COVID-19 Control and Prevention Protocols from CDC & OSHA

COVID-19 Control and Prevention Protocols from CDC & OSHA

Interim General Guidance for All Workers and Employers

For all workers, regardless of specific exposure risks, it is always a good practice to:

  • Wear cloth face coverings, at a minimum, at all times when around coworkers or the general public. If a respirator, such as an N95 respirator or better, is needed for conducting work activities, then that respirator should be used, and the worker should use their cloth face covering when they are not using the respirator (such as during breaks or while commuting).
  • Frequently wash your hands with soap and water for at least 20 seconds. When soap and running water are not immediately available, use an alcohol-based hand sanitizer with at least 60% ethanol or 70% isopropanol as active ingredients and rub hands together until they are dry. Always wash hands that are visibly soiled.
  • Avoid touching your eyes, nose, or mouth with unwashed hands.
  • Practice good respiratory etiquette, including covering coughs and sneezes or coughing/sneezing into your elbow/upper sleeve.
  • Avoid close contact (within 6 feet for a total of 15 minutes or more over a 24-hour period) with people who are visibly sick and practice physical distancing with coworkers and the public.
  • Stay home if sick.
  • Recognize personal risk factors. According to the U.S. Centers for Disease Control and Prevention (CDC), certain people, including older adults and those with underlying conditions such as heart or lung disease, chronic kidney disease requiring dialysis, liver disease, diabetes, immune deficiencies, or obesity, are at higher risk for developing more serious complications from COVID-19.

The CDC has also developed interim COVID-19 guidance for businesses and employers. The interim guidance is intended to help prevent workplace exposure to acute respiratory illnesses, including COVID-19. The guidance also addresses considerations that may help employers as community transmission of SARS-CoV-2 evolves. The guidance is intended for non-healthcare settings. Healthcare workers and employers should consult guidance specific to them, including the information below and on the CDC coronavirus webpage. Additional guidance from the Equal Employment Opportunity Commission (EEOC) and other federal agencies may be relevant to both workers and employers.

Interim Guidance for Job Tasks Associated with Lower Exposure Risk

Workers whose jobs do not require contact with people known to have or suspected of having COVID-19, nor frequent close contact with (within 6 feet for a total of 15 minutes or more over a 24-hour period) the general public or other workers, are at lower risk of occupational exposure.

As the Hazard Recognition page explains, workers' job duties affect their level of occupational risk and such risk may change as workers conduct different tasks or circumstances change.

Employers and workers in operations associated with a lower risk of exposure should remain aware of evolving trends in community transmission. Changes in community transmission, or work activities that move employees into higher risk categories, may warrant additional precautions in some workplaces or for some workers.

Employers should monitor public health communications about COVID-19 recommendations, ensure that workers have access to that information, and collaborate with workers to designate effective means of communicating important COVID-19 information. Frequently check the OSHA and CDC COVID-19 websites for updates.

Interim Guidance for Job Tasks Associated with Increased Risk of Exposure to SARS-CoV-2

Certain workers are likely to perform job duties that involve medium, high, or very high occupational exposure risks in areas with community transmission of SARS-CoV-2. Many critical sectors depend on these workers to continue their operations. Examples of workers in these exposure risk groups include, but are not limited to, those in healthcare, emergency response, meat and poultry processing, retail stores (e.g., grocery stores, pharmacies), childcare and schools, and other critical infrastructure or essential operations. These workers and their employers should remain aware of the evolving community transmission risk.

As the Hazard Recognition page explains, workers' job duties affect their level of occupational risk. Employers should assess the hazards to which their workers may be exposed; evaluate the risk of exposure; and, select, implement, and ensure workers use controls to prevent exposure. Control measures may include a combination of engineering and administrative controls, safe work practices, and PPE.

All employers should consider developing COVID-19 response plans that use the hierarchy of controls and other tools to address protecting workers who remain in, or will return to, their workplaces during the COVID-19 public health emergency—including as outbreak conditions evolve. This section provides general information about protecting workers whose job tasks are associated with medium, high, and very high risk of exposure to SARS-CoV-2 during the COVID-19 pandemic and is intended to be used in tandem with other industry-specific resources linked above. In addition to considerations discussed in those resources, COVID-19 response plans may need to address:

Protect Workers Performing Screening Duties

As part of screening programs, ensure that personnel performing screening activities, including temperature checks, are appropriately protected from exposure to potentially infectious workers entering the workplace:

  • Implement engineering controls, such as physical barriers or dividers or rope and stanchion systems, to maintain at least 6 feet of distance between screeners and workers being screened.
  • Ensure that screening is conducted in a safe area by, for example, directing parking lot or delivery traffic elsewhere.
  • If screeners need to be within 6 feet of workers, provide them with appropriate PPE based on the repeated close contact the screeners have with other workers.
    • Such PPE may include gloves, a gown, a face shield, and, at a minimum, a medical-grade face mask.
    • Train employees on how to properly put on, take off, and dispose of all PPE.
    • Filtering facepiece respirators, such as N95s, may be appropriate for workers performing screening duties. If respirators are needed, they must be used in the context of a comprehensive respiratory protection program that includes medical evaluation, fit testing, and training in accordance with OSHA's Respiratory Protection standard (29 CFR 1910.134).

Worker Screening

Screening workers for COVID-19 signs and/or symptoms (such as through temperature checks) is a strategy that employers may choose to implement as part of their efforts to maintain or resume operations and reopen physical work sites. Employers may consider developing and implementing a screening and monitoring strategy aimed at preventing the introduction of SARS-CoV-2 into the work site.* Those who may be infected with SARS-CoV-2 may not show any signs or symptoms, thus screening and monitoring may have limitations. The complexity of screening will depend on the type of work site and the risk of a COVID-19 outbreak among staff, but, if implemented, should include:

  • Protocols for screening workers before entry into the workplace (which may entail asking workers to take their own temperatures or otherwise perform self-screening measures before reporting to work).
  • Criteria for the exclusion of sick workers (including asymptomatic workers who have tested positive for SARS-CoV-2 and have not yet been cleared to discontinue isolation).
  • Criteria for return to work of exposed and recovered employees (those who have had signs or symptoms of COVID-19 but have gotten better).

Because people infected with SARS-CoV-2 can spread the virus even if they do not have signs/symptoms of infection, screening may play a part in a comprehensive program to monitor worker health during the pandemic but may have limited utility on its own. In many workplaces, screening efforts are likely to be most beneficial when conducted at home by individual workers. Employers' temperature screening plans may rely on workers self-monitoring, rather than employers directly measuring, temperatures. Consider implementing such programs in conjunction with sick leave policies that encourage sick workers, including those whose self-monitoring efforts reveal a fever, to stay at home. The Families First Coronavirus Response Act requires certain employers to provide employees with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19, eligible for 100% reimbursement through employer tax credits.

* Protocols for worker screening must be applied equally, without discrimination based on race, national origin, sex, age, disability, or other protected characteristics.

If employers choose to implement on-site screening or monitoring programs, they may need to be coordinated, as appropriate, with local public health authorities and occupational medicine and health and safety professionals.

Employers implementing on-site screening programs may need to plan for:

  • Providing verbal screening in appropriate languages to determine whether workers have had new or unexpected symptoms of COVID-19 in the past 24 hours.
  • Checking temperatures of workers at the start of each shift to identify anyone with a fever of 100.4°F or greater (or reported feelings of feverishness).1
  • Measures for testing workers for SARS-CoV-2 and responding to positive test results.
  • Prohibiting employees from remaining in the workplace if they have a fever of 100.4°F or greater (or report feelings of feverishness), or if screening or testing results indicate that the worker is suspected of having or known to have COVID-19. In such an event:
    • Encourage workers to self-isolate and contact a healthcare provider;
    • Provide information on the employer's return-to-work policies and procedures; and
    • Inform human resources, employer health unit (if applicable), bargaining unit representation (if applicable), and supervisor (so the worker can be moved off schedule during illness and a replacement can be assigned, if needed).
    • Conduct contact tracing to identify and inform coworkers or others that may have had exposure.
  • Measures to ensure worker privacy and confidentiality during any screening.
  • Regardless of how employers ultimately decide to implement temperature checks or other health screening measures, they should act cautiously on results. Employers should not presume that individuals who do not have a fever or other symptoms of COVID-19 do not have the virus.
  • Similarly, because of the limitations of current testing capabilities, employers who implement workplace testing strategies should act cautiously on COVID-19 test results. Employers should not presume that individuals who test negative for SARS-CoV-2 infection (i.e., COVID-19) present no hazard to others in the workplace.
  • Employers should ensure that screening protocols are consistent with other labor and disability laws, and with collective bargaining agreements where applicable.

Employers should continue to implement universal cloth face coverings, basic hygiene, physical distancing, workplace controls, flexibilities (e.g. sick leave, telework), and employee training described in this and other OSHA and CDC guidance in ways that reflect the risk of community spread of SARS-CoV-2 from the geographical area where the workplace is located.

Identify and Isolate Suspected Cases

In workplaces where exposure to SARS-CoV-2 may occur, prompt identification and isolation of potentially infectious individuals is a critical step in protecting workers, visitors, and others at the work site.

  • Wherever feasible, keep infectious people out of the workplace, including through the use of a system for employees to report if they are sick or have symptoms of COVID-19 or through the use of screening measures, as described above.
  • If a worker develops signs or symptoms of COVID-19 at the workplace, send the person home or to seek medical care. (Similarly, consider asking customers and visitors who develop signs and/or symptoms of COVID-19 at the workplace to leave to avoid infecting others.)
  • If the person cannot immediately leave the workplace, isolate the individual in a location away from workers, customers, and other visitors and with a closed door (e.g., in a single occupancy restroom), if possible, until they can go home or leave to seek medical care.

Implement the Hierarchy of Controls

Employers' COVID-19 response plans should utilize the hierarchy of controls, which generally labels and prioritizes controls in the following order from most to least effective: elimination/substitution, engineering controls, administrative controls and safe work practices, and PPE.

Efforts to exclude potentially infectious individuals from the workplace are consistent with the aim of eliminating the hazard.

Engineering controls typically require a physical change to the workplace to isolate workers from a hazard. Examples of engineering controls that employers may find useful for protecting workers from SARS-CoV-2 include:

  • Installing plexiglass, stainless steel, or other barriers between workers, such as on assembly lines, or between workers and customers, such as at points of sale.
  • Using rope and stanchion systems to keep customers/visitors from queueing within 6 feet of work areas.
  • Adjusting ventilation systems to introduce additional outside air and/or increase air exchange to introduce fresh air. Consult a qualified technician if necessary.
  • Modifying physical workspaces to increase the distance between employees.

Administrative controls and safe work practices change policies and procedures for how workers perform job duties to ensure work activities are conducted safely. Examples of administrative controls that employers may find useful for protecting workers from SARS-CoV-2 include:

  • Limiting the number of workers assigned to a particular shift in a facility and ensuring workstations are spaced at least 6 feet apart.
  • Posting signage, in languages the workers understand, to remind workers, customers, and visitors to maintain a distance of at least 6 feet between one another and to practice regular hand hygiene.
  • Providing training and information in languages the workers understand.
  • Increasing the frequency of cleaning and disinfection within the work site.
  • Encouraging or permitting workers to wear cloth face coverings, if appropriate, to help contain potentially infectious respiratory droplets.

PPE protects workers from hazards when engineering and administrative controls are insufficient on their own. The types of PPE that workers may need for protection from exposures to SARS-CoV-2 in areas with community transmission will vary based on work activities, exposure risks, and the results of the employer's hazard assessment. The Additional Considerations for PPE section provides additional details about PPE selection and use for all employers whose workers have increased risk of exposure to SARS-CoV-2 during the pandemic. Because of PPE supply chain concerns during the COVID-19 pandemic, employers should consider whether operations that require PPE can be delayed either until PPE is not needed (e.g., because the COVID-19 hazard diminishes) or until PPE supply chains stabilize. Employers should consider accommodations for religious exercise for those employees who, for instance, have or cannot trim facial hair due to religious belief, or provide reasonable modifications for persons with disabilities.