prevention (CDC) continues to issue a steady stream of new guidance and information on COVID-19, some of which has specific relevance to the workplace. During the first part of February 2021, such guidance includes new masking recommendations, when workers who are severely immunocompromised can return to work after a COVID-19 diagnosis, and customizable vaccine communications to essential workers (that may eventually be useful for all workers).
New Masking Guidance: Improve the Fit and Filtration of Your Mask to Reduce the Spread of COVID-19 was updated on February 13, 2021. In addition to emphasizing the need for a close-fitting mask with adequate filtration, the CDC suggests “double masking” to improve fit and filtration. This means layering a cloth mask on top of a medical procedure mask, like a surgical mask, which, according to studies, provides better protection to the wearer and to others around them. The CDC cautions that individuals should not layer two medical procedure masks, as such masks are not designed to fit tightly and therefore layering them does not improve fit. The CDC also warns that KN95 masks should not be layered with any other mask. And, of course, although breathing may require more effort with another layer, the CDC says layering is not recommended if it actually makes breathing difficult or if it blocks vision.
The CDC also suggests using a mask brace or fitter, which is a device that sits on top of a surgical or cloth mask, to improve fit. Another option for surgical masks is “knotting and tucking” – i.e. to knot the ear loops at the edge of the mask, then fold and tuck the extra material under the knot, which will provide a closer fit.
Employers may wish to consider recommending employees to double-mask in order to further reduce the risk of spread. If so, they should consider providing surgical masks to employees, who may not otherwise be able to find or afford them, to use with their own cloth masks (unless the employer is already providing cloth masks). Of course, employers must be receptive to concerns about difficulty breathing, and may need to provide reasonable accommodations for disabled employees who may not be able to tolerate a double mask (or even a single one). But given how many people’s masks do not fully cover the nose and mouth, it is most important for employers to make sure employees are wearing masks correctly!
Release of Severely Immunocompromised Individuals from Isolation: The CDC’s Interim Guidance on Duration of Isolation and Precautions for Adults with COVID-19 was updated on February 13, 2021 to revise the recommendation on when severely immunocompromised individuals can be released from isolation – and therefore return to work (as specifically referenced in the updated Return to Work Criteria for Healthcare Personnel with SARS-CoV-2 Infection (Interim Guidance)).
As we previously discussed in our August 2020 E-Update, the CDC had previously set forth guidelines on when those diagnosed with COVID-19 may be released from isolation. Specifically, the CDC stated:
- Those who had or likely had COVID-19 with symptoms may be around others if 10 days have passed since the symptoms first appeared, they have been fever-free without fever-reducing medications for at least 24 hours, and their other symptoms have improved.
- Those who tested positive for COVID-19 without symptoms may be around others once 10 days have passed since the positive test, as long as they remain asymptomatic.
- Those who were severely ill with COVID-19 may need to stay home for up to 20 days, and may need to be tested before being released from home isolation, depending on what their healthcare provider determines.
The CDC had also stated that those with COVID-19 and compromised immune systems may need to be tested before being released from home isolation, depending on what their healthcare provider determines. However, in the updated guidance, the CDC now states that severely immunocompromised individuals may remain infectious for more than 20 days following symptom onset or, if asymptomatic, a positive test. Therefore the CDC now recommends consultation with infectious diseases specialists and consideration of the use of a test-based strategy for determining when these individuals may be released from isolation and return to work.
Thus, employers should be thoughtful about handling employees that they know have severely compromised immune systems – requiring a return to work after the normal 10 day period may not be appropriate or wise.
Consultation with infectious diseases specialists is recommended. Use of a test-based strategy for determining when these HCP may return to work could be considered.
Vaccine Communications to Workers: The CDC has previously provided Frequently Asked Questions on vaccines and created toolkits for employers of essential workers (updated February 12, 2021), medical centers/clinics/clinicians, and long-term care facilities. The toolkits contain FAQs for employers and employees, sample communications, posters, social media content, and more. On February 13, 2021, it also issued updated Customizable COVID-19 Vaccine Content for Essential Workers, which provides a sample introductory letter for branches/offices/units, a letter for employees, and newletter content. Although the resources are specific to essential workers and healthcare employers, they are certainly applicable to employers generally as the vaccines become more generally available.