Virginia Department of Health
October 10, 2025
October 10, 2025
Health Advisory
Summary
October 10, 2025
Health Advisories and Alerts are significant public health notices intended for healthcare providers. Please review and share within your practice widely.
- A Health Alert conveys the highest level of importance; warrants immediate action or attention.
- A Health Advisory provides important information for a specific incident or situation; may not require immediate action.
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October 10, 2025
Health Advisory
Summary
- The Virginia Department of Health issued updated recommendations for exclusion of healthcare personnel (HCP) who test positive or have symptoms consistent with COVID-19 or influenza.
- HCP are those who provide direct healthcare services or who work in a location where healthcare is provided, including both clinical and support staff.
- The changes reduce the isolation period for COVID-19, remove return to work testing requirements, and align guidance for COVID-19 and influenza.
- The full recommendations can be found in the VDH health care provider guidelines (PDF).
- Healthcare providers and facilities should update HCP exclusion and return to work guidance for COVID-19 and influenza consistent with the new VDH recommendations (linked above and summarized in the ADDITIONAL INFORMATION section of this Advisory).
- Apply the updated guidance to HCP who test positive, HCP who have symptoms consistent with COVID-19 or seasonal influenza who have not been tested, and HCP with known exposures to either virus.
- Updated VDH guidance for exclusion of HCP with confirmed or suspected COVID-19 or influenza are provided below. Note that the day of symptom onset or of a positive test is defined as day 0.
- Infected (test positive) and Asymptomatic:
- Exclude for 3 days from the first positive test.
- Can return on day 4 if a facemask is worn for source control in all patient care and common areas of the facility through day 7, if not already wearing a facemask as part of universal source control masking.
- Infected (test positive or with compatible symptoms) with Mild to Moderate Illness:
- Exclude for 3 days from symptom onset*
- Can return on day 4 if ALL of the following criteria are met:
- At least 24 hours have passed with no fever (without using fever-reducing meds)
- Symptoms are improving
- They feel well enough to return to work
- A facemask is worn for source control in all patient care and common areas of the facility for at least 7 days, if not already wearing a facemask as part of universal source control masking.
*Facilities may consider temporary reassignment or exclusion of HCP from the care of patients/residents at highest risk of severe disease, including those with moderate or severe immunocompromising conditions. This reassignment is indicated for 7-10 days after symptom onset or until symptom resolution, whichever is longer.
- Infected (test positive) and Asymptomatic:
- For HCP with severe or critical illness or who are moderately or severely immunocompromised, follow CDC guidance on COVID-19 risk assessment and infection control for healthcare personnel.
- Exposed and Asymptomatic (who have not tested positive):
- Wear a facemask for source control in all patient care and common areas of the facility for at least 5 days after the exposure. *
- Monitor for symptoms for 5 days after last exposure. Any HCP who develops signs or symptoms of COVID-19 or influenza should be restricted from work as described above.
*Work restrictions may be considered if HCP are unable to wear source control, are moderately to severely immunocompromised, care for or work on a unit with patients who are moderately to severely immunocompromised or work on a unit experiencing ongoing COVID-19 transmission that is not controlled with initial interventions.
- Exposed and Asymptomatic (who have not tested positive):
- Current respiratory disease activity in Fairfax County, including COVID-19 and influenza diagnoses at emergency departments and urgent care centers, is displayed on the Fairfax County Health Department’s Respiratory Illness Dashboard. The dashboard is updated each week on Tuesdays.
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