QUESTION

What are the ways to avoid transmission of COVID ‘ 19’

ANSWER

1. Wash hands with soap and water often.
2. Cover your mouth and nose with a face mask.
3. Avoid crowds and practice social distancing and stay at least six feet apart from others.

WHY IS IT RIGHT

The Epidemiology

Infection prevention and control is required to prevent the transmission of communicable diseases in all health care settings. Infection prevention and control demands a basic understanding of the epidemiology of diseases; risk factors that increase patient susceptibility to infection; and the practices, procedures and treatments that may result in infections.

The risk of acquiring a healthcare-associated infection is related to the mode of transmission of the infectious agent (e.g. CDI, SSI, CRE, MRSA, etc.), the type of patient-care activity or procedure being performed and the underlying patient’s host defenses. Healthcare workers should be vaccinated against preventable diseases such as hepatitis B. Personnel at risk for exposure to tuberculosis should be screened per recommendations.

PREPARATION FOR COVID ‘ 19

Prevention / Responses to COVID ‘ 19

OSHA has issued guidance for business in the workplace to protect workers.

1. develop an infectious disease preparedness and response policy and plan;
2. implement basic infection prevention measures, such as promoting hand washing and other good hygiene practices, encouraging sick employees to stay home;
3. explore flexible workforce procedures to reduce the risk of infection, such as permitting remote work or staggered scheduling, modify attendance policies to disincentivize sick employees showing up to work, and modify sick leave policies; and
4. implement workplace controls to minimize potential exposure to COVID-19, including workforce training, making changes to accommodate non-traditional scheduling and to the workplace environment, minimizing face-to-face meetings, providing resources for good hygiene, and providing personal protective equipment.

The CDC has produced preventive and responsive measures for risk settings for business. There are four work risk settings.

1. Very High Exposure Risk, i.e. healthcare workers performing procedures and exams on known or suspected COVID-19 patients, laboratory personnel testing for the virus, and morgue workers handling bodies of known or suspected COVID-19 patients at the time of death;
2. High Exposure Risk, i.e. healthcare delivery and support staff that must enter to rooms of known or suspected COVID-19 patients, medical transport workers that have transported known or suspected COVID-19 patients, and mortuary workers that prepare the body of a known or suspected COVID-19 patient at the time of death;
3. Medium Exposure Risk, i.e. jobs that require frequent or close contact with people or the general public, e.g., schools, high-density work environments, etc.; and
4. Low Exposure Risk, i.e. jobs that do not require frequent close contact with the general public or coworkers, i.e. office jobs.

COVID ‘ 19 PREVENTION

The best way to prevent illness is to avoid being exposed to the virus. The CDC recommends everyday preventive actions to help prevent the spread of respiratory diseases like COVID ‘ 19

1. Wash your hands often with plain soap and water. The CDC recommends washing your hands often with soap and water for at least 20 seconds, especially after you have been in a public place, or after blowing your nose, coughing, or sneezing. If soap and water are not available, the CDC recommends using an alcohol-based hand sanitizer that contains at least 60 percent alcohol. Learn more about safely using hand sanitizer.
2. Cover your mouth and nose with a cloth face covering or non-surgical mask when around others.
3. Avoid crowds and practice social distancing (stay at least 6 feet apart from others).

WHY IS EVERYTHING ELSE WRONG

ASSUMPTION OF RISK

The basis of good infection control in the workplace is to assume that everyone is potentially infectious. Proper procedures have to be followed at all times. Every workplace should have an appropriate first aid kit, with at least one staff member trained in first aid. Equipment such as gloves, gowns, eye goggles and face shields should be provided if necessary.

Pathogens

• Infection is caused by pathogens (‘bugs’) such as bacteria, viruses, protozoa or fungi getting into or onto the body.
• It can take some time before the microbes multiply enough to trigger symptoms of illness, which means an infected person may unwittingly be spreading the disease during this incubation period.

Infection Control

• Infection control in the workplace aims to prevent pathogens from coming into contact with a person in the first place.
• Employers are to provide a safe workplace for their employees, including the provision of adequate infection control procedures and the right equipment and training.

Transmission of infection

Infectious agents can be spread in a variety of ways, including:

• breathing in airborne germs ‘ coughs or sneezes release airborne pathogens, which are then inhaled by others
• touching contaminated objects or eating contaminated food ‘ the pathogens in a person’s faces may be spread to food or other objects, if their hands are dirty
• skin-to-skin contact ‘ the transfer of some pathogens can occur through touch, or by sharing personal items, clothing or objects
• contact with body fluids ‘ pathogens in saliva, urine, faces or blood can be passed to another person’s body via cuts or abrasions, or through the mucus membranes of the mouth and eyes.

PREVENTION

Infection control procedures relating to cleanliness in the workplace include:

• regularly washing the floors, bathrooms and surfaces (such as tables and bench tops) with hot water and detergent.
• periodically washing the walls and ceilings
• thoroughly washing and drying mops, brushes and cloths after every use ‘ drying mops and cloths is particularly important, since many pathogens rely on moisture to thrive
• using disinfectants to clean up blood and other spills of bodily fluids
• when using disinfectants ‘ always wearing gloves, cleaning the surfaces before using the disinfectant, and always following the manufacturer’s instructions exactly
• spot cleaning when necessary.

Body fluid/spills

Examples of body fluids include blood, saliva, urine and feces. When dealing with spills of body fluids, infection control procedures need to be followed carefully. Always:

• Isolate the area.
• Wear gloves, a plastic apron and eye protection, such as goggles.
• Soak up the fluid with disposable paper towels, or cover the spill with a granular chlorine-releasing agent for a minimum of 10 minutes. Scoop up granules and waste using a piece of cardboard (or similar), place in a plastic bag and dispose of appropriately.
• Mix one part bleach to 10 parts water and apply to the area for 10 minutes.
• Wash the area with hot water and detergent.
• Dry the area.
• Dispose of paper towelling and gloves appropriately.
• Wash your hands.
• Rinse any contaminated clothing in cold running water, soak in bleach solution for half an hour, then wash separately from other clothing or linen with hot water and detergent.

To dispose of infectious waste that has been contaminated with blood or other body fluids:

• Wear heavy duty gloves.
• Place waste in plastic bags marked ‘infectious waste’.
• Dispose of waste in accordance with EPA guidance.

Infection control procedures when handling needles and other sharp contaminated objects include:

• Never attempt to re-cap or bend used needles.
• Handle by the barrel.
• Place in an appropriate puncture-proof container (that meets the Australian and New Zealand Standards AS 4031:1992 and AS/NZS 4261:1994) ‘ this will be yellow, labelled ‘Danger contaminated sharps’ and marked with a black biohazard symbol.

If you come in contact with blood or body fluids:

• Flush the area with running water.
• Wash the area with plenty of warm water and soap.
• Report the incident to the appropriate staff member.
• Record the incident via the Disease/Injury/Near Miss/Accident (DINMA) reporting procedure.
• Seek medical advice.