sábado, 16 de mayo de 2020

Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19), May 2020 | CDC

Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19), May 2020 | CDC



Interim Guidance for Businesses and Employers Responding to Coronavirus Disease 2019 (COVID-19), May 2020

Plan, Prepare and Respond to Coronavirus Disease 2019
Older adults and people who have severe underlying chronic medical conditions like heart or lung disease or diabetes seem to be at higher risk for developing more serious complications from COVID-19 illness.
Find more information here.
Summary of Changes to the Guidance:
Below are changes as of May 6, 2020
  • Updated strategies and recommendations for employers responding to COVID-19, including those seeking to resume normal or phased business operations:
    • Conducting daily health checks
    • Conducting a hazard assessment of the workplace
    • Encouraging employees to wear cloth face coverings in the workplace, if appropriate
    • Implementing policies and practices for social distancing in the workplace
    • Improving the building ventilation system
  • A table outlining the engineering controls, administrative controls, and personal protective equipment (PPE) that employers may use to help prevent the spread of COVID-19 in the workplace

Below are changes as of March 21, 2020
  • Updated cleaning and disinfection guidance
  • Updated best practices for conducting social distancing
  • Updated strategies and recommendations that can be implemented now to respond to COVID-19

Purpose

This interim guidance is based on what is currently known about the coronavirus disease 2019 (COVID-19). COVID-19 is a respiratory illness that can spread from person to person. The outbreak first started in China, but the virus continues to spread internationally and in the United States. There is much more to learn about the transmissibility, severity, and other characteristics of COVID-19 and investigations are ongoing. Updates are available on CDC’s web page at https://www.cdc.gov/coronavirus/2019-ncov/. CDC will update this interim guidance as additional information becomes available.
This interim guidance may help prevent workplace exposures to COVID-19 in non-healthcare settings (separate guidance is available for healthcare settings). CDC has also provided guidance for critical infrastructure workers who may have had exposure to a person known or suspected to have COVID-19. Unless otherwise specified, this interim guidance for businesses and employers applies to critical infrastructure workplaces as well.

Role of Businesses and Employers in Responding to COVID-19

Businesses and employers can prevent and slow the spread of COVID-19 within the workplace. Employers should respond in a way that takes into account the level of disease transmission in their communities and revise their business response plans as needed. Employers should follow the White House Guidelines for Opening Up America Againexternal icon, a phased approach based on current levels of transmission and healthcare capacity at the state or local level, as part of resuming business operations. Business operation decisions should be based on both the level of disease transmission in the community and your readiness to protect the safety and health of your employees and customers.
Businesses and employers are encouraged to coordinate with stateexternal icon and localexternal icon health officials to obtain timely and accurate information to inform appropriate responses. Local conditions will influence the decisions that public health officials make regarding community-level strategies. CDC has guidance for mitigation strategiespdf icon according to the level of community transmission or impact of COVID-19.
As an employer, if your business operations were interrupted, resuming normal or phased activities presents an opportunity to update your COVID-19 preparedness, response, and control plans. All employers should implement and update as necessary a plan that:
  • Is specific to your workplace,
  • identifies all areas and job tasks with potential exposures to COVID-19, and
  • includes control measures to eliminate or reduce such exposures.
Talk with your employees about planned changes and seek their input. Additionally, collaborate with employees and unions to effectively communicate important COVID-19 information.
See the OSHA COVID-19 guidancepdf iconexternal icon for more information on how to protect workers from potential exposures, according to their exposure risk. Plans should consider that employees may be able to spread COVID-19 even if they do not show symptoms.
All employers need to consider how best to decrease the spread of COVID-19 and lower the impact in your workplace. This should include activities to:
  • prevent and reduce transmission among employees,
  • maintain healthy business operations, and
  • maintain a healthy work environment.

Prevent and Reduce Transmission Among Employees

Monitor federal, state, and local public health communications about COVID-19 regulations, guidance, and recommendations and ensure that workers have access to that information. Frequently check the CDC COVID-19 website.
Actively encourage sick employees to stay home:
  • Employees who have symptoms should notify their supervisor and stay home.
  • Sick employees should follow CDC-recommended steps. Employees should not return to work until the criteria to discontinue home isolation are met, in consultation with healthcare providers.
  • Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and follow CDC recommended precautions.
Consider conducting daily in-person or virtual health checks (e.g., symptom and/or temperature screening) of employees before they enter the facility, in accordance with state and local public health authorities and, if available, your occupational health services:
  • If implementing in-person health checks, conduct them safely and respectfully. Employers may use social distancing, barrier or partition controls, or personal protective equipment (PPE) to protect the screener. However, reliance on PPE alone is a less effective control and is more difficult to implement, given PPE shortages and training requirements.
  • Complete the health checks in a way that helps maintain social distancing guidelines, such as providing multiple screening entries into the building.
  • Follow guidance from the Equal Employment Opportunity Commissionexternal icon regarding confidentiality of medical records from health checks.
  • To prevent stigma and discrimination in the workplace, make employee health screenings as private as possible. Do not make determinations of risk based on race or country of origin and be sure to maintain confidentiality of each individual’s medical status and history.
Identify where and how workers might be exposed to COVID-19 at work. Employers are responsible for providing a safe and healthy workplaceexternal icon. Conduct a thorough hazard assessmentexternal icon of the workplace to identify potential workplace hazards related to COVID-19. Use appropriate combinations of controls from the hierarchy of controls to limit the spread of COVID-19, including engineering controls, workplace administrative policies, and personal protective equipment (PPE) to protect workers from the identified hazards (see table below):
  • 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.
  • Remind employees and customers that CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain, especially in areas of significant community-based transmission. Wearing a cloth face covering, however, does not replace the need to practice social distancing.
  • See the OSHA COVID-19external icon webpage for more information on how to protect workers from potential COVID-19 exposures and guidance for employerspdf iconexternal icon, including steps to take for jobs according to exposure risk.
Separate sick employees:
  • Employees who appear to have symptoms upon arrival at work or who become sick during the day should immediately be separated from other employees, customers, and visitors, and sent home.
  • Have a procedure in place for the safe transport of an employee who becomes sick while at work. The employee may need to be transported home or to a healthcare provider.
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.
  • Clean dirty surfaces with soap and water before disinfecting them.
  • To disinfect surfaces, use products that meet EPA criteria for use against SARS-Cov-2external icon, the 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:
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.
  • Advise employees to:
  • Stay home if they are sick, except to get medical care, and to learn what to do if they are sick.
  • Inform their supervisor if they have a sick family member at home with COVID-19 and to learn what to do if someone in their home is sick.
  • Wash their hands often with soap and water for at least 20 seconds or to 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 you 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 SARS-CoV-2external icon, 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.
For employees who commute to work using public transportation or ride sharing, consider offering the following support:
  • Offer employees incentives to use forms of transportation that minimize close contact with others, such as offering reimbursement for parking or single-occupancy ride shares.
  • Allow employees to shift their hours so they can commute during less busy times.
  •  Ask employees to clean their hands as soon as possible after their trip.

Maintain Healthy Business Operations

Identify a workplace coordinator who will be responsible for COVID-19 issues and their impact at the workplace.
Implement flexible sick leave and supportive policies and practices:
  • Ensure that sick leave policies are flexible and consistent with public health guidance and that employees are aware of and understand these policies.
  • Maintain flexible policies that permit employees to stay home to care for a sick family member or take care of children due to school and childcare closures. Additional flexibilities might include giving advances on future sick leave and allowing employees to donate sick leave to each other.
  • Employers that do not currently offer sick leave to some or all of their employees should consider drafting non-punitive “emergency sick leave” policies.
  • Employers should not require a COVID-19 test result or a healthcare provider’s note for employees who are sick to validate their illness, qualify for sick leave, or to return to work.
    • Under the American’s with Disabilities Act, employers are permitted to require a doctor’s note from your employeesexternal icon to verify that they are healthy and able to return to work. However, as a practical matter, be aware that healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely manner. Most people with COVID-19 have mild illness and can recover at home without medical care and can follow CDC recommendations to determine when to discontinue home isolation and return to work.
    • The U.S. Equal Employment Opportunity Commission (EEOC) has established guidance regarding Pandemic Preparedness in the Workplace and the Americans with Disabilities Actexternal icon. The guidance enables employers to take steps to protect workers consistent with CDC guidance, including requiring workers to stay home when necessary to address the direct threat of spreading COVID-19 to others.
  • Review human resources policies to make sure that your policies and practices are consistent with public health recommendations and with existing state and federal workplace laws (for more information on employer responsibilities, visit the Department of Labor’sexternal icon and the Equal Employment Opportunity Commission’sexternal icon websites).
  • Connect employees to employee assistance program (EAP) resources, if available, and community resources as needed. Employees may need additional social, behavioral, and other services, for example, to help them manage stress and cope.
Protect employees at higher risk for severe illness through supportive policies and practices. Older adults and people of any age who have serious underlying medical conditions are at higher risk for severe illness from COVID-19.
  • Support and encourage options to telework, if available.
  • Consider offering vulnerable workers duties that minimize their contact with customers and other employees (e.g., restocking shelves rather than working as a cashier), if the worker agrees to this.
  • Offer flexible options such as telework to employees. This will eliminate the need for employees living in higher transmission areas to travel to workplaces in lower transmission areas and vice versa.
  • Ensure that any other businesses and employers sharing the same workspace also follow this guidance.
Communicate supportive workplace polices clearly, frequently, and via multiple methods. Employers may need to communicate with non-English speakers in their preferred languages.
  • Train workers on how implementing any new policies to reduce the spread of COVID-19 may affect existing health and safety practices.
  • Communicate to any contractors or on-site visitors about changes that have been made to help control the spread of COVID-19. Ensure that they have the information and capability to comply with those policies.
  • Create and test communication systems that employees can use to self-report if they are sick and that you can use to notify employees of exposures and closures.
  • Consider using a hotline or another method for employees to voice concerns anonymously.
Assess your essential functions and the reliance that others and the community have on your services or products.
  • Be prepared to change your business practices, if needed, to maintain critical operations (e.g., identify alternative suppliers, prioritize existing customers, or temporarily suspend some of your operations).
  • Identify alternate supply chains for critical goods and services. Some goods and services may be in higher demand or unavailable.
  • If other companies provide your business with contract or temporary employees, talk with them about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
  • Talk with business partners about your response efforts. Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce, and associations to improve community response efforts.
  • When resuming onsite business operations, identify and prioritize job functions for continuous operations. Minimize the number of workers present at worksites by resuming business operations in phases, balancing the need to protect workers with support for continuing operations.
Determine how you will operate if absenteeism spikes from increases in sick employees, those who stay home to care for sick family members, and those who must stay home to watch their children until childcare programs and K-12 schools resume.
  • Plan to monitor and respond to absenteeism at the workplace.
  • Implement plans to continue your essential business functions in case you experience higher-than-usual absenteeism.
  • Prepare to institute flexible workplace and leave policies.
  • Cross-train employees to perform essential functions so the workplace can operate even if key employees are absent.
Establish policies and practices for social distancing. Alter your workspace to help workers and customers maintain social distancing and physically separate employees from each other and from customers, when possible. Here are some strategies that businesses can use:
  • Implement flexible worksites (e.g., telework).
  • Implement flexible work hours (e.g., rotate or stagger shifts to limit the number of employees in the workplace at the same time).
  • Increase physical space between employees at the worksite by modifying the workspace.
  • Increase physical space between employees and customers (e.g., drive-through service, physical barriers such as partitions).
  • Use signs, tape marks, or other visual cues such as decals or colored tape on the floor, placed 6 feet apart, to indicate where to stand when physical barriers are not possible.
  • Implement flexible meeting and travel options (e.g., postpone non-essential meetings or events in accordance with state and local regulations and guidance).
  • Close or limit access to common areas where employees are likely to congregate and interact.
  • Prohibit handshaking.
  • Deliver services remotely (e.g., phone, video, or web).
  • Adjust your business practices to reduce close contact with customers — for example, by providing drive-through service, click-and-collect online shopping, shop-by-phone, curbside pickup, and delivery options, where feasible.
  • Move the electronic payment terminal/credit card reader farther away from the cashier, if possible, to increase the distance between the customer and the cashier.
  • Shift primary stocking activities to off-peak or after hours, when possible, to reduce contact with customers.
If you have more than one business location, consider giving local managers the authority to take appropriate actions outlined in their COVID-19 response plans based on their local conditions.

Maintain a healthy work environment

Since COVID-19 may be spread by those with no symptoms, businesses and employers should evaluate and institute controls according to the hierarchy of controls to protect their employees and members of the general public.
Consider improving the engineering controls using the building ventilation system. This may include some or all of the following activities:
  • Increase ventilation rates.
  • Ensure ventilation systems operate properly and provide acceptable indoor air quality for the current occupancy level for each space.
  • Increase outdoor air ventilation, using caution in highly polluted areas. With a lower occupancy level in the building, this increases the effective dilution ventilation per person.
  • Disable demand-controlled ventilation (DCV).
  • Further open minimum outdoor air dampers (as high as 100%) to reduce or eliminate recirculation. In mild weather, this will not affect thermal comfort or humidity. However, this may be difficult to do in cold or hot weather.
  • Improve central air filtration to the MERV-13 or the highest compatible with the filter rack, and seal edges of the filter to limit bypass.
  • Check filters to ensure they are within service life and appropriately installed.
  • Keep systems running longer hours, 24/7 if possible, to enhance air exchanges in the building space.
Note: Some of the above recommendations are based on the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Guidance for Building Operations During the COVID-19 Pandemicexternal icon. Review these ASHRAE guidelines for further information on ventilation recommendations.
Ensure the safety of your building water system and devices after a prolonged shutdown:
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.
  • 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.
  • 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.
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.
  • 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-19external icon 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, other work tools and equipment) before each use.
  • Store and use disinfectants in a responsible and appropriate manner according to the label.
  • Do not mix bleach or other cleaning and disinfection products together. This can cause fumes that could be very dangerous to breathe in.
  • Advise employees to always wear gloves appropriate for the chemicals being used when they are cleaning and disinfecting and that they may need additional PPE based on the setting and product.
Perform enhanced cleaning and disinfection after persons suspected/confirmed to have COVID-19 have been in the facility:
Limit travel and advise employees if they must travel to take additional precautions and preparations:
  • Minimize non-essential travel and consider resuming non-essential travel in accordance with state and local regulations and guidance.
  • Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country where you will travel. Specific travel information for travelers going to and returning from countries with travel advisories, and information for aircrew, can be found on the CDC website.
  • Advise employees to check themselves for symptoms of COVID-19 before starting travel and to notify their supervisor and stay home if they are sick.
  • Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and promptly call a healthcare provider for advice if needed.
  • If they are outside the United States, sick employees should follow company policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to help them find an appropriate healthcare provider in that country. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, or resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas.
Minimize risk to employees when planning meetings and gatherings:
  • Use videoconferencing or teleconferencing when possible for work-related meetings and gatherings.
  • Cancel, adjust, or postpone large work-related meetings or gatherings that can only occur in-person in accordance with state and local regulations and guidance.
  • When videoconferencing or teleconferencing is not possible, hold meetings in open, well-ventilated spaces continuing to maintain a distance of 6 feet apart and wear cloth face coverings.
The table below presents examples of controls to implement in your workplace. The most effective controls are those that rely on engineering solutions, followed by administrative controls, then PPE. PPE is the least effective control method and the most difficult to implement. Worksites may have to implement multiple complementary controls from these columns to effectively control the hazard.

Employers: Use the table below to implement the most appropriate controls for your workplace

TABLE: Example Controls to Prevent the Spread of COVID-19 in Work Environments
TABLE: Example Controls to Prevent the Spread of COVID-19 in Work Environments
EngineeringAdministrativePersonal Protective Equipment (PPE)
Facilities and Equipment
  • Assess job hazards for feasibility of engineering controls
  • Ensure ventilation and water systems operate properly
  • Alter workspaces to maintain social distancing. Examples include:
    • Configure partitions as a barrier shield
    • Move electronic payment reader away from cashier
    • Use verbal announcements, signage, and visual cues to promote social distancing
    • Remove/rearrange furniture
    • Provide remote shopping alternatives (e.g., delivery, pick-up)
Management and Communications
  • Monitor state and local public health communications about COVID-19
  • Encourage sick workers to report symptoms, stay home, and follow CDC guidance
  • Develop strategies to:
    • manage worker concerns
    • communicate with workers
  • Remind workers of available support services
  • Communicate to partners, suppliers, other contractors on policies and practices
  • Encourage social distancing and the use of cloth face coverings (if appropriate) in the workplace
  • Use technology to promote social distancing (e.g., telework and virtual meetings)
  • Cancel group events
  • Close/limit use of shared spaces
  • Ask customers who are ill to stay home
  • Consider policies that encourage flexible sick leave and alternative work schedules.
  • Schedule stocking during off-peak hours
Cleaning and Disinfection
  • Clean and disinfect frequently touched surfaces, (e.g., counters, shelving, displays)
  • Provide employees with disposable disinfectant wipes, cleaner, or sprays that are effective against the virus that causes COVID-19
Training
Provide employees with training on:
  • Policies to reduce the spread of COVID-19
  • General hygiene
  • Symptoms, what to do if sick
  • Cleaning and disinfection
  • Cloth face covers
  • Social distancing
  • Use of PPE
  • Safe work practices
  • Stress management
PPE
  • Conduct workplace hazard assessment
  • Determine what PPE is needed for their workers’ specific job duties based on hazards and other controls present
  • Select and provide appropriate PPE to the workers at no cost.

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