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COVID-19: What You Need to Know and What You Should Do Now

COVID-19: What You Need to Know and What You Should Do Now

Recommendations and protocols for a safe workplace

Vince McLeod

This article is part 2 of a two-part series detailing the COVID-19 pandemic. This article offers guidance from the best trusted sources for prevention and planning in the workplace and at home. To read the first part of this series discussing the history of coronaviruses and planning for pandemic responses, click here.

COVID-19 universal precautions

To address the first point on individual precautions, below is the most current guidance provided by the Centers for Disease Control and Prevention (CDC). Since the most likely route of transmission is through aerosolized respiratory droplets from infected individuals and the fact that infected and contagious individuals may be asymptomatic, especially during the early stages of incubation, we must limit close contact.


The CDC defines close contact as being within about six feet of anyone, but especially anyone that is coughing or sneezing. Therefore, personal universal precautions should also include:

  • Covering our own cough or sneeze with tissue or a shoulder or elbow
  • Repeated and diligent hand-washing, especially following contact with any public, frequently-touched surfaces such as door handles, elevator buttons, handrails, drinking fountains, keyboards, etc. Soap and water is effective along with alcohol-based (>60 percent) sanitizer or wipes
  • Avoid touching eyes, nose, or mouth
  • Keep up-to-date on the latest information on COVID-19 from the CDC, WHO, and local public health officials
  • Stay home if you begin to feel sick; even headache, runny nose, or allergies until you recover
  • Seek medical attention if you develop fever, dry cough, and difficulty breathing. Call your doctor or medical provider in advance for prescreening and direction to the proper health facility.

COVID-19 risk assessment and prevention

For risk assessment and public health management professionals, the CDC Interim Guidance1 provides needed information on assessing and managing risk of potential exposures to COVID-19 and implementing public health actions based on risk level and clinical presentation. The interim guidance recommends actions on monitoring, movement restrictions, isolation, and quarantine to delay the spread of virus in communities not experiencing sustained community transmission.  

The focus of these interim guidelines is to help local public health authorities handle potential cases of US-bound travelers and people identified through contact tracing as exposed to laboratory-confirmed cases. The guidance defines risk categories and discusses self-observation, self-monitoring, isolation, and quarantine.

Of primary importance are risk level definitions and management recommendations for contacts of asymptomatic people exposed to COVID-19. The CDC does not recommend testing or special management for “contacts of contacts,” (e.g. people exposed to asymptomatic people with potential exposure to COVID-19). The recommendations are for people who have been determined to have some risk for COVID-19 and provide risk levels and management guidelines for asymptomatic and symptomatic persons.

Preparing businesses and workplaces for COVID-19

The OSHA Guidance on Preparing Workplaces for COVID-19, OSHA 3990-03 20202 was released on March 10, 2020. It provides advisory recommendations to help employers reduce the impact of the COVID-19 outbreak on businesses, workers, customers, and the public. The focus is to help employers plan and prepare for continuity in light of expected worsening outbreak conditions.

In planning and preparing for the COVID-19 pandemic, employers should focus on infection prevention and traditional industrial hygiene practices including engineering, administrative, and work practice controls. Personal protective equipment (PPE) should also be considered, especially for building service and cleaning personnel.

Develop (or update if already existing) an Infectious Disease Preparedness and Response Plan.  Consider where, how, and what sources of COVID-19 exposures might impact workers. Take into consideration individual risk factors (age, medical conditions, pregnancy, etc.) and non-occupational risk factors at home and in the community and the controls needed to address those risks.

Develop contingency plans for increased absenteeism, working remotely, downsizing operations, staggering work shifts, and other measures to reduce exposures. Focus on maintaining essential operations. Include cross-training to do more with less. Do not forget to evaluate potentially interrupted supplies and delayed deliveries.

The response plan should include basic infection prevention measures. Train all employees on the Universal Precautions (see above) and encourage strict adherence. Ensure supplies of sanitizer, disinfectant wipes, cleaners, and PPE are not depleted. Develop and implement policies for identification and isolation of sick employees. Encourage employees to self-monitor and report any signs or symptoms promptly.

Recommendations for cleaning/disinfecting workplaces for COVID-19

These recommended disinfection procedures are based on the CDC’s Environmental Cleaning and Disinfection Recommendations for US community facilities with suspected or confirmed Coronavirus Disease 2019.3 As the COVID-19 knowledge base evolves, these recommendations will need to be updated to reflect the most applicable findings.

When designing cleaning and disinfecting protocols, the primary concern is the route of transmission. Current knowledge of COVID-19 is that spread of the virus occurs person-to-person via respiratory droplets (e.g. coughing and sneezing). It is unknown how long virus particles will remain viable on surfaces where the droplets may deposit, but it most likely is only hours, depending on the droplet size, type (saliva or mucus), humidity, temperature, and surface type. However, it is imperative to note that transmission of COVID-19 to persons from surfaces contaminated with the virus has not been documented.

Given the limited route of transmission, disinfection should be curtailed to areas reasonably expected to catch droplets, (e.g. surfaces within about six feet of an infected individual’s path through the facility or in proximity to their workstation). The aim of these procedures is to kill all surface-deposited virus within identified areas suspected of contamination. 

First, a period of time needs to elapse to allow potential contaminated droplets to settle to surfaces. The CDC recommends waiting up to 24 hours. However, this should occur rapidly, within seconds to an hour or so, even for very fine aerosols. The CDC also recommends opening outside doors and windows to increase circulation during this delay period.

The second most important consideration for COVID-19 potential infection and seriousness of disease is age and health of personnel. It is strongly recommended that cleaning staff be under 65 years of age and without underlying health conditions. This population has been shown to have infection rates much higher than younger individuals and more serious outcomes.

Third, all cleaning staff must be trained on COVID-19 exposure routes, symptoms, and proper PPE. PPE must be provided to all staff performing disinfection prior to performing duties. Cleaning and disinfecting measures can be divided into two main actions: routine or daily actions, and enhanced actions implemented following notification of an ill person or a confirmed COVID-19 case.

Protocol for routine or daily actions

Given the highly infectious properties of COVID-19, contagious nature of even asymptomatic persons, and exponential rise of cases in recent weeks, routine cleaning and disinfection of frequent touchpoints is recommended. The following steps provide a basic framework for daily actions: 

  1. Disinfection staff shall don appropriate PPE prior to working on disinfection projects. At a minimum, this should include N-95 respirators, safety glasses, and gloves (latex or nitrile).
  2. Determine areas to be disinfected and cordon off using signs and physical barriers such as caution banner tape, safety cones, etc.  
  3. Using an EPA-approved disinfection product, wipe all horizontal surfaces reasonably touched by all persons in the facility (see Universal Precautions above). This is usually from head height down to the floor. Follow manufacturers’ directions and allow to air dry for at least 30 minutes. Disinfection product may be applied using pump spray bottles or lightly wetted clean cloths.
  4. Wipe down PPE (safety glasses, respirators, etc.), dry, and store appropriately. Place used applicators, wipes, cloths, and gloves into plastic trash bags, seal well, and dispose in normal trash.

Enhanced protocol for confirmed COVID-19 cases

The following enhanced disinfection actions are recommended only after notification of a confirmed COVID-19 case in the workplace. Most likely a long time period will have passed between the time the confirmed COVID-19 positive individual would have been in the area and management personnel became aware of the individual’s COVID-19 status. Therefore, in most cases, disinfection should begin immediately upon receipt of notice. It is also recommended to close off all areas suspected to have been contaminated by the affected individual(s) prior to beginning the disinfection process.

Staff assigned disinfection work should clean and disinfect all areas (e.g., offices, bathrooms, and common areas) used by the confirmed COVID-19 case, focusing especially on frequently touched surfaces.   Use only EPA-approved disinfecting agents following manufacturer’s label directions. The EPA list is given in the reference section below4.

  1. Identify all employees having close contact (within six feet) of the ill customer and instruct them to return home and self-quarantine for 14 days.
  2. Disinfection staff shall don appropriate PPE prior to working on disinfection projects. At a minimum this should include N-95 respirators, safety glasses, and gloves (latex or nitrile).
  3. Determine as close as possible, all paths traveled and areas visited or used by the ill person during their time in the facility and cordon off using signs and physical barriers such as caution banner tape, safety cones etc.
  4. Using an EPA-approved disinfection product, wipe all horizontal surfaces reasonably touched by all persons in the facility (see Universal Precautions above). This is usually from head height down to the floor. Follow manufacturers’ directions and allow to air dry for at least 30 minutes. Disinfection product may be applied using pump spray bottles or lightly wetted clean cloths.
  5. Wipe down PPE (safety glasses, respirators, etc.), dry, and store appropriately. Place used applicators, wipes, cloths, and gloves into plastic trash bags, seal well, and dispose in normal trash.

Depending on the length of time in the facility and the areas traversed by the confirmed COVID-19 case, consideration may be given to using a professional cleaning/disinfection service and extreme measures such as ozonation, UV disinfection, and/or ULV fogging. 

Stay safe.

References:

  1. Interim US Guidance for Risk Assessment and Public Health Management of Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposures: Geographic Risk and Contacts of Laboratory-confirmed Cases, Centers for Disease Control and Prevention, Atlanta, GA. March 7, 2020 https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html
  2. Guidance on Preparing Workplaces for COVID-19, US Department of Labor, Occupation Safety and Health Administration. OSHA 3990-03 2020. March 2020
  3. Environmental Cleaning and Disinfection Recommendations, Centers for Disease Control and Prevention, Atlanta, GA. March 7, 2020 https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning-disinfection.html
  4. EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2, the Cause of COVID-19, US Environmental Protection Agency. Washington, D.C.  March 3, 2020. https://www.epa.gov/sites/production/files/2020-03/documents/sars-cov-2-list_03-03-2020.pdf