Health Update

Health Update:      


Update: Interim


Guidance for


Implementing Safety Practices for Critical




Workers Who May Have Had Exposure to a Person with Suspected or


Confirmed COVID-19


April 9, 2020


This document will be updated as new information becomes available. The current version can always be viewed at


The Missouri Department of Health & Senior Services (DHSS) is now using four types of documents to provide important information to medical and public health professionals, and to other interested persons:


Health Alerts convey information of the highest level of importance which warrants immediate action or attention from Missouri health providers, emergency responders, public health agencies or the public. 


Health Advisories provide important information for a specific incident or situation, including that impacting neighboring states; may not require immediate action.


Health Guidance’s contain comprehensive information pertaining to a particular disease or condition, and include recommendations, guidelines, etc. endorsed by DHSS.


Health Updates provide new or updated information on an incident or situation; can also provide information to update a previously sent Health Alert, Health Advisory, or Health Guidance; unlikely to require immediate action. __________________________________


Office of the Director


912 Wildwood


P.O. Box 570


Jefferson City, MO 65102


Telephone: 800-392-0272


Fax:  573-751-6041




Health Update


April 9, 2020






SUBJECT: Update: Interim Guidance for Implementing Safety


Practices for Critical Infrastructure Workers Who May


Have Had Exposure to a Person with Suspected or Confirmed COVID-19


***Missouri healthcare providers and public health practitioners: Please contact your local public health agency or the Missouri Department of Health and Senior


Services (DHSS), Bureau of Communicable Disease Control and Prevention


(BCDCP) at 573-751-6113 with questions regarding this Update.***


To ensure continuity of operations of essential functions, CDC advises that critical infrastructure workers may be permitted to continue work following potential exposure to COVID-19, provided they remain asymptomatic and additional precautions are implemented to protect them and the community. 


A potential exposure means being a household contact or having close contact within 6 feet of an individual with confirmed or suspected COVID-19. The timeframe for having contact with an individual includes the period of time of 48 hours before the individual became symptomatic.


Critical Infrastructure workers who have had an exposure but remain asymptomatic should adhere to the following practices prior to and during their work shift:


  • Pre-Screen: Employers should measure the employee’s temperature and assess symptoms prior to them starting work. Ideally, temperature checks should happen before the individual enters the facility.
  • Regular Monitoring: As long as the employee doesn’t have a temperature or symptoms, they should self-monitor under the supervision of their employer’s occupational health program.
  • Wear a Mask: The employee should wear a face mask at all times while in the workplace for 14 days after last exposure. Employers can issue facemasks or can approve employees’ supplied cloth face coverings in the event of shortages.
  • Social Distance: The employee should maintain 6 feet and practice social distancing as work duties permit in the workplace.
  • Disinfect and Clean work spaces: Clean and disinfect all areas such as offices, bathrooms, common areas, shared electronic equipment routinely.


If the employee becomes sick during the day, they should be sent home immediately. Surfaces in their workspace should be cleaned and disinfected. Information on persons who had contact with the ill employee during the time the employee had symptoms and 2 days prior to symptoms should be compiled. Others at the facility with close contact within 6 feet of the employee during this time would be considered exposed.







This interim guidance pertains to critical infrastructure workers, including personnel in 16 different sectors of work including:

Ø  Federal, state, & local law enforcement

Ø  911 call center employees

Ø  Fusion Center employees

Ø  Hazardous material responders from government and the private sector

Ø  Janitorial staff and other custodial staff

Ø  Workers – including contracted vendors – in food and agriculture, critical manufacturing, informational technology, transportation, energy and government facilities




Ø  Employees should not share headsets or other objects that are near mouth or nose.

Ø  Employers should increase the frequency of cleaning commonly touched surfaces.

Ø  Employees and employers should consider pilot testing the use of face masks to ensure they do not interfere with work assignments.

Ø  Employers should work with facility maintenance staff to increase air exchanges in room.

Ø  Employees should physically distance when they take breaks together. Stagger breaks and don’t

congregate in the break room, and don’t share food or utensils.




Employers should implement the recommendations in the Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 to help prevent and slow the spread of COVID-19 in the workplace. 

 Additional information about identifying critical infrastructure during COVID-19 can be found on the DHS CISA website or the CDC’s specific First Responder Guidance page .



Interim Guidance for Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19:– ncov/downloads/critical–workers –implementing– safetypractices.pdf    


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