Effective Date: March 9, 2020 

Revised: April 1, 2020 

Purpose: To educate our employees and clients on our policy and information regarding COVID-19 (Coronavirus) 

PROCEDURE:

What is a coronavirus?   

CDC is responding to an outbreak of respiratory disease caused by a novel (new) coronavirus that was first detected in China and which has now been detected in almost 90 locations internationally, including in the United States. The virus has been named “SARS-CoV-2” and the disease it causes has been named “coronavirus disease 2019” (abbreviated “COVID-19”). 

Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain that has not been previously identified in humans.   

The complete clinical picture with regard to COVID-19 is not fully known. Reported illnesses have ranged from very mild (including some with no reported symptoms) to severe, including illness resulting in death.  

What if I (Employee or Client) have been exposed to COVID-19?

 

FOR ALL EMPLOYEES:

Take temp: Please take your temperature before each shift and report any temperature over 100.0° to the office and your primary care physician. 

Washing hands: Wash hands with soap and water for at least 20 seconds upon arrival at client’s home, and periodically while on your shift.  Always wash hands before and after assisting client with any type of care, as well as before leaving your shift. 

Disinfecting: We are getting bleach to make disinfectant solution, to ONLY BE USED ON HARD

SURFACES:  Please follow these guidelines for diluting, wear gloves while using, and make client aware so as to avoid any damage to property.  All high touch surfaces should be wiped down at the beginning and end of your shift. 

BLEACH DILUTION:  Prepare carefully over a kitchen sink and use in a spray bottle:
5 TABLESPOONS (1/3 cup) bleach per 1 gallon water
4 TEASPOONS bleach per 1 quart (32 ounces) water
3 TEASPOONS bleach per 24 ounces water
2 TEASPOONS bleach per 16 ounces water
1 TEASPOON bleach per 8 ounces of water

Shoes: Please don shoe covers or bring an extra pair of shoes to keep at client’s home.  

Masks: Masks are being distributed to all employees. Please wear them at client’s home at all times.

Gloves: Gloves are to be worn anytime an employee is providing personal care or assisting a client. 

Gowns: Gowns have been provided to all staff. Please wear especially when performing close contact/personal care with clients. 

Face Shields/Goggles: Have been provided to all employees.  This is additional protection to be worn particularly with working ventilator dependent clients, while clients receiving nebulizer treatments, and/or when in close proximity of clients for additional protection.

Our goal will be to minimize any spread of the virus.    

EMPLOYEES & CLIENTS

If someone (client/client’s family in the home or employee) tests positive for COVID-19, they will be required to follow his/her medical doctor’s guidelines for self-quarantine. Your doctor will determine when you are no longer at risk of transmission.  We will require a doctor’s note releasing an employee back to work.  For employees, if you should have to be out of work, you may use accrued PTO during your absence from work or EPSL in accordance with the FFCRA if you have not already used this for COVID. For clients/client’s family, we will want to know from your doctor that everyone in the home is no longer at risk of transmitting the virus. Unfortunately, due to the unknowns of this virus and the seeming susceptibility for it to spread, we will not be able to provide care in the client’s home until the virus is no longer transmissible by any family members living in the home.  

If both client and caregiver have tested positive please contact the office about working - the CDC has approved guidelines that allow caregivers to continue to work if they are asymptomatic.

EDUCATIONAL INFORMATION BELOW

How COVID-19 Spreads

Person-to-person spread

The virus is thought to spread mainly from person-to-person. 

• Between people who are in close contact with one another (within about 6 feet).
• Through respiratory droplets produced when an infected person coughs or sneezes.

These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

Can someone spread the virus without being sick?

People are thought to be most contagious when they are most symptomatic (the sickest). 

Some spread might be possible before people show symptoms; there have been reports of this occurring with this new coronavirus, but this is not thought to be the main way the virus spreads.

Spread 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 this is not thought to be the main way the virus spreads. 

How easily the virus spreads

How easily a virus spreads from person-to-person can vary. Some viruses are highly contagious (spread easily), like measles, while other viruses do not spread as easily. Another factor is whether the spread is sustained, spreading continually without stopping. 

Watch for symptoms

Reported illnesses have ranged from mild symptoms to severe illness and death for confirmed coronavirus disease 2019 (COVID-19) cases. 

The following symptoms may appear 2-14 days after exposure. * 

• Fever
• Cough
• Shortness of breath

Call your doctor if you…Develop symptoms, and have been in close contact with a person known to have COVID-19 or Have recently traveled to an area with widespread or ongoing community spread of COVID-19 such as China, Iran, Italy, or South Korea 

Treatment

There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory diseases, including: 

• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
• Follow CDC’s recommendations for using a facemask
  • CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
  • Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

There is no specific antiviral treatment recommended for COVID-19. People with COVID-19 should receive supportive care to help relieve symptoms. For severe cases, treatment should include care to support vital organ functions. 

People who think they may have been exposed to COVID-19 should contact their healthcare provider immediately. 

Prevent the spread of COVID-19 if you are sick 

Call your doctor:  If you think you have been exposed to COVID-19 and develop a fever1 and symptoms of respiratory illness, such as cough or difficulty breathing, call your healthcare provider immediately. 

Steps to help prevent the spread of COVID-19 if you are sick 

Follow the steps below:  If you are sick with COVID-19 or suspect you are infected with the virus that causes COVID-19, follow the steps below to help prevent the disease from spreading to people in your home and community.  

Stay home except to get medical care 

• Stay home: People who are mildly ill with COVID-19 are able to isolate at home during their illness. You should restrict activities outside your home, except for getting medical care.
• Avoid public areas: Do not go to work, school, or public areas.
• Avoid public transportation: Avoid using public transportation, ride-sharing, or taxis.

Separate yourself from other people and animals in your home 

• Stay away from others: As much as possible, you should stay in a specific room and away from other people in your home. Also, you should use a separate bathroom, if available.
• Limit contact with pets & animals: You should restrict contact with pets and other animals while you are sick with COVID-19, just like you would around other people. Although there have not been reports of pets or other animals becoming sick with COVID-19, it is still recommended that people sick with COVID-19 limit contact with animals until more information is known about the virus.
• When possible, have another member of your household care for your animals while you are sick. If you are sick with COVID-19, avoid contact with your pet, including petting, snuggling, being kissed or licked, and sharing food. If you must care for your pet or be around animals while you are sick, wash your hands before and after you interact with pets and wear a facemask.

Call ahead before visiting your doctor 

• Call ahead: If you have a medical appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the healthcare provider’s office take steps to keep other people from getting infected or exposed.

Wear a facemask if you are sick 

• If you are sick: You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and before you enter a healthcare provider’s office.
• If you are caring for others: If the person who is sick is not able to wear a facemask (for example, because it causes trouble breathing), then people who live with the person who is sick should not stay in the same room with them, or they should wear a facemask if they enter a room with the person who is sick.

Cover your coughs and sneezes 

• Cover: Cover your mouth and nose with a tissue when you cough or sneeze.
• Dispose: Throw used tissues in a lined trash can.
• Wash hands: Immediately wash your hands with soap and water for at least 20 seconds or, if soap and water are not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.

Clean your hands often 

• Wash hands: Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing; going to the bathroom; and before eating or preparing food.
• Hand sanitizer: If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.
• Soap and water: Soap and water are the best option if hands are visibly dirty.
• Avoid touching: Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing personal household items 

• Do not share: You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or pets in your home.
• Wash thoroughly after use: After using these items, they should be washed thoroughly with soap and water.

Clean all “high-touch” surfaces everyday 

• Clean and disinfect: Practice routine cleaning of high touch surfaces.  High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables.
• Disinfect areas with bodily fluids: Also, clean any surfaces that may have blood, stool, or body fluids on them.
• Household cleaners: Use a household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

Monitor your symptoms 

• Seek medical attention: Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing).
• Call your doctor: Before seeking care, call your healthcare provider and tell them that you have, or are being evaluated for, COVID-19.
• Wear a facemask when sick: Put on a facemask before you enter the facility. These steps will help the healthcare provider’s office to keep other people in the office or waiting room from getting infected or exposed.
• Alert health department: Ask your healthcare provider to call the local or state health department. Persons who are placed under active monitoring or facilitated self-monitoring should follow instructions provided by their local health department or occupational health professionals, as appropriate.
• Call 911 if you have a medical emergency: If you have a medical emergency and need to call 911, notify the dispatch personnel that you have, or are being evaluated for COVID-19. If possible, put on a facemask before emergency medical services arrive. 

Discontinuing home isolation 

• Stay at home until instructed to leave: Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary transmission to others is thought to be low.
• Talk to your healthcare provider: The decision to discontinue home isolation precautions should be made on a case-by-case basis, in consultation with healthcare providers and state and local health departments.

When and How to Wash Your Hands  

Handwashing is one of the best ways to protect yourself and your family from getting sick. Learn when and how you should wash your hands to stay healthy. 

Wash Your Hands Often to Stay Healthy 

You can help yourself and your loved ones stay healthy by washing your hands often, especially during these key times when you are likely to get and spread germs: 

• Before, during, and after preparing food
• Before eating food
• Before and after caring for someone at home who is sick with vomiting or diarrhea
• Before and after treating a cut or wound
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• After blowing your nose, coughing, or sneezing
• After touching an animal, animal feed, or animal waste
• After handling pet food or pet treats
• After touching garbage

Follow Five Steps to Wash Your Hands the Right Way

Washing your hands is easy, and it’s one of the most effective ways to prevent the spread of germs. Clean hands can stop germs from spreading from one person to another and throughout an entire community—from your home and workplace to childcare facilities and hospitals. 

Follow these five steps every time. 

1. Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
2. Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails.
3. Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
4. Rinse your hands well under clean, running water.
5. Dry your hands using a clean towel or air dry them.

Use Hand Sanitizer When You Can’t Use Soap and Water  

You can use an alcohol-based hand sanitizer that contains at least 60% alcohol if soap and water are not available. 

Washing hands with soap and water is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an alcohol-based hand sanitizer that contains at least 60% alcohol. You can tell if the sanitizer contains at least 60% alcohol by looking at the product label. 

Sanitizers can quickly reduce the number of germs on hands in many situations. However, 

• Sanitizers do not get rid of all types of germs.
• Hand sanitizers may not be as effective when hands are visibly dirty or greasy.
• Hand sanitizers might not remove harmful chemicals from hands like pesticides and heavy metals.

Caution! Swallowing alcohol-based hand sanitizers can cause alcohol poisoning if more than a couple of mouthfuls are swallowed. Keep it out of reach of young children and supervise their use.  

How to use hand sanitizer 

• Apply the gel product to the palm of one hand (read the label to learn the correct amount).
• Rub your hands together.
• Rub the gel over all the surfaces of your hands and fingers until your hands are dry. This should take around 20 seconds.

The complete policy is being disseminated to all clients and employees.  Clients and Employees can contact the office should they need another copy of  the policy.

Please go to the CDC for up-to-date guidelines and information:

https://www.cdc.gov/coronavirus/2019-nCoV/index.html