Updated Corona Virus Guidance

March 09, 2020
Dr. Jay Butler, CDC’s Deputy Director for Infectious Diseases and Senior Response Official for the COVID-19 response provided a situational update for CDC partners, including members of the private sector, public health organizations, universities, and clinical societies.
 
Coronaviruses are a large family of viruses that are common in humans and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people, such as with MERS-CoV and SARS-CoV. The virus that causes COVID-19 is spreading from person-to-person in China and some limited person-to-person transmission has been reported in countries outside China, including the United States. However, respiratory illnesses like seasonal influenza, are currently widespread in many US communities.
 
The following interim guidance may help prevent workplace exposures to acute respiratory illnesses, including COVID-19, in non-healthcare settings. The guidance also provides planning considerations if there are more widespread, community outbreaks of COVID-19.
 
To prevent stigma and discrimination in the workplace, use only the guidance described below to determine risk of COVID-19. Do not make determinations of risk based on race or country of origin, and be sure to maintain confidentiality of people with confirmed COVID-19. There is much more to learn about the transmissibility, severity, and other features of COVID-19 and investigations are ongoing. Updates are available on CDC’s web page at www.cdc.gov/coronavirus/covid19.
 
Recommended strategies for employers to use now:
  • Actively encourage sick employees to stay home: 
    • Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever (100.4° F [37.8° C] or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.
    • Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
    • Talk with companies that provide your business with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
    • Do not require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
    • Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.
  • Separate sick employees:
    • CDC recommends that employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. Sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).
  • Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees: 
    • Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.
    • Provide tissues and no-touch disposal receptacles for use by employees.
    • Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol, or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.
    • Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations or in conference rooms to encourage hand hygiene.
    • Visit the coughing and sneezing etiquette and clean hands webpage for more information.
    • Perform routine environmental cleaning:
    • Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
    • No additional disinfection beyond routine cleaning is recommended at this time.
    • Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.
    • Advise employees before traveling to take certain steps:
    • Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country to which you will travel. Specific travel information for travelers going to and returning from China, and information for aircrew, can be found at on the CDC website.
    • Advise employees to check themselves for symptoms of acute respiratory illness before starting travel and 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 should promptly call a healthcare provider for advice if needed.
    • If outside the United States, sick employees should follow your company’s policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding 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, and resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas.
  • Additional Measures in Response to Currently Occurring Sporadic Importations of the COVID-19:
    • Employees who are well but who have a sick family member at home with COVID-19 should notify their supervisor and refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
    • If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with Disabilities Act (ADA). Employees exposed to a co-worker with confirmed COVID-19 should refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
 
Plan for a Possible COVID-19 Outbreak in the US
 
The severity of illness or how many people will fall ill from COVID-19 is unknown at this time. If there is evidence of a COVID-19 outbreak in the U.S., employers should plan to be able to respond in a flexible way to varying levels of severity and be prepared to refine their business response plans as needed. For the general American public, such as workers in non-healthcare settings and where it is unlikely that work tasks create an increased risk of exposures to COVID-19, the immediate health risk from COVID-19 is considered low. The CDC and its partners will continue to monitor national and international data on the severity of illness caused by COVID-19, will disseminate the results of these ongoing surveillance assessments, and will make additional recommendations as needed.
 
All employers need to consider how best to decrease the spread of acute respiratory illness and lower the impact of COVID-19 in their workplace in the event of an outbreak in the US. They should identify and communicate their objectives, which may include one or more of the following: (a) reducing transmission among staff, (b) protecting people who are at higher risk for adverse health complications, (c) maintaining business operations, and (d) minimizing adverse effects on other entities in their supply chains.
 
Some of the key considerations when making decisions on appropriate responses are:
  • Disease severity (i.e., number of people who are sick, hospitalization and death rates) in the community where the business is located;
  • Impact of disease on employees that are vulnerable and may be at higher risk for COVID-19 adverse health complications. Inform employees that some people may be at higher risk for severe illness, such as older adults and those with chronic medical conditions.
  • Prepare for possible increased numbers of employee absences due to illness in employees and their family members, dismissals of early childhood programs and K-12 schools due to high levels of absenteeism or illness:
    • Employers should 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.
    • Cross-train personnel to perform essential functions so that the workplace is able to operate even if key staff members are absent.
    • 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 customers, or temporarily suspend some of your operations if needed).
  • Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions outlined in their business infectious disease outbreak response plan based on the condition in each locality.
  • Coordination with state and local health officials is strongly encouraged for all businesses so that timely and accurate information can guide appropriate responses in each location where their operations reside. Since the intensity of an outbreak may differ according to geographic location, local health officials will be issuing guidance specific to their communities.
 
Important Considerations for Creating an Infectious Disease Outbreak Response Plan
All employers should be ready to implement strategies to protect their workforce from COVID-19 while ensuring continuity of operations. During a COVID-19 outbreak, all sick employees should stay home and away from the workplace, respiratory etiquette and hand hygiene should be encouraged, and routine cleaning of commonly touched surfaces should be performed regularly.
 
Employers should:
  • Ensure the plan is flexible and involve your employees in developing and reviewing your plan.
  • Conduct a focused discussion or exercise using your plan, to find out ahead of time whether the plan has gaps or problems that need to be corrected.
  • Share your plan with employees and explain what human resources policies, workplace and leave flexibilities, and pay and benefits will be available to them.
  • 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.
 
Recommendations for an Infectious Disease Outbreak Response Plan:
  • Identify possible work-related exposure and health risks to your employees. OSHA has more information on how to protect workers from potential exposures to COVID-19.
  • Review human resources policies to make sure that policies and practices are consistent with public health recommendations and are consistent with existing state and federal workplace laws (for more information on employer responsibilities, visit the Department of Labor’s and the Equal Employment Opportunity Commission’s websites).
  • Explore whether you can establish policies and practices, such as flexible worksites (e.g., telecommuting) and flexible work hours (e.g., staggered shifts), to increase the physical distance among employees and between employees and others if state and local health authorities recommend the use of social distancing strategies. For employees who are able to telework, supervisors should encourage employees to telework instead of coming into the workplace until symptoms are completely resolved. Ensure that you have the information technology and infrastructure needed to support multiple employees who may be able to work from home.
  • Identify essential business functions, essential jobs or roles, and critical elements within your supply chains (e.g., raw materials, suppliers, subcontractor services/products, and logistics) required to maintain business operations. Plan for how your business will operate if there is increasing absenteeism or these supply chains are interrupted.
  • Set up authorities, triggers, and procedures for activating and terminating the company’s infectious disease outbreak response plan, altering business operations (e.g., possibly changing or closing operations in affected areas), and transferring business knowledge to key employees. Work closely with your local health officials to identify these triggers.
  • Plan to minimize exposure between employees and also between employees and the public, if public health officials call for social distancing.
  • Establish a process to communicate information to employees and business partners on your infectious disease outbreak response plans and latest COVID-19 information. Anticipate employee fear, anxiety, rumors, and misinformation, and plan communications accordingly.
  • In some communities, early childhood programs and K-12 schools may be dismissed, particularly if COVID-19 worsens. 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 if dismissed from school. Businesses and other employers should prepare to institute flexible workplace and leave policies for these employees.
  • Local conditions will influence the decisions that public health officials make regarding community-level strategies; employers should take the time now to learn about plans in place in each community where they have a business.
  • If there is evidence of a COVID-19 outbreak in the US, consider canceling non-essential business travel to additional countries per travel guidance on the CDC website.
    • Travel restrictions may be enacted by other countries which may limit the ability of employees to return home if they become sick while on travel status.
    • Consider cancelling large work-related meetings or events.
  • Engage state and local health departments to confirm channels of communication and methods for dissemination of local outbreak information.
 
Resources for more information:
For your family:
 
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List of Disinfectants to Use Against COVID-19
 
On March 5, the EPA released a list of EPA-registered disinfectant products that have qualified for use against SARS-CoV-2, the novel coronavirus that causes COVID-19.
 
“Using the correct disinfectant is an important part of preventing and reducing the spread of illnesses along with other critical aspects such as hand washing,” said EPA Administrator Andrew Wheeler. “There is no higher priority for the Trump Administration than protecting the health and safety of Americans. EPA is providing this important information in a public and transparent manner on disinfectant products to help reduce the spread of COVID-19.”
 
Products appearing on EPA’s list registered disinfectant products have qualified for use against COVID-19 through the agency’s Emerging Viral Pathogen program. This program allows product manufacturers to provide EPA with data, even in advance of an outbreak, that shows their products are effective against harder-to-kill viruses than SARS-CoV-2. It also allows additional communications intended to inform the public about the utility of these products against the emerging pathogen in the most expeditious manner.
 
Coronaviruses are enveloped viruses, meaning they are one of the easiest types of viruses to kill with the appropriate disinfectant product. Consumers using these disinfectants on an enveloped emerging virus should follow the directions for use on the product’s master label, paying close attention to the contact time for the product on the treated surface (i.e., how long the disinfectant should remain on the surface).
 
Artificial Intelligence Used to Classify Occupational Injuries
 
Artificial intelligence (AI) is not just a thing of the future. Results from the National Institute for Occupational Safety and Health (NIOSH) crowdsourcing competition for AI programmers are in, exploring ways to automatically read injury records and classify them in occupational safety and health surveillance systems. The 1st place winner, Raymond van Venetië, is a doctoral student in Numerical Mathematics at the University of Amsterdam whose submission improves NIOSH’s ability to classify worker injuries from the NIOSH baseline of 82% accuracy to nearly 90% accuracy.
 
Currently, whenever an employee is injured at work, humans write explanations of how the injury occurred, read all narratives and assign codes to classify injuries. This takes time, has costs associated with it, and risks the potential for human error. A NIOSH team of researchers, nicknamed “BrainGineers,” decided to crowdsource an AI solution, and through an interagency agreement with the National Aeronautics and Space Administration (NASA)’s Tournament Lab, worked with vendor Topcoder to host the online competition. Programmers competed to develop an algorithm that would best employ the use of AI in reading and classifying injury records.
 
While not unique to AI, crowdsourcing involves asking the crowd – or people in the public – with a variety of skill sets to provide their unique solution to a problem. The AI competition resulted in 961 submissions from 388 unique persons representing over 26 countries, including Poland, Kenya, Macedonia, Romania, Bangladesh, Russia, and China. The United States and India provided the majority submissions, at 32% and 21%, respectively.
 
The international reach of this competition showcased highly-skilled individuals who are interested in helping advance and improve the field of public health. For instance, the 4th place winner, Dr. Zhensheng Wang, is a senior biostatistician at Emory University School of Medicine in Atlanta, GA. At his job, he uses machine learning to predict hospital readmission after kidney transplantation but invested his personal time to compete in this contest because the classification task was related to public health.
 
Those participating self-identified as having degrees in computer science and engineering, chemistry, computer engineering, computer science, data science, and economics to name a few. Second place was awarded to a senior data scientist at Sherbank AI lab in Russia; 3rd place was awarded to a developer and data scientist from China; as noted, 4th place was awarded to a biostatistician at the School of Medicine at Emory University in Atlanta, GA; and 5th place was awarded to a full stack engineer from Bangalore India.
 
As a result of this competition, NIOSH will be working with the 1st place solution to make an easy-to-use web tool for occupational safety and health professionals who have an interest in the classification of injury narratives.
 
This was the first-ever external crowdsourcing competition from NIOSH and its parent organization, the Centers for Disease Control and Prevention (CDC), and it produced 21% more registrants and 66% more submissions than the average Topcoder competition. The top 5 winning solutions are available on GitHub.
 
NIOSH Practices in Occupational Risk Assessment
 
Exposure to on-the-job health hazards is a problem faced by workers worldwide. Unlike safety hazards that may lead to injury, health hazards can lead to various types of illness. For example, exposures to some chemicals used in work processes may cause immediate sensory irritation (e.g., stinging or burning eyes, dry throat, cough); in other cases, workplace chemicals may cause cancer in workers many years after exposure.
 
There are millions of U.S. workers exposed to chemicals in their work each year. In order to make recommendations for working safely in the presence of chemical hazards, the National Institute for Occupational Safety and Health (NIOSH) conducts risk assessments. Risk assessment is a way of relating a hazard, like a toxic chemical in the air, to potential health risks associated with exposure to that hazard. Risk assessment allows NIOSH to make recommendations for controlling exposures in the workplace to reduce health risks.  NIOSH recently updated its practices on performing occupational risk assessments.
 
Preventing Workplace Violence, Other Topics Featured in Oregon OSHA Newsletter
 
Learn about the steps employers and workers can take to meaningfully reduce the risks of workplace violence. Get a refresher on the requirements for maintaining on-the-job injury and illness records. Find out how to take part in Safety Break for Oregon on May 13 – and get entered into a prize drawing.
These stories and information – and more – are now available in the February issue of Health and Safety Resource. The bimonthly online newsletter, published by Oregon OSHA, empowers employers and workers with knowledge about how to make their workplaces safer and healthier.
Inside the current issue:
  • Workplace violence: Prevention is paramount: This in-depth story encompasses insights from an Oregon OSHA expert, a case study, and links to more information and training resources.
  • Updated violence prevention guide offers more help: This updated publication, “Workplace violence: Can it happen where you work?”, includes information about employer and employee responsibilities, the importance of training, pre-employment screening, and security preparations.  
  • Going the Distance: Meet Patrick Cowan, sales manager, and Adam Wasniewski, quality and safety manager, for Timber Products Company – Spectrum Division.
  • Other features: 
  • Administrator’s message: Oregon OSHA moves forward in addressing the question of “reasonable diligence.”
  • Short takes: Employers and workers are invited to take a Safety Break for Oregon on May 13. It’s a time to pause and reflect on the importance of protecting people from hazards and harm while on the job. Companies that sign up to participate will be entered to win one of three $100 checks, to be used for a luncheon of their choice.  
  • Incident Alert! A foreman did not take an injured worker to the nearest medical facility as required by the employer’s safety plan.
 
Jim Bakker Show Cited for Corona Virus Scam
 
New York Attorney General Letitia James issued guidance to New Yorkers highlighting available resources and potential consumer scams related to the Coronavirus Disease 2019 (COVID-19). With several cases confirmed in New York, it is critical that New Yorkers are aware of their rights and the resources available to help them during this time. The Office of the Attorney General (OAG) is actively monitoring retailers for potential incidents of price gouging of necessary goods and entities selling bogus medical treatments that purport to effectively treat or cure COVID-19. This week, Attorney General James issued a “cease and desist” order to the Jim Bakker Show that is marketing a product as a treatment for the coronavirus even though there is currently no FDA-approved vaccine to prevent the disease or treatment to cure it.
 
“As we experience more cases of coronavirus, it is imperative that New Yorkers remain calm, but stay vigilant,” said Attorney General James. “In addition to being mindful about our health, we must also beware of unscrupulous actors who attempt to take advantage of this fear and anxiety to scam or deceive consumers. I encourage anyone who believes they are the victim of a scam or predatory action to contact my office and file a complaint.”
 
Scammers commonly exploit real public health concerns and use heightened public fear to prey on consumers and profit from frauds related to those health fears. New Yorkers should beware of fundraising solicitations and offers of goods and services related to COVID-19. There is currently no FDA-approved vaccine to prevent COVID-19, but scammers may still offer fake vaccines and other bogus medical products claiming to offer “cures” for the virus. They may also offer “get rich quick” investment schemes for unproven virus treatments.
 
Additionally, scammers may set up sham charity websites and crowd-funding sites that request donations for virus-relief efforts for victims. Scammers may use emails, texts, and social media posts that appear to give virus updates, but have malicious links that can steal sensitive personal identity information.
Attorney General James offers the following COVID-19 scam prevention tips:
  • Beware of scammers selling bogus medical treatments and learn the facts about the coronavirus. There is currently no FDA-approved vaccine to prevent the disease, so ignore offers promising otherwise. Stay informed about the disease by visiting the websites of the:
    • U.S. Centers for Disease Control and Prevention: www.cdc.gov
    • New York State Department of Health: www.health.ny.gov, or by calling a special COVID-19 hotline: 1-888-364-3065 
  • Report retailers that appear to take unfair advantage of consumers by selling goods or services that are vital to the health, safety, or welfare of consumers for an unconscionably excessive price. Report such incidents to the OAG.  
  • Use caution when making charitable donations. You should never feel rushed or pressured to donate, and never make donations in cash, by gift card, or by money wire. If you receive a charitable solicitation, do some research to determine whether the charity is legitimate. Here are some helpful resources:
  • Beware of coronavirus-related investment scams. The U.S. Securities and Exchange Commission recently warned investors about coronavirus investment frauds. If investors are aware of or suspect securities fraud or wrongdoing, they can contact the OAG’s Investor Protection Bureau online.
  • If you have questions or concerns about health insurance costs related to COVID-19 tests or care, please call the OAG’s Health Care hotline: 1-800-428-9071.
 
Dollar Tree Stores Inc. for Exposing Employees to Exit, Storage and Fire Hazards at Massachusetts Store
 
OSHA has cited Dollar Tree Stores Inc. for exit, storage and fire hazards at a store in Boston, Massachusetts. The national discount retailer faces $523,745 in penalties.
 
Responding to a complaint, OSHA inspectors found store employees exposed to fire hazards from obstructed exit routes, the risk of struck-by hazards caused by unstable stacks of merchandise and over-stocked materials, and electrical hazards from blocked working space around electrical panels. OSHA cited the retailer for two willful and three repeat violations. The agency has cited Dollar Tree multiple times for similar hazards at stores around the nation, including recently in Bloomfield, Connecticut, and Falmouth, Massachusetts.
 
"OSHA continues to receive complaints about unsafe working conditions at Dollar Tree stores across the nation," said Loren Sweatt, Principal Deputy Assistant Secretary for Occupational Safety and Health. "Workers should not be subjected to the same hazards previously identified and cited. This employer is required to follow the law, and comply with regulations that protect workers from injuries and fatalities."
 
OSHA also cited Dollar Tree Stores Inc. for exit and storage hazards at a store located in Bethlehem, Pennsylvania. The company faces $296,861 in penalties for the Pennsylvania violations.  Responding to a complaint, OSHA inspectors found blocked emergency exits, unsecured compressed gas cylinders, unsanitary bathrooms, electrical panels not properly maintained and materials stacked unsafely. OSHA cited Dollar Tree for two willful, one repeat and two other-than-serious violations for these conditions.
 
Additional information about OSHA requirements for keeping exits unobstructed is available in the agency’s  Emergency Exit Routes fact sheet. OSHA’s  Recommended Practices for Safety and Health Programs includes information on how to identify and assess hazards in the workplace. OSHA’s Restrooms and Sanitation Requirements webpage explain requirements for ensuring that employees do not suffer adverse health effects from unsanitary bathroom conditions.
 
Dollar Tree Stores Inc. has 15 business days from receipt of the Pennsylvania and Massachusetts  citations and penalties to comply, request an informal conference with OSHA’s area director or contest the findings before the independent Occupational Safety and Health Review Commission.
 
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