['Infectious Diseases']
['COVID-19']
03/12/2025
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You may need to be flexible with your sick leave policy to ensure that employees do not come to work when they have COVID-19 symptoms. Make sure your policy is in line with guidance from local public health officials. If you have more than one location, you may need to give local managers the authority to adjust your policy based on the severity of the outbreak in that area. Employers are encouraged by the Centers for Disease Control and Prevention (CDC) to not require a doctor’s note from employees who are sick with acute respiratory illness, as health providers may be too busy to provide this documentation.
CDC recommendations on isolation
Regardless of vaccination status, you should isolate from others when you have COVID-19. You should also isolate if you are sick and suspect that you have COVID-19 but do not yet have test results. If you test negative, you can end your isolation. If you test positive, follow the full isolation recommendations below:
- When you have COVID-19, isolation is counted in days, as follows:
- If you had no symptoms:
- Day 0 is the day you were tested (not the day you received your positive test result).
- Day 1 is the first full day following the day you were tested.
- If you develop symptoms within 10 days of when you were tested, the clock restarts at day 0 on the day of symptom onset.
- If you had symptoms:
- Day 0 of isolation is the day of symptom onset, regardless of when you tested positive.
- Day 1 is the first full day after the day your symptoms started.
- If you had no symptoms:
- If you test positive for COVID-19, stay home for at least 5 days and isolate from others in your home.
- You are likely most infectious during these first 5 days.
- Wear a high-quality mask if you must be around others at home and in public.
- Do not go places where you are unable to wear a mask. For travel guidance, see CDC’s Travel webpage.
- Do not travel.
- Stay home and separate from others as much as possible.
- Use a separate bathroom, if possible.
- Take steps to improve ventilation at home, if possible.
- Don’t share personal household items, like cups, towels, and utensils.
- Monitor your symptoms. If you have an emergency warning sign (like trouble breathing), seek emergency medical care immediately.
- End isolation based on how serious your COVID-19 symptoms were. Loss of taste and smell may persist for weeks or months after recovery and need not delay the end of isolation.
- If you had no symptoms, you may end isolation after day 5.
- If you had symptoms and:
- Your symptoms are improving, you may end isolation after day 5 if you are fever-free for 24 hours (without the use of fever-reducing medication).
- Your symptoms are not improving, continue to isolate until you are fever-free for 24 hours (without the use of fever-reducing medication), and your symptoms are improving.[1]
- If you had symptoms and had moderate illness (you experienced shortness of breath or had difficulty breathing), then you need to isolate through day 10.
- If you had symptoms and had severe illness (you were hospitalized) or have a weakened immune system, then you need to isolate through day 10, consult your doctor before ending isolation, and note that ending isolation without a viral test may not be an option for you.
- If you are unsure if your symptoms are moderate or severe or if you have a weakened immune system, talk to a healthcare provider for further guidance.
- Regardless of when you end isolation, until at least day 11:
- Avoid being around people who are more likely to get very sick from COVID-19.
- Remember to wear a high-quality mask when indoors around others at home and in public.
- Do not go places where you are unable to wear a mask until you are able to discontinue masking (see below).
- For travel guidance, see CDC’s Travel webpage.
- After you have ended isolation, when you are feeling better (no fever without the use of fever-reducing medications and symptoms improving):
- Wear your mask through day 10, OR
- If you have access to antigen tests, you should consider using them. With two sequential negative tests 48 hours apart, you may remove your mask sooner than day 10.
- Note: If your antigen test results[1] are positive, you may still be infectious. You should continue wearing a mask and wait at least 48 hours before taking another test. Continue taking antigen tests at least 48 hours apart until you have two sequential negative results. This may mean you need to continue wearing a mask and testing beyond day 10.
- After you have ended isolation, if your COVID-19 symptoms recur or worsen, restart your isolation at day 0. Talk to a healthcare provider if you have questions about your symptoms or when to end isolation.
[1] As noted in the Food and Drug Administration labeling for authorized over-the-counter antigen tests, negative test results do not rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment or patient management decisions, including infection control decisions.
Last Updated May 11, 2023
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Copyright 2025 J. J. Keller & Associate, Inc. For re-use options please contact copyright@jjkeller.com or call 800-558-5011.