As the U.S. begins to report lower numbers of COVID-19 deaths and transmissions, many employers that had been shut down are beginning to bring workers back into the office — a move wrought with implications on safety and regulations.

With the upcoming flu season, lags in COVID-19 testing, differing state and local rules on symptom screening and the challenges of contact tracing, employers eager to gets some of their workers back in the workplace face myriad uncertainties and need well-thought-out plans to deal with symptomatic or COVID-19-positive workers, experts say.

“You have to provide clear messaging and let (workers) know that policies and procedures are being developed to address the risks as we understand them today and the prevention measures,” said Tim Davidson, Franklin, Tennessee-based senior consultant and health care thought leader at Aon Risk Solutions.

This should also encompass the employer’s rules for symptom screening, testing, contact tracing, quarantining or self-isolating, said Dr. David Zieg, Denver-based partner and clinical services leader at Mercer Inc.

Although the U.S. Centers for Disease Control and Prevention released guidance Aug. 5 to help companies develop contact tracing programs for identifying potential workplace exposures, he said with concerns over delayed diagnostic tests — which can still take two weeks for a result in some areas of the country — employers need to develop plans to go off of worker symptoms and potential exposures when making their decisions on quarantines, Dr. Zieg said.

“Employers don’t have medical expertise or epidemiology experts” and need to ask employees who have been exposed to someone who tested positive for COVID-19 or exhibiting symptoms to simply ask the question, “Were you around anybody for 15 minutes or more?” he said. “Then have them isolate. Just stick with the guidance and keep it simple.”

Employers who have the capacity to take a more conservative approach and quarantine any worker who had contact with a symptomatic or positive employee may want to do so to mitigate the spread, Dr. Zieg said.

To identify these potential cases, it’s important for employers is to create a specific methodology for onsite screening of coronavirus symptoms, Mr. Davidson said. This screening should include a battery of questions — preferably yes/no questions that take you down a decision tree to determine whether the employee needs to quarantine at home, he said.

“Have defined, closed-end questions that don’t leave a lot of wiggle room and gray area for a person to give you a nebulous answer,” he said. “When you’re doing contact tracing, your yes/no answers drive you to the next step of the investigation.”

“Employers really need to get good information at the time of the reported event and potential exposure,” said Christina Bergman, Minneapolis-based managing consultant at Aon Global Risk Consulting. “It’s really important that employers don’t have a bunch of forms with a lot of white space narrative. Have specific questions to guide that.”

The way these questions are phrased is also important, said Christian Schiavone, Chicago-based director of professional services for risk solutions at Origami Risk LLC.

If the message is “framed around the concept that we’re in this together, that’s really the mentality that gets the honest and forthright response” from workers, he said. “I think that a safety culture has been extremely important.”

Dr. Zieg agrees that employers should “first and foremost” support a culture of safety to ensure adherence to safety measures and prompt honest symptom assessments.

“If an employee has an outside exposure and they disclose that in their questionnaire … then take action,” he said.

First, employers need to have a plan on how to get the employee who was exposed or symptomatic to get tested, Dr. Zieg said.

“If you leave it to the employee to go find their own test via either public health offer or local urgent care, what you’re leading into is potential delays and time is of the essence,” he said. “You want to identify folks as quickly as possible. Have a plan for testing.”

Such plans include reaching out to their local urgent care for test availability and inquiring on how to put employees on a list when a suspected case arises, or for larger employees, contracting with testing vendors or a pharmacy to provide testing. While symptomatic employees’ tests would be covered under group health plans, broad screening to identify risks would not, according to Dr. Zieg.

“Employers should not take risks and err on the side of caution, even if that means requiring more tests,” said Arlene Switzer Steinfeld, senior counsel in the Dallas office of Dykema Gossett PLLC. She noted that the U.S. Equal Employment Opportunity Commission has said that requiring employees to take a COVID-19 test is permissible, antibody testing cannot be required. However, some city and state laws could differ from EEOC guidance.

After a worker has been identified as symptomatic or potentially exposed, Dr. Zieg recommends that the employer interview the employee to determine anyone who may have had close contact with that worker in recent days. Those workers should be contacted and notified that they may have been exposed to a person with coronavirus — without identifying the worker — and advised to quarantine and test, he said.

However, employers need to be sure when they’re interviewing workers that they’re being respectful of their personal activities, Ms. Steinfeld said.

For example, if an employee was out at a bar with a friend who then tested positive, the employer may ask that employee to self-quarantine and to get tested, but should “be very careful to keep any issues that reveal personal activities out of the personnel decision-making,” she said.

“When you’re starting to do contact tracing, keep any information about that separate from the personnel files,” Ms. Steinfeld said. “Don’t use that information in any way to affect the terms and conditions of employment.”

Even with all precautions and effective contact tracing, COVID-19 exposures will happen, and employers need to balance their need to reopen with the potential negative reputational risk if something goes wrong, Mr. Schiavone said.

“There’s really an awareness that you want the folks that you employ to be as safe as possible,” he said. “But you also want to make sure your reputation, which is so hard to rebuild, is not put at risk by making a short-sighted decision.”

More insurance and workers compensation news on the coronavirus crisis here.