COVID-19 Outbreak Guidance for Businesses 04/08/2020

Posted: April 9, 2020

Preventing Outbreaks
Businesses should implement measures to enable social distancing as much as possible.

• Consider staggering shifts to reduce worker population at any given time.
• Stagger breaks to reduce staff interactions.
• Review procedures to identify ways to increase the physical separation of staff.
• Businesses should prioritize hand hygiene and respiratory etiquette among employees.
• Businesses should provide or allow employees to wear their own homemade cloth facemasks.
• Businesses should provide hand sanitizer or handwashing opportunities as frequently as possible.

Detecting Outbreaks
Screen all employees by taking their temperature and assessing for cough, sore throat, difficulty breathing or any other respiratory symptom at the beginning and end of each shift. For a screening algorithm click here.

Exclude all employees reporting fever or respiratory symptoms (these cases will be directed to stay home and isolate themselves from other people and animals in the home) until they:

• Have had no fever for at least 72 hours (that is three full days of no fever without the use of medicine that reduces fevers) AND
•  Other symptoms have improved (for example, when your cough or shortness of breath have improved) AND
• At least 7 days have passed since your symptoms first appeared.

Exclusion criteria must be followed with all symptomatic employees, regardless of whether the testing is completed (even if the employee tests negative for COVID-19 infection).

Please report to the Iowa Department of Public Health when 10% or greater of your employees are reporting COVID-19 symptoms (including fever, cough, sore throat, difficulty breathing, or any other respiratory symptom). Report to public health by filling out the survey at this link: https://redcap.idph.state.ia.us/surveys/?s=NRJ4FDMDPN

Managing Outbreaks
Coordinate with your occupational health provider to define a pathway to test symptomatic employees.

• Public health will approve State Hygienic Laboratory testing for symptomatic employees during outbreaks.
• The occupational health provider or employees’ personal health providers will be responsible for collecting the nasopharyngeal swab for testing and following-up for medical care as needed.

When employees test positive for COVID-19 infection, public health and occupational health will work jointly to investigate cases and identify the following contacts:

• household contacts,
• rideshare partners, and
• co-workers with prolonged contact (within 6 feet of the case for at least 30 minutes).

All of these contacts will be directed to stay at home and isolate themselves from other people and animals in the home for 14 days after the last known exposure to a person with COVID-19

Businesses should consider excluding high-risk employees when outbreaks are ongoing. High-risk employees would include:

• People aged 65 years and older
• People of all ages with underlying medical conditions, particularly if not well controlled, including:
  • People with chronic lung disease or moderate to severe asthma
  • People who have serious heart conditions
  • People who are immunocompromised
• Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
  • People with severe obesity (body mass index [BMI] ≥40)
  • People with diabetes
  • People with chronic kidney disease undergoing dialysis
  • People with liver disease

Business decisions to close, should be based upon workforce availability and the ability to follow the recommended measures outlined above.

* Outbreaks are defined as greater than 10% of employees ill with COVID-19 symptoms (fever, cough, sore throat, difficulty breathing, or other respiratory symptoms)