Safety

Educate employees about steps they can take to protect themselves at work and at home. Encourage employees to follow any new policies or procedures related to illness, cleaning and disinfecting, and work meetings and travel.

Checklist: Training to Employees

Check that employees were taught to:

Stay home if they are sick, except to get medical care, and what to do if they are sick.

Inform their supervisor if they have a sick family member at home with COVID-19 and what to do if someone in their home is sick.

Wash their hands often with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol if soap and water are not available. Inform employees that if their hands are visibly dirty, they should use soap and water over hand sanitizer.

Key times for employees to clean their hands include:

Before and after work shifts

Before and after work breaks

After blowing their nose, coughing, or sneezing

After using the restroom

Before eating or preparing food

After putting on, touching, or removing cloth face coverings

Avoid touching their eyes, nose, and mouth with unwashed hands

Cover their mouth and nose with a tissue when they cough or sneeze or use the inside of their elbow. Throw used tissues into no-touch trash cans and immediately wash hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer containing at least 60% alcohol. Learn more about coughing and sneezing etiquette on the CDC website.

Practice routine cleaning and disinfection of frequently touched objects and surfaces such as workstations, keyboards, telephones, handrails, and doorknobs. Dirty surfaces can be cleaned with soap and water prior to disinfection. To disinfect, use products that meet EPA’s criteria for use against SARSCoV-2, the cause of COVID-19, and are appropriate for the surface.

Avoid using other employees’ phones, desks, offices, or other work tools and equipment when possible. Clean and disinfect them before and after use.

Practice social distancing by avoiding large gatherings and maintaining distance (at least 6 feet) from others when possible.

Items to Provide

Give employees, customers, and visitors what they need to clean their hands and cover their coughs and sneezes.

Provide tissues and no-touch trash cans.

Provide soap and water in the workplace. If soap and water are not readily available, use alcohol-based hand sanitizer that is at least 60% alcohol. Ensure that adequate supplies are maintained.

Ideally, place touchless hand sanitizer stations in multiple locations to encourage hand hygiene.

Discourage handshaking. Encourage employees to use other noncontact methods of greeting.

Direct employees to visit CDC’s coughing and sneezing etiquette and clean hands webpage for more information.

Place posters that encourage hand hygiene to help stop the spread at the entrance to your workplace and in other workplace areas where they are likely to be seen. This should include signs for non-English speakers, as needed. See link below for posters.

www.cdc.gov/coronavirus/2019-ncov/communication/print-resources.html?Sort=Date%3A%3Ades

Perform Routine Cleaning

Follow the Guidance for Cleaning and Disinfecting to develop, implement, and maintain a plan to perform regular cleanings to reduce the risk of exposure to COVID-19.

www.cdc.gov/coronavirus/2019-ncov/community/ reopen-guidance.htm

Routinely clean all frequently touched surfaces in the workplace, such as workstations, keyboards, telephones, handrails, and doorknobs.

If surfaces are dirty, clean them using a detergent or soap and water before you disinfect them.

For disinfection, most common, EPA-registered, household disinfectants should be effective. A list of products that are EPA-approved for use against the virus that causes COVID-19 is available on the EPA website. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method, and contact time).

Discourage workers from using each other’s phones, desks, offices, or other work tools and equipment, when possible.

Provide disposable disinfecting wipes so that employees can wipe down commonly used surfaces (e.g., doorknobs, keyboards, remote controls, desks, and other work tools and equipment) before each use.

Store and use disinfectants in a responsible and appropriate manner according to the label.

Many products recommend:

Keeping surface wet for a period of time (see product label).

Precautions such as wearing gloves and making sure you have good ventilation during use of the product.

Tip: Diluted household bleach solutions may also be used if appropriate for the surface. Check the label to see if your bleach is intended for disinfection, and ensure the product is not past its expiration date. Some bleaches, such as those designed for safe use on colored clothing or for whitening, may not be suitable for disinfection.

Unexpired household bleach will be effective against coronaviruses when properly diluted.

Follow manufacturer’s instructions for application and proper ventilation. Never mix household bleach with ammonia or any other cleaners. Leave solution on the surface for at least 1 minute.

For soft surfaces such as carpeted floor, rugs, and drapes:

Clean the surface using soap and water or with cleaners appropriate for use on these surfaces.

Launder items (if possible) according to the manufacturer’s instructions.

Use the warmest appropriate water setting and dry items completely.

OR

Disinfect with an EPA-registered household disinfectant. These disinfectants meet EPA’s criteria for use against COVID-19.

Vacuum as usual.

For electronics such as tablets, touch screens, keyboards, remote controls, and ATMs:

Consider putting a wipeable cover on electronics.

Follow manufacturer’s instruction for cleaning and disinfecting.

If no guidance, use alcohol-based wipes or sprays containing at least 70% alcohol. Dry surface thoroughly.

For clothing, towels, linens, and other items:

Launder items according to the manufacturer’s instructions. Use the warmest appropriate water setting and dry items completely.

Wear disposable gloves when handling dirty laundry from a person who is sick.

Dirty laundry from a person who is sick can be washed with other people’s items.

Do not shake dirty laundry.

Clean and disinfect clothes hampers according to guidance above for surfaces.

Remove gloves and wash hands right away.

Cleaning and disinfecting your building or facility if someone is sick

Close off areas used by the person who is sick.

Companies do not necessarily need to close operations if they can close off affected areas.

Open outside doors and windows to increase air circulation in the area.

Wait 24 hours before you clean or disinfect. If 24 hours is not feasible, wait as long as possible.

Clean and disinfect all areas used by the person who is sick, such as offices, bathrooms, common areas, shared electronic equipment like tablets, touch screens, keyboards, remote controls, and ATMs.

Vacuum the space if needed. Use vacuum equipped with high-efficiency particular air (HEPA) filter, if available.

Do not vacuum a room or space that has people in it. Wait until the room or space is empty to vacuum, such as at night, for common spaces, or during the day for private rooms.

Consider temporarily turning off room fans and the central HVAC system that services the room or space, so that particles that escape from vacuuming will not circulate throughout the facility.

Once area has been appropriately disinfected, it can be opened for use.

Workers without close contact with the person who is sick can return to work immediately after disinfection.

If more than 7 days since the person who is sick visited or used the facility, additional cleaning and disinfection is not necessary.

Continue routing cleaning and disinfection. This includes everyday practices that businesses and communities normally use to maintain a healthy environment.

Cleaning and disinfecting outdoor areas

Outdoor areas, like playgrounds in schools and parks generally require normal routine cleaning but do not require disinfection.

Do not spray disinfectant on outdoor playgrounds—it is not an efficient use of supplies and is not proven to reduce risk of COVID-19 to the public.

High-touch surfaces made of plastic or metal, such as grab bars and railings, should be cleaned routinely.

Cleaning and disinfection of wooden surfaces (play structures, benches, tables) or groundcovers (mulch, sand) is not recommended.

Sidewalks and roads should not be disinfected.

Spread of COVID-19 from these surfaces is very low and disinfection is not effective.

Regular cleaning staff can clean and disinfect community spaces.

Ensure they are trained on appropriate use of cleaning and disinfection chemicals.

Wear disposable gloves and gowns for all tasks in the cleaning process, including handling trash.

Additional personal protective equipment (PPE) might be required based on the cleaning/ disinfectant products being used and whether there is a risk of splash.

Gloves and gowns should be removed carefully to avoid contamination of the wearer and the surrounding area.

Wash your hands often with soap and water for 20 seconds.

Always wash immediately after removing gloves and after contact with a person who is sick.

Hand sanitizer: If soap and water are not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains at least 60% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water.

Checklist: Equipping Employees With PPE

Identify where and how workers might be exposed to COVID-19 at work. Conduct a thorough hazard assessment to determine if workplace hazards are present, or are likely to be present, and determine what type of controls or PPE are needed for specific job duties.

When engineering and administrative controls cannot be implemented or are not fully protective, employers are required by OSHA standards to:

Determine what PPE is needed for their workers’ specific job duties,

Select and provide appropriate PPE to the workers at no cost, and

Train their workers on its correct use.

Encourage workers to wear a cloth face covering at work if the hazard assessment has determined that they do not require PPE, such as a respirator or medical facemask for protection.

CDC recommends wearing a cloth face covering as a measure to contain the wearer’s respiratory droplets and help protect their co-workers and members of the general public.

Cloth face coverings are not considered PPE. They may prevent workers, including those who don’t know they have the virus, from spreading it to others but may not protect the wearers from exposure to the virus that causes COVID-19.

Note: See the OSHA COVID-19 webpage for more information on how to protect workers from potential COVID-19 exposures and guidance for employers, including steps to take for jobs according to exposure risk.

Related Links:

www.osha.gov/SLTC/covid-19/

www.cdc.gov/coronavirus/2019-ncov/preventgetting-sick/how-covid-spreads.html

COVID-19 Procedure: Protocol for Donning and Removing PPE

1. Refer to related tables or graphics

COVID-19 Procedures: Donning PPE

Source: Handbook of COVID-19 Prevention and Treatment (2020) produced by The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU)

COVID-19 Procedures: Removing PPE

Source: Handbook of COVID-19 Prevention and Treatment (2020) produced by The First Affiliated Hospital, Zhejiang University School of Medicine (FAHZU)

2. Enter checklist details:

Who is responsible to implement?

Who is responsible to review?

3. Protocol for Donning PPE:

Put on special work clothes and work shoes

Wash hands

Put on disposable surgical cap

Put on medical protective mask (N95)

Put on inner disposable nitrite/latex gloves

Put on goggles and protective clothing

Put on outer disposable latex gloves

4. Protocol for Removing PPE:

Wash hands and remove visible bodily fluids

Replace outer gloves with new gloves

Remove respirator or full-face mask

Wash hands

Remove disposable gowns along with outer gloves (if used)

Wash hands and remove protective clothing

Wash hands and remove goggles

Wash hands and remove mask

Wash hands and remove cap

Wash hands and remove inner disposable latex gloves

Wash hands

Related Checklists:

COVID-19 Procedure: Isolation Area Management

COVID-19 Procedure: Disinfection Procedures for COVID-19 Isolation Ward Area

COVID-19 Procedure: Lung Transplantation Pretransplantation Assessment

COVID-19 Procedure: Nursing Care During Treatment (ALSS)

COVID-19 Procedure: Protocol for Donning and Removing PPE

COVID-19 Procedure: Staff Management (Workflow and Health)

COVID-19 Procedure: Daily Management and Monitoring of ECMO Audit

COVID-19 Procedure: Digital Support for Epidemic Prevention and Control

COVID-19 Procedure: Discharge Standards and Follow-Up Plan for COVID-19 Patients

COVID-19 Procedure: Disinfection of COVID-19 Related Reusable Medical Devices

COVID-19 Procedure: Disinfection Procedures for Infectious Fabrics of Suspected or Confirmed Patients

COVID-19 Procedure: Disposal Procedures for COVID-19 Related Medical Waste

COVID-19 Procedure: Disposal Procedures for Spills of COVID-19 Patient Blood/Fluids

COVID-19 Procedure: Procedures for Handling Bodies of Deceased Suspected or Confirmed Patients

COVID-19 Procedure: Procedures for Taking Remedial Actions Against Occupational Exposure to COVID-19

COVID-19 Procedure: Surgical Operations for Suspected or Confirmed Patients

Safety: Visitor Policy and Social Distancing

During these difficult times, visitors/vendors/ customers understand and expect that your business will be operating differently. However, they still expect transparency and timely updates as you establish a path forward. Follow these best practices when communicating with customers.

Checklist: Enforcing a Visitor Policy and Social Distancing at the Workplace

Use multiple channels to ensure your message is widely received and reinforced.

Demonstrate that customer interests are a priority and address their concerns directly.

Create and share an FAQ document outlining specific questions around your supply chain, your health and safety practices, and potential risks to your customers if they continue patronage of your business.

Reach out to affected customers and offer assistance where appropriate.

Consider the following when allowing visitors, customers, and vendors into the workplace:

Have all guests’ temperature taken (must be under 100.4).

Have all guests wear a mask.

Ensure all of the below screening question be asked before the guest enters the building. All questions must be answered ‘NO’ in order to pass.

Have you experienced any COVID-19 symptoms (fever, cough, shortness of breath, chills, muscle pain, sore throat, new loss of taste or smell) within the past 14 days?

Have you been in close contact with anyone with a presumed (as defined by a physician) or confirmed case of COVID-19?

Take action if an employee is suspected or confirmed to have COVID-19 infection:

In most cases, you do not need to shut down your facility. If it has been less than 7 days since the sick employee has been in the facility, close off any areas used for prolonged periods of time by the sick person.

Wait 24 hours before cleaning and disinfecting to minimize potential for other employees being exposed to respiratory droplets. If waiting 24 hours is not feasible, wait as long as possible.

During this waiting period, open outside doors and windows to increase air circulation in these areas.

If it has been 7 days or more since the sick employee used the facility, additional cleaning and disinfection is not necessary. Continue routinely cleaning and disinfecting all high-touch surfaces in the facility.

Follow the CDC cleaning and disinfection recommendations: www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning-disinfection. html

Clean dirty surfaces with soap and water before disinfecting them.

To disinfect surfaces, use products that meet EPA criteria for use against SARS-COVID-19 virus that causes COVID-19 and are appropriate for the surface.

Always wear gloves and gowns appropriate for the chemicals being used when you are cleaning and disinfecting.

You may need to wear additional PPE depending on the setting and disinfectant product you are using. For each product you use, consult and follow the manufacturer’s instructions for use.

Determine which employees may have been exposed to the virus and may need to take additional precautions:

Inform employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA) external icon.

Most workplaces should follow the Public Health Recommendations for Community-Related Exposure and instruct potentially exposed employees to stay home for 14 days, telework if possible, and self-monitor for symptoms.

Checklist for Delivering to Patients

Evaluate your business model and determine the best way to effectively deliver goods and services to your clients.

Evaluate your businesses capacity guidelines as to how many customers to allow in the retail lobby at once. Is curbside service an option while your waiting area or showroom remain closed? Will your restrooms be open to visitors?

Ensure your delivery drivers are protected with necessary PPE (see above paragraphs on PPE for more information).

Consider the following alternatives to delivery:

Ship the item using a shipping service and provide education virtually with telemedicine.

For direct deliveries, leave the item on the doorstep and have an in-depth phone conversation with the patient/caregiver explaining universal precautions that will be taking place as well as the education of the equipment.

Give an estimated timeframe for education (time spent in the home).

Safety: Employee Health Monitoring

Asymptomatic Healthcare Workers and Employees

Directions on how to manage and monitor all ASYMPTOMATIC healthcare workers for COVID-19, regardless of exposure in the community or healthcare setting.

Check Employees’ Temperature: All healthcare workers and employees self-monitor by taking their temperature twice daily and assessing for COVID-19- like illness. Signs and symptoms of COVID-19 include:

Fever (temperature greater than 100° Fahrenheit)

Shortness of breath

New onset persistent cough

Nasal congestion and runny nose not associated with seasonal allergies

Sore throat

New loss of taste or smell

OR at least two of these symptoms:

Chills

Muscle pain

Headache

If you have recently traveled, and do not have mandated quarantine restrictions, and have no symptoms of COVID-19, you are able to return to work or school.

Healthcare workers/employees who do not have any COVID-19 symptoms should report to work regardless of known COVID-19 exposure unless they have been instructed by their supervisor/ manager to work from home.

Use This Employee Monitoring Tool to screen employees before they enter a facility.

Staff who are concerned that they may have the COVID-19 virus but have not developed symptoms, may request a nasopharyngeal swab (PCR) test.

Staff are limited to one COVID-19 PCR test every 28 days

Healthcare workers who are antibody positive against SARS CoV-2 (COVID-19) will not qualify for PCR testing unless they develop new symptoms for COVID-19

Staff with previously positive PCR test are not eligible for retesting

The above guidance is subject to change based on local, state, and federal health authority guidelines.

Asymptomatic Healthcare Workers and Employees With Positive PCR Test for COVID-19

If the healthcare worker is asymptomatic but was tested and found to be positive, they must not report to work for at least 10 days after the date of the positive test.

If they develop symptoms during that time, they must not report to work for 10 days after symptom onset and must have been fever-free for at least 72 hours without taking fever reducing medications (e.g., aspirin, acetaminophen, etc.), along with resolving respiratory symptoms.

Symptomatic Healthcare Workers and Employees

If healthcare workers or other employees develop any of the above signs and symptoms, they should not report to work. If any signs and symptoms occur while working, the healthcare worker/employee MUST immediately leave the patient care area and inform their supervisor. Employees that have active COVID-19 symptoms are eligible for the nasopharyngeal swab (PCR test).

PCR testing is indicated when someone has developed acute COVID-19 symptoms:

a. One of the following: Fever [>100° F], cough, shortness of breath or difficulty breathing, sore throat, runny nose not associated with seasonal allergies, new loss of taste or smell,

OR

b. Two of the following: chills, muscle pain, headache

[ Symptomatic employees should NOT enter their local sites and should follow the protocol outlined above. ]

Symptomatic employees should NOT enter their local sites and should follow the protocol outlined above.

If someone has worsening symptoms, such as difficulty breathing, please contact a doctor and/or go to the nearest urgent care center or emergency department for immediate attention.

Personnel are able to return to work 10 days after symptom onset and being consistently afebrile (temperature <100° F) for at least 72 hours without taking fever-reducing medications (e.g., aspirin, acetaminophen), along with resolving respiratory symptoms.

Advice for symptomatic employees

WHAT (you should do)

Rest, staying hydrated, and sleep are typically helpful in your recovery.

Manage and treat your symptoms with fluids and medicines for fevers, cough, and other cold symptoms.

Call your doctor if you start to feel worse (increased congestion, coughing, or fevers).

Seek emergency medical treatment if you have difficulty breathing.

HOW (to wash hands and manage germs)

Clean your hands often. Wash your hands with soap and water for at least 20 seconds. If soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. Soap and water should be used preferentially if hands are visibly dirty.

Avoid touching your eyes, nose, and mouth with unwashed hands.

Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues into a lined trash can. Immediately wash your hands with soap and water or hand sanitizer

Employees and Healthcare Workers With Exposures in the Healthcare Setting

With the COVID-19 pandemic, at this time, contact investigations are not being performed in the hospital. In the event of a reported high-risk exposure (e.g., unprotected contact [> 10 minutes] with a confirmed COVID-19 patient or unprotected contact during an aerosolizing procedure performed on a COVID-19 patient), healthcare workers may report to work as long as they are asymptomatic and will be actively monitored by Environmental Health and Safety (EHS).

These personnel will be required to wear a surgical mask throughout their shift and self-monitor for 14 days by taking their temperature twice daily and assessing for COVID-19-like illness. Temperatures and symptom log must be submitted to EHS electronically. EHS will provide guidance on this process when the incident is reported. Additionally, employees will be eligible for COVID-19 serum antibody testing.

The above guidance is subject to change based on local, state. and federal health authority guidelines.

Notes:

1. Signs and symptoms of COVID -19 include:

Fever (temperature greater than 100° Fahrenheit)

Shortness of breath

New onset persistent cough

Nasal congestion and runny nose not associated with seasonal allergies

Sore throat

New loss of taste or smell

OR at least two of these symptoms:

Chills

Muscle pain

Headache

2. The registration process outlined in Sections 1, 2, 3, and 4 above are the same process. If an individual completed a form as noted in Sections 2 and 3, they are eligible for testing, and they DO NOT need to register a second time for the same exposure.

3. COVID-19 testing is NOT performed at local sites— testing logistics and testing sites will be provided as outlined in the table above.

4. Staff are able to return to work 10 days after symptom onset and being consistently afebrile (temperature < 100° F) for at least 72 hours without taking fever-reducing medications (e.g., aspirin, acetaminophen, etc.), along with resolving respiratory symptoms.

Employees and Healthcare Workers Return to Work

Employees and healthcare workers who are symptomatic and have had a PCR test for COVID-19 who are awaiting test results are required to selfisolate pending those results. If positive, the employee or healthcare workers cannot work for at least 10 days from the onset of symptoms. A person is able to return to work after 10 days of symptom onset, regardless of date of testing, if they have been consistently afebrile (temperature < 100° F) for at least 72 hours without taking fever-reducing medications (e.g., aspirin, acetaminophen, etc.), along with resolving respiratory symptoms. Check your local and state guidelines to verify whether repeat testing is required to return to work.

Employees that have a negative PCR result can volunteer to return to work before the 10 days post symptom onset, as long as they have been afebrile for 72 hours without fever-reducing medications.

EHS MUST clear all personnel before returning to duty; Clearance to return to work is done over the phone, and EHS will call the employee when they are eligible to return to duty.

The above guidance is subject to change based on local, state, and federal health authority guidelines.

References:

Centers for Disease Control and Prevention (CDC), Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19) April 30, 2020:

www.cdc.gov/coronavirus/2019-ncov/hcp/guidancerisk-assesment-hcp.html

www.cdc.gov/coronavirus/2019-ncov/symptomstesting/symptoms.html

www.cdc.gov/coronavirus/2019-ncov/travelers/index. html

www.cdc.gov/coronavirus/2019-ncov/hcp/return-towork.html