Along with widespread illness and death, the COVID-19 pandemic is also causing massive economic disruption. Stay-at-home measures and business shutdowns have prevented millions of people from working. In just four weeks, between mid-March and mid-April, 22 million Americans filed for unemployment benefits. These numbers are bound to spiral higher.

Given all the hardships — and new predictions that cases of COVID-19 will begin falling in most states in the coming weeks — when might people be able to return to work? Thus far, the answers are quite uncertain.

Although the Centers for Disease Control and Prevention (CDC) has issued some federal guidelines, you may need to follow stricter state or local regulations and employer policies. Some experts have suggested serologic (antibody) tests to determine who has had the virus and to guide decisions about returning to work. And the experiences of countries that have successfully slowed cases of COVID-19 and loosened restrictions on work will come into play, too. Below I’ve explained a bit about each approach.

Return-to-work recommendations from the CDC

Recent return-to-work guidelines from the CDC apply to relatively few American workplaces:

  • For workers in healthcare or outside of healthcare who have confirmed or suspected COVID-19: The guidelines allow discontinuation of isolation and returning to work once fever has resolved, symptoms have improved, and swab tests for SARS-CoV-2 are negative twice at least 24 hours apart. If testing is not available, those who had COVID-19 should wait until they’ve had three or more days of improved symptoms without fever and seven days have passed since symptoms began.
  • For critical infrastructure workers (such as healthcare workers and people who work in law enforcement) who were exposed to someone with confirmed or suspected COVID-19: New guidelines now permit continuing to work if people have no symptoms, no fever, wear a mask for 14 days, maintain six-foot physical distancing from others (“as work duties permit”), and disinfect and clean work spaces well. These new guidelines relax prior requirements that urged such workers to remain in quarantine for 14 days before returning to work.

As you might expect, there are caveats. As mentioned, local regulations or employer policies may be more stringent than these recommendations, so check with your employer and primary care physician before going back to work. And a disclaimer notes the guidelines “cannot prevent all instances of secondary spread.”

What about using serologic (antibody) tests to guide our return to work?

Serologic tests identify antibodies in your blood that your immune system produced to fight off the virus and to be ready in case you’re exposed to it again. If present, they indicate that you were previously infected, even if you were unaware of it. These tests are quite different from nasal swab testing performed to identify current infection.

If you never had symptoms or your symptoms completely resolved, a positive serologic test likely indicates that you have some protection from re-infection (for at least a while) and are unlikely to be contagious.

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