Understanding contact,
exposure and infection
Given the incomplete knowledge of the risk and specificcontribution of different modes of transmission of theSARS-CoV-2 virus, there is some discongruity and confusion
among the terms used to describe the behaviors that areassessed to determine an individual patient’s risk of having
an asymptomatic or presymptomatic viral infection. Thereare varied and changing definitions of terms as they relate
to “contact.”
AAOMS is providing definitions and examples of specificterms to aid in communication and consistent execution of
the interim guidance and patient/staff screening procedures.
Contact and close contact with a person under investigation
or a COVID-19-positive individual are generally consideredrisk factors for individuals who are not part of the healthcare
team and therefore not expected to be wearing PPE or inan environment with risk mitigation strategies provided by
AAOMS, the CDC and OSHA. When screening the OMS patientprior to an appointment, the purpose is to prevent undiagnosed
patients who may be spreading the virus from entering thefacility while avoiding the unnecessary delay or refusal ofnecessary surgical services.

Definition1

Contact

Close contact

Person underinvestigation

Exposure

Probable
COVID-19
caseConfirmed
COVID-19
case

To meet that goal, the OMS should
critically evaluate and/or interview patients
who affirmatively answer screening questions.
For example, if a patient is a healthcare worker who is actively
treating COVID-19-positive patients – and has not had any
break in appropriate PPE use – then the patient is not likely
to have been exposed to or infected by the virus. Though thepatient may be considered positive for screening purposes,
it may not be appropriate to delay or defer care. This example
is intended to further define and categorize patient behaviors
based on the subsequent risk for infection and spread. Thissituation is different than an individual who reports being neara person under investigation or a COVID-19-positive individual
without respiratory protection.
Although the SARS-CoV-2 virus, its characteristics and its
ability to transfer via aerosolization are better understoodas the COVID-19 pandemic has progressed, it is importantto understand the various levels of potential exchange aseach pathway offers varying levels of risk and recommendedactions.

ExamplesAny contact without proper
respiratory protection (e.g., N95
or higher filtrating respirator) withan infected individual (probable orconfirmed COVID-19 case) whilethat individual was infectious –starting two days before illness
onset (or, for asymptomaticclients, two days prior to positive
specimen collection) until the time
the patient is isolated.

• Walking past someone

Being within 6 feet of an
infected individual with proper
respiratory protection (e.g., N95
or higher filtrating respirator) fora cumulative total of 15 minutes
or more over a 24-hour period,starting two days before illness
onset (or, for asymptomaticpatients, two days prior to testspecimen collection) until
10 days after diagnosis.

• Treating a COVID-19 patient

Any individual who responds
positively to screening questions
without a clear non-COVID-19
explanation or has any symptoms
consistent with COVID-19 infection
until the individual no longer
responds positively, has completed
isolation or has had adequate
negative COVID-19 testing.

• Having risk factors forBeing within 6 feet of an infectedindividual without proper
respiratory protection (e.g., N95
or higher filtrating respirator) fora cumulative total of 15 minutes
or more over a 24-hour period,starting two days before illness
onset (or, for asymptomaticpatients, two days prior to test
specimen collection) until 10 days
after diagnosis.

• A COVID-19 positive patient

Report of individual meetingclinical AND epidemiologic
evidence of COVID-19 but without
confirmatory laboratory evidence.

• Having symptoms ofReport of individual with COVID-19
and meeting confirmatorylaboratory evidence.

• Receiving positive test

Risk to have Recommended
contracted action related
COVID-19 to COVID-192

or being briefly in thesame room.

• Running past an infectedindividual during a morningjog.

Lower risk

Continue everyday
activities andpreventative actions.

Medium risk

Monitor symptoms.

Medium risk

Isolate andmonitor symptoms
or get tested.

High risk

Isolate andget tested.

for multiple brief periods.

• Working in the sameroom or shared air space(based on HVAC systemand ventilation) withindividual who is COVID-19
positive and asymptomaticbut encountering periodicallymultiple times throughout
the day.

or symptoms of COVID-19
but not yet laboratory
confirmed.

sneezes on a treatingprovider.

• Walking into an aerosol mist
generated by a coughing
COVID-19-positive individual.

• Sitting across from a
COVID-19-positive individual
for an extended period oftime.

COVID-19 but not yet
completing a test toconfirm.

confirming COVID-19
infection; individual
may be asymptomaticor symptomatic.

Very high risk

Get tested andquarantine until
results are obtained.

Spread has
already occurred

Quarantine
for 14 days.

View the Interim Reopening Protocol for the OMS Officeand AAOMS.org/COVID for additional resources.
1
2

https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-plan/appendix.html
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

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