If you, an employee or a patient experience a known COVID-19 exposure, are symptomatic or test positive for COVID-19, what steps should you take? Resources identified by the AAO offer guidance that may be helpful in decision-making.

CEDR HR Solutions offers a comprehensive guide, “How to Handle Common COVID-19 Concerns in Your Office,” that provides specific recommendations.

The CEDR HR guide addresses topics such as requiring COVID-19 tests for employees returning to work, handling of symptomatic employees awaiting test results, asking employees to self-report potential or definite exposures, paying employees who need to quarantine, and more. Many of the recommendations involve decision-making processes that might lead to different outcomes from one orthodontic practice to another, and in some cases from one situation to another within a practice.

Below is a checklist of areas to address to ensure your practice is on track with planning and communication regarding COVID-19 situations that may arise:

#1: If you have not already done so, determine what health checks you will require of your team and under what specific circumstances you will send symptomatic employees home.

See the “If an Employee is Sick or Getting a COVID-19 Test” section of the CEDR HR guide. An AAO resource, the COVID-19 Daily Employee Screening Log, may also be helpful for tracking employee symptoms.

#2: Announce to your team that asymptomatic employees should self-report to you or the practice manager if they have had close contact with anyone who definitely has COVID-19 or is symptomatic.

Prepare in advance for structured risk assessment regarding whether an asymptomatic employee in this situation should be allowed to work. The CEDR HR guide provides key questions for this process and links to risk assessment steps. See the CEDR HR guide section, “When Employees are Exposed, Potentially Exposed or Awaiting Test Results.”

#3: Determine what your practice’s policy will be regarding paying employees when they are staying at home due to quarantine or awaiting COVID-19 test results. Communicate this policy along with a reminder of your practice’s sick leave policy that would apply should an employee become ill.

See the section of the CEDR HR guide, “Paying Employees When They are Not Working” for more information.

#4: Assuming that at some point there may be a known COVID-19 case or exposure within your practice – whether from an employee or a patient – prepare for the risk assessment process that will be needed for decision-making.

Determining how your practice should proceed with operations after being notified of a COVID-19 incident will depend on the circumstances and any applicable guidance or mandates specific to your jurisdiction. The first steps in decision-making will be to conduct an Investigation and complete a risk assessment. The CEDR HR guide provides steps and instructions for these processes. See “Notifying Staff, Cancelling Patients, and Closing the Office.”

Process-based decision-making takes time, however, and quick decisions may sometimes be necessary. To help prepare in advance, CEDR HR recommends reviewing the CDC guide, “Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19.

The American Dental Association guides, “What to Do If Someone on Your Staff Tests Positive for COVID-19” and “Steps to Take if a Patient Reports COVID-19 Exposure After Treatment” may also be helpful.

#5: Consider what will be required in order for employees who have recovered from COVID-19 to return to work, and for patients who have had COVID-19 to return for office visits.

Note that employees may not be asked to show you their medical records, including COVID-19 test results, but you can require documentation from an employee’s doctor that he or she is cleared to return to work following a COVID-19 test.

Public health guidelines in this area may change periodically. Of note: On July 22, the CDC announced that people who have had mild to moderate COVID-19 may leave isolation after 10 days (from the onset of symptoms) without having a second test.

In addition, CEDR HR recommends reviewing the CDC guide, “Criteria for Return to Work for Healthcare Personnel with SARS-CoV-2 Infection (Interim Guidance)”.

Ultimately, the CEDR HR guide recommends following the recommendations of the employee’s physician regarding return to work. See the “When should I let the employee come back to work?” subsection of the “When an Employee is Sick or Getting a COVID-19 Test” section. Note that the physician may or may not have had the employee get a COVID-19 test.

#6: Formulate COVID-19-related personal travel policies for your team and announce the policies to them.

Approving employee requests for time off for travel and whether to require employees to quarantine upon their return are also complex issues. The CEDR HR guide outlines questions to consider when making these decisions, addresses monitoring of employees who have traveled, and recommends keeping a close watch on your state and local regulations regarding quarantine following travel.

See the “Employees Who Are Traveling” section of the guide.

Since many orthodontic offices are closed on Fridays, of course, short-term travel may be practical for many employees without requesting time off or necessarily sharing weekend plans with employers. An additional resource, “Can You Restrict Employee Travel During the COVID-19 Pandemic?” from the Fox Rothschild law firm addresses the question of requiring your employees to notify you about planned travel. (You can do so, provided the requirement is consistent for all employees and does not vary depending on the travel destination or other factors.)

The law firm also notes that the CDC currently requires that anyone returning to the U.S. from another country quarantine for 14 days, and some states similarly require quarantine for residents returning from travel to other specific states. In addition, Fox Rothschild reminds readers that state laws may impact whether an employer can restrict employees’ personal travel on their own time.