On December 30, 2021, The California Department of Health (“CDPH”) published an All Facilities Letter (“AFL”) (AFL 21-08.6) to provide hospitals and health care personnel (“HCP”) with updated guidance related to healthcare personnel COVID-19 exposures and infections.

On January 8, 2022, the AFL was superseded by AFL 21-08.7 which additionally incorporates updated CDC guidance for healthcare personnel.

The CDPH AFL 21-08.7 only applies to:

  1. General Acute Care Hospitals (GACHs);
  2. Acute Psychiatric Hospitals (APHs); and
  3. Skilled Nursing Facilities

But, the Los Angeles Department of Public Health (“LADPH”) has specifically ordered (in its January 5, 2022 updated Health Officer Order) that healthcare personnel in any setting must comply with the State’s guidance as described in AFL 21-08.6, and now AFL 21-08.7 (read more from the LADPH here)  

Therefore, all healthcare personnel within the jurisdiction of the LADPH must comply with the requirements of AFLs.

Other local health authorities may make similar orders, so employers are encouraged to consult the requirements of their local health authority.

What Employers of Healthcare Personnel Need to Know

The below guidance reflects CDPH recommendations – covered entities always have the option to implement more protective procedures and follow prior guidance for a longer (i.e., 10-day) isolation and/or quarantine period.

  • From January 8, 2022 until February 1, 2022:
    • HCPs who test positive for COVID-19 and are asymptomatic may return to work immediately without isolation and without testing.
    • HCPs who have been exposed and are asymptomatic may return to work immediately without quarantine and without testing.
    • These HCPs must wear an N95 respirator for source control.
  • Effective February 1, 2022, the following isolation, quarantine, and work restrictions will apply to HCPs:

Work Restrictions for HCP with COVID-19 Infection (Isolation)

Vaccination Status

​Routine

​Critical Staffing Shortage

​Boosted

 

OR

 

Vaccinated but not booster-eligible

​5 days (if asymptomatic or mildly symptomatic) with negative diagnostic test same day or within 24 hours prior to return

 

OR 

 

10 days without a viral test

​ <5 days with most recent diagnostic test result to prioritize staff placement

 

If the most recent test is positive, then the HCP may provide direct care only for patients/residents with confirmed COVID-19 infection, preferably in a cohort setting.

​Unvaccinated

 

OR

 

Those that are vaccinated and booster-eligible but have not yet received their booster dose

​7 days (if asymptomatic or mildly symptomatic) with negative diagnostic test† same day or within 24 hours prior to return

 

OR

 

10 days without a viral test

​5 days with most recent diagnostic test result to prioritize staff placement

 

If the most recent test is positive, then the HCP may provide direct care only for patients/residents with confirmed COVID-19 infection, preferably in a cohort setting.

Work Restrictions for Asymptomatic HCP with COVID-19 Exposures (Quarantine)

Vaccination Status

Routine

Critical Staffing Shortage

​Boosted

 

OR

 

Vaccinated but not booster-eligible

​No work restriction with negative diagnostic test upon identification and at 5-7 days

​No work restriction with diagnostic test upon identification and at 5-7 days

Unvaccinated

 

OR

 

Those that are vaccinated and booster-eligible but have not yet received their booster dose

 

Including persons with prior infections

7 days with diagnostic test upon identification and negative diagnostic test within 48 hours prior to return

​No work restriction with diagnostic test upon identification and at 5-7 days

 

HCP whose most recent test is positive and are working before meeting routine return-to-work criteria must maintain separation from other HCP as much as possible (for example, use a separate breakroom and restroom) and wear a N95 respirator for source control at all times while in the facility.

Similarly, exposed unvaccinated and vaccinated HCP who are booster-eligible but have not yet received their booster dose who are working during their quarantine period should also wear a N95 respirator for source control at all times while in the facility until they meet routine return-to-work criteria.

Healthcare facilities should make N95 respirators available to any HCP who wishes to wear one when not otherwise required for the care of patients or residents with suspected or confirmed COVID-19. 

These recommendations will be updated as additional information becomes available.

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