At present, re-testing people who have experienced mild illness, and have recovered from COVID-19 is not recommended. A person is considered safe to return to the workplace and discontinue self-isolation if they are no longer infectious. This means they developed their first symptoms more than 10 days prior and have not experienced any symptoms for at least 3 days (72 hours). However, returning to work is dependent on the patient’s clinical state of health.

The most infectious period is thought to be 1 to 3 days before symptoms start, and in the first 7 days after symptoms begin. But some people may remain infectious for longer and this is because typically with viruses, the higher the viral load (the more virus circulating in the body), the higher the risk of transmission through known transmission pathways. So the more severe the illness and the higher the viral load, the longer you continue to shed the virus and are infectious.

If someone with mild disease has been symptom-free for 3 days and they developed their first symptoms more than 10 days prior, they are no longer considered to be infectious.

It is common for patients to continue to have symptoms for longer than the above time periods. Full recovery may take several weeks. Patients who are still symptomatic at the end of their isolation period can be de-isolated provided that their fever has resolved (without the use of antipyretics) and their symptoms have improved. If symptoms are persisting, the worker should seek medical assessment from their practitioner

If a worker has been diagnosed with COVID-19 and isolated in accordance with the guidelines, an employer may only allow a worker to return to work on the following conditions:

• The worker has completed the mandatory 7-days of self-isolation;
• The worker may need to undergo a medical evaluation confirming fitness to work.

The employee’s entitlement to sick leave is outlined in section 22 of the Basic Conditions of Employment Act. Further guidance on this around COVID-19 is found  on page 8 of  https://www.nioh.ac.za/wp-content/uploads/2020/06/C19-OHS-Directives-June-2020.pdf

People who have been self-quarantining, because they had contact with a confirmed case of COVID-19 and have completed their 7-day quarantine period without developing symptoms, can return to work on day 8. There is no requirement to be tested prior to returning to the work. It is, however, recommended they continue to practice social distancing and good hygiene as a precaution and wear a surgical mask.

People who have tested positive for COVID-19, currently re-testing people who have experienced mild illness, and have recovered from COVID-19 is not recommended. A person is considered safe to return to the work and discontinue self-isolation if they are no longer infectious. This means they developed their first symptoms more than 7-days prior and have not experienced any symptoms for at least 3 days (72 hours). There should be a work with precautions in place that include social distancing, employing good and hand respiratory hygiene and wearing a surgical mask for 21 days from the date of the test.  Medical evaluation may be necessary to determine fitness to do their job.

As per the updated regulation from Government, close contacts no longer need to quarantine. Refer to the Government Gazette here. 

A patient can have a false negative if they have very little virus up there or perhaps the specimen was taken inappropriately. It didn’t get up high enough to actually get to the place where the virus was located. If a patient presents with symptoms of COVID-19 — cough, fever, shortness of breath — but they test negative, they should consult their health practitioner for further assessment.

Patients can remain PCR positive even after they are no longer infectious. A positive PCR test does not equate to an infectious, viable virus. Patients may be de-isolated without the need for repeat PCR tests provided the patient’s fever has resolved and their symptoms have improved. 

Suspected COVID-19 cases who are or have mild disease, may be managed at home while awaiting test, isolated from the workplace. These workers should communicate with their manager and not be at work until they have results. Constant communication with their employer is essential during this time so that the workplace can take steps to manage and clean as appropriate.