HCWs with Symptoms or Exposure to an Infectious Disease

COVID-19 can present with a broad range of symptoms.  In order to standardize testing, the following symptoms are considered to be “COVID-19 Symptoms” for the purpose of Occupational Health management of SAH Health Care Worker (HCW) illness:

  • Groups A Symptoms: fever, chills, cough, shortness of breath, olfactory/taste disorder (change in taste or smell), sore throat
  • Group B Symptoms: runny nose, nasal congestion, headache, conjunctivitis (“pink eye”), gastro symptoms (nausea, vomiting, diarrhea, and/or abdominal pain), fatigue/lethargy (unexplained/long lasting), body aches, muscle aches, joint pain

You are considered to have symptom(s) of COVID-19 if you have at least 1 symptom from Group A or at least 2 symptoms from Group B, or 1 symptom from both Group A and Group B.  Note that gastro symptoms are considered 1 symptom only, so if you are experiencing nausea/vomiting/diarrhea/abdominal pain, but no other symptoms, then you are not considered to be experiencing COVID-19 symptoms.  

The direction below is for SAH HCWs only (specifically SAH employees, physicians, security staff, Ellis Don staff, and Marek’s staff) in order to aid in their decision making regarding when to report to work. 

Students and Volunteers should use this tool to guide their decision making.

Directions for HCWs with symptoms of COVID-19 (or symptoms within the past 10 days):

  • Ensure you have reported your symptoms and PCR test result to Occupational Health at x4317 or healthnurse@sah.on.ca
  • You can return to work when:
    1. Your respiratory symptoms** have been improving for at least 24 hours; AND
    2. You have not had a fever within the past 24 hours; AND
    3. Any gastro symptoms have ended at least 48 hours ago; AND
    4. You feel well enough to return to work.

**Note that if you have influenza-like illness, which includes a cough and/or fever and/or body aches and/or joint pain, then you must remain off work for 5 days, returning on day 6 from the onset of symptoms, or until your symptoms resolve, whichever is sooner.

  • Book a PCR test https://cac-sah.vertoengage.com/ (See #5 if you have previously tested positive for COVID-19 within the last 180 days)
  • Ensure you have reported your symptoms and PCR test result to Occupational Health at x4317 or healthnurse@sah.on.ca
  • You can return to work when:
    1. You have a negative PCR test; AND
    2. Your respiratory symptoms** have been improving for at least 24 hours; AND
    3. You have not had a fever within the past 24 hours; AND
    4. Any gastro symptoms have ended at least 48 hours ago; AND
    5. You feel well enough to return to work.

**Note that if you have influenza-like illness, which includes a cough and/or fever and/or body aches and/or joint pain, then you must remain off work for 5 days from the onset of symptoms, returning on day 6, or until your symptoms resolve, whichever is sooner.

  • Ensure you have reported your symptoms and PCR test result to Occupational Health at x4317 or healthnurse@sah.on.ca
  • You can return to work when:
    1. Your respiratory symptoms** have been improving for at least 24 hours; AND
    2. You have not had a fever within the past 24 hours; AND
    3. Any gastro symptoms have ended at least 48 hours ago; AND
    4. You feel well enough to return to work; AND
    5. You complete a Rapid Antigen Test daily for 10 days prior to your shifts AND practice work self-isolation.

**Note that if you have influenza-like illness, which includes a cough and/or fever and/or body aches and/or joint pain, then you must remain off work for 5 days from the onset of symptoms, returning on day 6, or until your symptoms resolve, whichever is sooner.

See #5 if you have previously tested positive for COVID-19 within the last 180 days.

  • Book a PCR test https://cac-sah.vertoengage.com/
  • Ensure you have reported your symptoms and PCR test result to Occupational Health at x4317 or healthnurse@sah.on.ca
  • You can return to work when:
    1. You have a negative PCR test; AND
    2. Your respiratory symptoms** have been improving for at least 24 hours; AND
    3. You have not had a fever within the past 24 hours; AND
    4. Any gastro symptoms have ended at least 48 hours ago; AND
    5. You feel well enough to return to work; AND
    6. You complete a Rapid Antigen Test daily for 10 days prior to your shifts AND practice work self-isolation.

**Note that if you have influenza-like illness, which includes a cough and/or fever and/or body aches and/or joint pain, then you must remain off work for 5 days from the onset of symptoms, returning on day 6, or until your symptoms resolve, whichever is sooner.

  • Ensure you have reported your symptoms to Occupational Health at x4317 or healthnurse@sah.on.ca
  • You can return to work once
    1. You have had 2 negative Rapid Antigen Tests collected two days in a row; AND
    2. Your respiratory symptoms** have been improving for at least 24 hours; AND
    3. You have not had a fever within the past 24 hours; AND
    4. Any gastro symptoms have ended at least 48 hours ago; AND
    5. You feel well enough to return to work.

**Note that if you have influenza-like illness, which includes a cough and/or fever and/or body aches and/or joint pain, then you must remain off work for 5 days from the onset of symptoms, returning on day 6, or until your symptoms resolve, whichever is sooner.

Directions for HCWs who have tested positive for COVID-19 (either a PCR or Rapid Antigen Test) within the last 10 days:

  • Report your absence to Workforce Planning x1465
  • Report your positive test result to Occupational Health at x4317 or healthnurse@sah.on.ca. Occupational Health will follow up with you and provide you direction on when you can return to work.
  • Continue to report your absence for any scheduled shifts until you receive further direction from Occupational Health. Typically, a worker with a positive test will be off at least 5 full calendar days from when your symptoms first started and will also need to meet specific criteria in order to return to work, which Occupational Health will provide.  If it has been more than 5 days since your symptoms first started, and you have not yet received direction from Occupational Health, please refer to the directions in #2, below.

Report your absence to Workforce Planning x1465. You will need a negative Rapid Antigen Test 2 days in a row in order to return to work, so if you tested positive today, you cannot work tomorrow, and should make sure Workforce Planning is aware of your absence. You must continue to report your absence to Workforce Planning until you are able to return to work (see criteria below):

You can return to work on or after day 6** of your illness when:

    1. Your respiratory symptoms have been improving for at least 24 hours; AND
    2. You have not had a fever within the past 24 hours; AND
    3. Any gastro symptoms have ended at least 48 hours ago; AND
    4. You feel well enough to return to work; AND
    5. You have a negative Rapid Antigen Test 2 days in a row

If your Rapid Antigen Test on day 4 or day 5 is positive, but you meet all other criteria (#1-4 above), then you should continue to complete Rapid Antigen Tests daily and can return to work when:

  • You have a negative Rapid Antigen Test 2 days in a row; OR
  • On day 10, even if you still have a positive Rapid Antigen Test.

Occupational Health will call you on the next business day to confirm this direction. If you do not hear from Occupational Health in time to report for your next scheduled shift, but you meet the criteria above, please report for your shift.

** How do I calculate day 6? Add 6 days to the date when you first started symptoms.  For example, if your symptoms started on the 1st, day 6 would be the 7th

Directions for asymptomatic HCWs with known or potential exposure to COVID-19 within the last 10 days:

  • Come to work if you are asymptomatic; AND
  • Complete Rapid Antigen Testing daily prior to shifts for 10 days (not indicated if you have previously tested positive for COVID-19 within the last 90 days); AND
  • Practice work self-isolation for 10 days from the last known exposure
  • Come to work if you are asymptomatic; AND
  • Complete Rapid Antigen Testing daily prior to shifts for 10 days from the last shift worked in the outbreak area (not indicated if you have previously tested positive for COVID-19 within the last 90 days); AND
  • Practice work self-isolation for 10 days from the last shift worked in the outbreak area
  • Follow the directions provided to you by the border officials; AND
  • If not directed to quarantine, come to work as long as you are asymptomatic
  • Come to work if you are asymptomatic; AND
  • Complete Rapid Antigen Testing daily prior to shifts and practice work self-isolation for 10 days; AND
  • If your household member has a negative PCR, you no longer need to complete Rapid Antigen Testing or work self-isolation

Directions for HCWs with another communicable disease (for example, gastrointestinal illness, conjunctivitis, shingles, strep throat):

  • If you do not have any other symptoms, and you have no known exposure to COVID-19, then you can return to work once:
    1. Your vomiting has resolved at least 24 hours ago; AND
    2. Your diarrhea has resolved at least 48 hours ago.
  • If you do not have any other symptoms, and you have no known exposure to COVID-19, then you can return to work when:
    1. Your symptoms have resolved
  • You can return to work immediately as long as:
    1. You have NOT been diagnosed with disseminated zoster, AND
    2. Your lesions are covered or in an area that will not be in contact with a patient (e.g. your face); UNLESS
      1. You work in one of the following areas:
        • Maternity, Pediatrics, NICU, Renal, or ADCP
      2. In which case, you can return to work when:
        • All of your lesions have dried and crusted over
  • You must have a negative COVID-19 PCR test prior to returning to work; AND
  • Report your symptoms to Occupational Health at x4317 or healthnurse@sah.on.ca; AND
  • You can return to work 24 hours after the start of effective antibiotic therapy as long as your symptoms have been improving and your COVID-19 PCR test is negative
  • You must have a negative COVID-19 PCR test prior to returning to work; AND
  • Report your symptoms to Occupational Health at x4317 or healthnurse@sah.on.ca; AND
  • You must remain off work for a full 5 days, returning on the 6th day after your symptoms first started as long as you are feeling well enough to work and your symptoms have been improving for at least 24 hours and you do not have a fever.
  • Do not attend work; AND
  • Report your diagnosis to Occupational Health at x4317 or healthnurse@sah.on.ca; AND
  • Await direction from Occupational Health regarding return to work. Continue to report your absence to Workforce Planning until you receive further direction from Occupational Health.

The initial symptoms of hand-foot-and-mouth disease can present similar to COVID-19, therefore:

  • You must have a negative COVID-19 PCR test prior to returning to work (NOTE: If you’ve previously had COVID-19 within the past 180 days, you only require 2 Rapid Antigen Tests); AND
  • Report your symptoms to Occupational Health at x4317 or healthnurse@sah.on.ca; AND
  • You can return to work after you do not have a fever and all symptoms are improving for at least 24h and any blisters have healed (e.g. are no longer filled with fluid).