Infectious Diseases and the Workplace

Getting sick can sometimes cause far more problems with your employer than you might imagine. Can you be fired for getting sick, or be forced to stay home when a family member is sick? What do you do if you contract a serious contagious illness? What can employers do when there is an identified health risk or pandemic in the news, like swine flu, Ebola, or measles? It is important for workers and employers alike to know what employment actions are lawful in the face of serious illnesses, and how individuals and companies can protect themselves when infectious diseases are going around. 

There is no requirement related to federal contractors and COVID-19 vaccination.

No. Federal agencies no longer need to screen employees based on their vaccination status, and the federal government does not treat employees differently based on whether they are up-to-date with their vaccinations. In addition, employees, contractors and visitors aren’t asked for proof of vaccination before entering federal buildings. Some facilities in settings that require it will continue testing all employees. See the Safer Federal Workforce website for more information.

In addition, the Equal Employment Opportunity Commission requires employers to assess pandemic and workplace circumstances in order to justify mandatory COVID-19 testing of employees. See the Equal Employment Opportunity website for more information.

It depends. Federal law does not require private employers to mandate COVID-19 vaccinations, but employers themselves may choose to. State laws vary on this topic, with some requiring specific exemptions to these mandates when they exist. See the National Academy for State Health Policy website for more information.

Information and guidance by the CDC on masking for COVID-19 can be found here.

State laws for mask mandates vary by state. See the AARP Guide to State Mask Mandates for information on mask requirements by state.

Vaccine passports are forms that certify a person has been vaccinated against a particular disease. You do not need one to travel within the U.S., as no states currently require vaccine passports. In fact, multiple states prohibit laws that would require them.

Coronaviruses are a large family of viruses that are common in people and many different types of animals, including camels, cattle, cats, and bats. Like other coronaviruses, it has come from animals. Many of those originally infected either worked or frequently shopped in the Huanan seafood wholesale market in Wuhan, Hubei Province, China.

Have supplies on hand

  • Contact your healthcare provider to ask about obtaining extra necessary medications to have on hand in case there is an outbreak of COVID-19 in your community and you need to stay home for a prolonged period of time.
  • If you cannot get extra medications, consider using mail-order for medications.
  • Be sure you have over-the-counter medicines and medical supplies (tissues, etc.) to treat fever and other symptoms. Most people will be able to recover from COVID-19 at home.
  • Have enough household items and groceries on hand so that you will be prepared to stay at home for a period of time.
  • Take everyday precautions
  • Avoid close contact with people who are sick

Take everyday preventive actions

  • Clean your hands often
  • Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
  • If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
  • To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
  • Wash your hands after touching surfaces in public places.
  • Avoid touching your face, nose, eyes, etc.
  • Clean and disinfect your home to remove germs: practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks & cell phones)
  • Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick. 

The CDC recently issued an interim guidance for businesses and employers to respond to COVID-19, which overlap significantly with OSHA‘s guidance on coronavirus.

The CDC encourages employees with symptoms of acute respiratory illness such as fevers or cough to stay home until they are without symptoms for at least 24 hours.

Call your healthcare provider and let them know about your symptoms. Tell them that you have or may have COVID-19. This will help them take care of you and keep other people from getting infected or exposed.

Pay attention for potential COVID-19 symptoms including, fever, cough, and shortness of breath. If you feel like you are developing symptoms, call your doctor. If you develop emergency warning signs for COVID-19 get medical attention immediately. In adults, emergency warning signs:

  • Difficulty breathing or shortness of breath
  • Persistent pain or pressure in the chest
  • New confusion or inability to arouse
  • Bluish lips or face

Not necessarily. According to the CDC, some people are at higher risk of getting very sick from this illness. This includes:

  • Older adults
  • People who have serious chronic medical conditions like:
  • Heart disease
  • Diabetes
  • Lung disease

Typically your boss may fire you for missing work due to the flu, but it depends on the seriousness of the flu symptoms you have. If the flu makes you very sick and causes non-typical health complications, it may be illegal for your employer to fire you. The Family and Medical Leave Act (FMLA) protects employees by stating that certain employers may not fire employees for missing 12 weeks or less of work due to serious illness. While it is very rare for courts to prevent employers from firing employees due to the flu, courts have granted FMLA protection to employees that caught the flu and had severe reactions. To determine if the flu counts as an FMLA covered condition, certain factors must be met. The most important factor is that your flu must be considered a “serious health condition.” The flu may count as a serious health condition if the following occur:

  • It prevents you from being able to complete essential functions of your job for four or more consecutive calendar days;
  • It causes you to visit a healthcare provider at least twice, and the visits must be in person and not over the phone follow-ups;
  • It requires you to receive continued treatment;
  • Even if your doctor advises you to stay home for a week, if the other FMLA conditions are not met, the flu is not considered a serious health condition.

Yes. While FMLA does protect sick employees, you still must call your employer and follow any call-in procedure your employer has established. However, if your illness is sudden and prevents you from calling your employer immediately, then you may not need call in immediately, so long as you DO call in as soon as reasonably possible. If you fail to do so, you will not be given FMLA’s protection.

Yes. Generally, your boss may make it a job requirement that you be vaccinated and remove the risk of exposer to infectious disease. If your employer creates such a policies, your employer may fire you for failing to vaccinate yourself or your children. Your employer may assume that having an unvaccinated child could lead to an unreasonable risk that you could catch the flu or another illness, and as a result, your employer is legally allowed to fire you.

According to the Centers for Disease Control and Prevention (“CDC”), the best option to avoid the flu is to get the flu shot, and the best way to avoid other infectious diseases is to get the corresponding vaccination. For other contagious illnesses do the following:

  • Avoid close contact with others when you, or they, are sick;
  • Stay at home when you are sick;
  • Cover your mouth and nose with a tissue when you cough or sneeze;
  • Washing your hands often, with soap and water for at least 20 seconds;
  • Avoid touching your eyes, nose or mouth with unwashed hands (this is an important step to avoid catching the flu);
  • Clean and disinfect surfaces and objects at work.

For more information about stopping the spread of germs at work, refer to the  CDC website.

Zika

Zika is a virus spread mostly by the bite of an infected Aedes species mosquito. It can be passed from a pregnant woman to her fetus, causing certain brith defects. At present, there is no vaccine or medicine for Zika. Symptoms of Zika may include fever, rash, headache joint pain, conjunctivitis, and muscle pain, lasting from several days to a week. If you suspect that you may have been affected, a blood or urine test can confirm Zika infection. The CDC advises that you see a doctor or healthcare provider if you develop symptoms.

To prevent Zika infection, the CDC recommends protecting yourself from mosquito bites. You may do so by using an Environmental Protection Agency (EPA)- registered insect repellant containing one of the active ingredients: DEET, picardin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. For the latest information about Zika, see the CDC Zika page.

Ebola

Ebola is a rare and deadly disease that was first discovered in 1976 in the Democratic Republic of the Congo. Some nations have seen a dramatic increase in the numbers of individuals with Ebola. Recently, there have even been a few rare scares of Ebola in the USA. To avoid catching Ebola the CDC recommends:

  • Washing your hands with soap or hand sanitizer;
  • Avoid contact with blood and body fluids;
  • Do not handle items that came into contact with infected blood or body fluids;
  • Avoid bats and nonhuman primates, their blood, their fluids, and their raw meat;
  • Avoid funeral rituals that handle bodies of those that died from Ebola;
  • For the latest information about Ebola, see the CDC Ebola page.

Measles

Measles is a disease that, in the early half of the twentieth century, lead to the hospitalization of 48,000 people and the death of 400 to 500 people per year. In the year 2000, the CDC declared that measles had been eliminated in the USA because it had not been transmitted for 12 consecutive months. This success was attributed to the success of vaccination policies for school-aged children. However, recently, measles has again begun to break out in parts of the USA.

To avoid catching measles the CDC recommends:

  • Get an MMR vaccination
  • The CDC states that it there is no link between the MMR vaccination and autism
  • Most children have no side effects from the vaccination

Measles is very contagious. You can catch it by being in a room where someone with measles breathed within the last two hours. Nearly everyone that doesn’t have a vaccination will catch measles if they are exposed to the measles virus.

For more information about Measles see the CDC measles page.

Under the Family and Medical Leave Act (FMLA), covered employees may take up to 12 weeks of unpaid leave for serious medical conditions. Whether any infectious disease is considered a serious medical condition will depend on the disease and the degree to which it affects you. When there is a fear of a nationwide pandemic, and the spread of a disease makes the news, employers are likely to consider the illness serious medical condition.

Employers commonly require workers to provide a note from their doctor to prove that the reason they missed work was due to an illness or other medical reason. 

Sick notes are only meant to confirm why the employee missed work and to inform the employee of any work restrictions the employee may have due to their condition. 

Employers should not ask for detailed information, as doing so would intrude on workers’ privacy and risk violating the Americans with Disabilities Act (ADA).

Yes, under the Americans with Disabilities Act (ADA), an employer may force an employee to stay home if the employer believes that the employee will pose a direct threat to the workplace due to having or being exposed to, a serious infectious disease. This includes employees that are still willing and able to work. Many diseases are very infectious. For example, the Measles virus can be caught if you enter a room where an infected individual was located thirty minutes ago. Sometimes the best way an employer can prevent the threat of exposure to all employees is to require one employee to stay home from work.

No, if an overly cautious employer forces an employee who does not have an infectious disease to stay home from work, this time cannot be charged against the employee’s 12-week entitlement under the FMLA. As a general rule, employers are not allowed to charge employees with FMLA leave when that leave is required by the employer.

Yes. Employers may require employees to engage in sanitary practices, such as regular handwashing and potentially wearing face masks to maintain a healthy workplace.

Yes. According to  OSHA, the law that requires employers to provide a safe workplace, your employer does have a duty to protect you from recognized hazards. However, there is no specific duty that details what an employer must do to protect you from an infectious disease.

Yes. If an employee arrives to work showing signs of an acute respiratory illness (such as cough or shortness of breath) or becomes sick during the day, the CDC recommends that the employee be separated and sent home immediately. Advising such workers to go home is not a disability-related action if the illness is similar to seasonal influenza or COVID-19. Additionally, the action would be permitted under the ADA if the illness were serious enough to pose a direct threat.

It depends. Typically employers cannot force you to tell them if you have a disability or a sickness that others are not at risk of catching. However, under the ADA, during a pandemic, an employer may require employees to disclose whether they or their family members have been exposed to an infectious disease.

Yes. Employers can and do commonly require employees to provide a doctor’s note to verify that they missed work due to medical reasons. Employers may also request a doctor’s note to verify the need for accommodations at work. 

Yes, the ADA does permit potential employers to require medical examinations of entering employees after they have already extended an offer of employment. However, employers cannot administer these medical exams in a discriminatory fashion and must require these medical exams from all new employees in the same job category.

Under the ADA, if there is an outbreak of a serious health concern, then employers are allowed to require employees to work from home. However, employers are not allowed to single out employees to work from home.

If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace. Employers should not, however, disclose to co-workers the identity of the quarantined employee because confidentiality requirements under federal law, such as ADA, or state law may apply.

Many states do not have laws preventing employers from firing someone who is quarantined by the state, so long as there is no contract or union agreement. However, some states do have laws that prevent employers from firing any employee or any full-time employee. For more information on state laws regarding quarantine, visit our Workers’ Rights During Public Health Emergencies page.

Yes, full-time workers are generally entitled to unemployment insurance if they are furloughed when a business temporarily shuts down and all other unemployment requirements are met. Depending on the size and length of the temporary shutdown, the jurisdiction may require notification to the applicable unemployment department as a mass separation. For more information visit our Workers’ Rights During Public Health Emergencies page.

Employees must tell their employer if they are requesting an exception to a COVID-19 vaccination requirement because of a conflict between that requirement and their sincerely held religious beliefs, practices, or observances.  Under Title VII, this is called a request for a “religious accommodation” or a “reasonable accommodation.” 

An employer should proceed on the assumption that a request for religious accommodation is based on sincerely held religious beliefs, practices, or observances.  However, if an employer has an objective basis for questioning either the religious nature or the sincerity of a particular belief, the employer would be justified in making a limited factual inquiry and seeking additional supporting information.  An employee who fails to cooperate with an employer’s reasonable requests for verification of the sincerity or religious nature of a professed belief, practice, or observance risks losing any subsequent claim that the employer improperly denied an accommodation. See the EEOC website for more information.

Yes. Caregiver discrimination violates federal employment discrimination laws when it is based on an applicant’s or employee’s sex (including pregnancy, sexual orientation, or gender identity), race, color, religion, national origin, age (40 or older), disability, or genetic information (such as family medical history). Caregiver discrimination also is unlawful if it is based on an applicant’s or employee’s association with an individual with a disability, within the meaning of the Americans with Disabilities Act, or on the race, ethnicity, or other protected characteristic of the individual for whom care is provided. Finally, caregiver discrimination violates these laws if it is based on intersections among these characteristics (for example, discrimination against Black female caregivers based on racial and gender stereotypes, or discrimination against Christian female caregivers based on religious and gender stereotypes). See the EEOC website for more information.

As of 2023, only California employers are required by law to notify employees of potential COVID exposure. 

Within one day of discovering there was a person positive with COVID in the workplace, California employers must provide written notice of the exposure to all employees who were physically present (AB 2693). This law was amended to remain effective until January 1, 2024.

There is no federal requirement for employers to notify of potential exposure. OSHA had enacted an Emergency Temporary Standard (ETS) in 2021 to require this in certain circumstances, but this came to an end in early 2022.

Although not required by law in most of the U.S., employers are advised to notify their employees of COVID exposure.

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Madeline Messa

Madeline Messa is a 3L at Syracuse University College of Law. She graduated from Penn State with a degree in journalism. With her legal research and writing for Workplace Fairness, she strives to equip people with the information they need to be their own best advocate.