For all the COVID-19 safety guidelines circulating, some hundreds of pages long, basic best practices are straightforward and known by most Americans. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases since 1984, recently recounted them in an interview with the Journal of the American Medical Association.
• Wear a mask consistently and correctly. “We need, as a nation, to show a degree of consistency of everybody” following public-health recommendations on wearing masks or other face coverings, said Dr. Fauci.
“…One of the purposes of the masks is that if you may be inadvertently walking around not knowing you’re infected—(you need to) protect others from getting infected,” Dr. Fauci said.
The goal should be “universal wearing of masks,” Dr. Fauci said.
• Avoid crowds. A major of vector of the surging case counts this summer has been crowded spaces—large house parties or nightspots, for example—where people gather and can easily spread COVID-19.
“You want to stay away from places where people congregate,” he said.
• Stay six feet apart. Wearing masks and avoiding crowds are two keys to stopping COVID-19’s spread, but even smaller gatherings can be a problem if physical distancing of six feet or more isn’t observed.
• Opt for the outdoors. “Outdoor is always better than indoor if you want to do any kind of a function,” Dr. Fauci said.
• Wash your hands. Keeping your hands clean is essential because of how often people touch their faces or rub their eyes, giving virus particles their pathway into the body.
“That sounds really simple. It’s not rocket science, but it can really be effective,” Dr. Fauci said.
Best practices from the field
- Have a plan. Establish, implement and maintain an effective COVID-19 protection plan that is in effect at all times in every unit, service, and operation. Your plan should be in writing; specific to the hazards and corrective measures for the unit, service, or operation, and should be available to all employees. Identify the names or job titles of the person or persons responsible for implementing the plan. Set protocols to ensure supervisory and non-supervisory employees comply with the plan. Substantial compliance with your procedures includes recognition of employees, training and retraining, disciplinary actions, or any other such means to ensure worker compliance.
- Communicate. Develop and implement a system to communicate with your workers regarding the risk of COVID-19 in the workplace, in a form readily understandable by all affected workers. This includes provisions to encourage workers to inform you of COVID-19 risks at the worksite without fear of reprisal. Substantial compliance with communication provisions include meetings, training programs, postings, written communications, a system for anonymous notification by workers about hazards, labor/management committees, or any other means that ensures communication with workers.
- Assess and control risks. Identify and evaluate COVID-19 risks. Review of all COVID-19 cases that have occurred in your facility or operation, active community spread, and level of risk associated with individual work tasks and work environment, including worker exposure to the public. Identifying and mitigating COVID-19 risks should occur when your program is first implemented; whenever you recognize a new COVID-19 risk in the workplace; and whenever governmental agencies issue new information relating to risks in the employer’s workplace. Investigate COVID-19 confirmed cases that result from exposure in the workplace. Address COVID-19 risks in a timely manner based on the severity of the hazard.
- Train. Effective training should be given to your workers on workplace COVID-19 risks workers are reasonably anticipated to encounter in their jobs. You need procedures to obtain the active involvement of workers in developing training curricula and training materials, participating in training sessions, and reviewing and revising the training program. Training material should be used when your program is first established; when new workers are brought onboard; when any employee is given new job assignments for which training has not previously been received; whenever you are aware of a new or previously unrecognized COVID-19 risk in the workplace; and; and supervisors must be trained to familiarize themselves with the COVID-19 hazards to which workers under their immediate direction and control may be exposed.
- Ask questions. Says one expert: “I get literally dozens and dozens of calls and questions every week - basically asking for advice and checking to ensure that what safety and health pros are doing is going in the right direction - lot of questions on masks and respirators and face shields, lot of questions on building/room ventilation, and on social distancing, work schedules, hygiene and so forth.
- Keep current. Says this expert: “The safety and health professionals I know and work with are constantly checking the OSHA and CDC guidelines, trying to attend any seminars and webinars on the subject.”
- Benchmark. Share information. “Most companies do not view safety and health information as a competitive advantage, and unlike other aspects of their businesses, they are open to sharing safety and health procedures, especially during the pandemic,” says Doug Pontsler of the Center of Visual Literacy (COVE).
- Leadership. With many safety and health professionals working from home, the onus is on plant leadership – from top managers to supervisors and operations personnel, to constantly engage the frontline on COVID-19 concerns, compliance, and risk findings.
- Collaborate. Several reports from the field: “EHS professionals and medical professionals for the first time are working closely together.” “Safety may be coordinating with HR more than before.” “EHS and operations are on the same page. Communicating daily.”
- Don’t break up your normal safety rhythms. “I am hearing some organizations have suspended fundamental safety processes over COVID-19 concerns. For example, morning huddles, safety reviews of various types, etc. This is being done in the interest of physical distancing, but may be difficult to reclaim at some point in the future,” says Pontsler.
- Leave no worker behind. Address and confront all questions, complaints and frontline issues. “COVID-19 is polarizing. Some workers have become germophobes while others think it is just a bad flu,” says longtime safety pro Mark Hansen, CSP. “Not surprisingly, there are obvious employee complaints and fears. Some employees do not want to return to work but rather keep working remotely. Use fact-based information, the latest updates, when dealing with your workers. No not speculate. If you don’t know an answer; say so and get back to the worker.”
- Give yourself a break. “All I can say is that most of safety and health professionals with whom I have spoken are overwhelmed,” says Elizabeth Trainor of the Phylmar Group consultancy. Bring balance to your life; find ways to de-stress; realize you cannot have all the answers in this uncharted territory we’re in; there are limits to your expertise and contributions.
Tools are available to walk employers through the process of developing customizable COVID-19 protection plans. There are processes for small and medium-size businesses without dedicated EHS staff on site. Tools using the latest COVID-19 guidelines from CDC, NIOSH, WHO and others use interactive questions and answers to conduct risk assessments by specific location, work groups — and facilities within regions with local guidelines to conform to. Employees are asked (digitally) questions about recent travel, health status and other risk factors.
Low, medium or high-risk ratings result from these surveys, and risk assessment and operation plans are developed. Employers know who at their work sites have COVID-19, who may have been exposed, and work groups at low, medium or high risk. Risk ratings can be reduced due to controls being installed. This is part of essential management of change with EHS staff reviewing and updating plans as work conditions change and new guidelines are published.
One 90-minute training course covers the basics of safe reopening practices for employees, employers, contractors and suppliers. Knowledge checks are inserted throughout the course, as are many videos. The course is not a static reading of text and bullet points. Rather it is interactive, with students supplying answers to questions and getting feedback.
A risk communication course stresses communicating risk information to employees, customers and the local community — and how to communicate honestly and openly. The course has a COVID-19 case study on how to deal with the pandemic, and other risk communication topics, such as what to do if EPA comes knocking. All courses are customizable.
A wealth of tests is on the market, with many more to come. Examples: non-intrusive saliva or nasal swab tests, rapid tests, and home kits using saliva tests. Some consultants work with labs giving 24-hour turnaround on test results. Some also provide telemedicine services for positive cases, with physicians contacting positive cases to give medical instructions.
Technology exists that allow facility staff to upload all employees in the company, with HIPAA-protected information, to a database that physicians can use to contact positive cases. Only names and contact information is accessible. Employees use their smart phones to answer questions about their health status. Symptom-free employees can go to work; at-risk employees either stay home or get tested, depending on their company protocol. Using an online portal, employers can see who can come to work each day, and who can’t, based on symptoms and laboratory “go/no go” test results.
Groundbreaking work is being done on indoor environmental tracing of airborne COVID-19 pathogens to reduce transmission risk. Technology can mimic a viral droplet, with tracers placed throughout facilities with unique DNA identifiers that release aerosol droplets in a manner similar to a sneeze or cough. Droplets are traced circulating airborne through an indoor environment and samples are taken to determine concentration/exposure levels. The result is a heat map for a facility indicating safe areas and hot spots. Tracing can be done for entire facilities or special areas such as rest rooms, conference rooms high-traffic pathways and enclosed spaces with poor ventilation. A heat map can display risk thresholds — high, moderate high, moderate low and low risk. Heat maps can be critical in making business reopening decisions, and monitoring can be done after mitigation efforts to determine their effectiveness.
Air filtration and purification equipment originally designed for high-stakes situations such as patient isolation in healthcare, and asbestos, lead, mold and other toxic exposures in industry, residences and schools has been modified to reduce the airborne viral load of COVID-19 contamination. Some portable machines are equipped with medical-grade 99.999% HEPA filters and UV-C germicidal lights to eliminate sub-micron particulates.
Testing is now being done using these machines in conference rooms and other non-medical indoor environments. Mitigation strategies for now are based on three methods: 1) high-capacity air flow; 2) UV-C continuous irradiation in a sealed chamber so rooms do not need to be emptied out; and 3) High-efficiency HEPA filters to trap particulates while airborne and preventing them from settling on surfaces.
Much more technology and science on what eliminates COVID-19 contamination is coming. Making it all the more important for EHS professionals to stay abreast of new developments, solutions and guidance.