Puerto Rico Department of Health Issues Updated Protocol for COVID-19 Case Management in the Workplace

Under the authority delegated by the different executive orders currently in effect, on January 4, 2022, the Puerto Rico Department of Health (PR DOH) updated its Protocol for COVID-19 Case Management in the Workplace (Protocol) to help prevent exposure and provide recommendations for case management in the workplace amid the spread of the Omicron variant. The Protocol is prepared in accordance with recommendations of the United States Occupational Safety and Health Administration (OSHA), the Centers for Disease Control and Prevention (CDC) and all current executive orders (EOs) and administrative orders issued by the government of Puerto Rico regarding the COVID-19 pandemic.


The Protocol reiterates the vaccination mandates imposed by EO-2021-075 and EO-2021-087: to wit, that employees of the executive branch, health sector, hospitality sector, restaurant sector, beauty salons, barber shops, spas, gyms, childcare centers, supermarkets, grocery stores, casinos and gas station stores, must be fully vaccinated against COVID-19 or have a booster shot (applicable to eligible population). Exclusions apply to those with a compromised immune system or a medical contraindication that prevents vaccination, or those who do not wish to get vaccinated for religious reasons. These exempt employees must present a negative COVID-19 result from a viral test SARS-CoV-2 qualified test every seven days.1

Maximum Occupancy

The Protocol emphasizes the maximum occupancy limit requirements established in EO-2021-085. In summary, activities in large-capacity theaters, amphitheaters, stadiums, coliseums, and entertainment centers in closed settings must operate at 50% of their capacity. If these establishments operate outdoors, they must function at 75% of their capacity. Likewise, restaurants (including fast foods, food courts and cafeterias), bars, cafes, sport bars, cinemas, community centers or activities, and establishments that serve drinks or prepared food in closed settings must operate at 50% of their capacity. If these establishments operate outdoors, they must function at 75% of their capacity.

Precautionary Measures Against COVID-19

As per Administrative Order No. 512, the Protocol reiterates mask2 use is required in closed spaces, regardless of the individual’s COVID-19 vaccination status. Likewise, masks are required in outdoor spaces, regardless of vaccination status, when it is not possible to comply with the six-foot physical distancing requirement.

Some of the strategies to mitigate the spread of COVID-19 established in the Protocol are: encouraging regular hand washing with soap and water, or hand sanitizers approved by official health entities; providing paid time off for employees to get booster shots; instructing employees with COVID-19 symptoms, employees who test positive for COVID-19, and employees who have had close contact with someone who has tested positive for COVID-19 to stay home from work; and implementing physical distancing of six feet, especially in closed or poorly ventilated spaces.

Reporting of COVID-19 Cases in the Workplace, Quarantine and Isolation Measures

If a case of COVID-19 is identified in the workplace, the employer must notify the PR DOH immediately in order to initiate the investigation of cases and contact tracing.3 Employees with COVID-19-related symptoms4 should notify their supervisor and should not be present in the workplace. Those who have contracted COVID-19 should not return to work until they have completed the appropriate isolation requirements. If an employee who has COVID-19-related symptoms becomes ill during their shift, they should be immediately separated from other employees and be sent home.

For this Protocol, the PR DOH maintained the same quarantine requirements previously issued amid the COVID-19 case increase linked to the Omicron variant. Notably, the Protocol provides that, regardless of vaccination status, in cases of prolonged exposure (e.g., there is a case at home), the DOH case investigator will determine the quarantine period.

Criteria for Reentry to Work for Confirmed or Probable Cases

Isolation guidelines have not been amended, providing that confirmed or probable cases, whether symptomatic or asymptomatic, must isolate for a period of 10 days.  If employees who test positive have completed their required isolation period, they are not required to submit a negative antigen or molecular test to return to work. According to the Protocol, employers may not condition an employee’s return to work upon their submittal of a negative COVID-19 test result or health certificate from a health care provider. Even though, according to the Americans with Disabilities Act, employers may require medical certificates from employees to confirm that they are healthy and eligible to return to work, employers should be mindful and consider that healthcare facilities may be very busy and in no position to manage said documentation at this time.

See Footnotes

1 “NAAT” molecular test or antigen test or a positive test result for COVID-19 of the previous three (3) months, along with documentation of the employee’s recovery.

2 A "mask" is understood to mean any fabric product or other material, covering the mouth, nose and chin.

3 The employer must notify the PR DOH via email at: covidpatronos@salud.pr.gov using the Agency’s form.

4 Symptoms include fever, chills, cough, shortness of breath, tiredness or fatigue, muscle pain, headache, loss of smell or taste, sore throat, congestion runny nose, diarrhea, and nausea or vomiting.

Information contained in this publication is intended for informational purposes only and does not constitute legal advice or opinion, nor is it a substitute for the professional judgment of an attorney.