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Acute Communicable Disease Control
COVID-19 Home COVID-19 Vaccine Guidance for the Public Orders and Protocols

6-24-22: Added considerations for large indoor airspaces to the definition of a close contact based on the CDPH Isolation and Quarantine Q&A updated June 20, 22.

6-16-2022: The California Health Officer Order of June 8, 2022 defines a close contact as someone sharing the same indoor airspace for a cumulative total of 15 minutes or more over a 24-hour period during an infected person's infectious period. Per Cal/OSHA COVID-19 Emergency Temporary Standards (ETS) the CDPH definition of a close contact now applies for workplace exposures.

Review the ETS and the COVID-19 Emergency Temporary Standards Frequently Asked Questions for more details on the current revision of the ETS.

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Employers are required to investigate and respond to any COVID-19 cases in the workplace as outlined by Cal/OSHA COVID-19 Prevention Emergency Temporary Standards (ETS). As approved, the full text of these standards appears under the Title 8 sections 3205-3205.4 of the California Code of Regulations. The following are guidelines to support employers responding to COVID-19 cases identified in non-healthcare, non-residential worksites.

For guidance on preventing infections in the workplace please refer to LAC DPH Best Practices in the Workplace to Prevent the Spread of COVID-19.

Reporting COVID-19 Cases

Employers are required to report any cluster of worksite COVID-19 cases. A cluster is when three (3) or more cases of COVID-19 are known or reported at the worksite within a 14-day period. Reports to the Los Angeles County Department of Public Health (LAC DPH) should be made as soon as possible and no later than 48 hours after reports or knowledge of at least three cases. Report to LAC DPH online or by phone: 1-888-397-3993.

Once LAC DPH receives a cluster report, they will initiate a response to determine the risk of worksite transmission based on number of cases, their work location and duties, how/if the cases interacted with each other and if they share a household or carpool with each other.

If the cluster meets worksite outbreak criteria, a public health case manager will be assigned to help guide the worksite response which includes providing infection control recommendations, workplace exclusion guidance, technical support, and site-specific COVID-19 prevention and control measures.

Definitions

A COVID-19 case is a person who:

  1. has a positive viral test (i.e., a PCR or antigen test, including self-administered and self-read tests) for COVID-19 and/or
  2. has a positive COVID-19 diagnosis from a licensed healthcare provider.

    A COVID-19 case is considered as able to spread the virus to others (infectious):
    • If symptomatic-- from 2 days before their symptoms first started until their isolation period ends, OR
    • If symptoms never develop--from 2 days before their positive viral test was taken until their isolation period ends.

A close contact is defined as someone sharing the same indoor airspace for a cumulative total of 15 minutes or more over a 24-hour period while the case was infectious.

An example of "a total of 15 minutes or more" is being in the same airspace with the person for 5 minutes at least 3 different times in 24 hours.

*This is regardless of use of face masks by the case or contact. Exception: Cal/OSHA states that employees are not a close contact if they wore a respirator required by the employer and used in compliance with section 5144, whenever they were sharing the same airspace of the COVID-19 case while they were infectious.

Note: In large indoor spaces, employers may determine close contacts by using a smaller shared airspace area within the larger airspace (such as an individual room, break or eating area, or waiting area) or by using a distinct cohort of employees (such as departments or shifts). When a larger indoor space cannot be easily divided into smaller discrete spaces or distinct cohorts of individuals, then close contacts may be determined based on proximity to the case. Those persons closer to the infected person or in a more enclosed shared airspace are at the greatest risk of exposure. See CDPH Isolation and Quarantine Q&A: How should entities respond to a potential exposure when using this updated definition?--updated June 20, 2022.

Recently recovered from COVID-19 is a person who had a positive viral COVID-19 test within the past 3 months (90 days) who is no longer considered infectious (i.e., their isolation period is over). 

If they had symptoms with their most recent infection, the 90 days are from the onset of the initial COVID-19 symptoms. If they never had symptoms, then the 90 days are from the date of collection of the first positive viral COVID-19 test.

Note: Cal-OSHA ETS refers to these workers as a “returned case”.

COVID-19 symptoms means fever of 100.4 degrees Fahrenheit or higher, chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea, unless a licensed health care professional determines the person's symptoms were caused by a known condition other than COVID-19.

In accordance with the updated Cal-OSHA ETS, a COVID-19 test means a test for SARS-CoV-2 that is:

  1. Cleared, approved, or authorized, including in an Emergency Use Authorization (EUA), by the United States Food and Drug Administration (FDA) to detect current infection with the SARS-CoV-2 virus (e.g., a viral test); and
  2. Administered in accordance with the authorized instructions.

Over-the-counter (OTC) self-tests. To comply with the Cal-OSHA testing requirements of the ETS, an OTC COVID-19 test may be both self-administered and self-read if verification of the results, such as a time and date stamped photograph of the result or an OTC test that uses digital reporting with time and date stamped results, is provided.

See Cal-OSHA Testing FAQs for examples of acceptable self-tests.

Responding to COVID-19 in the Workplace

Employers should have procedures in place for seeking information from employees related to COVID-19 cases and close contacts in the workplace. This includes collecting and keeping records of all COVID-19 cases: their date of symptom onset, COVID-19 testing dates and results, last date present at workplace and their workplace locations and duties.

Once a COVID-19 case is identified at the workplace, the employer must follow the Cal-OSHA ETS and

  • Make sure the case follows isolation instructions and does not return to work until their isolation is completed.
  • Determine who may have been a close contact to the case at the workplace. This includes assessing the case’s activities and workplace locations while they were infectious.
  • Inform all close contacts in the workplace via written notice of their close contact within 1 business day. Provide instructions regarding the requirements to mask, test, and monitor their health (see Table 2).
  • Additionally, provide written notice of potential exposure within one business day to all employees, independent contractors, and other employers who were on the premises at the same worksite as the case during their infectious period. Direct them to instructions for contacts available at ph.lacounty.gov/covidcontacts.
  • Review Best Practices in the Workplace to Prevent the Spread of COVID-19 to reduce future workplace exposures to COVID-19.
  • Report a potential outbreak to LAC DPH if three (3) or more cases of COVID-19 are known or reported among employees within a 14-day period. Report online or by phone: 1-888-397-3993. See Outbreak Response for more information.
Exclusion Requirements and Return to Work

The following exclusion and return to work requirements are for employees in non-high-risk settings. For printable versions of these tables, click here.

For healthcare workers please refer to COVID-19 Infection Prevention Guidance for Healthcare Personnel and COVID-19 Infection Prevention in EMS Personnel. For workers in other high-risk settings-see Instructions for Close Contacts-High Risk Settings

See the Cal/OSHA Isolation and Quarantine FAQ for more information.

Table 1: Exclusion and Return to Work Requirements for Employees with COVID-19 (Isolation)
Persons with COVID-19 (Isolation) Requirements
Everyone identified as a COVID-19 case must isolate, regardless of vaccination status, previous infection, or lack of symptoms.
 Employee must be excluded from workplace for at least 5 days after the start of symptoms or after date of first positive test if no symptoms.
  • Isolation can end and employee may return to the workplace after Day 5* ONLY if all of the following criteria are met:
    1. A COVID-19 viral test** collected on Day 5 or later is negative, AND
    2. No fever^ for at least 24 hours without the use of fever-reducing medicine, AND
    3. Other symptoms are not present or are improving

--or--

  • If an employee is unable or chooses not to test or if they continue to test positive on or after Day 5 isolation can end, and the employee may return to the workplace after Day 10* as long as they have not had a fever for at least 24 hours, without the use of fever reducing medicine.
    • If they do have a fever, isolation must continue, and the employee may not return to work until 24 hours after the fever resolves.

Generally, employers may determine if their employees/contractors with COVID-19 must complete the full 10 days of isolation before returning to work or if they may return to work after Day 5, if the criteria listed above are met. Employees/contractors are advised to obtain information from their employer.

Employee must wear a highly protective mask around others for a total of 10 days after the positive test, especially in indoor settings.

  • Employers must provide—at no expense to the employee—well-fitting medical masks and well-fitting respirators (e.g., N95, KN95, KF94).
  • See Wear a Mask and Know Your Rights.
Employee must follow the full isolation instructions for people with COVID-19 at ph.lacounty.gov/covidisolation.

Notes

*To count the days:

  • For symptomatic employees: Day 0 is the first day of symptoms. Day 1 is the first full day after symptoms developed.
  • For employees without symptoms: Day 0 is the day the first positive test was collected. Day 1 is the first full day after the positive test was collected.

**The test must be an FDA-authorized viral test such as an antigen or NAAT/PCR test. An antigen test is preferred. Testing must be provided by the employer free of charge and during work hours. Self-administered and self-read OTC tests are acceptable per Cal-OSHA if verification of the results, such as a time and date stamped photograph of the result or an OTC test that uses digital reporting with time and date stamped results, is provided. For more information see Cal-OSHA Testing FAQs.

^A fever is a measured body temperature of 100.4 degrees Fahrenheit or higher.

 

Table 2. Requirements for Employees that are Close Contacts [Non-Outbreak Setting1]
Persons with Close Contact Exposure to Someone with COVID-19 Requirements
These requirements apply to all asymptomatic employees that are identified as close contacts, regardless of vaccination status

 

 
Employee must wear a highly protective mask around others for a total of 10 days* after their last close contact.
  • Employers must provide—at no expense to the employee— well-fitting medical masks and well-fitting respirators (e.g., N95, KN95, KF94)

See Wear a Mask and Know Your Rights.

Employee must test** within 3-5 days* after their last close contact with the case unless they have recently recovered from COVID-19.

  • If they test positive, they must follow isolation requirements and workplace exclusions in Table 1.

Employee must monitor their health for 10 days*

If symptoms develop, the employee must stay home and be excluded from work pending the results of a test.

  • If they test positive or their doctor diagnoses them with COVID-19, they must follow isolation requirements and workplace exclusions in Table 1.
  • If the employee is unable to test or chooses not to test, exclusion must continue for 10 days.
  • If the employee tests negative and returns to work earlier than 10 days after the close contact, the employee must wear a highly protective mask around others for 10 days following the close contact. Note: CDPH recommends continuing exclusion and retesting in 1-2 days if testing negative with an antigen test, particularly if tested during the first 1-2 days of symptoms.
  • For symptomatic employees who have tested positive within the previous 90 days, an antigen test is preferred.

Notes

*Day 1 is the first full day after their last exposure

**The test must be an FDA-authorized viral test such as an antigen or NAAT/PCR test. Testing must be provided by the employer free of charge and during work hours. For more information see Cal-OSHA Testing FAQs.

1 These requirements are for non-outbreak settings only. During outbreaks, additional requirements will be applicable and guided by public health investigation.

Testing

Cal/OSHA COVID-19 ETS states that employers must offer testing at no cost to employees during paid time:

  • To all employees with COVID-19 symptoms;
  • To employees who had a close contact at work, with an exception for symptom-free employees who recently recovered from COVID-19 (returned cases);
  • During an outbreak, to all employees within an exposed group during an outbreak, at least once or twice per week depending on the magnitude of the outbreak, except for employees who were not at work during the relevant period and symptom-free employees who recently recovered from COVID-19; and
  • When following CDPH and local Health Department Isolation and Quarantine Guidance to keep employees working or return them sooner, if tested.

Employers must provide testing in a manner that ensures employee confidentiality.

Testing Resources

  • Employers must inform all employees on how they can obtain COVID-19 testing. This could be through the employer, local health department, the federal government, a health plan or at a community testing site.
  • Cal/OSHA Test FAQs
  • LAC DPH COVID-19 Testing for general information about testing including types of tests, when, where, and how to get a test, and understanding test results.
Additional Information

Cal/OSHA

LAC DPH

See the LAC DPH COVID-19 website for additional resources related to COVID-19.


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Public Health has made reasonable efforts to provide accurate translation. However, no computerized translation is perfect and is not intended to replace traditional translation methods. If questions arise concerning the accuracy of the information, please refer to the English edition of the website, which is the official version.

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