Center for Disease Control & Prevention

This interim guidance is based on what is currently known about the coronavirus disease 2019 (COVID-19). The Centers for Disease Control and Prevention (CDC) will update this interim guidance as needed and as additional information becomes available.

WHAT'S NEW?

CDC is responding to a pandemic of respiratory disease spreading from person-to-person caused by a novel (new) coronavirus. The disease has been named “coronavirus disease 2019” (abbreviated “COVID-19”). This situation poses a serious public health risk. The federal government is working closely with state, local, tribal, and territorial partners, as well as public health partners, to respond to this situation. COVID-19 can cause mild to severe illness; most severe illness occurs in older adults.

 

Situation in U.S.
Different parts of the country are seeing different levels of COVID-19 activity. The United States nationally is in the initiation phase of the pandemic. States in which community spread is occurring are in the acceleration phase. The duration and severity of each pandemic phase can vary depending on the characteristics of the virus and the public health response.

  • CDC and state and local public health laboratories are testing for the virus that causes COVID-19. View CDC’s Public Health Laboratory Testing map.
  • All 50 states have reported cases of COVID-19 to CDC.
  • U.S. COVID-19 cases include:
    • Imported cases in travelers
    • Cases among close contacts of a known case
    • Community-acquired cases where the source of the infection is unknown.
  • Twenty-seven U.S. states are reporting some community spread of COVID-19.
  • View latest case counts, deaths, and a map of states with reported cases.

HOW TO PREPARE

Find Local Information
Know where to find local information on COVID-19 and local trends of COVID-19 cases.

Follow Official Sources for Accurate Information!
Help control the spread of rumors. Visit FEMA’s rumor control pageexternal icon.
Beware of fraud schemes related to the novel coronavirus (COVID-19). Visit Office of Inspector General’s COVID-19 fraud alert pageexternal icon.

Know the Signs & Symptoms
Know the signs and symptoms of COVID-19 and what to do if symptomatic:

  • Stay home when you are sick
  • Call your health care provider’s office in advance of a visit
  • Limit movement in the community
  • Limit visitors

Take Steps for Those at Higher Risk
Know what additional measures those at higher risk and who are vulnerable should take.

Protect Yourself & Family
Implement steps to prevent illness (e.g., stay home when sick, handwashing, respiratory etiquette, clean frequently touched surfaces daily).

Create a Household Plan
Create a household plan of action in case of illness in the household or disruption of daily activities due to COVID-19 in the community.

  • Consider 2-week supply of prescription and over the counter medications, food and other essentials. Know how to get food delivered if possible.
  • Establish ways to communicate with others (e.g., family, friends, co-workers).
  • Establish plans to telework, what to do about childcare needs, how to adapt to cancellation of events.

Stay Informed About Emergency Plans
Know about emergency operations plans for schools/workplaces of household members.

WHAT YOU SHOULD KNOW?

Watch for symptoms
Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. These symptoms may appear 2-14 days after exposure (based on the incubation period of MERS-CoV viruses).

  • Fever

  • Cough

  • Shortness of breath

Testing
There are laboratory tests that can identify the virus that causes COVID-19 in respiratory specimens. State and local public health departments have received tests from CDC while medical providers are getting tests developed by commercial manufacturers. All of these tests are Real-Time Reverse Transcriptase (RT)-PCR Diagnostic Panels, that can provide results in 4 to 6 hours.

Who should be tested?
Not everyone needs to be tested for COVID-19. Here is some information that might help in making decisions about seeking care or testing.

  • Most people have mild illness and are able to recover at home.
  • There is no treatment specifically approved for this virus.
  • Testing results may be helpful to inform decision-making about who you come in contact with.

CDC has guidance for who should be tested, but decisions about testing are at the discretion of state and local health departments and/or individual clinicians.

  • Clinicians should work with their state and local health departments to coordinate testing through public health laboratories, or work with clinical or commercial laboratories.

How to get tested
If you have symptoms of COVID-19 and want to get tested, try calling your state or local health department or a medical provider. While supplies of these tests are increasing, it may still be difficult to find a place to get tested.

What to do after you are tested

  • If you test positive for COVID-19, see If You Are Sick or Caring for Someone.
  • If you test negative for COVID-19, you probably were not infected at the time your specimen was collected. However, that does not mean you will not get sick. It is possible that you were very early in your infection at the time of your specimen collection and that you could test positive later, or you could be exposed later and then develop illness. In other words, a negative test result does not rule out getting sick later.

CDC expects that widespread transmission of COVID-19 in the United States will occur. In the coming months, most of the U.S. population will be exposed to this virus. You should continue to practice all the protective measures recommended to keep yourself and others free from illness. See How to Protect Yourself.

If you are very sick get medical attention immediately
If you develop emergency warning signs for COVID-19 get medical attention immediately. Emergency warning signs include*:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

*This list is not all inclusive. Please consult your medical provider for any other symptoms that are severe or concerning.

For healthcare professionals
For information on testing for healthcare professionals, see recommendations for reporting, testing, and specimen collection at Interim Guidance for Healthcare Professionals.

COMMUNICATION RESOURCES

CDC offers free resources including video, fact sheets, and posters. Below are links to current communication tools and resources available for use and distribution.

Print Resources

Videos

Resources for Travelers 

Guidance for Public Health Communicators

    

SCHOOLS & WORKPLACE

15-DAY PAUSE

What is the 15-day pause?
While every community is unique and experiencing varying levels of community transmission, the 15-day pause recommended by the White House presents the entire country with an opportunity to assess how prepared we are and take steps to implement actions designed to slow and limit the spread of COVID-19.  We understand that the pause may last longer than 15 days.

Thinking ahead
At some point, the recommended actions will change. Community leaders must come together to facilitate services and businesses re-opening in an orderly way. The resumption of activities needs planning so that it does not negatively affect ongoing mitigation efforts in local areas or the country as a whole.

Identify leaders from every sector who can join a task force to jointly plan for and implement a coordinated effort

  • Communicate with the public to share considerations and decisions about when to start reopening – prepare them that 15 days may not be long enough and will depend on a variety of factors, which look different from community to community.

  • Identify organizations serving at risk and underserved populations and help them prepare

  • Access critical gaps in resources and supply chain

    • Medical equipment

    • Food supply

    • Cleaning and disinfection products

  • Identify childcare for critical infrastructure workforce

    • Healthcare workers

    • First responders

    • Teachers and school administrators

    • Utility company staff

    • Mental health professionals

  • Begin planning for an orderly return to daily life

    • Identify leaders from every sector who can join a task force to jointly plan for a coordinated effort

    • Work with public health authorities to determine which interventions should continue and identify local factors that might assist determining when and how to resume services.

      • Local factors to examine

        • Local spread

        • Strain on critical infrastructure

        • Supply chain relief

        • Public mood, tolerance and community resilience

    • For those interventions that should remain in place, consider how to lessen the adverse effects of them

    • Prepare public communication materials to explain what people can do to alleviate the negative effects of interventions that remain in place.

      • Prepare the public that this may be a slow, staged progression back to normalcy

      • Restrictions will be lifted as soon as it is safe to do so

      • Communities need to stick together to help one another through these challenging times

SCHOOLS

At all times…

  1. Encourage your staff or community members to protect their personal health.

  2. Post the signs and symptoms of COVID-19:
    fever, cough, shortness of breath.

  3. Encourage people to stay home when sick.

  4. Clean surfaces that are frequently touched – things such as shared desks, countertops, kitchen areas, electronics, and doorknobs.

  5. Limit events and meetings that require close contact.

  6. Stay up to date on developments in your community.

  7. Create an emergency plan for possible outbreak.

  8. Assess if community members are at higher risk and plan accordingly.

During an outbreak in your area

  1. Send home or separate anyone who becomes sick.

  2. If you identify a case, inform people who might have been exposed.

  3. Continue to safely clean and disinfect the person's area.

  4. Connect with your local health departments.

  5. Cancel large meetings or events.

  6. Put your infectious disease outbreak plan into action.

WORKPLACE

Purpose
This interim guidance is based on what is currently known about the coronavirus disease 2019 (COVID-19). COVID-19 is a respiratory illness that can spread from person to person. The outbreak first started in China, but the virus continues to spread internationally and in the United States. The Centers for Disease Control and Prevention (CDC) will update this interim guidance as additional information becomes available.

The following interim guidance may help prevent workplace exposures to COVID-19, in non-healthcare settings. (CDC has provided separate guidance for healthcare settings.) This guidance also provides planning considerations for community spread of COVID-19.

To prevent stigma and discrimination in the workplace, use only the guidance described below to determine risk of COVID-19 infection. Do not make determinations of risk based on race or country of origin and be sure to maintain confidentiality of people with confirmed coronavirus infection. There is much more to learn about the transmissibility, severity, and other features of COVID-19 and investigations are ongoing. Updates are available on CDC’s web page.

Preparing Workplaces for a COVID-19 Outbreak
Businesses and employers can prevent and slow the spread of COVID-19. Employers should plan to respond in a flexible way to varying levels of disease transmission in the community and be prepared to refine their business response plans as needed. According to the Occupational Safety and Health Administration (OSHA), most American workers will likely experience low (caution) or medium exposure risk levels at their job or place of employment (see OSHA guidance for employers for more information about job risk classifications).

Businesses are strongly encouraged to coordinate with state and local health officials so timely and accurate information can guide appropriate responses. Local conditions will influence the decisions that public health officials make regarding community-level strategies. CDC has guidance for mitigation strategie according to the level of community transmission or impact of COVID-19.

All employers need to consider how best to decrease the spread of COVID-19 and lower the impact in their workplace. This may include activities in one or more of the following areas:

  1. reduce transmission among employees,

  2. maintain healthy business operations, and

  3. maintain a healthy work environment.

Reduce Transmission Among Employees

Actively encourage sick employees to stay home:

  • Employees who have symptoms (i.e., fever, cough, or shortness of breath) should notify their supervisor and stay home.

  • Sick employees should follow CDC-recommended steps. Employees should not return to work until the criteria to discontinue home isolation are met, in consultation with healthcare providers and state and local health departments.

  • Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and follow CDC recommended precautions.

Identify where and how workers might be exposed to COVID-19 at work:

  • See OSHA COVID-19 webpage for more information on how to protect workers from potential exposures and guidance for employers, including steps to take for jobs according to exposure risk.

  • Be aware that some employees may be at higher risk for serious illness, such as older adults and those with chronic medical conditions. Consider minimizing face-to-face contact between these employees or assign work tasks that allow them to maintain a distance of six feet from other workers, customers and visitors, or to telework if possible.

Separate sick employees:

  • Employees who appear to have symptoms (i.e., fever, cough, or shortness of breath) upon arrival at work or who become sick during the day should immediately be separated from other employees, customers, and visitors and sent home.

  • If an employee is confirmed to have COVID-19 infection, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA). The fellow employees should then self-monitor for symptoms (i.e., fever, cough, or shortness of breath).

Educate employees about how they can reduce the spread of COVID-19:

  • Employees can take steps to protect themselves at work and at home. Older people and people with serious chronic medical conditions are at higher risk for complications.

  • Follow the policies and procedures of your employer related to illness, cleaning and disinfecting, and work meetings and travel.

  • Stay home if you are sick, except to get medical care. Learn what to do if you are sick.

  • Inform your supervisor if you have a sick family member at home with COVID-19. Learn what to do if someone in your house is sick.

  • Wash your hands often with soap and water for at least 20 seconds. Use hand sanitizer with at least 60% alcohol if soap and water are not available.

  • Avoid touching your eyes, nose, and mouth with unwashed hands.

  • Cover your mouth and nose with a tissue when you cough or sneeze or use the inside of your elbow. Throw used tissues in the trash and immediately wash hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer containing at least 60% alcohol. Learn more about coughing and sneezing etiquette on the CDC website.

  • Clean AND disinfect frequently touched objects and surfaces such as workstations, keyboards, telephones, handrails, and doorknobs. Dirty surfaces can be cleaned with soap and water prior to disinfection. To disinfect, use products that meet EPA’s criteria for use against SARS-CoV-2, the cause of COVID-19, and are appropriate for the surface.

  • Avoid using other employees’ phones, desks, offices, or other work tools and equipment, when possible. If necessary, clean and disinfect them before and after use.

  • Practice social distancing by avoiding large gatherings and maintaining distance (approximately 6 feet or 2 meters) from others when possible.

Maintain Healthy Business Operations

Identify a workplace coordinator who will be responsible for COVID-19 issues and their impact at the workplace.

Implement flexible sick leave and supportive policies and practices.

  • Ensure that sick leave policies are flexible and consistent with public health guidance and that employees are aware of and understand these policies.

  • Maintain flexible policies that permit employees to stay home to care for a sick family member or take care of children due to school and childcare closures. Additional flexibilities might include giving advances on future sick leave and allowing employees to donate sick leave to each other.

  • Employers that do not currently offer sick leave to some or all of their employees may want to draft non-punitive “emergency sick leave” policies.

  • Employers should not require a positive COVID-19 test result or a healthcare provider’s note for employees who are sick to validate their illness, qualify for sick leave, or to return to work. Healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely manner.

  • Review human resources policies to make sure that policies and practices are consistent with public health recommendations and are consistent with existing state and federal workplace laws (for more information on employer responsibilities, visit the Department of Labor’sexternal icon and the Equal Employment Opportunity Commission’s websites).

  • Connect employees to employee assistance program (EAP) resources (if available) and community resources as needed. Employees may need additional social, behavioral, and other services, for example, to cope with the death of a loved one.

Assess your essential functions and the reliance that others and the community have on your services or products.

  • Be prepared to change your business practices if needed to maintain critical operations (e.g., identify alternative suppliers, prioritize existing customers, or temporarily suspend some of your operations if needed).

  • Identify alternate supply chains for critical goods and services. Some good and services may be in higher demand or unavailable.

  • Talk with companies that provide your business with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.

  • Talk with business partners about your response plans. Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce, and associations to improve community response efforts.

Determine how you will operate if absenteeism spikes from increases in sick employees, those who stay home to care for sick family members, and those who must stay home to watch their children if dismissed from childcare programs and K-12 schools.

  • Plan to monitor and respond to absenteeism at the workplace.

  • Implement plans to continue your essential business functions in case you experience higher than usual absenteeism.

  • Prepare to institute flexible workplace and leave policies.

  • Cross-train employees to perform essential functions so the workplace can operate even if key employees are absent.

Consider establishing policies and practices for social distancing. Social distancing should be implemented if recommended by state and local health authorities. Social distancing means avoiding large gatherings and maintaining distance (approximately 6 feet or 2 meters) from others when possible (e.g., breakrooms and cafeterias). Strategies that business could use include:

  • Implementing flexible worksites (e.g., telework)

  • Implementing flexible work hours (e.g., staggered shifts)

  • Increasing physical space between employees at the worksite

  • Increasing physical space between employees and customers (e.g., drive through, partitions)

  • Implementing flexible meeting and travel options (e.g., postpone non-essential meetings or events)

  • Downsizing operations

  • Delivering services remotely (e.g. phone, video, or web)

  • Delivering products through curbside pick-up or delivery

Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions outlined in their COVID-19 response plan based on local conditions.

Maintain a healthy work environment

Consider improving the engineering controls using the building ventilation system. This may include some or all of the following activities:

  • Increase ventilation rates.

  • Increase the percentage of outdoor air that circulates into the system.

Support respiratory etiquette and hand hygiene for employees, customers, and worksite visitors:

  • Provide tissues and no-touch disposal receptacles.

  • Provide soap and water in the workplace. If soap and water are not readily available, use alcohol-based hand sanitizer that is at least 60% alcohol. If hands are visibly dirty, soap and water should be chosen over hand sanitizer. Ensure that adequate supplies are maintained.

  • Place hand sanitizers in multiple locations to encourage hand hygiene.

  • Place posters that encourage hand hygiene to help stop the spread at the entrance to your workplace and in other workplace areas where they are likely to be seen.

  • Discourage handshaking – encourage the use of other noncontact methods of greeting.

  • Direct employees to visit the coughing and sneezing etiquette and clean hands webpage for more information.

Perform routine environmental cleaning:

  • Routinely clean all frequently touched surfaces in the workplace, such as workstations, keyboards, telephones, handrails, and doorknobs.

    • If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection.

    • For disinfection, most common EPA-registered household disinfectants should be effective. A list of products that are EPA-approved for use against the virus that causes COVID-19 is available here. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).

  • Discourage workers from using other workers’ phones, desks, offices, or other work tools and equipment, when possible. If necessary, clean and disinfect them before and after use.

  • Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks, other work tools and equipment) can be wiped down by employees before each use. To disinfect, use products that meet EPA’s criteria for use against SARS-Cov-2, the cause of COVID-19, and are appropriate for the surface.

Perform enhanced cleaning and disinfection after persons suspected/confirmed to have COVID-19 have been in the facility:

Advise employees before traveling to take additional preparations:

  • Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country to which you will travel. Specific travel information for travelers going to and returning from countries with travel advisories, and information for aircrew, can be found on the CDC website.

  • Advise employees to check themselves for symptoms of COVID-19 (i.e., fever, cough, or shortness of breath) before starting travel and notify their supervisor and stay home if they are sick.

  • Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and promptly call a healthcare provider for advice if needed.

  • If outside the United States, sick employees should follow company policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas.

Take care when attending meetings and gatherings:

  • Carefully consider whether travel is necessary.

  • Consider using videoconferencing or teleconferencing when possible for work-related meetings and gatherings.

  • Consider canceling, adjusting, or postponing large work-related meetings or gatherings that can only occur in-person.

  • When videoconferencing or teleconferencing is not possible, hold meetings in open, well-ventilated spaces.

    

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