Indoor settings and close contact environments, such as workplaces, are among the areas where the coronavirus (COVID-19) can easily and quickly spread.
However, if employers and employees follow established health safety guidelines, the risk of exposure can be greatly minimised.
Now that Jamaica is in the throes of COVID-19 community spread, with almost 8,000 confirmed cases to date, health officials contend that there is the likelihood of persons who are unknowingly infected being present in the work environment.
It is, therefore, imperative that all the necessary infection prevention and control precautions be taken to avoid or limit further spread.
The Ministry of Health and Wellness has provided an updated set of workplace protocols, which are outlined in the document ‘Environmental Health Guidelines for Employers: Interim Guidance for COVID-19 Prevention and Control”, which was revised in September.
The guidelines are intended to, primarily, guard against risks posed to human health by contamination of the workplace environment as well as institutions such as educational, healthcare, penal, commercial, industrial, residential care, and other related facilities across Jamaica.
The document details three approaches to cleaning procedures for workplaces, based on the extent of spread at this time, and outlines environmental health considerations and the implications for infection prevention and control.
Additionally, it incorporates ‘A Quick Guide – Dealing with COVID-19 at the Workplace’.
In the event that there is suspected or confirmed exposure to COVID-19 in the workplace, the document outlines procedures businesses can follow to address this.
The guidelines stipulate that if it is noted that someone in the workplace is ill and displays a fever or respiratory symptoms, that person should be given a mask immediately, if they are not wearing one, and sent home.
Additionally, the area that the person occupies should be wiped with a mild bleach solution, disinfectant or alcohol. Once this is done and the area is dry, then that section is deemed safe to be used by others.
Importantly, if persons who were in contact with the symptomatic individual have been adhering to the infection prevention and control measures, then there is no need for those individuals to go home, and they are allowed to go to work.
Chief Medical Officer (CMO), Dr. Jacquiline Bisasor-McKenzie, who gave a presentation on the document during a digital press conference in September, stressed the importance of management teams being engaged in knowing what they must do to inform their workers.
She further said they must play an important part in advising workers about COVID-19, as is outlined in the guidelines.
“Workers are to be advised that if they develop a fever or they’re not feeling well, then they should call in and stay home. Workplaces must make those allowances to prevent the possibility of somebody who is symptomatic coming to work,” Dr. Bisasor McKenzie said.
The CMO added that if persons are not feeling better after a few days at home, they should seek medical advice, which may include doing a test.
If they have done a test that returns a positive result, they will be required to stay at home for a minimum 14 days, including three symptom-free days.
She informed that the Ministry revised the recommendations for infection prevention and control measures in the workplace in light of the community spread, which has seen an exponential rise in the number of cases.
“With community transmission, it is likely that you will be at work with COVID-19 positive persons who have no symptoms and will not know that they are positive – wearing a mask, physical distancing [of at least six feet], hand sanitising, and infection control measures in the workplace, such as daily cleaning and frequent wiping of [heavily] used surfaces, will be sufficient to prevent exposure,” the CMO pointed out.
She advised that if the infection prevention and control protocols for the workplace are adhered to, businesses will not need to suspend operations to facilitate deep-cleaning activities in the event of suspected exposure to COVID-19.
“Organisations need to put in place daily cleaning protocols that are sufficient to kill any virus particles that may remain on surfaces where droplets may fall. Frequently used surfaces may need to be… cleaned several times during the day, Dr. Bisasor-McKenzie further indicated.
She pointed out that “depending on what your business is, then you may find that the intervals may vary”.
“If infection prevention and control measures are adhered to in daily operations, then there is no need to close offices or other workplaces,” she added.
As stated in the guidelines, the local health department will investigate each case of COVID-19, and based on these investigations, the necessary actions will be determined.
The Ministry of Health and Wellness does not currently require any workplace/entity to automatically shut down its operations due to suspected or confirmed cases of COVID-19.
Suspension of business operations is dependent on the size of the entity, nature of work, number of people, suspected areas of contamination in the workplace, and interaction the employee had with co-workers and the general public.
The guidelines stipulate that an effective way in which businesses can protect workers and others from the risk of exposure to COVID-19 is by implementing appropriate cleaning and disinfecting measures for the workplace.
In addition, it is advised that an assessment of the workplace should be done, and a cleaning and disinfection plan developed.
This should include an outline of the cleaning and disinfection methodology as well as the cleaning schedule, which should be in line with the Health Ministry’s cleaning and disinfection guidelines.
The document notes that the COVID-19 virus is easily killed by using a number of cleaning agents available on the general market. Incorporating agents such as soap and water, bleach (sodium hypochlorite) and alcohol into the routine cleaning process helps to break the chain of transmission from fomites/objects in the environment.
A combination of cleaning and disinfection will be most effective in removing the COVID19 virus. Cleaning involves physically removing germs (bacteria and viruses), dirt and grime from surfaces using a detergent and water solution; while disinfecting entails using chemicals to kill germs (bacteria and viruses) on surfaces.
The guidelines highlight the importance of cleaning before disinfecting because dirt and grime can reduce the ability of disinfectants to kill germs.
It notes as well that disinfectants require sufficient contact time to be effective at killing viruses. If no time is specified, the disinfectant should be left for at least 10 minutes before removing.
The document recommends that in routine cleaning, particular attention should be paid to cleaning and disinfecting frequently touched surfaces and items, such as light switches, door handles, tables, desks and hard-back chairs, telephones, water/beverage pitchers, trays, elevator buttons, TV remotes and sinks, which should be performed frequently.
More frequent cleaning may be required in some circumstances. For example, if equipment is shared by workers, it should be cleaned between usages, where practicable.
Once cleaned, surfaces should also be disinfected regularly. More frequent disinfection may be required at workplaces with a high volume of workers, customers or visitors who are likely to touch surfaces.
The document also advises that business operators should empower all employees to undertake cleaning and disinfection, especially in personal spaces of operation, and that management should provide the necessary items to support this activity.
The guidelines further encourage the promotion of regular and thorough handwashing by employees, contractors and customers. Additionally, businesses are advised to erect sanitising hand-rub dispensers in prominent places around the workplace and care should be taken to ensure that these are regularly refilled.
Posters promoting proper handwashing procedures should also be displayed and it should be ensured that staff, contractors, and customers have access to places where they can wash their hands with liquid soap and safe water.
In the instance of confirmed or suspected exposure to COVID-19 in the workplace, it is recommended that all areas that were used (for example, offices, bathrooms, and common areas) be cleaned and disinfected.
It is recommended that the affected area be closed off before cleaning and disinfection. Also, outside doors and windows are to be opened, if possible, to increase air circulation, and then commence cleaning and disinfection.
Additionally, hard surfaces are to be cleaned and disinfected using detergent and water followed by the application of an approved disinfectant agent such as household bleach or hospital-grade bleach solutions that are readily available at retail outlets. Bleach solutions should be made fresh daily, as outlined in the guidelines.
If another type of disinfectant is to be used, the material safety data sheet must be available, and the approval of the health department sought. Other surfaces can be disinfected with an approved agent such as 70 per cent proof alcohol, after cleaning is completed.
The guidelines also recommend that cleaning staff dispatched to an area suspected of contamination must be equipped with appropriate personal protective equipment (PPE). These include masks, disposable gloves and safety eyewear or face shields to protect against chemical splashes.
If there is visible contamination with respiratory secretions or other body fluids in the area, a waterproof apron should be worn.
Once cleaning and disinfection are complete, disposable cloths, PPE and covers are to be placed in a plastic rubbish bag, then placed inside another (double-bagging) and disposed of in the general waste.
Also of note, routine application of disinfectants to environmental surfaces by spraying or fogging (also known as fumigation or misting) for indoor spaces is not recommended for COVID-19. This is according to the World Health Organization (WHO).
The document also provides important notes regarding mops and wiping cloths, noting that these will become contaminated with microorganisms from the environment and must be laundered daily and dried.
It recommends that mops and wiping clothes must be available in adequate quantities, and there should be dedicated supplies for cleaning and disinfection of contact surfaces, following a suspected or confirmed case, as also for sanitary facilities, and food-serving and preparation areas.
The guidelines also state that mop heads and cloths should be laundered, disinfected, and completely dried before reuse and buckets should be emptied and cleaned with a new batch of disinfectant and allowed to dry completely before reuse.
For further details, the document can be accessed on the Ministry of Health and Wellness’ website at the following link: https://www.moh.gov.jm/covid-19-resources-and-protocols/.