Workplace outbreak guidance

Updated September 09, 2020.

Available languages: English | Español | Tiếng Việt | 中文 | Soomaali | العربية | नेपाली 

 

This guidance offers workplaces and non-healthcare, non-residential facilities best practices for preventing and reducing the severity of outbreaks and contains tools for reporting outbreaks to public health.

We will update this guidance as better understanding of the virus and new recommendations become available.

Definitions 

Confirmed outbreak: two or more people who are confirmed cases of COVID-19 in a workplace/facility, with onset within 14 days. 

Suspected outbreak: two or more people who are probable cases of COVID-19 (or one confirmed and one or more probable cases) in a workplace/facility, with onset within 14 days. 

Recent COVID-19 exposure: Having close contact (generally less than 6 feet for at least 15 minutes, depending on the exposure) with a person with COVID-19 from two days before their symptom onset (or positive COVID-19 test) until they meet criteria to discontinue isolation. Depending on the workplace environment and types of person-to-person interactions, high-risk "close contact" exposures can occur in fewer than 15 minutes. Note, close contact isn't necessarily 15 consecutive minutes.  Someone who was close to a sick person multiple times during a work shift may have been exposed and need to be quarantined. Consult with public health authorities for guidance.

Preventing outbreaks

Workplaces/facilities can help prevent outbreaks by reducing the spread among staff, maintaining healthy business operations, promoting a healthy work environment, and following state and local public health orders. 

Reduce spread among staff

Screen employees daily, and send sick employees home.

  • Self-screening means having employees monitor themselves for fever and other COVID-19 symptoms daily. Employees report symptoms to the workplace/facility before entering. Ask employees who report symptoms to stay home, encourage them to get tested, and refer them to the Colorado COVID Symptom Support Tool.
  • Instead of relying on employees to self-screen, public health recommends workplaces/facilities screen employees daily, either in person or virtually, before they enter the workplace/facility.
    • Screenings should include a temperature check and questions about COVID-19 symptoms and recent COVID-19 exposure.
    • Document symptom checks using an employee health screening form
    • Send employees with COVID-19 symptoms home immediately. Refer them to the Colorado COVID Symptom Support Tool, and encourage them to get tested.
    • Support Tool, and encourage them to get tested.
      Maintain social distancing when screening onsite. For example, provide multiple screening entry sites to allow employees to remain at least 6 feet apart while they wait for screening.
    • To prevent stigma and discrimination, make employee health screenings as private as possible. Do not make determinations of risk based on race or country of origin, and maintain employee confidentiality.
    • Provide screening materials in languages employees understand. CDC materials in languages other than English are available here: CDC Resources in languages other than English

Identify where and how employees might be exposed to COVID-19 at work.

  • Conduct a thorough hazard assessment to determine if workplace hazards are present, or are likely to be present, and determine what type of controls or personal protective equipment (PPE) are needed for specific job duties. 
    • When engineering and administrative disease controls* cannot be implemented or are not fully protective, OSHA standards require employers to:
      • Determine what PPE is needed for their workers’ specific job duties.
      • Select and provide appropriate PPE to the workers at no cost.
      • Train their workers on correct use.
    • Keep logs of where/with whom employees work (in other words, who works in what location and on which shifts) so it is easy to assist public health if an outbreak occurs and contact tracing is needed.
    • Re-arrange work shifts or units to allow cohorting of employees. This creates smaller groups of employees to work together consistently, rather than having individuals crossing into different shifts.

*Engineering controls refer to actions such as changing the workplace layout. Administrative controls refer to measures such as ensuring employees are following precautions.

Educate employees on how to reduce the spread of COVID-19.

  • Ensure employees and customers wear masks, following state and local orders.
  • Promote proper hand washing and ensure employees are correctly covering coughs/sneezes. Post easy-to-follow signs on these techniques in languages employees and customers understand. 
  • Practice social distancing by avoiding large gatherings (more than 10 people) and maintaining distance (at least 6 feet) from others. Continue to follow social distancing in areas where mask need to be removed, such as break.
  • Avoid sharing equipment and personal items such as cell phones, keyboards, tools. If workers must share equipment, clean and disinfect items before and after use.

Know isolation and quarantine requirements, and help employees follow them.

  • Isolation is for sick employees. Employees with symptoms or a positive COVID-19 test should stay home until they can discontinue isolation. Generally, this means:
    • 10 days have passed since symptoms started (or 10 days since their positive test if they did not have any symptoms), and 
    • The employee has been fever-free for 24 hours without using fever-reducing medicine, and
    • Symptoms are improving.
  • Quarantine is used to keep someone who might have been exposed to COVID-19 away from others. Quarantine helps prevent the spread of disease before a person knows that they are ill or infected with the virus without symptoms. People generally need to quarantine when they have been in close contact with someone who has COVID-19. People in quarantine should stay home, separate themselves from others, monitor their health, and follow directions from their state or local health department. It is possible that a person may have to quarantine more than once if they are exposed again following their quarantine.
    • Healthy, exposed people who develop symptoms during this quarantine period should get tested and begin isolation.
    • Healthy, exposed people who don’t develop symptoms do not need to get tested. A negative test result does not clear a person to end quarantine and return to work as the person may still become ill.  However, if they decide to get tested, they should wait until at least seven days have passed since they were with the sick person.  A test completed before the end of the quarantine period may result as negative due to being collected too early in a person's illness which may actually test positive if repeated on subsequent days.
Maintain healthy business operations

Designate a workplace coordinator to be responsible for COVID-19 issues and their impact.

Implement flexible sick leave and supportive policies and practices.

  • Review human resources policies to ensure policies and practices are consistent with public health recommendations and existing state and federal workplace laws. Ensure sick leave policies are flexible and employees are aware of and understand these policies. 
  • Draft “emergency sick leave” policies if you currently do not offer sick leave to some or all employees. 
  • Do not require a COVID-19 test result or a health care provider’s note for employees to qualify for sick leave or to return to work. 
  • Connect employees to employee assistance programs and community resources as needed.
  • Avoid incentive programs that encourage sick or exposed employees to come to work.

Communicate supportive workplace policies clearly, frequently, and via multiple methods.

  • Communicate with non-English speakers in their preferred languages.
  • Place signs about policies in languages workers can understand.
  • Train workers on how new policies to reduce the spread of COVID-19 may affect existing health and safety practices.
  • Communicate changes in policy and practice to contractors and onsite visitors. Ensure that they have the information and capability to comply with those policies.
  • Share policies with employees through multiple methods. Use email, text, signs, and verbal communication in meetings.
  • Tell employees when there are changes to policies. If there are no changes, remind employees of policies monthly.
  • Create and test communication systems that employees can use to self-report if they are sick and that you can use to notify employees of exposures and closures.
  • Consider using a hotline or other method for employees to voice concerns anonymously.

Assess essential functions and the reliance others have on your services or products.

  • Be prepared to change your business practices if needed to maintain critical operations. (For example, identify alternative suppliers, prioritize existing customers, stagger shifts, or temporarily suspend/reduce some of your operations.)
  • Identify alternate supply chains for critical goods and services. 
  • If other companies provide your business with contract or temporary employees, talk with those staffing companies and the contract or temporary staff about the importance of sick employees staying home. Encourage those staffing companies to develop adequate leave policies.
  • When resuming onsite business operations, identify and prioritize job functions for continuous operations. Minimize the number of workers present at worksites by resuming business operations in phases, balancing the need to protect workers with support for continuing operations.
  • Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce, and associations to improve community response efforts.

Determine how you will operate if absenteeism increases.

  • Monitor absenteeism.
  • Have plans in place to continue essential functions if you experience higher than usual absenteeism.
  • Cross-train employees to perform essential functions so the workplace can operate if key employees are absent.

Establish policies and practices for social distancing among employees. Here are some ideas:

  • Implement flexible worksites (for example, remote work).
  • Implement flexible work hours.
  • Phase or stagger work shifts and breaks to reduce the number of employees in one place at the same time. 
  • Increase physical space between onsite employees by rearranging work stations, placing distance markers, installing partitions, discouraging the use of shared spaces, etc.
  • Implement flexible meeting and travel options; for example, postpone meetings and events or use teleconferencing.
  • Close or limit access to common areas where employees can mingle.
  • Discourage handshaking. Encourage employees to greet each other without contact (for example, smile and wave).
  • Downsize operations to reduce the number of employees at the workplace at the same time.

Establish policies and practices for social distancing between employees and customers. Here are some ideas:

  • Offer drive-through service, click-and-collect online shopping, shop-by-phone, curbside pickup, or delivery options.
  • Rearrange customer flow.
  • Place distance markers. 
  • Install partitions.
  • Limit the number of customers. 
  • Use touchless payment options. 
  • Move the electronic payment terminal/credit card reader farther away from the cashier.
  • Shift primary stocking activities to off-peak or after hours to reduce contact with customers.
  • Deliver services remotely (for example, by phone, video, or web).

Provide local managers with the authority to take appropriate actions based on local conditions.

Consider sequestering healthy critical workers in separate housing to keep them from being exposed in the community.

  • Employees eligible to sequester must not be symptomatic or have recent exposure to a person with COVID-19 within the last 14 days. 
  • Before sequestration, interview eligible employees to rule out potential exposures, and screen them to rule out COVID-19 symptoms or recent COVID-19 exposure. 
  • During sequestration, re-screen sequestered employees daily for fever and other COVID-19 symptoms and potential exposures.
  • Request detailed sequestration guidelines from CDPHE.

Help employees who use shared transportation get to work.

  • Offer reimbursement for parking or single-occupancy rideshares.
  • Allow employees to change their hours so they can commute during less busy times.
  • Ask employees to clean their hands as soon as possible after their trip.
  • Discourage carpooling among employees from different households as much as possible.
  • Remind employees to wear face coverings when using shared transportation.

Provide accommodations for employees at higher risk for serious illness.

  • Employees at higher risk for serious illness should stay at home as much as possible.
  • Prioritize teleworking for higher-risk employees as they cannot be compelled to go to work at this time.

Limit travel and advise employees who must travel to take additional precautions.

  • Minimize non-essential travel.
  • Advise employees to check themselves for symptoms of COVID-19 before starting travel. If they are sick they should notify their supervisor and stay home.
  • Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and promptly call a health care provider for advice if needed.

Minimize risk to employees when planning meetings and gatherings.

  • Use videoconferencing or teleconferencing for work-related meetings and gatherings.
  • When videoconferencing or teleconferencing is not possible, hold meetings in open, well-ventilated spaces. Stay at least 6 feet apart and wear face coverings.
  • Cancel, adjust, or postpone large gatherings that can only occur in-person. Follow state and local regulations and guidance.
Maintain a healthy work environment

Improve building ventilation. This may include some or all of the following:

  • Increase ventilation rates. Set rates to the highest settings allowed by the system.
  • Keep systems running longer hours, 24/7 if possible, to enhance air exchanges in the building space.
  • Ensure ventilation systems operate properly and provide acceptable indoor air quality for the current occupancy level for each space.
  • Increase outdoor air ventilation, using caution in highly polluted areas. With a lower occupancy level in the building, this increases the effective dilution ventilation per person.
  • Disable demand-controlled ventilation (DCV) settings.
  • Further open minimum outdoor air dampers (as high as 100%) to reduce or eliminate indoor air recirculation. In mild weather, this will not affect thermal comfort or humidity. However, this may be difficult to do in cold or hot weather.
  • Improve central air filtration to MERV-13 or the highest compatible with the filter rack, and seal edges of the filter to limit bypass.
  • Check filters to ensure they are within service life and appropriately installed.
  • Some of the above recommendations are based on the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Guidance for Building Operations During the COVID-19 Pandemic. Review these ASHRAE guidelines for further information on ventilation recommendations.
  • In buildings without HVAC systems, consider using portable room air cleaners with HEPA filters or open windows to increase outdoor air ventilation when feasible (using caution in highly polluted areas). More information on portable air cleaners can be found on the US EPA’s webpage: Air Cleaners and Air Filters in the Home.

Ensure the safety of water systems and devices from mold and Legionella after a prolonged shutdown.

Make it easy to follow the rules.

  • Enforce state and local mask orders for employees and customers. Workers who require PPE should wear appropriate PPE instead of a cloth face covering. 
  • Provide tissues and no-touch trash cans.
  • Provide soap and water or hand sanitizer that is at least 60% alcohol in multiple locations. Ensure that adequate supplies are maintained. 
  • Schedule frequent breaks for employees to wash or sanitize their hands.
  • Provide disposable wipes so employees can wipe down commonly used surfaces before each use. Use products that meet EPA criteria and are appropriate for the surface.

Clean and disinfect.

  • Routinely clean and disinfect all frequently touched surfaces in the workplace, such as workstations, keyboards, telephones, handrails, and doorknobs. If surfaces are dirty, clean them using a detergent or soap and water before disinfection. For disinfection, use products that meet EPA criteria and are appropriate for the surface. Follow the manufacturer’s instructions.
  • Store and use disinfectants responsibly, according to the label.
  • Do not mix bleach or other cleaning and disinfection products. This can cause toxic fumes.
  • Ensure cleaning crews wear gloves appropriate for the chemicals being used. They may need additional PPE based on the setting and product.
  • Perform enhanced cleaning and disinfection after people suspected or confirmed to have COVID-19 have been in the workplace/facility.

COVID-19 cases and exposures in employees

When a single employee has confirmed or probable COVID-19:

  • You probably will not need to shut down the workplace.
  • Send any sick employee who has reported to work home immediately.
  • Inform fellow employees of possible exposure.
  • Maintain the sick employee’s confidentiality as required by the Americans with Disabilities Act
  • Clean and disinfect.
    • If it has been fewer than 7 days since the sick employee was in the workplace, close off areas the sick person used.
      • Wait 24 hours since the sick person used the area before cleaning and disinfecting. Doing so minimizes the potential for cleaning crews to be exposed to respiratory droplets. If waiting 24 hours is not feasible, wait as long as possible.
      • During the waiting period, open outside doors and windows to increase air circulation.
    • If it has been 7 days or more since the sick employee used the facility, additional cleaning and disinfection is unnecessary. Continue routinely cleaning and disinfecting all high-touch surfaces in the facility.
    • Follow the CDC cleaning and disinfection recommendations.

When employee(s) have been exposed to a person with confirmed or probable COVID-19 (at work or elsewhere):

  • Non-critical workers with recent exposure to a person with COVID-19 should be quarantined at home for 14 days after exposure and self-monitor for symptoms and follow any other instructions provided by public health.
    • If they develop symptoms of COVID-19, they should get tested and begin isolation. 
    • If they want to get tested but don’t have symptoms, they should wait at least 7 days since they were last with a person with COVID-19.
    • Remote work during quarantine is acceptable.
  • Employers should confer with public health authorities and consider creative solutions to maintain the essential functions of the workplace while allowing all who were exposed to quarantine. However, while advisable, it is recognized that quarantining for 14 days may not be feasible for certain critical workers (read our Critical Worker FAQ | Español) for more information about those with work functions that cannot be performed by any other workers) with recent exposure to a person with COVID-19.In consultation with public health, these workers may be allowed to continue reporting to their work site and should:
    • Be regularly screened and sent home if they develop symptoms of COVID-19.
    • Wear a face covering at all times during work.
    • Practice frequent and thorough hand hygiene.
    • Keep at least 6 feet of distance between themselves and others.
    • Ensure workspaces are cleaned and disinfected routinely.

COVID-19 outbreaks

Close the workplace/facility temporarily, and report the suspected outbreak to public health.

  • If two or more cases are confirmed within 14 days among employees, the workplace/facility should temporarily close. Managers must report the suspected outbreak to the local public health agency in the county where the workplace or facility is located. 

Work with your local public health agency to determine if longer-term closing is necessary.

  • Workplaces/facilities may not need to close for an extended period if there is an outbreak. When a workplace/facility is working closely with public health, it may be possible to conduct a rapid risk assessment and implement immediate control measures instead of longer-term closing. Local public health will help:
    • Confirm whether an outbreak exists.
    • Identify additional cases.
    • Determine the extent of the outbreak.
    • Work with the facility to determine additional steps.
    • If closing is necessary, determine when it is safe to reopen.
Lessen the severity of the outbreak.

Follow the measures outlined throughout this guidance. Prioritize the following actions:

  • Send employees with symptoms of COVID-19 home immediately for isolation. Encourage them to get tested and consult a health care provider if needed. Do not encourage or allow sick employees to return to work until they can discontinue isolation.
  • Send healthy employees with recent exposure to a person with COVID-19 home to quarantine for 14 days.
    • Guidelines that permit certain critical workers to report to their workplace during  quarantine may not be feasible during an outbreak. Your local public health agency can help you determine whether or not employees can report to their workplace during  quarantine. Remote work is allowable during quarantine.
    • Compile information on healthy employees with recent exposure for the local public health agency.
  • Keep higher-risk employees out of the workplace when there is an outbreak.
    • Employers must provide work accommodations to higher-risk employees (such as allowing telework or time off) during workplace/facility outbreaks. They cannot be compelled to go to work.
  • Ensure employees who remain onsite, and customers, wear face coverings.
  • Actively screen employees daily for fever, COVID-19 symptoms, and recent COVID-19 exposure before they enter the workplace/facility. Document these daily checks using an employee health screening form
    • See the preventing outbreaks section for screening best practices.
    • Employees who don’t have fever, symptoms, or recent exposure should self-monitor under the supervision of their employer’s occupational health program.
  • Close off areas used by sick people. Increase ventilation as outlined above. Open outside doors and windows and use ventilating fans to increase air circulation in the area. Wait 24 hours or as long as practical before beginning cleaning and disinfection.
  • Perform enhanced cleaning and disinfection, focusing on frequently touched surfaces.

Public health may require additional workplace/facility closure if widespread transmission continues to occur despite the above measures or if there are not enough staff available to run operations safely.

  • Consult with your local public health agency on when and how to re-open safely. 
  • Closure may need to last until enough staff have finished their appropriate isolation (if infected) or quarantine (if healthy but exposed) to safely resume operations.
  • Perform enhanced cleaning and disinfection before re-opening. Cleaning staff should clean and disinfect all areas such as offices, bathrooms, common areas, shared electronic equipment (like tablets, touch screens, keyboards, remote controls, and ATMs) used by the ill people, focusing especially on frequently touched surfaces.
  • Public health may require additional steps to control the outbreak in certain situations.

Testing considerations

Be aware of the limitations of COVID-19 testing in the workplace.

Testing by itself cannot “clear” employees to work.

  • There are two main types of COVID-19 tests.
    • Viral test (RT-PCR/nucleic acid or antigen detection) is the only way to confirm current COVID-19 infection. 
    • Antibody (serological) tests check a person’s blood to look for antibodies, which may determine a past COVID-19 infection. This does not mean the person is immune.
  • Employees with COVID-19 symptoms are encouraged to get tested for COVID-19 using a viral test. 
    • Employees confirmed to have COVID-19 should stay at home until they have finished isolation. 
    • All positive viral test results must be reported to CDPHE. Businesses doing onsite testing must ensure labs they contract with are aware of this requirement.
  • CDPHE does not recommend re-testing people who have already been confirmed to have COVID-19 for 90 days following their positive test.
  • In most circumstances, CDPHE does not recommend routine testing of healthy employees because test results alone should not clear them to return to work.
  • Routine viral testing of healthy employees may be recommended in workplaces where there is an outbreak or in certain high-risk settings. In this case, routine testing would be part of a targeted response plan developed in conjunction with your local public health agency.
  • People with COVID-19 may receive negative viral test results if they get tested too soon after exposure. If someone has been exposed to COVID-19, that individual should quarantine for a full 14 days regardless of negative test results. The goal of testing some workers who don’t have symptoms is to identify workers who may be contagious. 
  • Any asymptomatic healthy worker who tests positive using a viral test must isolate for 10 days from the date of their test. If they develop symptoms during isolation, isolation time may need to be extended.  
  • A negative test cannot clear someone from quarantine nor does it guarantee that a person will not develop COVID-19 in the future.
  • Anyone with recent close contact to a healthy worker who tests positive for COVID-19 using a viral test must be quarantined for 14 days from when they were last around the person.
  • Be aware testing capacity may still be limited in some settings.
  • Do not use antibody tests to prove immunity, clear employees to work, or make decisions about grouping people in congregate settings, such as schools, dormitories, or correctional facilities.
    • Antibody tests do not test for current COVID-19 infection and do not prove immunity.
    • In areas with low prevalence, false positives can still occur even among serologic (antibody) tests with relatively good specificity and sensitivity. 
    • Some antibody tests may be cross-reactive with other common coronaviruses and may not be specific for COVID-19, resulting in false positives. 
    • The FDA has removed some antibody tests from its authorized list because of quality issues.
  • Until more information is available about the dynamics of IgA detection in serum, CDPHE does not recommend testing for IgA antibodies.

Preventing outbreaks

To reduce spread among staff:

 Screen employees daily, and send sick employees home.

 Identify where and how workers might be exposed to COVID-19 at work.

 Educate employees on how to reduce the spread of COVID-19.

 Know isolation and quarantine requirements, and help employees follow them.

To maintain healthy business operations:

 Designate a workplace coordinator to be responsible for COVID-19 issues and their impact.

 Implement flexible sick leave and supportive policies and practices.

 Communicate supportive workplace policies clearly, frequently, and via multiple methods.

 Assess your essential functions and the reliance that others have on your services or products.

 Determine how you will operate if absenteeism increases.

 Establish policies and practices for social distancing among employees.

 Establish policies and practices for social distancing between employees and customers.

 Provide local managers with the authority to take appropriate actions based on local conditions.

 Consider sequestering healthy critical workers in separate housing to keep them from being exposed in the community.

 Help employees who use shared transportation get to work.

 Provide accommodations for employees at higher risk for serious illness.

 Limit travel and advise employees who must travel to take additional precautions.

 Minimize risk to employees when planning meetings and gatherings.

To maintain a healthy work environment:

 Improve building ventilation.

 Ensure the safety of your water system and devices after a prolonged shutdown.

 Make it easy to follow the rules on masking, social distancing, hand hygiene, and cleaning/disinfection.

 Routinely clean and disinfect all frequently touched surfaces in the workplace.

 Perform enhanced cleaning and disinfection after people or employees suspected/confirmed to have COVID-19 have been in the workplace/facility.

Reporting outbreaks

Workplaces/facilities that suspect an outbreak should immediately:

 Fill out the CDPHE COVID-19 outbreak report form and send it to your local public health agency.

 Begin identifying staff with COVID-19-like symptoms using the CDPHE COVID-19 line list template.  

 Work with your local public health agency on next steps. 

In case of an outbreak

 Send employees with symptoms of COVID-19 home immediately for isolation.  

 Identify healthy employees with recent exposure to a person with COVID-19, and send them home to quarantine for 14 days. 

 Keep higher-risk employees out of the workplace.

 Work with your local public health agency to determine additional actions and whether/when it is safe to re-open.

 Be aware of the limitations of COVID-19 testing in the workplace.

For customers and employees who remain onsite:

 Ensure employees and customers wear face coverings.

 Screen employees for COVID-19 symptoms and exposure daily (in-person or virtually) before they enter the workplace/facility.

 Close off areas used by sick people, and increase ventilation.

 Perform enhanced cleaning and disinfection, focusing on frequently touched areas.

Additional resources