Updated Covid-19 guidelines for South African workers – including ‘new tests’ and when you can return to work

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The National Institute of Communicable Diseases (NICD) has released new guidelines that clarify the new Covid-19 test and return to work.

At present, the institute has said that reexamination of people who have suffered from mild illness and have recovered from Covid-19 is not recommended.

“A person is considered safe to return to the workplace and stop isolating themselves if they are no longer contagious,” he says.

“This means that they developed their first symptoms more than 10 days before and that they have not experienced any symptoms for at least three days (72 hours). However, the return to work depends on the patient’s clinical state of health.


Infectious period

The NICD said the most contagious period is between one and three days before symptoms start and within the first seven days after symptoms start.

“But some people can stay infected longer and that’s because generally with viruses, the higher the viral load (the more the virus circulates in the body), the greater the risk of transmission through known routes of transmission.

“So the more severe the disease and the higher the viral load, the more you continue to shed the virus and are contagious.”

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If a person with mild illness has had no symptoms for three days and developed their first symptoms more than 10 days previously, they are no longer considered infectious, the NICD said.


Do I need a negative test to return to work?

If a worker has been diagnosed with Covid-19 and has been isolated according to guidelines, an employer may only allow a worker to return to work under the following conditions:

  • The worker has completed the mandatory 10 days of self-isolation;
  • The worker may be required to undergo a medical assessment confirming fitness for work;
  • Upon return to work, the worker must then wear a surgical mask for 21 days from the positive result of the test at work and practice social distancing and good respiratory and hand hygiene.

“People who have self-quarantined themselves, because they have been in contact with a confirmed case of Covid-19 and have completed their 10-day quarantine period without developing symptoms, can return to work on day 11 “said the NICD.

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“It is not necessary to be tested before returning to work. However, it is recommended that they continue to practice social distancing and good hygiene as a precaution and to wear a surgical mask.


False negatives and prolonged positive periods

The NICD said a patient can have a false negative if they have very little virus in the nasal passages or perhaps the sample was taken inappropriately.

In these cases, if a patient has symptoms of Covid-19 – cough, fever, shortness of breath – but tests negative, they should see their healthcare professional for further evaluation, the NICD said.

Patients can also remain PCR positive (from the polymerase chain reaction test) even after they are no longer infectious.

“A positive PCR test does not equate to an infectious and viable virus. Patients can be disisolated without the need to repeat PCR tests provided the patient’s fever has resolved and their symptoms have improved.

“People with mild illness may be disisolated 10 days after symptom onset, while those with severe illness may be disisolated 10 days after reaching clinical stability (for example, after the supplemental oxygen is interrupted). “

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The NICD said it is common for patients to continue to have symptoms for longer than the above periods (10 days) and full recovery may take several weeks.

“Patients who still have symptoms at the end of their isolation period can be disisolated as long as their fever has cleared (without the use of antipyretics) and their symptoms have improved. If symptoms persist, the worker should seek medical evaluation from their physician. “


I was tested over two weeks ago and have yet to receive my results. Can I return to work?

Suspected cases of Covid-19 who are or have mild illness should be managed at home pending test results, isolated from the workplace, the NICD said.

“These workers should contact their manager and not be at work until they get results. Constant communication with their employer is essential during this time so that the workplace can take action to manage and clean up if necessary. “


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