COVID-19 Clinical Protocols – Employees

SARS-CoV2 TESTING, ISOLATION, & QUARANTINE GUIDELINESr SARS-CoV-2

The following protocols pertaining to the clinical management of SARS-CoV-2 at Hamilton Health Box have been developed by Toby Hamilton MD-CEO, Dr. Glenn Roderick Davis MD-CMO, Dr. Anthony Rogers MD, and Dr. Timothy Brewer MD and are in accordance with the current Centers for Disease Control and Los Angeles County Department of Public Health requirements and guidelines; protocols will be updated according to changes made by the CDC & LADPH.

FULLY VACCINATED – Employees

KNOWN EXPOSURE Vaccinated:

*Known Exposure is defined as being within 6 feet [2 meters] of an individual with known COVID-19 infection, with or without a facial covering, for at least a total of 15 minutes or greater over a 24 hour period. Known exposure also includes unprotected contact with the bodily fluids or secretions of an infected person, for example, respiratory droplets from coughing, sneezing, or sharing utensils.

a. ASYMPTOMATICMay resume working on-campus/in-person while following mandatory safety precautions: masking in all indoor, on-campus facilities, social distancing, and practicing hand hygiene when applicable. Obtain a PCR COVID-19 test 5-7 days after the date of last exposure. Monitor for symptoms for a total of 14 days since the date of last known exposure.

*If symptoms develop at any point within the 14-day post-exposure period then follow the protocols in (b), below. Refer to ER or Urgent Care for immediate medical evaluation if trouble breathing, confusion, chest pain or cyanosis.

  • If SARS-CoV-2 Test Positive: Initiate at-home isolation for a minimum of 10 days from the date of positive test, and may safely end isolation to return to campus after completing 10-day isolation, if the patient shows improved symptoms and remains fever-free for at least 24 hours without the use of fever-reducing/antipyretic.
  • If SARS-CoV-2 Test Negative: May resume working on-campus/in-person while following mandatory safety precautions: masking in all indoor, on-campus facilities, social distancing, and practicing hand hygiene when applicable. Monitor for symptoms for a total of 14 days since the date of last known exposure.

b. SYMPTOMATIC: Initiate at-home quarantine, schedule next available Diagnostic PCR COVID-19 Test Appointment with HHB, or obtain PCR test locally and provide results to HHB via email. Refer to ER or Urgent Care for immediate medical evaluation if trouble breathing, confusion, chest pain or cyanosis.

  • If SARS-CoV-2 Test Positive: Initiate at-home isolation for a minimum of 10 days from the date of positive test, and may safely end isolation to return to campus after completing 10 day isolation, if the patient shows improved symptoms and remains fever-free for at least 24 hours without the use of fever-reducing/antipyretic
  • SARS-CoV-2 Test Negative: Seek an alternative diagnosis from Primary Care Provider and return to work when cleared to return by PCP.

*Non-testing approach: (Use-case determined by HHB Physician) initiate quarantine housing immediately, must complete 10 day quarantine from the date of last known exposure to a positive COVID-19 case and may safely end quarantine to return to campus after completing 10th day of quarantine, if the patient remains without symptoms and is fever-free for at least 24 hours without the use of fever-reducing/antipyretic medications upon the 9th day of isolation.

NO KNOWN EXPOSURE Vaccinated:

a. ASYMPTOMATIC – May resume working on-campus/in-person while following mandatory safety precautions: masking in all indoor, on-campus facilities, social distancing, and practicing hand hygiene when applicable. Encouraged to participate in once per week Surveillance Testing.

b. SYMPTOMATIC: Initiate at-home quarantine, schedule next available Diagnostic PCR COVID-19 Test Appointment with HHB, or obtain PCR test locally and provide results to HHB via email. Refer to ER or Urgent Care for immediate medical evaluation if trouble breathing, confusion, chest pain or cyanosis.

  • If SARS-CoV-2 Test Positive: Initiate at-home isolation for a minimum of 10 days from the date of positive test, and may safely end isolation to return to campus after completing 10-day isolation, if the patient shows improved symptoms and remains fever-free for at least 24 hours without the use of fever-reducing/antipyretic
  • If SARS-CoV-2 Test Negative: Seek an alternative diagnosis from Primary Care Provider and return to work when cleared to return by PCP.

NOT FULLY VACCINATED – Employee

(Unvaccinated or Pending Full Vaccine Dosage)

KNOWN EXPOSURE Unvaccinated: Known Exposure is defined as being within 6 feet [2 meters] of an individual with known COVID-19 infection, with or without a facial covering, for at least a total of 15 minutes or greater over a 24-hour period. Known exposure also includes unprotected contact with the bodily fluids or secretions of an infected person, for example respiratory droplets from coughing, sneezing, or sharing utensils.

a. ASYMPTOMATIC: Initiate at-home quarantine immediately; obtain a PCR COVID-19 test 5 days after the date of last exposure, if negative and remains asymptomatic may be released from Quarantine on or after Day 7 Post Exposure.

*If symptoms develop at any point during the designated period of isolation/quarantine then follow the protocols in (b), below. Refer to ER or Urgent Care for immediate medical evaluation if trouble breathing, confusion, chest pain or cyanosis.

  • If SARS-CoV-2 Test Positive: Initiate at-home isolation for a minimum of 10 days from the date of positive test, and may safely end isolation to return to campus after completing 10 day isolation, if the patient shows improved symptoms and remains fever-free for at least 24 hours without the use of fever-reducing/antipyretic
  • If SARS-CoV-2 Test Negative: If PCR COVID-19 test specimen was collected on or after day 5 post-exposure, and patient remains asymptomatic, may be released from Quarantine on Day 7 post-exposure.

*Non-Testing Approach: (Use-case determined by HHB Physician) initiate quarantine housing immediately, must complete 10-day quarantine from the date of last known exposure to a positive COVID-19 case and may safely end quarantine to return to campus after completing 10th day of quarantine, if the patient remains without symptoms and is fever-free for at least 24 hours without the use of fever-reducing/antipyretic medications upon the 9th day of isolation.

b. SYMPTOMATIC: Initiate at-home quarantine, schedule next available Diagnostic PCR COVID-19 Test Appointment with HHB, or obtain PCR test locally and provide results to HHB via email. Refer to ER or Urgent Care for immediate medical evaluation if trouble breathing, confusion, chest pain or cyanosis.

  • If SARS-CoV-2 Test Positive: Initiate at-home isolation for a minimum of 10 days from the date of positive test, and may safely end isolation to return to campus after completing 10 day isolation, if the patient shows improved symptoms and remains fever-free for at least 24 hours without the use of fever-reducing/antipyretic
  • If SARS-CoV-2 Test Negative: Initiate at-home quarantine for a minimum of 10 days from the date of last known exposure, and may safely end isolation to return to campus after completing 10 day isolation, if the patient shows improved symptoms and remains fever-free for at least 24 hours without the use of fever-reducing/antipyretic. Encouraged to seek an alternative diagnosis from Primary Care Provider.

2. NO KNOWN EXPOSURE Unvaccinated:

a. ASYMPTOMATIC Complete mandatory twice per week COVID-19 Surveillance Testing.

b. SYMPTOMATIC: Initiate at-home quarantine, schedule next available Diagnostic PCR COVID-19 Test Appointment with HHB, or obtain PCR test locally and provide results to HHB via email. Refer to ER or Urgent Care for immediate medical evaluation if trouble breathing, confusion, chest pain or cyanosis.

  • If SARS-CoV-2 Test Positive: Initiate at-home isolation for a minimum of 10 days from the date of positive test, and may safely end isolation to return to campus after completing 10 day isolation, if the patient shows improved symptoms and remains fever-free for at least 24 hours without the use of fever-reducing/antipyretic
  • If SARS-CoV-2 Test Negative: Seek an alternative diagnosis from Primary Care Provider and return to work when cleared to return by PCP.

Please note the following exceptions:

  • All SARS-CoV-2 positive results must be reported to the Los Angeles County Department of Public Health
  • Immunocompromised individuals that have tested positive for COVID-19 may be subject to prolonged isolation periods
  • All protocols will be used as baseline parameters for SAR-CoV2 investigation and evaluation, but may be altered and enhanced by MD clinical judgement.

Surveillance Testing:

Unvaccinated Employees – Mandatory COVID-19 Surveillance Testing twice per week. Unless exempt from Surveillance Testing due to a verified recent COVID-19 infection within the past 90 Days.

Unvaccinated Employees (After International Travel) – will be subject to a 7 day quarantine designated by a healthcare professional and must obtain a COVID-19 test within 3-5 days arrival after the international travel and must participate in twice per week routine testing thereafter until fully-vaccinated with an FDA emergency use approved Vaccine. *Also applicable to persons who received an international vaccine that is not authorized/approved by the World Health Organization.

Vaccinated Employees – Encouraged to participate in once per week Surveillance testing.

Vaccinated Employees (After International Travel) – must obtain a COVID-19 test within 3-5 days of arrival from international travel.

Exemption from Surveillance Testing:

Recent COVID-19 Infection within 3 Months of Exposure: Regardless of vaccination status, persons who present proof/documentation of a positive for COVID-19 test result within the last 90 days, are not subject to Surveillance Testing or Quarantine Protocols after known exposure, unless they develop symptoms. HHB to review and approve all documentation of recent COVID-19 infection in order to apply.


Last updated November 1, 2021