As new coronavirus cases climb in Arizona, the state is directing agency leaders not to independently inform state employees about positive COVID-19 tests in their departments, according to internal emails shared with The Arizona Republic.

The state also isn't stopping employees exposed to confirmed cases of COVID-19 from coming to work unless they have symptoms, the emails show — despite evidence that individuals can spread the disease before or without becoming symptomatic.

"If an employee tests positive for COVID-19 … do not notify the entire agency or other employees unless directed to by a health authority," a March 19 "agency operations update" reads. The "county will handle each situation on a case-by-case basis."

The update also repeats guidance shared the day before by the state's Human Resources director.

"If an employee is exposed to a confirmed case and asymptomatic (free of symptoms related to COVID-19), they should not be restricted from the workplace but should monitor for compatible symptoms of COVID-19 (fever and cough or shortness of breath) for 14 days," it reads.

What the CDC recommends

Some state employees have been given the option to work remotely. The Arizona Department of Administration, which includes the Human Resources Division, did not immediately respond to questions about how officials developed their guidelines for those still showing up in person.

The day after The Republic inquired about the recommendations, an ADOA spokeswoman said officials used guidance from state and federal health officials to create them. But she said supervisors were "encouraged to work with their employees on specific concerns or circumstances."

The U.S. Centers for Disease Control and Prevention — whose lead Gov. Doug Ducey has repeatedly said the state is following — deems those who've had "close contact" with a confirmed case of COVID-19 "medium risk," even if they do not have symptoms. More than a half-dozen studies have shown asymptomatic people can spread the virus, CNN reported last week.

"Close contact," as defined by the CDC, can happen two ways. You can spend a "prolonged period of time" within six feet of someone with COVID-19 — for example, sitting in a waiting room — or have "direct contact" with an infected person's cough or sneeze.

Those who have had close contact with a positive case should "remain at home or in a comparable setting" while monitoring themselves for signs of the virus, the CDC says, rather than continuing to work or go out in public.

It considers those who have shared an environment with an infected person without close contact lower risk and says those individuals don't have to stay home while monitoring themselves for symptoms.

The state guidelines don't appear to distinguish between those levels of exposure, however — meaning it's possible someone the CDC would advise to stay home could come in.

That, in turn, could put other employees at risk, according to James Hodge, director of ASU's Center for Public Health Law and Policy.

"We've seen time and time again that people can spread the virus without having symptoms. It can also keep living on surfaces," he said. "People are right to be worried about asymptomatic cases."

Will Humble, executive director of the Arizona Public Health Association and the state's former Health Department director, took a more flexible tack, saying he didn't think "trivial contact with a positive case" should keep people away from work.

Someone who's been "in the vicinity of a positive person" but didn't shake hands or spend much time with the individual, for example, shouldn't have to stay home for weeks, he said. But "if a person was exposed for a lengthy time in close quarters with a confirmed positive case, then that person should definitely work remotely."

"To be honest, it's that back-of-the-envelope risk assessment that matters," he said. "There's no substitute for good judgment."

County informed city of positive case 3 days after death

Arizona’s first known COVID-19 death was a man who worked in Phoenix's Aviation Department. The city said managers didn’t know the man was infected until three days after he died, when the Maricopa County Department of Public Health called to say he'd tested positive.

As a result, the city and department scrambled to inform co-workers and close contacts that they may have been exposed to the virus, they said.

A few hours after receiving the news, Phoenix City Manager Ed Zuercher sent an email notifying the city's 15,000 employees about the situation.

The county's COVID-19 page for businesses says it will not contact every employer to notify them of positive test results — that notification "depends on investigation information, potential exposure and whether the employee was in a high-risk job."

Humble and Hodge both said employers have to be incredibly sensitive when it comes to privacy concerns and health information protected by law. But Hodge said "responsible employers" have been erring on the side of caution and "alerting their entire enterprise if there is a known exposure, not waiting for the county to get the time and opportunity to play that out."

"Some employers are saying, 'We wanted to let you know we had an active case here, and you may have been exposed' without saying whether it was an employee, a customer, whatever," he said.

"It would be very smart for them to have all non-essential employees working from elsewhere anyway."

Republic reporters Andrew Oxford and Melissa Yeager contributed to this article.

Reach the reporter at maria.polletta@arizonarepublic.com or 602-653-6807. Follow her on Twitter @mpolletta.

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