Worried about catching COVID at work? Here’s what to know in California

Roxanna Torres, wearing a mask, prepares a take-out order at Baker & Commons in Berkeley. Photo by Martin do Nascimento/CalMatters

Look no further than your favorite restaurant, your child’s school or your local hospital to see the effect of the latest bout of infections in California.

Cases have exploded since the holidays, reaching nearly 7 million people infected since the start of the pandemic. This means that so many workers are calling in sick that many businesses and offices find themselves understaffed and co-workers stretched thin.

Health officials distinguish between keeping essential services and the economy afloat and controlling the spread of the virus. But a labor shortage has materially influenced national and state COVID-19 policies — even temporarily allowing healthcare workers to continue working despite testing positive as long as they don’t experience any symptoms and wear a ventilator. N95. These guidelines have raised questions about safety and whether public health is at risk.

Since the start of the pandemic, top California officials have insisted that the state’s response to COVID-19 is based on science. But those policies must also be flexible, Governor Gavin Newsom recently told reporters.

“It’s called facing reality,” the governor said in defense of recent healthcare workplace guidelines during his Jan. 10 budget briefing. “Pragmatism – not what you want, but what you should do in times of challenge.”

Experts note that the virus and pandemic environment are changing rapidly and policies in response must adapt quickly.

But aside from workforce needs and politics, when it comes to returning to work safely, what do the experts and research tell us about omicron? When is it safe for an infected employee to return to work and how dangerous is it to shorten this period? What if you have no symptoms? And what should your employer do to keep you and your colleagues safe? Here’s what you need to know.

With Omicron, people get infected faster

A red flag with omicron is that early research suggests that the incubation period – the time from when one is infected to when one begins to show symptoms – is shorter with this variant – approximately three days, compared to the four to five days of previous strains.

Usually the day before symptoms start and the day symptoms appear are when people are most contagious, said Sanghyuk Shin, director of UC Irvine’s infectious disease science initiative.

This means that people can become highly infectious faster with omicron than with previous variants. For example, if person A is contagious and A infects B, then person B can infect person C faster with omicron than with delta.

“It creates epidemic dynamics that are really difficult to get a handle on,” said Andrew Noymer, epidemiologist and professor of public health at UC Irvine. “Because it’s so fast.”

Here’s how fast omicron moves: It was first identified in late November; in the week ending December 18, the omicron variant was responsible for about 38% of cases in the United States, according to the CDC’s Variant Surveillance System. During the week ending January 15, omicron accounted for 99.5% of cases.

Experts suggest self-isolating until test negative

In late December, the Centers for Disease Control and Prevention shortened the recommended isolation period for someone who tests positive but no longer has symptoms from 10 days to five. Those who were exposed but did not test positive should also quarantine for five days, the agency said.

The CDC said the change was prompted by growing data showing that much of the transmission occurs earlier “typically one to two days before symptoms appear and two to three days after.”

But that decision was accompanied by quite a bit of backlash and criticism from some members of the public health and medical communities who deemed it too lax, particularly because federal rules do not require no negative test to leave isolation. California has updated its guidelines to align with those of the CDC, but the state is asking people to stay in isolation until they test negative.

Some research has shown that people can still be infectious after five days of testing positive. A small Harvard study, for example, looked at infected NBA players and found that 25% of players infected with omicron were still infectious on day six after their first positive test and 13% were still infectious on day seven. . The study has not yet been peer reviewed.

Bringing people back to work who might still be contagious could of course result in more people being infected and forcing more workers to self-isolate,” Shin said.

The World Health Organization says people with symptoms should self-isolate for at least 10 days after the first day of symptoms, plus an additional three days after their symptoms end. Meanwhile, asymptomatic people should self-isolate for at least 10 days after testing positive.

While recommendations on isolation and quarantine can be difficult to follow, the bottom line is that people should test negative before returning to work and meeting with others, regardless of symptoms, said Drown.

Asymptomatic transmission is a big problem

Asymptomatic transmission occurs and is a major reason the pandemic has been so difficult to control.

“We can tell everyone who feels sick to stay home, but not everyone feels sick,” Shin said.

Experts say the best public health practice is to isolate anyone who tests positive, no matter how they feel.

Studies — though many were conducted before omicron — have shown that a large percentage of COVID-positive people have no symptoms. Research published in December reviewed 95 studies involving approximately 30 million people worldwide. Of those who tested positive, 40% had no symptoms at the time of testing. “The high percentage of asymptomatic infections highlights the potential risk of transmission of asymptomatic infections in communities,” the research authors concluded.

Meanwhile, separate studies show that the viral loads of asymptomatic patients were comparable to those with symptoms.

Your risks at work depend on many factors

Trying to calculate the odds of you contracting COVID at work isn’t really possible because there are so many factors to consider, experts say.

Research has shown that wearing masks indoors can significantly reduce transmission, and with omicron, a high quality mask is more important than ever. N95 masks are the gold standard, especially with such an infectious variant as the omicron, Noymer said. Cloth masks are much less effective unless they have multiple layers and a nose wire. And it’s essential that masks fit snugly around the mouth, nose and chin.

“A well-fitting N95 mask should do a pretty good job. But nothing is guaranteed,” he said. “Surgical masks do something, but they’re not great…and some masks are just pure theater.”

N95 masks can filter out about 95% of particles in the air, according to the CDC. UC Davis experts say it’s okay to reuse an N95 mask, but they recommend waiting one to two days between uses so the virus particles can die off.

The size of a room also plays an important role. If you’re in a busy kitchen or warehouse without a lot of windows, the risk will be greater, Shin said.

Repeated testing is best

A molecular PCR test is the most sensitive and most likely to detect infection, but rapid antigen tests are also effective tools, experts say.

Antigen tests are often used for routine screening of people who are not sick. If used as a precaution for an in-person gathering, for example, Shin says repeat testing could help rule out a false negative — testing the day before and testing on the day of an event.

However, given the shortage of rapid tests, this might seem like a luxury. People with symptoms looking to confirm whether or not they are infected should ideally request a PCR test, Shin said. But with a delay in testing, the results sometimes take more than three days.

Due to increased demand for testing, some counties in California have issued new recommendations. Some urged residents to only get tested if they have symptoms and others asked people to seek tests first from their health care provider rather than county-run testing sites. , because they are overwhelmed.

In an ideal world without supply shortages, workers who come into contact with large numbers of people, such as those working in customer service or grocery stores, could easily access testing and test repeatedly and routinely, say the experts.

That said, routine testing of essential workers should go hand-in-hand with adequate paid sick leave, Shin said. “I’ve definitely known people who said they didn’t want to get tested because they didn’t know what to do if they tested positive. They can’t not go to work, they have to pay rent.

California’s COVID sick leave expired in September, and lawmakers and unions are negotiating how to restore it.

Workplaces can do a lot to minimize risks to workers

Shin said there was room for better education of workers on how the virus spreads. For example, if someone is alone in an office, they may think it is safe to remove their mask, but if that same space is occupied by others throughout the day, then people should keep their mask on as COVID-19 is airborne. and infectious respiratory particles can stay in the air for up to three hours.

Improving ventilation also helps.

“Opening the windows seems like a no-brainer, but opening the windows reduces the risk,” Shin said.

According to experts, workplaces should also consider investing in high-quality filtration systems or high-efficiency particulate (HEPA) filters. According to the Environmental Protection Agency, filters must be able to remove small air particles between 0.1 and 1 micron in size to help remove viruses.

CalMatters is a public interest journalism company committed to explaining how the California State Capitol works and why it matters.

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Maria D. Ervin