On October 21, 2020, the Centers for Disease Control and Prevention revised its guidance regarding those who are considered in “close contact” with someone who is infected with the coronavirus.
The CDC previously defined close contact as being within 6 feet of someone infected with COVID-19 for at least 15 minutes or more. The updated guidance now defines close contact as being within 6 feet of someone with the virus for a cumulative total of 15 minutes (or more) over a 24-hour period.
The new Close Contact definition will require an employer to tally all short-duration contacts over the course of a full work shift (or even over two work shifts spanning a 24-hour period), potentially resulting in many more close contacts that will require quarantine.
Close Contact - Someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated. Individual exposures added together over a 24-hour period (e.g., three 5-minute exposures for a total of 15 minutes)
Factors to consider when defining close contact include proximity (closer distance likely increases exposure risk), the duration of exposure (longer exposure time likely increases exposure risk), whether the infected individual has symptoms (the period around onset of symptoms is associated with the highest levels of viral shedding), if the infected person was likely to generate respiratory aerosols (e.g., was coughing, singing, shouting), and other environmental factors (crowding, adequacy of ventilation, whether exposure was indoors or outdoors). the determination of close contact should generally be made irrespective of whether the contact was wearing respiratory PPE. At this time, differential determination of close contact for those using fabric face coverings is not recommended.
The new guidance makes it clear that the use of masks or other face coverings does not impact the determination of a Close Contact. This means that even if an employee was wearing a face covering during the time they spent with an employee who was infected or became infected, will count toward a Close Contact scenario.
This revision may impact the ability to maintain staffing as it establishes a much lower threshold trigger for required quarantine. Both the CDC and OSHA recommend that an employee quarantine for 14 days if they experience a Close Contact exposure with someone who later is determined to have been COVID positive at the time of the contact.
As a result of this new Close Contact definition, employers should review their COVID-19 infection control plans with this new definition in mind and, at minimum, update their contact tracing questionnaires to include inquiries focused on the cumulative approach, such as:
- ID individuals with whom you had close contact within 48 hours of illness onset or sample collection.
- Were you in close contact with anyone for any amount of time during the infectious period?
- Did those contacts happen within a 24-hour period?
- Added together, did the contacts add up to 15 or more minutes?