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Mitigate the Spread of COVID-19

in Office Settingswith Dr. Shannon Magari

July 1, 2020

The views or opinions expressed in this presentation belong solely to the presenter and do not necessarily represent those of Quill Lincolnshire Inc or its affiliates. Quill makes no guarantee regarding the accuracy or reliability of the content. This webinar is for informational purposes only and should not be considered or relied upon as legal advice. Companies are encouraged to consult an attorney for legal advice regarding workplace safety.

ALBANY, NY n ATLANTA, GA n BOSTON, MA n ERIE, PA n NEW YORK, NY n PHILADELPHIA, PA n SYRACUSE, NY

Occupational Health, Safety & Environmental Consultants

Shannon R. Magari, ScD, MS, MPHPrincipal

Vice President, Health Sciences

www.colden.com

COVID-19 Health and Safety

Response

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Coronaviruses (CoV) Family

Common Colds &

Pneumonia

SARS – CoV

(2003)

2019 n – CoV

(2019)

MERS – CoV

(2012)

Quick Fact

“The coronavirus is named after the

crownlike spikes that protrude from its

surface. The virus is enveloped in a

bubble of oily lipid molecules, which

falls apart on contact with soap.”

What is COVID-19?

Corum and Zimmer, The New York Times, How

Coronavirus Hijacks Your Cells, 3/11/2020.

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History – 1918-1919 Flu

The deaths due to the virus were estimated to be about 358 people per 100,000 in St Louis, compared to 748 per 100,000 in Philadelphia during the first six months—the deadliest period—of the pandemic. (National Geographic Reprint)

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Infectivity 1918 vs SARS-CoV-2

R0: Basic Reproduction Number - the average number of

secondary cases produced by one infected person (i.e. how

many people does 1 sick person infect)

• 1918 flu = 1.4-2.8

• SARS-CoV-1 = 0.4-3.5

• SARS-CoV-2 = 1.5 – 5?

• Measles = 12-18

• At R0 = 5.7, >82% of the population must be immune (by vaccine or

prior infection) to achieve herd immunity to stop transmission

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R0 Example

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Routes of Exposure

Inhalation

Large Droplets – Majority of

Transmission

Micronuclei – Smaller Portion

Absorption

Hand to Eyes, Nose, Mouth –

Smaller Portion

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Hazard Control

https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html

Elimination

▪ Remove sick people from the workplace

▪ Screening

▪ Mass vaccination (when available)

Substitution

▪ Vulnerable population restrictions

▪ Someday, maybe - antibody testing to determine which employees have immunity

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Elimination and Substitution

▪ Heating Ventilation and Air Conditioning (HVAC) controls

– More fresh air

– More air changes

– Better filtration

– Ultra violet light

▪ In room HEPA units

▪ Installing sneeze guards at points of sale

▪ Installing physical barriers between people

▪ Touchless surfaces where feasible (e.g. doors, faucets)

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Engineering Controls

▪ Performing proper consistent hand hygiene

▪ Social distancing – maintaining AT LEAST 6 feet between people

▪ Limiting the number of people gathered

▪ Fewer desks in offices, fewer tables in cafeterias

▪ Placing hand sanitizing stations at entrances and throughout facilities

▪ Staggering work shifts to minimize contact between people

▪ Continue with work from home practices

▪ What can we do outside?

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Administrative Controls

Administrative Controls

Surface Survivability

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van Doremalen et al., 2020 Chin et al., 2020

Copper 8 hours

Stainless Steel 3 days 7 days

Wood 2 days

Paper 3 hours

Cardboard 2 days

Glass 4 days

Plastic 3 days 7 days

Cotton Gown 2 days

Surgical Mask (inner layer) 7 days

Surgical Mask (outer layer) >7 days

▪ Cleaning and Disinfecting

Clean ---- Sanitize ---- Disinfect ---- Sterilize

▪ Ensure use of EPA N-List Registered Agents

▪ Note contact times required for effective kills

▪ Day cleaning vs. night cleaning

▪ Who should clean, how often, what surfaces?

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Administrative Controls

▪ Germicidal Ultraviolet Light (UVC) – Pros and Cons

▪ Electrostatic Spraying – Pros and Cons

▪ Hard surfaces vs. soft surfaces

▪ Material compatibilities – what is sustainable

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Administrative Controls

▪ Glove use

– Refer to original Job Safety Analysis PPE matrix

– Few jobs require glove use for COVID 19 protection

– Emphasis should be placed on proper hand hygiene

▪ Work uniforms for most all situation provide sufficient coverage

▪ Consider the need for eye protection if social distancing cannot be

maintained

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Personal Protective Equipment

▪ Face Coverings for EVERYONE!

▪ N95 respirator or equivalent, generally reserved for healthcare

workers

▪ Face shields are NOT a replacement for a close fitting face covering

▪ Non-woven fabrics tend to have better capture than woven fabrics

▪ Policies should note when employees need to wear them and

importantly, when they can take a break

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Personal Protective Equipment

▪ Communication, Communication, Communication!

▪ You cannot overcommunicate at this time.

– What will the new workplace look like?

– What behaviors do you want to support?

– How do you improve compliance?

▪ How will you solicit feedback from employees?

▪ How can you include employees in the decision making?

▪ Look to the elements of Safety Management Systems (OSHA VPP, ISO

45001, etc.)

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Training

▪ Communication, Communication, Communication!

▪ How will employees communicate with each other?

– Verbal

– Non-verbal signals

▪ How will employees communicate with clients and customers?

– Do employees need scripts?

– How far can signage go on its own?

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Do We Need a New Language?

▪ Work from home ergonomics issues

▪ Heat stress and strain issues

– Hydration

▪ Working alone

▪ Working odd hours

▪ Stress and mental health issues

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Collateral EHS Issues

▪ What to test for?

– Virus

– Antigen

– Antibody

▪ Who to test?

▪ How often?

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Testing Strategies

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FAQ: COVID-19 vs. Influenza (Flu)

▪ How are COVID-19 and the flu similar?

• Similar disease presentation; both cause respiratory disease.

• Both presents a wide range of illness from asymptomatic or mild through to

severe disease and death.

• How are COVID-19 and the flu different?

• The flu has a shorter median incubation period (the time from infection to

appearance of symptoms).

• The flu can spread faster than COVID-19; time between successive cases for

COVID-19 is 5 to 6 days, where the flu is 3 days.

• Children are important drivers of influenza virus transmission in the community.

For COVID-19 virus, initial data indicates that children are less affected than

adults.

▪ You need a plan!

▪ Identify close contacts in the workplace,

within 6 feet for 15 minutes or more

▪ Close contacts of positive cases need to

quarantine for 14-days

▪ Work with your Departments of Health

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What to do with a positive case?

▪ You need a plan!

▪ Do you have a general emergency response plan you can adapt for COVID?

▪ How will the sick employee safely get home?

▪ Do they need emergency service?

▪ How will you protect others at work during an incident?

▪ How will you protect those remaining at work after an incident?

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What to do if someone gets sick at work?

▪ You need a plan!

▪ Were they symptomatic or asymptomatic?

▪ Currently Two Strategies

– Testing

– Symptom Based

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How Will Sick Employees be Cleared for Return?

▪ White House Gating Criteria

– https://www.whitehouse.gov/openingamerica/

▪ CDC Gating Criteria

– https://www.cdc.gov/coronavirus/2019-ncov/downloads/php/CDC-Activities-Initiatives-for-COVID-19-Response.pdf

▪ Vetted sources for information, state and local Departments of Health

▪ Benchmarking with not for profits such as:

– https://coronavirus.jhu.edu/data/new-cases

– www.covidexitstrategy.org

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To Open or Close is the Question

▪ www.cdc.gov

▪ www.who.gov

▪ https://www.backtoworksafely.org/

▪ State and Local Departments of Health

▪ www.colden.com

▪ https://www.colden.com/people/shannon-r-magari/

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Resources

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Questions?Submit your questions via the Live event Q&A which is located on the right-side panel.

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Thank You!

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Mitigate the Spread of COVID-19

in Office Settingswith Dr. Shannon Magari

July 1, 2020

The views or opinions expressed in this presentation belong solely to the presenter and do not necessarily represent those of Quill Lincolnshire Inc or its affiliates. Quill makes no guarantee regarding the accuracy or reliability of the content. This webinar is for informational purposes only and should not be considered or relied upon as legal advice. Companies are encouraged to consult an attorney for legal advice regarding workplace safety.