Message to Employers and Area Businesses

As Valley Health System navigates these uncharted waters of the COVID 19 outbreak, we must be diligent in our stewardship of resources that are in limited supply. One of the most valuable, limited resources we have to protect our community is the time of our health care providers.

Employers: Do Not Require Doctors’ Notes

We are no longer in a position to ask our health care providers to compose individualized work notes or complete medical leave/disability forms addressing quarantine related to potential or documented exposure to COVID-19, respiratory symptoms, the presence of chronic illness, or concerns regarding contracting COVID 19 in the workplace itself.

Doctor’s offices may be extremely busy and not able to provide such documentation in a timely way.

We look to you, our community partners, to use your leaders, your management, your human resource department and, if applicable, your internal infection control personnel to develop your own processes around communication to you from an employee regarding such individual concerns. As a general reference, we can provide the following information.

• Patients who have been exposed to someone with documented COVID 19 could be contagious without symptoms. The level and duration/timing of transmissibility during the asymptomatic period is not yet known but is likely less than for symptomatic patients.
• For patients who have a diagnosis of COVID 19 or, based on symptoms, could have COVID 19, the CDC recommends that they be excluded from work until: At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath) AND at least 7 days have passed since symptoms first appeared.

One challenge we are all facing is how to protect our most vulnerable employees. According to CDC guidelines, patients who are at higher risk for developing severe illness with COVID 19 are those age 65 or older OR have ONE of the following health issues:

• Chronic lung disease or moderate to severe asthma
• Serious heart conditions
• Conditions that can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications.
• Severe obesity (body mass index [BMI] of 40 or higher)
• Diabetes
• Chronic kidney disease and who are undergoing dialysis
• Liver disease

These are folks you may want to allow to work remotely or take time away until the pandemic has passed. Though not designated on the CDC website, pregnant women are considered higher risk in our organization. By managing this internally, you are providing an invaluable service by helping us focus our resources where they are needed the most to manage the spread of COVID 19.

Additional Actions to Take

• Share absenteeism data with local health departments and community partners.
• Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions based on the condition in each locality.
• If employees have cough or shortness of breath upon arrival to work, separate them from other employee and send them home immediately.
• Use teleconferencing instead of face-to-face meetings when possible, and allow teleworking for employees who are able to do so.
• Consider cancelling non-essential business travel, and if widespread community transmission is occurring, consider cancelling large work-related meetings or events

Once COVID-19 Has Passed

Recommendations to consider in this phase of response include:

• Meet with the emergency operations coordinator or planning team for your company to discuss and note lessons learned.
• Maintain and expand your planning team.
• Participate in community-wide emergency preparedness activities.

The Virginia Department of Health recently published a Considerations for Businesses and Employers memo, which offers more guidance to area businesses. To view the full document, click here.