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Final Clearance Measures

As our government takes the beginning steps of loosening social distancing restrictions in an effort to reopen the economy, we each have a responsibility to implement, and adhere to, safe and practical standards.

The Opening Up America Again plan released by the federal government, depends on leaders at all levels to make smart choices for the health and prosperity of their employees and businesses. In accordance with these guidelines, stages of reopening should and will look different from area to area. Each state is encouraged to meet certain criteria for reopening, and just as the outbreak of COVID-19 has been different from Wyoming to New York, so will the timeline for reopening.

State and local officials may need to tailor the application of these criteria to local circumstances (e.g., metropolitan areas that have suffered severe COVID outbreaks, rural and suburban areas where outbreaks have not occurred or have been mild). Additionally, where appropriate, Governors should work on a regional basis to satisfy these criteria and to progress through the phases” ~excerpt; Opening Up America Again whitehouse.gov

In our previous blog, we addressed preparation steps for returning to business. These steps include: creating policies for social distancing, hand hygiene, how to handle sick personnel, and use of protective wear such as face masks.

As your area reopens, having a clear plan and steady implementation at each step will be an asset to your employees and business for getting back on track. You may wish to consider taking time for staff education, both for new policies as well as for the best practices for maintaining a safe and healthy working environment. Implementing a clear and consistent company policy based on factual information can also positively benefit employee morale and customer confidence. At a time when many people are feeling uncertainty, clear leadership policies and implementation can provide structure and security for moving forward.

With rather broad national guidelines it may be hard to see how your specific workplace and workforce fit in and what precautionary steps you should take. Here are some final clearance measures to consider;

1) Know Where to Go for Information

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Know where to look for information.

As a leader of your business or in your community, you should familiarize yourself with local regulations while keeping abreast of the larger picture surrounding or influencing your area. Basing policies by the local region or state allows for a closer response to the situation at hand, however as we live in an interconnected world, we cannot ever fully view one part without the whole. Reopening will look different for each community based on factors such as location, population density, and case numbers. Familiarize yourself with both local and national sources for this data and look to these numbers for guidance in any company policy change.

For state information:
https://www.cnn.com/interactive/2020/us/states-reopen-coronavirus-trnd/

https://www.nytimes.com/interactive/2020/us/states-reopen-map-coronavirus.html

For a timeline by state and region:
https://www.npr.org/2020/03/12/815200313/what-governors-are-doing-to-tackle-spreading-coronavirus

2) Start With a Clean Slate

By now most of us have seen some version of data on how long Coronavirus lives on a surface. These numbers may lead to the false conclusion that after an amount of time has passed there is no longer need for concern. While this may be true in a laboratory setting without other influences, in the real world there are numerous factors which can aid the survival of unwanted pathogens. A lack of cleanliness, or even improperly applied cleaning products, can lead to buildup which creates a perfect environment for hosting germs. Additionally, if your workplace has been unoccupied for any length of time, coronavirus may not be the only pathogen to be concerned about; stagnant water or humid conditions can be a breeding ground for mold or bacteria such as legionella.

https://www.cdc.gov/coronavirus/2019-ncov/php/building-water-system.html

https://wusfnews.wusf.usf.edu/post/health-officials-warn-about-legionnaires-disease-state-reopens

Methods used to prepare the workplace should take into consideration any possible health risks. Readiness may require some attention to detail and education on what methods are being employed. Many people use the terms “cleaning”, “disinfecting” as if they are interchangeable. The truth is each one of these terms describes a level or method, and each has a use either alone or in combination for achieving the goals of your facility. The CDC has specific definitions for each of these terms:

Cleaning:

The physical removal of foreign material (e.g., dust, soil) and organic material (e.g., blood, secretions, excretions, microorganisms). Cleaning physically removes rather than kills microorganisms. It is accomplished with water, detergents, and mechanical action.

Disinfection:

A thermal or chemical process for inactivating microorganisms on inanimate objects.

These and other definitions can be found at:
https://www.cdc.gov/hai/prevent/resource-limited/definitions.html#anchor_1585234497534

Moreover, the CDC recommends that dirty surfaces be cleaned with soap and water before disinfecting them. https://www.cdc.gov/coronavirus/2019-ncov/community/general-business-faq.html

Pyramid of the Difference Between Cleaning, Disinfecting, & Sterilizing

Understanding the Difference between Cleaning, Disinfecting, & Sterilizing

As you can see, cleaning and disinfecting are different processes, each with their own goal. Knowing the difference between the two is only part of the information. It is also important to know what you are using to accomplish this goal. When looking at products, be careful not to be fooled by clever marketing. Look on the label for the type of chemical which is doing the work and whether it is effective enough to achieve your goals. Once you’ve decided what to use, how you use it is also important. Staff responsible for environmental cleaning need to make sure products are being used properly: Do they need measured diluting? Are there possible material interactions? Are they being left on a surface long enough to work? A little label reading can go a long way towards effective use.

As a leader, you should know HOW your facility is being cared for, by WHOM, and using WHAT product(s).

Lastly, be sure that no part of your facility goes unnoticed. Your staff may not occupy a space such as the HVAC ducting, but the airflow of that ducting affects the whole work area. Know who is responsible for these types of areas as that responsibility may differ depending on if you own or rent your facility. No matter whose responsibility, aeration systems should be considered as important spaces to include in your decontamination process.

Most likely your cleaning and disinfecting process will have multiple elements. For many workplaces it may be impossible or improbable to physically touch every surface for disinfection. Materials such as carpet, curtains, couches, and porous materials can present a challenge. In these instances, consider utilizing a no-touch disinfection system. Consider proper disinfection, as well as cleaning, to be a part of your workplace’s routine cycle.

3) Conduct an Assessment of Your Workplace

Once your space is safe for re-occupancy, it is time to take a critical look to identify areas where improvements can be made. The CDC tells us that employers are responsible for providing a safe and healthy workplace. In doing this, there are many elements to consider. In addition to safety measures, such as social distancing and using protective gear, take time to think critically about what your workplace physically looks like. Assess the floor plan or workstations of employees, looking for possible points of exposure and ways to minimize this risk. As we understand COVID-19 to be most contagious in airborne droplet particles or aerosols, take a critical look at your floor plan and the airflow of your workspace.

Airflow is understood to influence how a virus is able to spread from an infected person to coworkers downwind of them. Unfortunately, common open office plans can exacerbate this potential spread, as there are fewer obstacles to stop the spread of aerosol particles. Increasing airflow and creating a downward trajectory can help improve indoor air quality. If altering the building’s airflow is an impossible task, look for ways to adjust the floor plan or seating arrangements to enhance space between individuals and remove them from each other’s airflow.

 

ashrae.org/file%20library/about/position%20documents/pd_infectiousaerosols_2020.pdf

Case of outbreak associated with airflow:
https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

Aerosol transmission 3D
https://www.nytimes.com/interactive/2020/04/14/science/coronavirus-transmission-cough-6-feet-ar-ul.html

https://www.theverge.com/2020/5/7/21249496/building-ventilation-design-health-humidity-cost

Be sure to include all office spaces in your assessment. Break rooms, conference rooms or any gathering places should all be reviewed, and clear policies should be set in place.

It is important to review factors such as the layout of the break room, how many employees are in the facility at one time, and whether staff can eat in their individual offices, if they have one. Breaks can be staggered to avoid too many people in the room at one time and the setup rearranged to allow staff to “mingle” but at a safe distance. It is very important for the staff to enjoy their well-earned breaks and have some unmasked time with each other. However, maintaining distance is imperative and a well thought out plan is important.  https://www.iccs-home.com/covid19-perioperative-infection-prevention-and-safety-11-faqs

When ready, the government recommends returning employees to work in phases, allowing for some to work-from-home to continue in an effort to avoid the possibility of exposure of your entire workforce at one time. However, for industries who require the workforce to be present, it is important to include in your assessment how interaction with your customers takes place and ways to minimize these exposure risks. Any employee who shows symptoms of being ill should be encouraged to stay home, work from home, or at minimum wear a mask to prevent spreading germs to additional members of the workforce.

https://www.cdcfoundation.org/pr/2015/worker-illness-and-injury-costs-us-employers-225-billion-annually

4) Create a Plan

The negative aspects you, your employees, and your company may have experienced during this time can be used to plan in a positive manner for the future. Be mindful to use this experience to create a plan for future outbreaks while the lessons of this one are fresh in mind. If your business was one that worked from home, what were the best and worst parts of this? If possible, establish a framework both for individuals and the whole company to enable a continuation of workflow should there be disruptions to business in the future. Include in this plan the ability to enable workers needing to isolate to work from home or even for whole team to do so should this become necessary. The CDC recommends that

Employers that do not currently offer sick leave to some or all of their employees may want to draft non-punitive “emergency sick leave” policies. Ensure that sick leave policies are flexible and consistent with public health guidance and that employees are aware of and understand these policies.https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

As stated in the government plan, the worst case calls for scaling back openings and restarting phases as necessary. While we all hope to not face increased or reinstated restrictions, planning for the worst can be in your best interest. Businesses that are well prepared to prevent, and react as needed, to infection, will be influential as we all move forward. The steps you take now are important to your health and well-being, and that of your employees and the larger community with which you do business. Creating and implementing company specific guidance for each stage of reopening will help your company put its best foot forward while getting back to business.

-CURIS System Biologist

Resources:

Whole-space Decontamination: CURIS system achieves a 99.9999% kill of C. diff spores in a tri-part soil load. https://www.curissystem.com

Federal Government Guidelines:
https://www.whitehouse.gov/openingamerica/

https://context-cdn.washingtonpost.com/notes/prod/default/documents/f99f42b3-55c4-4613-9f9c-3ac174f10a4b/note/1a8a55a6-68f9-4b76-8e02-01779290c1a5.#page=1

for state by state reopening status:
https://www.cnn.com/interactive/2020/us/states-reopen-coronavirus-trnd/

for a more detailed look and timeline:
https://www.npr.org/2020/03/12/815200313/what-governors-are-doing-to-tackle-spreading-coronavirus

For guidance on Mitigation Strategies:
https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf

CDC Reopening Guidance
https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

Baron, Paul. “Generation and Behavior of Airborne Particles.” CDC.gov/NIOSH, www.cdc.gov/niosh/topics/aerosols/pdfs/aerosol_101.pdf.

 

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