Doctor’s Note, Negative Test Should Not Be Required to Return to Work, School, TMA Says
By David Doolittle


COVID-19 patients with mild to moderate symptoms who isolated themselves at home should not be required to receive a negative test or a physician’s note to return to work or school, the Texas Medical Association COVID-19 Task Force said.

“A test-based strategy is no longer recommended to determine when to discontinue home isolation of a COVID positive patient, except in specific circumstances,” the task force said in a statement that quoted the Centers for Disease Control and Prevention (CDC). “Some tests can yield false negatives if taken too soon, or alternatively, false positives can occur when individuals with confirmed COVID-19 continue to test positive even after the infectious period has passed.”

Instead, the task force recommends using a symptom-based strategy for returning to work or school, based on interim CDC guidance.

“Specifically, researchers have reported that people with mild to moderate COVID-19 remain infectious no longer than 10 days after their symptoms began, and those with more severe illness or those who are severely immunocompromised remain infectious no longer than 20 days after their symptoms began,” the statement says.

Physicians should remind confirmed or probable COVID-19 patients about the importance of staying home if they are showing symptoms. However, patients can discontinue isolation under the following conditions:

  • At least 10 days have passed since symptom onset, and
  • At least 24 hours have passed since resolution of fever without the use of fever-reducing medications, and
  • Other symptoms have improved.

As always, physicians should strongly encourage all Texans to continue using safe practices to prevent the spread of COVID-19, including wearing a mask in public, social distancing, and hand hygiene.

As schools begin to open across the state, the TMA School Reopening Workgroup created several materials to help schools adopt safe procedures, require safe behaviors, create a safe environment, and manage sick students and staff.

Find more tools, information, and resources on the TMA COVID-19 Resource Center, which is updated regularly.

Last Updated On

August 18, 2020

Originally Published On

August 18, 2020

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David Doolittle


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Dave Doolittle is editor of Texas Medicine and Texas Medicine Today. Dave grew up in Austin, where he attended culinary school as well as the University of Texas. He spent years covering Central Texas for the Austin American-Statesman newspaper. He is the father of two girls, a proud Longhorn, and an avid motorsports fan.

More stories by David Doolittle