Practice Resources

Employers without an employee health service should perform a limited form of contact identification and notification when they learn that an employee has COVID-19.¹ More extensive contact tracing can be conducted if there is medical oversight.

Contact identification and notification involves determining who were the close contacts of a worker with COVID-19 and sending employees home to self-monitor for 14 days if they were exposed. OSHA also requires that employers “review the employee's work environment for potential SARS-CoV-2 exposure including other workers in that environment contracting COVID-19 illness” as part of their responsibility to investigate work-relatedness.²

An employer interested in a more comprehensive form of contact tracing should undertake a 2-part analysis: 
 

1. What are the advantages of conducting contact tracing rather than having this performed by public health agencies?
2.  If there are sufficient reasons for an employer to pursue contact tracing, how can this be done effectively?

The benefits of allowing public health departments to conduct contact tracing include the availability of trained personnel with tracking systems at no cost to the employer. However, not all public health departments have the necessary staffing or systems in place to handle the current number of cases. Additionally, these departments are focused on infection control in general and are not necessarily able to address specific issues in the workplace. Many hospitals and larger employers with sophisticated employee or occupational health programs have chosen to pursue their own contact tracing to speed up the process of identifying workplace contacts to protect co-workers and patients and because the complexity of certain work settings may make it hard for some health departments to adequately reach contacts. These activities can supplement the work of health departments and usually involve collaboration. It is important to avoid duplication in situations where employers want to pursue contact tracing while local health departments are also doing it.

Employers that pursue contact tracing should understand the challenges. Per the CDC:
Case investigation and contact tracing is a specialized skill. To be done effectively, it requires people with the training, supervision, and access to social and medical support for patients and contacts. Requisite knowledge and skills for case investigators and contact tracers include, but are not limited to: 

• An understanding of patient confidentiality, including the ability to conduct interviews without violating confidentiality (e.g., to those who might overhear their conversations) 
• Understanding of the medical terms and principles of exposure, infection, infectious period, potentially infectious interactions, symptoms of disease, pre-symptomatic and asymptomatic infection 
• Excellent and sensitive interpersonal, cultural sensitivity, and interviewing skills such that they can build and maintain trust with patients and contacts 
• Basic skills of crisis counseling, and the ability to confidently refer patients and contacts for further care if needed 
• Resourcefulness in locating patients and contacts who may be difficult to reach or reluctant to engage in conversation 
• Understanding of when to refer individuals or situations to medical, social, or supervisory resources 
• Cultural competency appropriate to the local community³ 

People who perform contact tracing should complete a training course and are usually overseen by medical professionals.

Employers subject to the Americans with Disability Act (ADA) must maintain all medical information, including a diagnosis of COVID-19, in a confidential medical record that is maintained separately from personnel files.⁴ If an employer chooses to perform either contact identification and notification or contact tracing, any medical information obtained in the process would also need to be maintained separately.⁴