CDPH Updates Isolation Guidance to Align with CDC’s Recommended Reentry for COVID-19 Cases

By Megan S. Shaked

A little over a month into the life of the Cal/OSHA COVID-19 Non-Emergency Rule and we already have our first significant update. Effective March 13, 2023, the California Department of Public Health (CDPH) has updated its Guidance on Isolation and Quarantine to modify the period of isolation for COVID-19 cases and the definition of “infectious period.” The change was implemented to align California’s guidance with the CDC Recommendations for Isolation. This CDPH guidance does not apply to certain healthcare and emergency medical services personnel who are covered by other guidance documents. Cal/OSHA has also revised its Frequently Asked Questions accordingly.

Timing for COVID-19 Cases to End Isolation

Individuals who test positive for COVID-19 should continue to isolate for at least 5 days, starting the day after the start of symptoms or a first positive test. But now, such individuals may leave isolation after day 5 if they are experiencing no symptoms or symptoms are improving, AND have been fever-free for 24 hours (without the use of fever-reducing medication).

The CDPH guidance generally calls for infectious individuals to wear a well-fitting mask around others for a total of 10 days, though it also permits such individuals who have ended isolation to remove their masks sooner than day 10 with two sequential negative tests one day part. However, the Cal/OSHA Non-Emergency Rule still requires COVID-19 cases to wear face coverings in the workplace until a full 10 days have passed since the date their symptoms began or from the date of their first positive COVID-19 test (if asymptomatic). This face covering requirement is regardless of vaccination status, previous infection or lack of symptoms.

Definition of “Infectious Period”

The guidance also updates the definition of infectious period to align with the shorter isolation period described above. Because the Cal/OSHA Non-Emergency Rule relies on the definition of “infectious period” in determining the return-to-work criteria for excluded employees, this new definition of “infectious period” may hasten an employee’s return to work under certain circumstances.

For symptomatic confirmed cases, the CDPH definition of “infectious period” is now “2 days before the confirmed case had any symptoms (symptom onset date is Day 0) through Days 5-10 after symptoms first appeared AND 24 hours have passed with no fever, without the use of fever-reducing medications, and symptoms have improved.” For asymptomatic confirmed cases, the “infectious period” is now “2 days before the positive specimen collection date (collection date is Day 0) through Day 5 after positive specimen collection date for their first positive COVID-19 test.”

Cal/OSHA’s FAQs on the March 13, 2023 updates largely repeat the guidance itself. However, Cal/OSHA does offer further explanation of the definition of “infectious period” for symptomatic confirmed cases. Specifically, Cal/OSHA explains that “[s]tarting any time after Day 5, the infectious period has ended if the COVID-19 case has no fever for 24 hours and symptoms have improved, with no testing necessary.” The FAQ further explains that “[a]fter Day 10, the infectious period has ended if the COVID-19 case has no fever for 24 hours, whether or not other symptoms are improving, with no testing necessary.”

Note these guidance updates do not impact the requirements for close contacts to test following exposure. Close contacts should still test within 3-5 days after their last exposure, wear a well-fitting mask around others for a total of 10 days, and stay home and test if they develop symptoms.

Now is a good time to review your procedures for responding to COVID-19 cases in the workplace to adjust to the new guidance from CDPH and Cal/OSHA.

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