ALtogether Alabama:

It is strongly recommended that all businesses follow applicable covid-19-related safety guidelines from the Food and Drug Administration and the Centers for Disease Control and Prevention (CDC) publication, Reopening Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes, at https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html

State Questionnaire:

Have you been in close contact with a confirmed case of COVID-19?

Are you experiencing a cough, shortness of breath or sore throat?

Have you had a fever in the last 48 hours?

Have you experienced new loss of taste or smell?

Have you experienced vomiting or diarrhea in the last 24 hours?

Additional information:

Reopen Alaska Responsibly:

There are a number of strategies and actions that individuals, businesses, and communities can take to help reduce the spread of the virus that causes COVID-19. This document outlines these strategies and provides resources Alaskans can use to keep themselves, their families, and their communities safe. Alaskans have a proud history of taking care of themselves and their communities during difficult times – Alaska wins when we work together.

Core practices that should remain in place once facilities begin to reopen include:

• Have a staff management plan that includes non-punitive and flexible sick leave policies, staffing patterns in case of restrictions or shortage, and pre-shift screening

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Arizona Together

Stay Healthy. Return Smarter. Return Stronger.

Requirements for Preventing COVID-19 Transmission

Pursuant to the previous and updated guidance issued by the Centers for Disease Control and Prevention (CDC) and the Arizona Department of Health Services (ADHS), under all circumstances, the following precautions are required for businesses operating in Arizona:

• Implement symptom screening for employees prior to the start of their shift.
• Wellness/symptom checks, including temperature checks for all personnel, when possible, as they arrive on premises or before opening.
• Health checks should be done in a private location to avoid stigma and discrimination in the workplace. Information should be kept confidential.

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Arkansas Department of Health

The Secretary of Health has issued this Directive in conjunction with Executive Order 20-25, which imposed limitations on businesses in the state of Arkansas to limit the spread of COVID-19. This directive to include the following steps thatmust be taken to protect the people of the State of Arkansas from COVID-19.

All businesses, manufacturers, and construction companies must implement the following protocols for diminishing the threat of COVID-19:

• Employees should be screened for fever, cough, shortness of breath, sore throat, or loss of taste or smell as they are entering the building at the beginning work.

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Resilence Road Map Phase 2 (May 14, 2020):

Before reopening, all facilities must:

• Train employees on how to limit the spread of COVID-19, including how to screen themselves for symptoms and stay home if they have them

• Implement individual control measures and screenings

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Safer At Home

Second Amended Public Health Order 20-28

Employers with over fifty (50) employees in any one location shall implement the following protocols:

• implement employee screening systems in one of the following ways:
• Set up stations at the worksite for symptom screening and temperature checks; or
• Create a business policy that requires at-home employee self-screening each work day and reporting of the results to the employer prior to entering the worksite;

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Reopen Connecticut:

Daily Health Check

Ask employees resuming on-premise work to confirm they have not experienced COVID-19 CDC-defined symptoms and to monitor their own symptoms, including cough, shortness of breath, or any two of the following symptoms:

• Fever

• Chills

• Repeated shaking with chills

• Muscle Pain

• Headache

• Sore throat

• New loss of taste or smell

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Documents containing the rules for the first phase of reopening have been published on the state’s coronavirus website – ct.gov/coronavirus– and are available to download directly at these links:

• Hair Salons & Barbershops

• Museums & Zoos

• Offices

• Restaurants

• Retail and Malls

For more information visit: Connecticut's Rules for Businesses Under First Phase of Reopening Plans

Delaware's Economic Reopening:

All employees required to go to work should perform a daily health check as prescribed by the Delaware Division of Public Health.

Delaware Division of Public Health's Screening Recommendations:

Employers must screen each incoming employee with a basic questionnaire, which should include at least the below, however can be made more comprehensive and/or employer-specific in consultation with medical professionals

• Do you have symptoms of respiratory infection (feveror shaking chills, cough, shortness of breath, severe sore throat, loss of taste or smell, or muscle aches)?
• Have you been in close contact(e.g., within 6 feet for more than 10minutes) with a person with confirmed COVID-19 infection?

State Questionnaire:

• Do you have symptoms of respiratory infection (feveror shaking chills, cough, shortness of breath, severe sore throat, loss of taste or smell, or muscle aches)?
• Do your symptoms have a known cause (asthma, COPD, chronic sinusitis, etc.)?
• Have you been in close contact(e.g., within 6 feet for more than 10 minutes) with a person with confirmed COVID-19 infection?

Additional information:

Florida's Plan for Recovery:

Consider conducting daily in-person or virtual health checks (e.g., symptom and/or temperature screening) of employees before they enter the facility, in accordance with state and local public health authorities and, if available, your occupational health services:

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Reviving A Healthy Georgia:

All Restaurants, Dining Rooms, and non-critical businesses that continue in-person operations during the effective dates of this order shall implement measures wheich mitigate the exposure and spread of COVID-19 among its workforce. Such measures shall include the following:

• Screening and evaluating Workers who exhibit symptoms of COVID-19

Critical Infrastructure that continue in-person operation during the effective dates of this order shall implement measures which mitigate the exposure and spread of COVID-19. Such measures may include, byt shall not be limited to the following, which shall be implemented to the maximum extent practicable:

• Screening and evaluating Workers who exhibit symptoms of COVID-19

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Hawaii's Roadmap to Recovery and Resilience

Restaurants for Dine-In Service, Retail Food Markets, Food Processors & Manufacturers:

Before starting their shift, all staff should be screened and evaluated for signs of illness.

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Idaho Rebounds: Our Path to Prosperity

Governor Brad Little, with the help of the Department of Health and Welfare and guidance issued by President Donald Trump and the Centers for Disease Control and Prevention, has established a data-driven approach to opening up Idaho’s economy. This approach reduces the risk of COVID-19 to Idaho’s most vulnerable populations and preserves capacity in our healthcare system, while opening up businesses safely. From an economic standpoint, Idaho’s rebound from COVID-19 starts with employee and consumer confidence, which leads into business stability and growth and eventually promotion and attraction.

General Businesses:

On a case-by-case basis, include other practices such as screening of employees for illness and exposures upon work entry, requiring non-cash transactions, etc.

Restaurants:

Monitor employee health by screening employees for fever and symptoms before every shift

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Restore Illinois: A Public Health Approach to Safely Reopen our State

Restore Illinois is about saving lives and livelihoods. This five-phased plan will reopen our state, guided by health metrics and with distinct business, education, and recreation activities characterizing each phase. This is an initial framework that will likely be updated as research and science develop and as the potential for treatments or vaccines is realized. The plan is based upon regional healthcare availability, and it recognizes the distinct impact COVID-19 has had on different regions of our state as well as regional variations in hospital capacity.

All employers should have a wellness screening program. Resources outlining screening program best practices are posted on the DCEO Restore Illinois guidelines website.

Employers should conduct in-person screening of employees upon entry into workplace and mid-shift screening to verify no presence of COVID-19 symptoms;

State Questionnaire:

Employers may ask employees to respond “Yes” or “No” to each question below OR show a list of symptoms to employees and ask them to answer whether or not they are experiencing any of them.

• Have you felt feverish?
• Do you have a cough?
• Do you have a sore throat?
• Have you been experiencing difficulty breathing or a shortness of breath?
• Do you have muscle aches?
• Have you had a new or unusual headache (e.g., not related to caffeine, diet, or hunger, not related to a history of migraines, clusters, or tension, not typical to the individual)?
• Have you noticed a new loss of taste or loss of smell?
• Have you been experiencing chills or rigors?
• Do you have any gastrointestinal concerns (e.g., abdominal, pain, vomiting, diarrhea)?
• Is anyone in your household displaying any symptoms of COVID-19?
• To the best of your knowledge, have you or anyone in your household come into close contact with anyone who has tested positive for COVID-19?

Additional information:

Back On Track Indiana:

Employee Screening Procedures– Conduct daily health assessments by utilizing a screening procedure for COVID-19 symptoms for employees who are reporting for work. Examples include self-assessments before arrival in the workplace, screening questions, or taking temperatures with a no-touch thermometer

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Reopening Iowa

Workplaces, particularly in areas where community transmission of COVID-19 is occurring, should consider developing and implementing a comprehensive screening and monitoring strategy aimed at preventing the introduction of COVID-19 into the work site. Consider a program of screening workers before entry into the workplace, criteria for exclusion of sick workers, including asymptomatic workers who have tested positive for COVID-19; and criteria for return to work of exposed and recovered (those who have had signs or symptoms of COVID-19 but have gotten better).. This type of program should be coordinated to the extent possible with local public health authorities

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Ad Astra: A Plan to Reopen Kansas

Protect Your Team

Monitor employees temperatures and symptoms regularly. Issue or approve face coverings. Be mindful of spaces where 6 feet of distance can’t be maintained. Disinfect workspaces at the beginning and end of each shift/work day.

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Kentucky Healthy at Work:

Daily temperature and health checks may be administered by the employer at the business site or self-administered by the employee prior to arriving at work (at least once every 24-hour period).

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Is there anyone in your household who is showing COVID-19 symptoms or who has been diagnosed with COVID-19?

Have you been in close contact with anyone exhibiting sign or symptoms of fever, persistent cough or shortness of breath consistent with COVID-19 who has not been tested or is still awaiting testing?

Additional information:

Reopening Louisiana

Workplaces, particularly in areas where community transmission of COVID-19 is occurring, should consider developing and implementing a comprehensive screening and monitoring strategy aimed at preventing the introduction of COVID-19 into the work site. Consider a program of screening workers before entry into the workplace, criteria for exclusion of sick workers, including asymptomatic workers who have tested positive for COVID-19; and criteria for return to work of exposed and recovered (those who have had signs or symptoms of COVID-19 but have gotten better).. This type of program should be coordinated to the extent possible with local public health authorities.

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Restarting Maine's Economy

The State of Maine has adopted a staged approach, supported by science, public health expertise, and industry collaboration, to allow Maine businesses to safely open when the time is right.

State Questionnaire:

Ask employees and customers the following questions to screen for illness:

• Have you had a cough or sore throat?
• Have you had a fever or do you feel feverish?
• Do you have shortness of breath?
• Do you have a loss of taste or smell?
• Have you been around anyone exhibiting these symptoms within the past 14 days?
• Are you living with anyone who is sick or quarantined?
• Have you been out of state in the last 14 days?

Additional information:

Maryland is Back to Business

Maryland is following Governor Hogan’s Maryland Strong: Roadmap to Recovery plan, which includes a phased approach to reopening business. Effective May 15 at 5 p.m., Maryland is in Stage One of recovery, which includes the reopening of some businesses, such as manufacturing, retail stores, and some personal services. Business owners are urged to review Governor Hogan’s Executive Order and Interpretive Guidance for more details on reopening.

For Employers:

• Screen employees for COVID-19 symptoms at start of work.

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Reopening Massachusetts

The Baker-Polito Administration’s comprehensive plan to safely reopen the Massachusetts economy, get people back to work, and ease social restrictions while minimizing the health impacts of COVID-19.

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Michigan: COVID-19 Workplace Guidelines

Employee Screening Procedures - Prior to Work

• Temperature, self monitoring symptoms (Cough, fever, shortness of breath)

State Questionnaire:

Have you had any of the following COVID-19 symptoms since your last day at work or the last time you were here:

• Fever (100.4F or higher) or chills?
• Cough?
• Shortness of breath or difficulty breathing?
• Fatigue?
• Muscle or body aches?
• Headache?
• New loss of taste or smell?
• Sore throat?
• Congestion or runny nose?
• Nausea or vomiting?
• Diarrhea?
• Persistent pain or pressure in the chest?
• New confusion?
• Inability to wake or stay awake?
• Bluish lips or face?

Additional information:

Minnesota: Safely Returning to Work

Ensure sick workers stay home

• Establish health screening protocols for workers at the start of each shift (e.g. health screening survey, taking temperature). See the Minnesota Department of Health (MDH)’s Visitor and Employee Health Screening Checklist (www.health.state.mn.us/diseases/coronavirus/facilityhlthscreen.pdf). The checklist is also available in Hmong, Somali, and Spanish (www.health.state.mn.us/diseases/coronavirus/businesses.html).

State Questionnaire:

Have you had any of the following symptoms since your last day at work or the last time you were here that you cannot attribute to another health condition?

• Fever or feeling feverish?
• Chills?
• A new cough?
• Shortness of breath?
• A new sore throat?
• New muscle aches?
• New headache?
• New loss of smell or taste?

Additional information:

Reopening New York

Implement mandatory health screening assessment (e.g. questionnaire, temperature check) for employees, contractors, and other visitors, asking about (1) COVID-19 symptoms in past 14 days, (2) positive COVID-19 test in past 14 days, and/or (3) close contact with confirmed or suspected COVID-19 case in past 14 days. Responses must be reviewed and documented daily.

State Questionnaire:

Have you knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had symptoms of COVID-19?

Have you tested positive for COVID-19 in the past 14 days?

Have you experienced any symptoms of COVID-19 in the past 14 days?

Besides to and from works, have you traveled to the states that are subjected to self-quarantine within the last two weeks?

Additional information:

North Carolina: Staying Ahead of the Curve

North Carolina is taking a three-phased approach – based on data from testing, tracing and trends and in consultation with members of the business community – to lift restrictions in place to slow the spread of the COVID-19 coronavirus pandemic and save lives.

Easing Restrictions on Travel, Business Operations, And Mass Gatherings: Phase I:

• Conduct daily symptom screening of workers, using a standard interview questionnaire of symptoms, before workers enter the workplace.

State Questionnaire:

Have you had close contact (within 6 feet for at least 10 minutes) in the last 14 days with someone diagnosed with COVID-19,or has any health department or health care provider been in contact with you and advised you to quarantine?

Since you last worked, have you had any of these symptoms:

• Fever?
• Chills?
• Shortness of breath or difficulty breathing?
• New cough?
• New loss of taste or smell?

Since you last worked, have you been diagnosed with COVID-19?

A worker can return to work when they can answer YES to ALL three questions:

• Has it been at least 10 days since you first had symptoms?
• Has it been at least 3 days since you’ve had a fever (without using fever reducing medicine)?
• Has it been at least 3 days since your symptoms have improved, including cough and shortness of breath?

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• severe difficulty breathing (e.g., struggling for each breath, speaking in single words)?
• severe chese pain?
• having a very hard time waking up?
• feeling confused?
• lost consciousness?

2. Are you experiencing any of the following:

• shortness of breath at rest
• inability to lie down because of difficulty breathing
• chronic health conditions that you are having difficulty managing because of your current respiratory illness

3. In the past 10 days, have you experienced any of the following:

• Fever
• New on set cough or worsening of chronic cough
• New or worsening shortness of breath
• New or worsening difficulty breathing
• Sore throat
• Runny nose

4. Do you have any of the following:

• Chills
• Painful swallowing
• Stuffy nose
• Headache
• Muscle or joint ache
• Feeling unwell, fatigue or severe exhaustion
• Nausea, vomiting, diarrhea or unexplained loss of appetite
• Loss of sense of smell or taste
• Conjunctivitis (pink eye)

5. In the past 14 days, has your employer or AHS told you you’ve been in close contact with a confirmed case of COVID-19?

6. In the past 14 days, did you return from travel outside of Canada?

7. Asymptomatic testing is now only available for specific Albertans. Do you require testing for the purpose of upcoming travel?

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
• Severe chest pain
• Having a very hard time waking up
• Feeling confused
• Losing consciousness

2. Are you experiencing any of the following:

• Mild to moderate shortness of breath
• Inability to lie down because of difficulty breathing
• Chronic health conditions that you are having difficulty managing because of difficulty breathing

3. Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones? Symptoms include: Fever*, chills, cough or worsening of chronic cough, shortness of breath, sore throat, runny nose, loss of sense of smell or taste, headache, fatigue, diarrhea, loss of appetite, nausea and vomiting, muscle aches. While less common, symptoms can also include: stuffy nose, conjunctivitis (pink eye), dizziness, confusion, abdominal pain, skin rashes or discoloration of fingers or toes. Fever: Average normal body temperature taken orally is about 37°C. For more on normal body temperature and fevers, see HealthLinkBC's information for children age 11 and younger and for people age 12 and older.

4. Have you travelled to any countries outside Canada (including the United States) within the last 14 days?

5. Do you provide care or have close contact with a person with confirmed COVID-19? Note: This means you have been contacted by your health authority’s public health team

Additional information:

State Questionnaire:

1. Do you or the person you are inquiring about have any of the following symptoms: severe difficulty breathing (e.g., struggling for each breath, speaking in single words), chest pain, confusion, extreme drowsiness or loss of consciousness?

2. Do you or the person you are inquiring about have shortness of breath at rest or difficulty breathing when lying down?

3. Do you have a new onset of any of the following symptoms?

• fever / chills
• cough
• sore throat / hoarse voice
• shortness of breath
• loss of taste or smell
• vomiting or diarrhea for more than 24 hours

4. Do you have a new onset of 2 or more of any of the following symptoms?

• runny nose
• muscle aches
• fatigue
• conjunctivitis (pink eye)
• headache
• skin rash of unknown cause
• nausea or loss of appetite
• if the patient is an infant, poor feeding

A.1 Have you been in close contact in the last 14 days with someone that is confirmed to have COVID-19?

A.2 Have you had laboratory exposure while working directly with specimens known to contain COVID-19?

A.3 Have you been in a setting in the last 14 days that has been identified by public health as a risk for acquiring COVID-19, such as on a flight, in a workplace or community with a cluster of cases, or at an event?

A.4 Have you received a notification from the COVID Alert app that you may have been exposed to COVID-19?

A.5 Have you travelled outside of Canada, or within Canada excluding travel to western Canada the territories or Ontario west of Terrace Bay in the last 14 days?

A.6 In the last 14 days has anyone living in your household travelled outside of Canada, or within Canada excluding travel to western Canada, the territories or Ontario west of Terrace Bay?

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
• Severe chest pain
• Having a very hard time waking up
• Feeling confused
• Losing consciousness

2. Are you experiencing any of the following:

• Mild to moderate shortness of breath
• Inability to lie down because of difficulty breathing
• Chronic health conditions that you are having difficulty managing because of difficulty breathing

3. Are you experiencing any of the following:

• new or worsening cough
• shortness of breath or difficulty breathing
• temperature equal to or over 38°C
• feeling feverish
• chills
• fatigue or weakness
• muscle or body aches
• new loss of smell or taste
• headache
• gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
• feeling very unwell

4. Have you travelled to any countries outside Canada (including the United States) within the last 14 days?

5. Within the last 14 days did you provide care or have close contact with a symptomatic person known or suspected to have COVID-19?

A close contact is defined as a person who:

• Provided care for the individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
• Lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
• Had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment.

6. Did you have close contact with a person who travelled outside of Canada in the last 14 days who has become ill (new or worsening cough; shortness of breath or difficulty breathing; temperature equal to or over 38°C; feeling feverish; chills; fatigue or weakness; muscle or body aches; new loss of smell or taste; headache; gastrointestinal symptoms (abdominal pain, diarrhea, vomiting); feeling very unwell)?

A close contact is defined as a person who:

• Provided care for the individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
• Lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
• Had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment.

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
• Severe chest pain
• Having a very hard time waking up
• Feeling confused
• Losing consciousness

2. Are you experiencing any of the following:

• Mild to moderate shortness of breath
• Inability to lie down because of difficulty breathing
• Chronic health conditions that you are having difficulty managing because of difficulty breathing

3. Are you experiencing 2 or more of the following symptoms (new or worsening)?

• Fever (or signs of a fever such as chills, sweats, muscle aches and lightheadedness)
• Cough
• Headache
• Sore throat
• Painful swallowing
• Runny nose
• Unexplained loss of appetite
• Diarrhea
• Loss of sense of smell or taste
• Or

4. Are you experiencing small red or purple spots on your hands and/or feet?

5. Have you received a notification from the COVID Alert app that you may have been exposed to COVID-19?

6. Are you a resident of an Atlantic province (New Brunswick, Nova Scotia, Prince Edward Island and Newfoundland and Labrador) and traveled outside of these areas within the last 14 days?

7. Are you a resident of a community along the Labrador-Quebec border (Labrador City, Wabush, Fermont, the Labrador Straits area and Blanc Sablon) and traveled outside of these areas in the last 14 days?

8. In the last 14 days, did you have close contact with a person who has been confirmed as having COVID-19?

9. In the last 14 days, did you have close contact with a person who travelled outside of Newfoundland and Labrador who has become ill?

Additional information:

State Questionnaire:

1. Are you experiencing any of the following symptoms:

• difficulty breathing (e.g. unable to finish sentences because of your breathing, short of breath at rest, unable to lie down because of difficulty breathing);
• chest pain;
• having a very hard time waking up;
• fainted or lost consciousness; OR
• difficulty managing your daily life because of breathing difficulties.

2. Are you experiencing ONE of the following symptoms:

• Fever
• New or worsening cough
• Shortness of breath

OR

• TWO of the following symptoms:
• Tiredness
• Generally feeling unwell
• Sore throat
• Muscle aches
• Runny nose
• Headache
• Diarrhea
• Vomiting
• Loss of sense of smell/taste
• Loss of appetite

3. Have you been outside of Canada within the last 14 days?

4. Have you returned to the Northwest Territories from other parts of Canada within the last 14 days (other than Nunavut)?

5. Has anyone in your household been outside of the NWT (other than Nunavut) in the past 14 days?

6. In the last 14 days, have you:

• been in close contact with someone or their respiratory secretions (i.e. saliva and mucous) who is:
• confirmed to have COVID-19; OR
• has COVID-19 symptoms and has had possible exposure to COVID-19 (i.e. travel outside of the NWT in the last 14 days or any points below); OR
• had lab exposure to biological material; OR
• attended a gathering where COVID-19 was spread; OR
• lived or worked in a closed facility experiencing a COVID-19 outbreak.

A close contact is :

• a person who provided care for the person with COVID-19, including family, or other caregivers, and healthcare workers who did not use protective equipment; or
• a person who lived with or otherwise had close contact (within 2 metres) with the person with COVID-19 while they were sick; or
• a person who had direct contact with bodily fluids of someone who has been confirmed to have COVID-19 (e.g. was coughed or sneezed on).

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
• Severe chest pain
• Having a very hard time waking up
• Feeling confused
• Losing consciousness

2. Are you experiencing any of the following:

• Mild to moderate shortness of breath
• Inability to lie down because of difficulty breathing
• Chronic health conditions that you are having difficulty managing because of difficulty breathing

3. Are you experiencing any of the following:

• new or worsening cough
• shortness of breath or difficulty breathing
• temperature equal to or over 38°C
• feeling feverish
• chills
• fatigue or weakness
• muscle or body aches
• new loss of smell or taste
• headache
• gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
• feeling very unwell

4. Have you travelled to any countries outside Canada (including the United States) within the last 14 days?

5. Within the last 14 days did you provide care or have close contact with a symptomatic person known or suspected to have COVID-19?

A close contact is defined as a person who:

• Provided care for the individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
• Lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
• Had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment.

6. Did you have close contact with a person who travelled outside of Canada in the last 14 days who has become ill (new or worsening cough; shortness of breath or difficulty breathing; temperature equal to or over 38°C; feeling feverish; chills; fatigue or weakness; muscle or body aches; new loss of smell or taste; headache; gastrointestinal symptoms (abdominal pain, diarrhea, vomiting); feeling very unwell)?

A close contact is defined as a person who:

• Provided care for the individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
• Lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
• Had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment.

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
• Severe chest pain
• Having a very hard time waking up
• Feeling Confused
• Losing Consciousness

2. Are you experiencing any of the following:

• Mild to moderate shortness of breath at rest
• Inability to lie down because of difficulty breathing
• Chronic health conditions that you are having difficulty managing because of difficulty breathing

3. Are you experiencing any of the following:

• Fever
• New onset or worsening Cough
• Sneezing
• Sore throat
• Have you travelled to any countries outside Canada (including the United States) within the last 14 days?
• Have you returned to Nunavut from somewhere else in Canada in the past 14 days?
• Did you have close contact with a person who travelled outside of Nunavut in the last 14 days who has become sick (cough, fever, sneezing or sore throat)?

Additional information:

State Questionnaire:

1. Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.

• Fever or chills
• Difficulty breathing or shortness of breath
• Cough
• Sore throat, trouble swallowing
• Runny nose/stuffy nose or nasal congestion
• Decrease or loss of smell or taste
• Nausea, vomiting, diarrhea, abdominal pain
• Not feeling well, extreme tiredness, sore muscles

2. Have you travelled outside of Canada in the past 14 days?

3. Have you had close contact with a confirmed or probable case of COVID-19?

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• Severe pain or tightness in the chest;
• Severe difficulty breathing (i.e. struggling for each breath, speaking in single words);
• Severe abdominal pain;
• Loss of consciousness;
• Prolonged and persistent dizziness or headache;
• An injury that may require stitches or involve a broken bone;
• A child who has prolonged diarrhea or vomiting; or
• A baby under six months of age with a fever of 38C (100.4F) or higher;

2. Do you have any ONE of the following symptoms:

• New or worsening cough;
• Shortness of breath or difficulty breathing;
• Fever;
• Chills;
• Sore Throat;
• Runny nose, sneezing, congestion;
• Headache;
• Muscle aches;
• Unusual fatigue; or
• Acute loss of sense of smell or taste;

Additional information:

State Questionnaire:

1. Are you experiencing any of the following:

• Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
• Severe chest pain
• Having a very hard time waking up
• Feeling confused
• Losing consciousness

2. Are you experiencing any of the following:

• Mild to moderate shortness of breath
• Inability to lie down because of difficulty breathing
• Chronic health conditions that you are having difficulty managing because of difficulty breathing

3. Are you experiencing any of the following:

• new or worsening cough
• shortness of breath or difficulty breathing
• temperature equal to or over 38°C
• feeling feverish
• chills
• fatigue or weakness
• muscle or body aches
• new loss of smell or taste
• headache
• gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
• feeling very unwell

4. Have you travelled to any countries outside Canada (including the United States) within the last 14 days?

5. Within the last 14 days did you provide care or have close contact with a symptomatic person known or suspected to have COVID-19?

A close contact is defined as a person who:

• Provided care for the individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
• Lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
• Had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment.

6. Did you have close contact with a person who travelled outside of Canada in the last 14 days who has become ill (new or worsening cough; shortness of breath or difficulty breathing; temperature equal to or over 38°C; feeling feverish; chills; fatigue or weakness; muscle or body aches; new loss of smell or taste; headache; gastrointestinal symptoms (abdominal pain, diarrhea, vomiting); feeling very unwell)?

A close contact is defined as a person who:

• Provided care for the individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
• Lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
• Had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment.

Additional information:

State Questionnaire:

1. Are you working / volunteering in a Long Term or Continuing Care Home or affiliate facility for any period of time today?

2. Are you working / volunteering in any other SHA facility (not LTC) for any period of time today?

3. Are you experiencing any of the following:

• severe difficulty breathing (e.g., struggling for each breath, speaking in single words)
• severe chest pain
• having a very hard time waking up
• feeling confused
• lost consciousness

4. Are you experiencing any of the following:

• short of breath at rest
• inability to lie down because of difficulty breathing
• chronic health conditions that you are having difficulty managing because of your current respiratory illness

5. Do you have any of the following:

• Fever
• Muscle or joint aches and pains
• Cough
• Loss of sense of smell or taste
• Shortness of breath
• Dizziness
• Sore throat
• Nausea
• Chills
• Vomiting
• Headache
• Diarrhea
• Runny nose
• Loss of appetite (or difficulty feeding for children)
• Conjunctivitis
• Fatigue
• Nasal congestion

6. Were you exposed to someone who is under investigation for COVID-19 or has been confirmed as having COVID-19 within the last 14 days?

7. In the past 14 days have you returned from international travel?

Additional information:

State Questionnaire:

1. Are you experiencing any of the following?

• severe difficulty breathing (for example, struggling for each breath, speaking in single words);
• severe chest pain;
• having a very hard time waking up;
• feeling confused;
• lost consciousness.

2. Are you experiencing any of the following?

• shortness of breath at rest;
• inability to lie down because of difficulty breathing;
• chronic health conditions that you are having difficulty managing because of your current respiratory illness.

3. Do you have any of the following?

• fever/chills
• cough
• shortness of breath
• runny nose
• sore throat
• loss of sense of taste or smell
• headache
• fatigue
• loss of appetite
• nausea or vomiting
• diarrhea
• muscle aches

4. In the past 14 days have you had close contact with someone who is confirmed as having COVID-19?

A close contact is someone who:

• provided care for the individual, including health care workers, family members or other caregivers, or who had other similar close physical contact without consistent and appropriate use of personal protective equipment; or
• who lived with or otherwise had close prolonged contact (within 2 metres) with the person while they were infectious; or
• had direct contact with infectious bodily fluids of the person (such as, was coughed or sneezed on) while not wearing recommended personal protective equipment.

5. In the past 14 days have you returned from travel to any other locations outside of Yukon? Travel includes passing through an airport.

Additional information: