The following is a summary of the guidance put forth by OSHA to properly prepare the workplace for COVID-19.
OSHA has developed this COVID-19 preparation guidance based on traditional infection prevention and industrial hygiene practices. Preparing and planning right now is critical in order to reduce the impact of COVID-19 and substantially lower the number and severity of workplace illnesses.
Here are the steps that you can take to reduce workers’ risk of exposure to SARS-CoV-2 (the virus that causes COVID-19).
Step 1: Know Your Risk To SARS-CoV-2
There are 4 risk exposure levels, including very high, high, medium and low risk. Knowing what your risk level is will allow you to determine which engineering and administrative controls, safe work practices and personal protective equipment must be implemented in your practice. It is more likely your practice will fall under the medium or high-risk jobs. For a complete description of each risk level, review the OSHA Guidance on Preparing Workplaces for COVID-19 document.
Very high exposure risk jobs include healthcare workers performing aerosol-generating procedures on known or suspected COVID-19 patients or collecting or handling specimens from known or suspected COVID-19 patients.
High exposure risk jobs include healthcare delivery and support staff who enter the rooms of known or suspected COVID-19 patients and medical transport workers moving known or suspected COVID-19 patients.
Medium exposure risk jobs include those that require frequent and/or close contact (within 6 feet) with those who are suspected of having COVID-19.
Low exposure risk jobs include those that do not require contact with people known to be or suspected to be infected with SARS-CoV-2.
The next steps are going to be general to all exposure risks, so you may not need to implement some of action items below based on your exposure risk. Be sure to identify your exposure risk first and then figure out what specific action items you must implement.
Step 2: Develop and Infectious Disease Preparedness and Response Plan
If you don’t already have a plan for infectious disease exposure, now is the time to develop one! Your plan should consider and address the level of risk associated with various worksites and job tasks workers perform at those sites. For example, take into consideration where, how and to what sources of SARS-CoV-2 might workers be exposed, non-occupational risk factors at home and in community settings, and workers’ individual risk factors. The most important risk factors to consider include:
Older than 65 years of age
Chronic lung disease
Chronic kidney disease being treated by dialysis
Those who live in nursing homes or other long-term care facilities.
For more information on how to care for those with these risk factors, review the advice put forth by the CDC.
Make sure you stay up-to-date on guidance from federal, state, local, tribal and/or territorial health agencies. Once you are updated on specific guidance’s, implement these into your infectious disease plan. Use the following resources for up-to-date information:
Step 3: Prepare to Implement Basic Infection Prevention Measures
In order to protect workers, basic infection prevention measures must be implemented. These include the following:
Promote frequent and thorough hand-washing with soap and running water for at least 20 seconds. Alternatively, you can use alcohol-based hand rubs containing at least 60% alcohol.
Encourage workers to stay at home if they are sick.
Encourage workers to cover their coughs and sneezes.
Discourage workers from using another workers’ equipment, if possible.
Regular cleaning and disinfecting of surfaces, equipment and other aspects of the work environment. Check out this list of EPA approved disinfectant products that are expected to be effective at killing SARS-CoV-2
Step 4: Develop Policies and Procedures for Quick Identification and Isolation of Sick People
Identifying a sick individual is a critical step in preventing the spread of the virus and protecting your workers and other patients. Educate your workers on the signs and symptoms of COVID-19, and encourage your workers to self-monitor for those signs and symptoms. Here is a resource for COVID-19 signs and symptoms put out by the CDC.
Establish policies and procedures for the following:
How workers should report when they are sick or experiencing symptoms of COVID-19
Immediately isolate anyone who has signs or symptoms of COVID-19. Decide on a designated location or room to isolate potentially sick people. If you suspect someone has COVID-19, provide them with a face mask if they can wear one.
If you can, isolate those suspected of having COVID-19 from those who have been confirmed to have COVID-19.
Protect workers in close contact with a sick person who have prolonged/repeated contact with such persons by the four main types of workplace controls, which include engineering and administrative controls, safe work practices and personal protective equipment.
Four Main Types of Workplace Controls
Engineering controls involves reducing exposure without relying on worker behavior. This can be the most cost-effective solution to implement in your practice. Engineering controls include:
Installing high-efficiency air filters
Installing physical barriers like clear plastic sneeze guards
Specialized negative-pressure ventilation for aerosol-generating procedures, such as intubation, cough-inducing procedures, bronchoscopies, some dental procedures and exams, and any other invasive specimen collection on known or suspected COVID-19 patients.
Administrative controls involve changes in work policy or procedures to reduce exposure to the virus. These include:
Encouraging sick workers to stay home
Implementing more virtual communication for meetings or patient visits (Telehealth)
Providing workers with current education and training on COVID-19 risk factors and protective behaviors.
Safe work practices include the following:
Providing tissues, no-touch trash cans, hand soap, alcohol-based hand rubs containing at least 60% alcohol, EPA-approved disinfectants, disposable towels for employees to clean their work surfaces, hand-washing signs in the bathrooms for employees and patients
Require regular hand-washing or use of alcohol-based hand rubs when the hands are either visibly soiled, after using the bathroom, or after removing personal protective equipment.
Personal protective equipment should not replace the use of engineering controls, administrative controls and safe work practices. Examples of PPE include:
Gloves, face shields, face masks and respiratory protection.
The recommendation of PPE use will be dependent on your location, updated risk assessment for workers, and any updated information on the effectiveness of specific PPE.
For updated information on PPE use, check out www.OSHA.gov/covid-19.
Any employees who are working within 6 feet of patients either confirmed or suspected of being infected with SARS-CoV-2 are required to use respirators, specifically an N95 mask.
If N95 is unavailable, other effective options include R/P95, N/R/P99, or N/R/P100 filtering respirators.
All PPE must be properly fitted, replaced as necessary, and properly removed, cleaned, and stored or disposed of to avoid contamination of yourself, others or the environment. Here is an OSHA training on using respirator devices.