1.Protecting Yourself from COVID-19 in the Workplace
2.Goal and learning objectives
Goal: Increase health and safety awareness for responders and workers with potential exposure to the SARS-CoV-2 virus that causes COVID-19.
Learning objectives: After attending participants will be able to:
Explain basic facts about SARS-CoV-2 virus.
Explain basic facts about COVID-19 disease.
Assess the risk of workplace exposure to COVID-19.
Define key steps in worker protection and infection prevention and control.
Identify methods to prevent and respond to COVID-19 exposure in the workplace.
This presentation by itself is not sufficient training for personnel who have potential for occupational exposure to the SARS-CoV-2 virus.
Personnel must be trained to their employer’s site-specific policies and procedures. Training must include practice in putting on and taking off PPE and respirators and performing decontamination procedures until competency and confidence can be demonstrated.
4.Information on COVID-19 is rapidly changing, sometimes daily. Refer to reliable sources such as the CDC, OSHA, NIOSH, State Health Departments and peer reviewed science publications.
5.Employer and worker responsibilities
Employers and workers have responsibilities under the OSH Act.
• The Occupational Safety and Health Act requires that employers provide a safe and healthy workplace free of recognized hazards and follow OSHA standards.
• Workers should participate in the development and implementation of the employer’s safety and health policies and help ensure that they are appropriate and implemented.
Speak up! You have a right to file a complaint with OSHA, the state or local health department, the mayor, or the police!
6.Worldwide distribution map
Click the link to see the latest global numbers and numbers by country visit.
7.US distribution map
Click the link to see the current cases in the U.S.
On March 11, 2020, the World Health Organization (WHO) characterized COVID-19 as a pandemic.
It has caused severe illness and death. It features sustained person-to-person spread worldwide.
It poses an especially high risk for the elderly (60 or older), people with preexisting health conditions such as high blood pressure, heart disease, lung disease, diabetes, autoimmune disorders, and certain workers.
Be informed and prepared.
Wear a mask.
Maintain social distancing (6 feet).
Wash your hands frequently.
Use alcohol-based hand sanitizer.
Avoid touching your eyes, nose, and mouth.
Stay home when you are sick.
Cough or sneeze into a tissue or your elbow.
Clean and disinfect frequently touched objects and surfaces such as cell phones.
What can individuals do?
10.Five steps to proper handwashing
Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
Rinse your hands well under clean, running water.
Dry your hands using a clean towel or air dry them.
When it comes to worker safety, we should be driven by the ‘precautionary principle’ that reasonable steps to reduce risk should not await scientific certainty about the nature of the hazard or risk.
12.Module 1: COVID-19 Basics
13.What is SARS-CoV-2?
SARS-CoV-2 is the virus that causes coronavirus disease 2019 (COVID-19)
SARS = severe acute respiratory distress syndrome
Spreads easily person-to-person
Little if any immunity in humans
Detailed information: https://www.cdc.gov/coronavirus/2019-ncov/index.html
Droplet - respiratory secretions from coughing or sneezing landing on mucosal surfaces (nose, mouth, and eyes)
Aerosol - a solid particle or liquid droplet suspended in air
Contact -Touching something with SARS-2 virus on it and then touching mouth, nose or eyes
Other possible routes: Through fecal matter
COVID-19 is spread from person to person mainly through coughing, sneezing, and talking and breathing.
The incubation period is the time between exposure to a virus and the onset of symptoms.
With COVID-19, symptoms may show 2-14 days after exposure.
CDC indicates that people are most contagious when they are the most symptomatic.
Several studies show people may be contagious before developing symptoms.
16.COVID-19 can cause mild to severe symptoms
Most common symptoms include:
Shortness of breath
Other symptoms may include:
Runny or stuffy nose
Gastrointestinal: diarrhea, nausea
Loss of smell and taste
Most people will have mild symptoms and should recover at home and NOT go to the hospital or emergency room.
Get medical attention immediately if you have:
Difficulty breathing or shortness of breath.
Persistent pain or pressure in the chest.
New confusion or inability to arouse.
Bluish lips or face.
Severe symptoms – emergency warning signs for COVID-19
A person who has both consistent signs or symptoms and risk factors as follows:
What is a person under investigation?
A confirmed case is a suspect case with laboratory-confirmed diagnostic evidence of SARS-CoV-2 virus infection.
U.S. Centers for Disease Control and Prevention via AP
20.How long does SARS-CoV-2 survive outside of the body?
It is not clear yet how long the coronavirus can live on surfaces, but it seems to behave like other coronaviruses.
Virus may persist on surfaces for a few hours or up to several days, depending on conditions and the type of surface.
It is likely that it can be killed with a simple disinfectant on the EPA registered list below.
There are ongoing investigations to learn more.
COVID-19 poses a greater risk for severe illness for people with underlying health conditions:
Lung disease such as asthma
Suppressed immune systems
The elderly have higher rates of severe illness from COVID-19. Children and younger adults have had less severe illness and death. Because COVID-19 is new, there are a lot of scientific unknowns such as the impact on pregnant women and their fetuses.
Increased risk of severe illness
22.Seasonal flu vs. COVID-19
COVID-19 has the potential to cause more deaths and hospitalizations
SARS-CoV-2 is much more infectious and spreads faster than the seasonal flu
23.Seasonal flu vs. COVID-19
So far, the case fatality rate (CFR) of COVID-19 is estimated to be at around 2%. The CFR of seasonal influenza is estimated to be around 0.1%, making SARS-CoV-2 about 20 times more deadly than the seasonal flu.
An estimated 15-20% of infected individuals may suffer from severe symptoms that require medical attention, including pneumonia with shortness of breath and lowered blood oxygen saturation.
Immunity: unknown how long it will last post illness or vaccination.
Flu pandemic fatalities, worldwide, in the last century:
1918 – between 40 and 100 million
1957 – 2 million
1968 – 1 million
Experts have been recommending preparedness, warning about the likelihood of future pandemic influenza outbreaks for decades.
25.Treatment and vaccines
In December 2020, the FDA gave emergency use authorization to two COVID-19 vaccines, with many more in the pipeline.
There is no specific FDA -Cleared medication or treatment for COVID-19.
Treatment is supportive.
People who are mildly ill with COVID-19 should isolate at home during their illness.
26.Module 2: Assessing the Potential for Exposure to COVID-19 in the Workplace
27.Key exposure factors in the workplace
Does the work setting require close contact with people potentially infected with the COVID-19 virus?
Do specific job duties require close, repeated or extended contact with people with known or suspected COVID-19?
Has the community spread of the virus included cases in the workplace?
Examples of work settings
Examples of job activities
working with specimens in laboratories
some dental procedures
some autopsy procedures
High exposure risk occupations are those working with people with known or suspected COVID-19, especially while performing aerosol generating procedures.
High potential for exposure
Examples of work settings
hospitals and other types of healthcare facilities
drug treatment centers
home health care
environmental clean-up of SARS-CoV-2
long term and resident care facilities
Examples of job activities
direct patient or long term resident care
emergency medical services
housekeeping and maintenance in patient and resident areas
High potential for exposure
30.Medium potential for exposure
Examples of work settings
Home visiting occupations
Postal and warehouse workers
Examples of job activities
Checking out customers
Emergency home repairs
Handling mail and goods
Processing public benefits
31.Low potential for exposure
Low potential for exposure occupations are those that do not require contact with people known to be infected nor frequent contact with the public.
The next few slides will review key considerations for the health care and emergency services industries as well as continuity of operations and the role of public health.
The CDC site includes guidelines for infection control, EMS, home care, long term care, clinical care, evaluating persons under investigation,and more.
Refer to the CDC and state health department guidelines for protection of healthcare workers. In the current and past coronavirus outbreaks, healthcare workers have had a high rate of infection. It is especially important to ensure that procedures, equipment, and training are fully protective.
34.Long term, nursing, and resident care
There have been a very large number of COVID-19 cases among resident care workers because of the high prevalence and severity of cases of residents in long term care.
Many agencies have guidance for long term care, nursing homes, assisted living facilities, and other resident care facilities.
Emergency services and critical infrastructure include:
fire and EMS
Emergency services and critical infrastructure must be able to function during a national emergency.
36.Healthcare facility identification and isolation
The most important steps to prevent spread of COVID-19
Procedures for rapid identification and isolation of suspect COVID-19 cases.
Community and hospital procedures to ensure symptomatic people are not in public places, waiting rooms, reception areas, emergency departments, or other common areas
Collect a travel history for patients presenting with fever, cough, or shortness of breath.
Immediately isolate – using standard, contact, and droplet precautions for suspect or confirmed cases.
Examples of work settings
sports and arts events
high density of coworkers
high contact with the general public including retail and grocery stores
Examples of job activities
When a community outbreak occurs, any workplace or event location where people gather has a high potential for exposure.
Nuclear Power Plants
Food and Agriculture
Banking and Finance
Chemical Manufacturing and Storage Facilities
Defense Industrial Base
Postal and Shipping
Keeping critical infrastructure and key resources operating is a priority!
39.Continuity of Operations (COOP)
All businesses and agencies should have a strategy to overcome potential disruptions to operations for:
maintaining critical utilities and infrastructure;
rostering personnel with authority and knowledge of functions;
policies that enable employees to work remotely;
communications with employees and customers, including during disruptions to usual services;
stockpiling supplies or developing multiple suppliers in the event of a supply chain disruption.
40.Role of public health officials
Cases reported by employer to local health department to do contact tracing.
Investigate contacts of worker who is infected to determine what other cases may be present and to identify potential source.
Case identification and containment.
Communication and education.
Mitigation may include restrictions on public events and gatherings, transportation, and other activities.
Promote physical and social distancing and other safety and health measures.
Module 3:Methods to Prevent COVID-19 in the Workplace
Preparing for the threat.
Implementing preventive measures.
Implementing the continuity of operations plan.
Managing business recovery post-epidemic.
Key steps for preparing for and managing epidemics in the workplace
43.Community spread can impact any workplace
Mitigation may include shutting down events and worksites where people gather.
For example, the National Basketball Association suspended its season on March 11, 2020.
Many universities and colleges have suspended in person classes and have moved to distance learning.
Workers at stadiums, arts centers, and other places where people gather are impacted.
44.Consider the impact on workers
Will a worker be paid if their workplace shuts down or they are quarantined?
What can be done for workers who are sick but have no paid sick leave?
How can workers cope with the impact if their child’s school is shut down or their child is placed in quarantine?
What can be done for low wage and immigrant workers who have no access to health care?
45.Stay home when sick.
Wear a mask.
Wash hands or use sanitizer frequently and after coughing, sneezing, blowing nose, and using the restroom.
Avoid touching your nose, mouth, and eyes.
Cover coughs and sneezes with tissues or do it in your sleeve.
Dispose of tissues in no-touch bins.
Avoid close contact with coworkers and customers (6 feet)
Avoid shaking hands/wash hands after physical contact with others.
Basic hygiene and social distancing
STOP shaking hands!
47.Key elements: COVID-19 workplace plan
Management leadership and employee participation
Hazard identification and assessment
Hazard prevention and control
Risk communication, education, and training
System evaluation and improvement
Emergency operations procedures
Post pandemic recovery
Start with the most effective method to protect workers.
Physically remove the hazard
Replace the hazard
Isolate people from the hazard
Change the way people work
Protect the worker with Personal Protective Equipment
Plastic shields and other barriers
50.Engineering controls for high exposure potential jobs in health care and laboratories
Negative pressure isolation rooms
Biological safety cabinets/HEPA filtration
UV irradiation systems
51.Administrative controls and work practices to reduce exposure
Enable sick workers to stay home
Establish work from home policy
Minimizing contact among workers and clients
Discontinue non-essential travel
Limiting the number of staff present for high potential exposure tasks
52.Additional administrative controls
Soft barriers include use of tables, ropes, signs, and floor markings to maintain social distancing.
53.Adjust policies to reduce exposures
Policies that can help to reduce exposure to COVID-19 include:
Encouraging workers who are ill to stay home without fear of reprisals or loss of pay or benefits
Using email, phone, teleconferences instead of face-to-face contact
Where applicable, the OSHA PPE standard requires employers to:
Conduct an assessment for PPE
Provide PPE at no cost, appropriate to the hazard
Train employees on how to don (put on) and doff (take off) PPE
Train workers to maintain, store, and replace PPE
Provide medical evaluation and fit testing
OSHA PPE standard
Employers should develop site specific decontamination procedures.
Depending on the workplace, decontamination may require consultation with the health department or use of a consultant specializing in environmental cleanup.
Use of an EPA registered disinfectant effective is recommended.
Worker and building occupant protection is essential to protect against the virus and adverse effects of the disinfectant.
EPA List: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
An N95 respirator is the minimum level of protection to prevent inhaling coronavirus.
Respirators are needed when there is a potential for aerosol transmission.
Advantages of reusable respirators:
Stand up to repeated cleaning & disinfection
Maintain fit over time
Powered air-purifying respirator (PAPR)
Half or full-face elastomeric respirators
Surgical masks do not:
Fit tightly against the skin to form a seal
Filter tiny particles, such as viruses or bacteria that are in the air
Surgical masks are not respirators!
Selection according to hazard
Medically fit to wear
Ensure proper use of respirators
Labeling/color coding filters
Respiratory programs must comply with all elements of OSHA Standard 29 CFR 1910.134
Respiratory protection standard
60.PPE for jobs with high potential exposure
At least N95
PAPR or full or half face elastomeric for greater protection
NOTE: there is a worldwide shortage of PPE!
Must be hands-on and frequent
Should not be primarily computer based or lecture
Must include an opportunity to drill the actual process of donning and doffing PPE and respirators
Should include a trained observer
Cover site specific decontamination procedures.
Training and drills
62.Prevention in all work settings
Wash hands after removing gloves or when soiled.
Wear a mask.
Keep common surfaces such as telephones, keyboards clean.
Avoid sharing equipment if possible.
Minimize group meetings by using phone, email, and avoid close contact when meetings are necessary.
Limit unnecessary visitors to the workplace.
Maintain your physical and emotional health with rest, diet, exercise, and relaxation.
63.Protection of essential workers
Fire, police, grocery stores, gas stations, utilities, communications, and health care facilities are examples of essential industries and operations that remain open during a pandemic shutdown.
A site and job task specific risk assessment should be conducted to document the necessary protective measures.
Social distancing measures include use of barriers, signs, modifying work procedures that require close human interaction. Other steps include increased cleaning and disinfection, use of PPE and respirators, and training.
64.OSHA Hazard Communication standard
The hazard communication standard, 29 CFR 1910.1200, establishes a worker’s right to know about chemicals in the workplace
Employers are required to develop:
List of all hazardous chemicals in the workplace
Labels on containers
Chemical information (safety data sheets)
Written program and worker access to information
These rights may be relevant to the cleaning and disinfecting of chemicals
Portable containers must be labeled
Exception: portable containers do not have to be labeled if only the worker who transfers the chemical uses it during that shift
66.Cal OSHA Aerosol Transmissible Disease (ATD) Standard
Enforceable in California, it applies to many types of health care settings, police services, correctional facilities, drug rehab centers, homeless shelters, and other settings.
Requires different types of engineering controls, work practices and administrative controls, and PPE depending on the level of potential exposure.
It is a useful reference for all states.
67.Mental health and stress
As the number of cases of COVID-19 increase, so does the associated anxiety and stress. Consider the following steps:
Use your smart phone to stay connected to family and friends. Shift from texting to voice or video calling to feel more connected.
Keep comfortable. Do more of the things you enjoy doing at home.
Practice stress relief whenever you feel anxiety building – do some deep breathing, exercise, read, dig in the garden, whatever works for you.
Avoid unhealthy behavior such as excess drinking – that will just increase your anxiety afterwards.
Keep looking forward. Think about plans you’d like to make down the road.
68.The Role of the Vaccine
Cases of COVID-19 will decrease with the administration of the vaccine.
With uptake of the vaccine and continued workplace controls in place, occupational exposures will decrease.
People who are vaccinated can still be exposed and potentially expose someone else even if they don’t become sick.
A continued focus on maintaining workplace preventive measures is important to protect workers in all industries.
69.Workers have the right to:
Receive workplace safety and health training in a language you understand.
Be protected from potentially toxic chemicals like cleaners and disinfectants.
Request an OSHA inspection and speak to the inspector.
Report an injury or illness and get copies of your occupational medical records.
Get copies of the employer’s log of recordable work-related injuries and illnesses.
Complaints can be filed by calling 800-321-OSHA or filing an online complaint, as well as in person.
Information is available on OSHA’s website at https://www.osha.gov/workers/file-complaint.
The PSD Training Module trains workers how to use existing resources to research and evaluate the characteristics of infectious disease hazards and also to understand the recommended methods for controlling them.
Adult training techniques
Designed for workers & community
All hazards approach
Structured training materials
Upon taking this module, participants will be able to:
Access and use existing resources for pathogen safety data.
Look up key terminology used in pathogen safety data resources.
Explain the use of pathogen safety data resources in risk assessment and infection prevention and control activities.
The PSD Guide
Four case studies that can be used as alternative to activities
An instructor guide
Download the PSD materials: https://tools.niehs.nih.gov/wetp/index.cfm?id=2554
PSD guide training materials
CDC Centers for Disease Control and Prevention
EPA U.S. Environmental Protection Agency
HEPA high-efficiency particulate air
HHS U.S. Department of Health and Human Services
JCAHO Joint Commission on Accreditation of Healthcare Organizations
LRN Laboratory Response Network
NIOSH National Institute for Occupational Safety and Health
OSH Act Occupational Safety and Health Act of 1970
OSHA Occupational Safety and Health Administration
PAPR Powered air-purifying respirator
PPE Personal protective equipment
SNS Strategic National Stockpile
WHO World Health Organization
75.For more information
Centers for Disease Control and Prevention (CDC)
Occupational Safety and Health Administration (OSHA)
World Health Organization
National Institute for Occupational Safety and Health (NIOSH)
NIEHS Worker Training Program
76.Why this training tool was created
This training tool was created by the NIEHS National Clearinghouse for Worker Safety and Health Training under a contract (HHSN273201500075U) from the National Institute of Environmental Health Sciences Worker Training Program (WTP).
WTP has trained more than 2 million emergency responders and hazardous waste workers since 1987 to do their jobs safely. WTP is a part of the U.S. Department of Health and Human Services, which is a cooperating agency under the Worker Safety and Health Support Annex of the National Response Plan. As part of the coordinated effort, the National Clearinghouse worked with NIEHS, WTP to create this orientation briefing for those who may be exposed to COVID-19 (coronavirus disease 2019).