Community mitigation strategies are crucial to slowing the transmission of coronavirus disease 2019 (COVID-19), particularly before a vaccine or treatment becomes available.
By Teri Snow, CSP, Snow Advisory, LLC & eDriving’s Brain Trust EHS Advisor
These strategies provide essential protections to individuals at risk of severe illness and to health care and other critical workforces. Preventing a sudden, sharp increase in the number of people infected with COVID-19 will help minimize disruptions to daily life and limit the demand on health care providers and facilities.
These recommended strategies apply at the individual, organizational, and community levels. They apply to businesses, workplaces, schools, community organizations, health care institutions, and individuals of all ages, backgrounds, and health profiles. Everyone has some measure of responsibility to help limit the spread of this disease. Even individuals who are healthy can help prevent the spread of COVID-19 to others.
Recently we all have been preparing for COVID-19 for weeks, and all individuals should continue to take the following basic personal hygiene measures to prevent the spread of the virus:
- Wash your hands often with soap and water or use hand sanitizer (U.S. Centers for Disease Controls and Preventions officially recommends hand sanitizer comprised of at least 60 percent alcohol).
- Avoid touching your eyes, nose, or mouth with unwashed hands.
- Cover your mouth and nose with a tissue when coughing or sneezing.
- Avoid handshakes.
- Avoid contact with people who are sick; and
- Stay home when you are sick.
Together we all must take further action, however. To help avoid a rapid increase of cases, the US Health and Human Services (HHS) recommends implementing now the following community mitigation strategies. Please note, guidance for health care providers is not addressed in this document, but is available at https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/cleaning-disinfection.html
Individuals and Families at Home (Includes Working Remotely):
- Don’t panic! Embrace your anxiety and follow good practice to prevent the spread.
- Think about what you can control – examine your behaviors and adjust where necessary.
- Learn about the signs and symptoms of COVID-19. Symptoms include fever, cough, sore throat, muscle aches, diarrhea, and shortness of breathing.
- If you have respiratory symptoms, STAY HOME. Use services such as Teledoc or call your health care provider in advance of your visit so they can take precautions or simply provide guidance by phone.
- Regularly clean and disinfect frequently touched surfaces, like doorknobs/handles of any kind, keyboards, cell phones, and light switches (keep in mind that metal surfaces tend to hold contaminates less than wood and plastics).
- Communicate and reinforce best practices for washing hands and covering coughs and sneezes.
- Be prepared if there is COVID-19 in your household or a disruption of daily activities in your community. For example, maintain a supply of medications, food, and other essentials in your house. Consider alternative shopping options such as curbside pickups, online deliveries, or shopping at less peak times.
- Access services as much as possible online or by phone.
Individuals at Risk of Severe Illness: These individuals include, but are not limited to, older adults and persons of any age with underlying medical conditions, such as persons with a blood disorder (e.g., a disorder being treated with blood thinners), an endocrine disorder (e.g., diabetes), or a metabolic disorder; those with heart disease, lung disease (including asthma or chronic pulmonary disease), chronic kidney disease, or chronic liver disease; those with a compromised immune system (e.g., those who are receiving treatments such as radiation or chemotherapy, who have received an organ or bone marrow transplant, who are taking high doses of immunosuppressant, or who have HIV or AIDS); those who are currently pregnant or were pregnant in the last two weeks; and those with neurological or neurologic and neurodevelopment conditions.
Everyone should take the following precautions (and especially individuals at risk as defined above):
- Individuals at risk of severe illness should stay at home and keep away from others who are sick. Wash your hands often, particularly after contact with high-touch surfaces. Avoid crowds and closed-in settings with little air ventilation as much as possible. Avoid cruise travel and non-essential air, train, bus travel.
- Regularly clean and disinfect frequently touched surfaces, like steering wheels, doorknobs/handles (i.e., faucets, cabinets, etc.), keyboards, cell phones, remote controls, light switches, stair railings, and workout equipment.
- Don’t share dishes/eating utensils and don’t reuse drinking containers. Sanitize food prep surfaces with food safe sanitizers. Use sanitizing selections on machines such as dishwashers, washing machines, etc.
- Don’t share or reuse towels in the kitchen and bathrooms. Don’t share soap dispensers or consider cleaning between use.
- In households with individuals at risk of severe illness, provide a protected space for those individuals and have healthy people conduct themselves as if they were a significant risk to those individuals. For example, healthy people should wash their hands before feeding or caring for an at-risk individual.
- Have a plan for if you get sick, including staying in touch with others by phone or email.
- Watch for symptoms and emergency warning signs that require immediate medical attention.
- It is recommended to close off areas used by the ill person(s) and wait, if practical, before beginning cleaning and disinfection to minimize potential for exposure to respiratory droplets. Open outside doors and windows to increase air circulation in the area. If possible, wait up to 24 hours before beginning cleaning and disinfection.
- Family members and caregivers can support older adults by knowing what medications they are taking and ensuring there is an extra supply on hand.
- Family members and caregivers can support older adults by monitoring food and other necessary medical supplies (e.g., oxygen, incontinence, dialysis, and wound care supplies) and by creating a back-up plan for securing those essentials if they run out.
- Family members who visit health care facilities, nursing homes or assisted living facilities should be particularly mindful of hygiene practices entering these facilities and after leaving the facilities to ensure they are limiting the possibilities of unknowingly spreading germs.
- If caring for an individual living in a care facility, monitor the situation, ask about the health of the other residents frequently, and know the protocol if there is an outbreak. Check to see how the facility will implement social distancing measures, such as reducing large gatherings, altering meal schedules to reduce mixing, and limiting programs with external staff.
- Cancel or postpone attending large gatherings, conferences, and sporting events (e.g., greater than 100 people in a shared space).
- Consider tele-learning opportunities, as feasible.
- Communicate and reinforce best practices for washing hands and covering coughs and sneezes.
Workplaces (Including Fleet Drivers):
- Encourage employees to stay home when sick and to notify supervisors of illness.
- Consider providing alternative transportation options (such as personal car versus leased vehicle) as many sales drivers may wish to use their own personal vehicles during this period.
- Remind drivers that even if they are using a personal vehicle instead of a fleet vehicle they’re still required to drive safely and follow company policy.
- If driving long distances, watch out for fatigue!
- Communicate and reinforce best practices for washing hands, and covering coughs and sneezes.
- Regularly clean and disinfect frequently touched surfaces, like doorknobs, keyboards, phones, light switches, copy machines, printers, remote controls, material handling equipment, breakrooms, restrooms and shared workspaces and vehicles.
- Ensure hand hygiene and cleaning supplies are readily accessible throughout the workplace including in vehicles and in remote situations. Have touchless hand sanitizers installed.
- Encourage staff to tele-work when feasible, particularly individuals at risk of severe illness.
- Implement social distancing measures, as feasible, including limiting in-person meetings. Challenge staff to find ways to perform work activities by connecting virtually as much as possible.
- Limit large work-related gatherings (e.g., staff meetings and after-work functions).
- Carry disinfectant wipes and other cleaning supplies and use after visiting any public facility.
- Cancel or postpone large gatherings, conferences, and sporting events (e.g., greater than 100 people in a shared space).
- Discourage employees from eating meals in a large group setting, such as a cafeteria, breakroom, or crowded restaurants.
- Tailor continuity of operation plans to the COVID-19 threat.
There is much to learn about the novel coronavirus that causes coronavirus disease 2019 (COVID-19). Based on what is currently known about the virus, spread from person-to-person happens most frequently among close contacts (within about 6 feet). This type of transmission occurs via respiratory droplets. Transmission of novel coronavirus to persons from surfaces contaminated with the virus has not been documented. Transmission of coronavirus in general occurs much more commonly through respiratory droplets than through objects or materials that are likely to carry infection.
Current evidence suggests that novel coronavirus may remain viable for hours to days on surfaces made from a variety of materials. Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19 and other viral respiratory illnesses in community settings.
This guidance provides recommendations on the cleaning and disinfection of rooms or areas that those with suspected or with confirmed COVID-19 have visited. It is aimed at limiting the survival of novel coronavirus in key environments.
How to Clean and Disinfect Surfaces
- If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection.
- For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.
- Diluted household bleach solutions can be used, if appropriate, for the surface. Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.
- Prepare a bleach solution by mixing:
- 5 tablespoons (1/3rdcup) bleach per gallon of water or
- 4 teaspoons bleach per quart of water
- Products with EPA-approved emerging viral pathogens are expected to be effective against COVID-19 based on data for harder-to-kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
- For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination, if present, and clean with appropriate cleaners indicated for use on these surfaces. After cleaning:
- If the items can be laundered, launder items in accordance with the manufacturer’s instructions using the warmest appropriate water setting for the items and then dry items completely.
- Otherwise, use products with the EPA-approved emerging viral pathogens claims (examples) that are suitable for porous surfaces.
Laundry – Linens, Clothing, and Other Items
- Do not shake dirty laundry to minimize the possibility of dispersing virus through the air.
- Wash items, as appropriate, in accordance with the manufacturer’s instructions. If possible, launder items using the warmest water setting for the items and dry items completely. Dirty laundry that has been in contact with an ill person can be washed with other people’s items.
- Clean and disinfect hampers or other carts for transporting laundry according to guidance above for hard or soft surfaces.
Personal Protective Equipment (PPE) and Hand Hygiene:
Persons who are performing cleaning activities should wear disposable gloves and gowns for all tasks in the cleaning process, including handling of trash.
- Gloves and gowns should be compatible with the disinfectant products being used.
- Additional 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. Be sure to clean hands after removing gloves.
- Gloves should be removed after cleaning a room or area occupied by ill persons. Clean hands immediately after gloves are removed.
- Cleaning staff should immediately report breaches in PPE (e.g., tear in gloves) or any potential exposures to their supervisor.
- Cleaning staff and others should clean hands often, including immediately after removing gloves and after contact with an ill person, by washing hands with soap and water for 20 seconds. If soap and water are not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains 60%-95% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water.
- Follow normal preventive actions while at work and home, including cleaning hands and avoiding touching eyes, nose, or mouth with unwashed hands.
- Additional key times to clean hands include:
- After blowing one’s nose, coughing, or sneezing
- After using the restroom
- Before eating or preparing food
- After contact with animals or pets
- Before and after providing routine care for another person who needs assistance (e.g., a child)
- Additional key times to clean hands include:
Additional Considerations for Employers:
- Employers should work with their local and state health departments to ensure appropriate local protocols and guidelines, such as updated/additional guidance for cleaning and disinfection, are followed, including for identification of new potential cases of COVID-19.
- Employers should educate staff and workers performing cleaning, laundry, and trash pick-up activities to recognize the symptoms of COVID-19 and provide instructions on what to do if they develop symptoms within 14 days after their last possible exposure to the virus. At a minimum, any staff should immediately notify their supervisor and the local health department if they develop symptoms of COVID-19. The health department will provide guidance on what actions need to be taken.
- Employers should develop policies for worker protection and provide training to all cleaning staff on site prior to providing cleaning tasks. Training should include when to use PPE, what PPE is necessary, how to properly don (put on), use, and doff (take off) PPE, and how to properly dispose of PPE.
- Employers must ensure workers are trained on the hazards of the cleaning chemicals used in the workplace in accordance with OSHA’s Hazard Communication standard (29 CFR 1910.1200) and Bloodborne Pathogens (29 CFR 1910.1030), including proper disposal of regulated waste, and PPE (29 CFR 1910.132).
About Teri Snow
eDriving’s Brain Trust EHS Advisor Teri Snow, CSP, is the CEO/President of Snow Advisory, LLC. As a Global EHS Leader, she has over 30 years of practical experience supporting multifaceted complex Safety and Health risk reduction strategies and is a recognized technical expert with diverse experience in developing and leading high hazard industrial safety in various industries including, at risk mitigations associated with the implications of health and safety at-risk behaviors both for commercial and general industries.