COVID-19: Managing Risks in the Workplace

JOHN MOORE: Hi, this is John Moore.

SONYA CONNOR: And Sonya Connor.

JOHN MOORE: And we want to welcome you to Mcgriff Risk Solutions presentation regarding the novel coronavirus. This coronavirus, or COVID-19, has reached pandemic proportions around the world and is forcing all responsible businesses to plan and prepare to reduce the impact of the outbreak.

We're glad that you joined us today to explore the control measures that you, the employer, can implement based on specific occupational exposures for practical guidance for managing an outbreak in the workplace. In this presentation, we will discuss an overview of the key facts related to COVID-19 along with information about how it's spreading, the occupational risk associated with OSHA's risk exposure levels, various risk reduction strategies, COVID-19 controls for the workplace, crisis management planning that organizations should be undertaking, and finally, what to do if you have an employee who is exposed.

SONYA CONNOR: Let's begin with a few facts about COVID-19. It's called by a new respiratory virus named SARS-CoV-2, which causes coronavirus disease 2019, known as COVID-19. Illnesses range from very mild to severe, including illnesses resulting in death. We do know that older people and people of all ages with severe underlying health conditions seem to be higher risk of developing serious COVID-19 illnesses. Children, however, do not seem to be at higher risk than the general population.

The main symptoms include fever, cough, and shortness of breath. Though there is currently no vaccine or approved medications to treat COVID-19, there is, however, a vaccine in the clinical trial phases. Communities that are affected are recommended to stay current through state and local departments of health regarding current strategies such as screening and managing exposures.

On March 11, the World Health Organization declared COVID-19 to be a pandemic, as it is able to infect people easily and spread from person to person globally in an efficient and sustained way. On March 16, President Trump recommends no gatherings of 10 or more people, and the CDC also recommended that organizers cancel or postpone in-person events that consist of 50 people or more throughout the US. While these restrictions have been implemented at a national level, many regions have their own unique restrictions pursuant to local outbreaks and/or exposures.

Most of you have heard how it spreads. But to review, it's mainly by way of person-to-person spread. Which means when people were within 3 to 6 feet from one another and the infected person coughs or sneezes, expelling respiratory droplets that could land in the mouth, nose, or be inhaled by others nearby. There have been rare cases of people spreading the virus prior to showing symptoms, but people are felt to be most contagious when they are showing the most symptoms, such as having a fever or cough. This is why it's crucial for sick people to stay home.

Another way it's spreading is from contact with contaminated surfaces or objects. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes. But it is not thought to be the main way the virus spreads. This virus is spreading easily, and evidence suggests that SARS-CoV-2 can remain alive for hours, up to three days, on surfaces made from a variety of materials.

As you can see on the slide, OSHA has broken workers risk exposure categories down into four levels of risk—very high, high, medium, and low. Much of this is based on industry type, need for close contact of people who are known or suspected to be infected with SARS-CoV-2 or are required to have repeated or extended contact with those persons. We will discuss each level. So let's start with the very high risk level.

The very high risk level are those workers who are working directly with and performing aerosol-generating procedures on patients. This would be procedures such as intubation, cough induction procedures, and some dental procedures. Examples of workers in this category are doctors, nurses, dentists, paramedic, respiratory therapists, and medical examiners. The high risk workers are very similar to those in the previous list, in that they work with persons with known or suspected COVID-19. But due to the circumstances of their job, they're not required to perform any procedures that would generate an increase in respiratory droplets or exposure to respiratory secretions from real or potentially infected persons. Examples of workers in this category our health care support staff, medical transport staff, phlebotomists, and mortuary workers.

As we move into the medium exposure risk jobs, you will see that these are workers that their job requires a great deal of close public contact, which could contain individuals that may be infected with SARS-CoV-2. Workers in this category can range from workers in airports who come in contact with travelers who are returning from locations with widespread COVID-19 transmission to workers who use public transportation.

Lower exposure risk jobs are those where the worker has minimal occupational contact with the public and other co-workers. When they are in contact with others, they can typically stay within six feet or further from co-workers and/or the public. Most American workers will likely fall in the lower exposure risk to medium exposure risk levels. For today's purposes, we will discuss the exposure reduction in those lower categories, as well as strategies all employers can implement to reduce occupational exposure to SARS-CoV-2. Guidance for higher risk categories continues to change rapidly, and is also based on the transmission rates occurring in each community. If you have workers who would be considered high to very high risk, please stay current with the CDC recommendations as well as your state and local health departments.

So now, let's discuss some key strategies every employer can take to reduce the risk of workplace exposures to SARS-CoV-2. First, develop and update your infectious disease preparedness and response plan. Basically, this is your pandemic plan. This involves planning, preparing your workplace for crisis due to the impact of the spread of COVID-19 in your community. John will go into greater detail on this plan later in the presentation.

Another key strategy is to implement basic infection control prevention measures. This probably isn't new to your organization, but can serve as a reminder to reinforce your current protocol. Key practices would include enforced thorough handwashing-- provide soap and running water. If this isn't immediately available, provide alcohol-based hand rubs containing at least 60% alcohol. Remind workers to stay home if they're sick.

Educate and remind workers to use respiratory etiquette by covering coughs and sneezes with a tissue or coughing into their elbow, provide your customers and the public with tissues and trash receptacles, discourage workers from using other workers phones, desks, offices, and other work tools and equipment if possible. Maintain regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the work environment. Pay close attention to frequently touched surfaces, such as door handles, elevator buttons, sink handles, entry key pads, office equipment, and other surfaces multiple workers would touch on a daily basis.

A key reminder here is to also educate your employees that if they wash their hands following contact with a high touch surface, they will likely prevent transmission, even if the surface was contaminated with SARS-CoV-2. The CDC, along with the EPA, provides several resources on appropriate cleaning and disinfecting techniques along with approved products that kill SARS-CoV-2 when used per manufacturer's instructions.

The CDC and the World Health Organization have downloadable posters and training videos to help educate workers, keep these measures in the forefront of everyone's mind. Strategy number three is develop policies and procedures for prompt identification and isolation of sick workers. This is a critical step in protecting workers, customers, visitors, and others within your organization.

It's imperative to educate your employees on signs and symptoms to self monitor if they suspect they have been exposed. If you identify workers with the signs and symptoms of COVID-19, isolate them and then send them home as soon as possible. Please contact your local health department for instructions on next steps. State and local health departments are best positioned to make such decisions within their jurisdiction based on the local situation.

Next, develop and implement and communicate about workplace flexibilities and protections. It's important to be aware of workers' concerns about pay, leave, safety, and health, and other issues that may arise during an infectious outbreak. Communicate with workers on any of your policy changes, what your organization is doing to prepare, how you're protecting them, and general education about workplace control. Please access our on-demand webinar, Employee Benefit Considerations in our Mcgriff Corona Advisory Series for more information on human resources and employee benefit policy and procedures.

The fifth strategy is implementation of workplace controls. During the COVID-19 outbreak, it may be impossible to eliminate the hazards. The most effective protection measures are implementing engineering controls, administrative controls, and providing personal protective equipment. OSHA has outlined examples of each of these controls in their recently published 2020 guidance on preparing workforces for COVID 19. We will discuss options of specific controls for workers who fall in the medium and low risk categories, as well as general SARS-CoV-2 exposure prevention in just a moment.

The final strategy is to follow the existing OSHA standards. These are the standards that most organizations already have procedures in place to manage, such as OSHA's personal protective equipment, respiratory protection, and bloodborne pathogen standards. Keep in mind-- OSHA's general duty calls requires employers to furnish each worker with a place of employment, which is free from recognized hazards that are causing or are likely to cause death or serious physical harm.

Now, let's discuss the workplace controls that all employers should consider. Routinely monitor public health communications about COVID-19 recommendations, and ensure that information is communicated to your workers. Frequently check the CDC's COVID-19 website. Encourage sick workers to stay home. Minimize contact among workers, clients, and customers by replacing face-to-face meetings with virtual communications and implementing telework if feasible.

Establishing alternating days or extra shifts that reduce the total number of employees in a facility at a given time, which allows them to maintain distance from one another while maintaining a full on-site workweek. Discontinue any non-essential travel to locations with ongoing COVID-19 outbreaks. Don't necessarily rely on the CDC for travel information when you are sending employees to other countries or regions in the US. Go to the public health department websites for those areas to review their travel advisories.

Develop a way to communicate with your employees and customers to force out messages, as well as answer questions. Internet-based communications and applications are great ways to accomplish this. But remember to collaborate with your workers to identify the most effective way that works for them. Provide personal protective equipment, or PPE, and train workers on which tasks should require use of PPE, how to put it on, and how to take it off correctly.

Training materials should be easy to understand and available in appropriate language and literacy levels for all workers. Examples of PPE would include gloves, goggles, face shields, face mask, and respiratory protection when appropriate. These will be primarily used for those workers who fall in the medium to very high categories.

During an outbreak of an infectious disease such as COVID-19, recommendations for PPE specific to occupations or job tasks may change depending on the geographic location. Employers should check the OSHA and CDC websites regularly for updates about recommended PPE. Many of the other controls will be a part of your infection prevention measures that we discussed earlier, such as providing the workers with the up-to-date education and training COVID-19, risk factors, and protective behaviors such as cough etiquette, promoting personal hygiene by providing the tissues, no-touch trash cans, handsoap, alcohol-based hand roads containing at least 60% alcohol, disinfectant, and disposable wipes for workers to clean their work surfaces, requiring regular handwashing for at least 20 seconds or use of alcohol-based hand rubs, and finally, posting handwashing signs and restrooms and other educational posters, available on the CDC website, in high traffic areas in the workplace.

So for the workers who may fall in the medium risk category, some additional workplace controls could be to install physical barriers such as clear glass sneeze guards where feasible. Consider offering face masks to ill employees and customers to contain respiratory secretions until they are able to leave the work site. Where appropriate, limit customers' and public access to your work site, or restrict access to only certain areas.

Consider strategies to minimize face-to-face contact, such as drive-through windows, phone-based communications, and telework. Communicate the availability of medical screening or other health resources to your workers, such as an on-site nurse or telemedicine services. It's important to also note that there's specific guidance available for some high risk industries such as various health care providers and for special populations that typically involve large groups of people in one area, such as schools and churches.

Here's a list from the CDC website. This list continues to grow and change as the pandemic worsens. And many of these have become irrelevant due to cancellations and closings. Now, I'd like to turn it over to John to discuss crisis management planning that organizations should be undertaking, and what to do if you have an employee who is exposed.

JOHN MOORE: Thanks, Sonya. Despite mixed guidance regarding the COVID-19 pandemic from the World Health Organization, CDC, or OSHA, all businesses should remember their duty to protect employees from known hazards at work. Under the Occupational Safety and Health Act, these hazards include infectious diseases which may be contracted in the workplace, like the coronavirus. Organizations should establish, if you haven't already done so, a crisis management plan that outlines the processes the organization will use to respond to the COVID-19 pandemic. The failure to plan may negatively affect the company's profitability, reputation, or ability to operate.

While you likely have already initiated crisis management strategies associated with COVID-19 pandemic, we're going to review some key considerations for the planning process. First, plan for the impact of the pandemic on your business. Identify a pandemic coordinator or team with defined roles and responsibilities for preparedness and response planning. The planning process should include input from labor representatives, as their frontline perspective helps ensure the plan is feasible.

Identify essential employees and other critical contributors required to maintain business operations by location and function during the pandemic. Depending on your business, these may include material suppliers, subcontractor services, and/or logistics. Train and prepare an ancillary workforce, which may include contractors, temporary staffing, employees from other departments or locations, or even retirees.

Develop and plan for scenarios likely to result in an increase or decrease in the demand for your products or services during the pandemic. Consider fluctuations in company financials using multiple possible scenarios that affect different product lines or production sites. Understand that business-related domestic and international travel will be disrupted. Sign up to reliable pandemic information from community public health, emergency management, and other sources, and make sustainable links. The internet is a great resource for your search.

Establish an emergency communications plan, and revise periodically. This plan includes identification of key contacts, including backups, chain of communications, including suppliers and customers, and processes for tracking and communicating business and employee status. Normally, I'd say to practice your plan and revise it periodically, which should absolutely be done. But this plan, depending on your scenario, may need to be acted upon immediately.

Next, plan for the impact of the pandemic on your employees and customers. Allow for employee absences due to the pandemic, due to factors such as personal or family illness, community containment measures and quarantines, or school, business, or public transportation closures. Implement guidelines to modify the frequency and type of face-to-face contact among employees and between employees and customers, such as handshaking, seating in meetings, office layout, and shared workstations.

The Centers for Disease Control has numerous recommendations regarding this issue. Evaluate employee access to and availability of health care services during the pandemic, and seek improved services needed. Also, evaluate employee access to and availability of mental health and social services during the pandemic-- again, including a corporate community and faith-based resources. And again, seek improved services as needed.

The next step is for companies to establish policies to be implemented during the pandemic. Be non-punitive regarding employee compensation and sick leave absences unique to the pandemic. Seek guidance from your local health department. Be open to remote work options, such as telecommuting or working staggered shifts. Promote coronavirus prevention in the worksite regarding the controls Sonya previously mentioned. Establish infection control response and immediate mandatory sick leave policies for employees who have been exposed to COVID-19, are suspected to be ill, or become ill at the workplace.

As previously mentioned restrict travel to affected geographic areas, which at this point could either be domestic or international sites. Evacuate employees working in or near affected areas when an outbreak begins, and provide guidance for employees returning from those infected areas. Set up authorities, triggers, and procedures for activating and terminating the company's response plan, altering the business operations, and transferring business knowledge to key employees.

Next, allocate resources to protect your employees and customers during the pandemic. Provide sufficient and accessible infection control supplies in all business locations. This includes products such as hand sanitizers, tissues, and receptacles for their disposal. Enhance communications and information technology infrastructures as needed to support employee telecommuting and remote customer access. Ensure availability of medical consultation and advice for emergency response. Know who to call, what their number is, and their hours of operation.

Next, companies need to consider how best to communicate to and educate their employees. Develop and distribute programs and materials covering pandemic fundamentals, such as signs and symptoms of the coronavirus and modes of transmission, personal and family protection and prevention strategies, such as the aforementioned hand hygiene, coughing and sneezing etiquette, and contingency plans.

Anticipate employee fear and anxiety, rumors and misinformation, and plan communications accordingly. Ensure that communications are culturally and linguistically appropriate, translating as required and using visuals as much as possible to help relay the message. Disseminate information to employees about your pandemic preparedness and response plan. Let them know you care and you're making the efforts to be ready, if needed.

Provide information for the at-home care of ill employees and family members. Your health insurance provider is a great place to start for that information. Develop platforms, such as hotlines or dedicated websites, for communicating pandemic status and actions to employees, vendors, suppliers, and customers inside and outside of your organization in a consistent and timely way, including redundancies in the emergency contact information.

Identify community sources for timely and accurate pandemic information and resources for obtaining countermeasures. Keep in mind that while continuous news TV channels and internet search engines are great resources for the broad view of the coronavirus outbreak and controls thereof, your local health department and other community resources will inform you of local outbreaks and controls.

Finally, coordinate with external organizations and help your community. Collaborate with insurers, health plans, major local health care facilities, public health agencies, and emergency responders to share your pandemic plan and understand their capabilities and services. When possible, participate in the planning process of public health agencies and emergency responders. Communicate with public health agencies and/or emergency responders about the assets and services your organization could contribute to the community during the pandemic. Share best practices with other businesses in your communities, chamber of commerce, or trade organizations to improve community response efforts.

OK, now that you've planned for the pandemic, let's discuss what happens in the event of a coronavirus infection in your facility. The US Department of Health and Human Services advises the following. First, call your county health department to the location of your organization. Inform them of the outbreak at your facility, provide the names of all persons potentially exposed to the coronavirus, and, once informed, the health department should assist in managing the potential outbreak from there.

Disinfect everything as well as possible. Consider using an environmental cleanup company to help deep clean the affected workspaces. Their workers have been trained on effective disinfection processes and have the appropriate equipment and specialized PPE for the work. If you work in a building shared with other companies, such as an office building or strip mall or other, you should inform the building manager so they can take the necessary precautions they deem appropriate for the situation. This procedure will also apply to scenarios in which an employee informs the employer that they lived with someone or may be in close contact with someone with COVID-19.

Thank you for participating in this presentation about managing COVID-19 risk in the workplace. We hope you have a better understanding of the control measures to take in helping prevent an outbreak and practical guidance for managing an outbreak in the workplace, should it occur. This is John Moore.

SONYA CONNOR: And Sonya Connor.

JOHN MOORE: Reminding you to be safe.