The Centers for Disease Control and Prevention (CDC) have implemented guidelines with regards to protecting the health and safety of America's workers and workplaces during COVID-19. These are recommendations as well as descriptions of mandatory safety and health standards and are intended to assist employers in providing a safe and healthy workplace.
No Wait Medical Partners focuses on the need to follow appropriate guidelines during work shifts and while at home.
Assess the hazards to which your workers may be exposed; evaluate the risk of exposure; and select, implement, and ensure workers use controls to prevent exposure.
Promote frequent and thorough hand washing, including providing employees and customers with a place to wash their hands. If soap and running water are not immediately available, alcohol-based hand rubs containing at least 60% alcohol should be provided. Young children must be supervised when using hand sanitizer to prevent swallowing alcohol. Regular hand washing or using of alcohol- based hand rubs are necessary. Hands should be washed when they are visibly soiled and after removing any Personal Protective Equipment (PPE). Provide resources and environment that promotes personal hygiene, including tissues, no-touch trash cans, hand soap, disinfectants, and disposable towels to clean surfaces. Post hand washing signs in restrooms. Ensure clean toilet and hand washing facilities. Fill hand sanitizer dispensers regularly. Disinfect frequently touched items, including door pulls and toilet seats often.
The importance of covering coughs and sneezes with a tissue should be emphasized. Afterwards, throw the tissue away into the trash and perform hand hygiene. Staff, students, and campers should be permitted to wear masks over their nose and mouth to prevent them from spreading the virus, though it is not PPE. Cloth face coverings should not be placed on babies and children younger than 2 years old, anyone who has trouble breathing or is unconscious, or anyone who is incapacitated or otherwise unable to remove the cloth face covering without help.
Maintain regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the environment. When equipment must be shared, instruct staff and older children to use alcohol-based wipes to clean before and after use. When cleaning tools and equipment, staff should consult manufacturer recommendations for proper cleaning techniques and restrictions (e.g., concentration, application method and contact time, PPE).
When choosing cleaning chemicals, employers should consult information on Environmental Protection Agency (EPA)-approved disinfectant labels from List N, or that have claims against emerging viral pathogens, or that have label claims against the coronavirus for cleaning frequently touched surfaces like tools, handles, and machines. Products with EPA-approved emerging viral pathogens claims are expected to be effective against COVID-19, based on data for harder to kill viruses. Keep cleaning agents securely away from children.
Develop a disinfection schedule or routine plan, especially for high contact areas like restrooms. Ensure sufficient stocks of cleaning and disinfecting supplies to accommodate ongoing cleaning and disinfection. High touch areas should be cleaned and disinfected (e.g. doorknobs, display cases, equipment handles) more frequently.
A. Physical Distancing
Have measures (e.g. tape on floors/sidewalks, create 1-way routes in halls, partitions, 6-foot distance between tables, and signage on walls) to allow a 6-foot distance between staff and students and minimize face-to-face contact.
Signage explaining social distancing should be posted highly visible locations (e.g. entrances, restrooms, dining areas, classrooms, auditorium).
Space desks 6-feet apart and align them in the same direction so no desks are facing each other.
Assign the same children and staff to a group each day. Each group should be in a separate room and mixing of groups should be limited (e.g. staggering playground times, special activities).
Create a separate classroom or group for children of healthcare providers or first responders, or only serve children of healthcare providers or first responders.
For camp or childcare nap times, space out the mats 6-feet apart and place children head to toe.
Have students or campers bring their own lunches and eat in their cohorts rather than eating in a large cafeteria setting
If serving food, use disposable utensils for individually plated meals. If those are not available, handle with gloves and use soap and hot water to clean utensils between uses.
For events, uses prepackaged food instead of self-service buffet or family style.
D. Drop off and Pick up
Have hand hygiene stations with soap and water or 60% alcohol stored out of children's reach for parents to supervise use.
Stagger arrival and drop off times to limit contact between different cohorts and their guardians.
Having the same person drop off and pick up the child who is not high risk (e.g. older adults, people with underlying medical conditions) is ideal.
School buses should follow bus transits operator guidelines as well as implementing other staff safety guidelines like wearing a mask and practicing hand hygiene.
E. Personal objects
Label belongings and store separately in cubbies, lockers, or areas.
Items that are difficult to sanitize should not be shared.
Supplies of high-touch materials should be enough to minimize sharing (e.g. assign supplies or equipment to one person) or limited to one cohort.
Review local and state gathering regulations to determine whether events (e.g. sports, extracurricular activities) may be held.
Evaluate if the activity can be done virtually. If that is not possible, develop a protocol to maintain social distancing as much as possible. Limit group size.
Limit nonessential visitors like volunteers and visitors. Retrain from activities with other organizations, especially those that are not local (e.g. community, town, city, county).
Pursue virtual activities and events (field trips, assemblies, performance, spirt nights). Prioritize outdoor activities that can maintain social distancing.
Sporting activities, if offered, should minimize transmission to families, coaches, and communities.
If state and local regulatory bodies allow for sport activities, assess the risk of spread among players. Coaches and parents should assess risk for each player individually; consider players at higher risk for severe illness.
Close contact sports may make social distancing difficult to maintain. Coaches can focus on building individual skill rather than competition and only play full contact in game-time situations. Coaches can also assign players to cohorts and cycle through stations to avoid mixing or switching groups.
The among of competitions in a season can be decreased. Also, compete among teams in the local area (e.g. neighborhood, town, community) instead of travelling.
Minimize sharing equipment and gear. If equipment must be shared, clean and disinfect between use by different players.
Social distance during time not engaged in play. Consider the age of the player when giving instructions to social distance. Youth sports group players may need to sit with guardians during downtime and need supervision to take other protective actions (e.g. not sharing water bottles).
Asthma treatment in school, camp, and childcare facilities should minimize creating aerosolized droplets. Inhalers do not create excessive aerosolized droplets while nebulizers do. Monitoring asthma using a peak flow is monitor does not create droplets, but may make the child cough.
Staff helping the child to use their inhaler need to use appropriate PPE.
Students, campers, and children should use personal spacers when possible; when using the facility's stock, disinfect afterwards according to manufacturer instructions.
Toys that cannot be cleaned and sanitized should be removed from the play setting.
Do not share toys between cohorts of infants or toddlers unless they are washed and sanitized before moving groups. Machine washable toys should laundered between individuals.
Separate body secretion soiled toys for hand cleaning with PPE or a mechanical dishwasher. Use detergent, then an EPA-registered disinfectant and air dry.
Books and other paper-based materials are not considered high risk and do not need additional cleaning or disinfection.
J. Infants and Toddlers
Diapering: Wash your and the child's hands before beginning. Wear gloves and follow safe steps diaper changing. At the end, remove gloves and perform hand hygiene. Disinfect with EPA-registered fragrance-free bleach. If the area is dirty, clean with detergent and water before disinfection.
Washing or holding a child: Wear a large button down, conserved shirt, and tie up hair for self-protection. Wash anywhere on self that was touched by child's secretions. Change the child's clothes if there are secretions and place soiled clothes in a plastic bag to be machine washed. Infants and toddlers should have multiple changes of clothes available in the facility.
Feeding: Before and after handling infant bottles, childcare providers should wash their hands. Equipment used for bottle feeding (e.g. bottles, bottle caps, nipples) should be washed in a dishwasher or with bottlebrush, soap, and water.
Water systems (e.g. faucets, fountains) should be evaluated. Fountains should be sanitized. Encourage staff, students, and campers to bring their own water.
Ventilation systems should be adequate. Increase circulation during the day by opening windows and doors when needed. Ensure fans do not blow from one person onto another.
Provide staff with up-to-date education and training on COVID-19 risk factors and protective behaviors (e.g., cough etiquette, proper hygiene practices, and care of PPE). Employees should wear face coverings.
Train staff who need to use protecting clothing and equipment, and on how to put it on, use/wear it, and take it off correctly, within the context of their current and potential duties. Training should be conducted virtually or maintain social distancing.
Staff should be trained on the signs and symptoms of COVID-19 with an explanation of how the disease is potentially spread, including the fact that infected people can spread the virus even if they do not have symptoms. Employees should know when to stay home to prevent spread.
Emphasis should be placed on the need for staff to report any safety and health concerns.
Designate a staff member at the organization (e.g. school nurse) to respond to COVID-19 concerns from other staff and families.
Communicate with the public, families, and staff over changed hours of operation or closures due to COVID-19.
Mental health support should be provided to all workers, including access to an employee assistance program (EAP) if available. Emergency communications plans should be developed, including a forum for answering workers' concerns and internet-based communications, if feasible.
No wait medical could help schools find a third-party mental health provider upon request.
Schools and childcare programs are not expected to screen for COVID-19 in children, staff, or students. If there is spread in the community, local health officials should follow up.
Conduct daily health checks on staff, students, and campers (e.g. upon arrival). Verbally screen to determine whether children have had a fever, respiratory symptoms (e.g. coughing, shortness of breath) or other symptoms in the past 24 hours. Anyone with a fever of 100.4 F or greater should not enter the facility. Screeners should be are trained to use temperature monitors that are accurate under conditions of use and wear appropriate PPE.
Method 1 of screening does not require PPE. Screeners can stay 6-feet away from the guardian and child and ask if the child has fever, shortness of breath, cough, or other symptoms. The child can be visually inspected for signs of illness (e.g. flushed cheeks, fatigue, extreme fussiness).
Method 2 of screening requires a barrier or partition. In addition to visual inspection, a temperature check can be conducted by reaching around the partition or through a window while keeping the screener's face behind the barrier.
Method 3 of screening requires PPE, used if barrier controls cannot be implemented. The screener must know how to don and doff PPE and be certified with all applicable regulatory health bodies. With PPE, they may be within 6-feet of the child for screening.
Health checks should be conducted in a way that helps maintain social distancing guidelines, such as providing multiple screening entries into the building. Administration should inform and encourage employees to self-monitor for signs and symptoms of COVID-19 if they suspect possible exposure.
Confidentiality of the medical records should be maintained. To prevent stigma and discrimination in the workplace, health screenings should be made as private as possible, and determinations of risk, should not be made based on race or country of origin.
No Wait Medical Partners ensures ongoing follow-up of employees sent home who may be at risk.
If there is a steady increase in student and staff absences, schools should notify heath officials.
Flexible sick leave policies should allow staff to stay at home in the event of sickness, possible exposure, or caring for someone who is sick. Evaluate whether the work duties can be done through telework.
Coordinate with other programs for staff substitutes if regular staff is absent. Ask higher risk people (e.g. older adults, people with underlying medical conditions) to assess risk with a medical provider if there is a community outbreak. Cross train staff and establish a roster of back-up staff.
Administration should inform and encourage staff to self-monitor for signs and symptoms of COVID-19 if they suspect possible exposure.
Staff who have symptoms should notify their supervisor and be encouraged to stay home, and a note from their healthcare provider does not need to be provided in order to validate illness, or their ability to return to work. Sick leave policies should be flexible and consistent with public health guidance and with No Wait Medical Partners, and employees should be made aware of these policies. Employees should not return to work until the criteria to discontinue home isolation are met, in consultation with No Wait Medical Partners. Prompt identification and isolation of potentially infectious individuals is a critical step in protecting employees and customers.
Staff who are well but who have a sick family member at home with COVID-19 should notify their supervisor and consult with No Wait Medical Partners regarding the mandatory precautions. Policies should permit employees to stay home to care for sick family members, including sick children or children who are in schools or day care centers that have been closed, or who have immunocompromised family members, and are afraid to come to work because of fear of possible exposure. Staff concerns about pay, leave, safety, health, and other issues that may arise during infectious disease outbreaks should be addressed, and employers are encouraged to work with insurance companies (e.g., those providing employee health benefits) and state and local health agencies to provide information to staff and families about medical care in the event of a COVID-19 outbreak.
No Wait Medical Partners will provide daily follow up on employees who are self-isolating at home, and on what their expected return to work dates will be.
A confirmed case is a positive test for COVID-19. Suspected cases are people who have signs and symptoms consistent with COVID-19.
In the event of a sick person, close off areas used by the person who was sick. Have an isolation area or room. Depending on the severity of their symptoms, transport them home or to a healthcare facility. Notify healthcare personnel that the person may have COIVD-19 if calling an ambulance or bringing them to a facility.
Increase circulation by opening windows and doors. Clear the area and wait 24 hours, or long as possible for droplets to settle, before disinfecting areas the person used using EPA approved disinfectants. If 7 days have passed since the person used the facility, extra cleaning is not required.
In a confirmed case, dismiss students and staff for 2-5 days.
Trace the person's contacts from 2 days before symptom onset to identify other exposed people. Inform them if there is a case of confirmed COVID-19 while keeping confidentiality according to the Americans with Disabilities Act (ADA). In a confirmed case, also notify relevant state health or environmental safety departments.
No Wait Medical Partners enables safe and timely triage, testing, monitoring, contact tracking and containment of suspected or confirmed COVID 19 positive employees. No Wait Medical Partners contributes to limiting exposure and risk management and enables contact tracing for suspected COVID-19 positive employees.
The Centers for Disease Control and Prevention (CDC) have implemented guidelines on how employees can protect themselves and their co-workers from COVID-19. Employees are encouraged to forward any questions or concerns that they may have to No Wait Medical Partners.
Practice good hygiene. Wash your hands frequently with soap and water for at least 20 seconds, or if soap and water are not immediately available, then use an alcohol-based hand sanitizer that contains at least 60% alcohol and rubbing hands until they are dry. Avoid touching your face.
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Follow the proper guidelines for covering coughs and sneezing (i.e., sneezing or coughing into a tissue or into the upper sleeve). Always wear a face mask while in the workplace, and the mask should cover your nose and mouth. Learn how to properly put on, use/wear, and take off protective clothing and equipment.
If possible, wear cloth face coverings protect others in case the wearer is unknowingly infected. Cloth face coverings should not be placed on babies and children younger than 2 years old, anyone who has trouble breathing or is unconscious, or anyone who is incapacitated or otherwise unable to remove the cloth face covering without help.
Maintain 6-feet of social distancing as work duties permit, and avoid physical contact with others, including other staff, students, or campers.
Use alternatives ways to shake hands upon entry, and it is important to not touch your face (i.e., mouth, nose, eyes).
Drive to facilities or parking areas individually; when possible, an avoid having passengers or foods.
Notify your supervisor and No Wait Medical Partners immediately, complete the self-assessment (self-checker).
Quarantine if one has been in close contact (e.g. within 6-foot distance for 15 minutes, cared for, direct contact, shared utensils, coughed, sneezed) with someone who has COVID-19.
Stay home for 14 days after last close contact incident and monitor for symptoms (e.g. fever over 100.4 F, cough, shortness of breath).
If your child is sick with symptoms of COVID-19 (e.g. fever of 100.4 F or greater, coughing, shortness of breath) call the healthcare facility before going.
Remain calm when talking to children about COVID-19 and avoid language that may blame others. Reassure them of their safety and tell them it is okay to feel stressed. Let children know they can go to you with their questions. Provide age appropriate information. Additionally, Sesame Street has tools targeted for children.