Infection control is not a new topic, but since COVID-19 entered our lives, infection control has been a number one priority. We all know that this time in our lives is unprecedented, but you may still be asking yourself, “What do I do now?”
The Centers for Disease Control and Prevention (CDC) outline certain measures that may answer your concerns as a clinic director. You are already putting plans into action, but you may be wondering, “Is it enough?” Let’s review a specific scenario and break it down.
Your full-time therapist calls you at home in the evening to tell you “Hey boss! I was exposed to COVID-19 and now I am coughing and have a low-grade fever.” Your immediate internal reaction may be “What do I do first? What do I tell him/her? How do I handle the clinic, clients, and other employees?”
Thanks to the CDC’s General Business Frequently Asked Questions, the myriad queries above have been covered. Let us highlight some key details surrounding this topic.
According to the CDC, those employees who develop symptoms should immediately tell their employer and stay home. They are not to return until they have met the criteria.
As the owner, director or manager of the clinic, the CDC states that, in most cases, you do not need to shut down. If there were certain areas that the infected person used at the workplace, you may need to restrict use and ensure proper cleaning procedures prior to using this space.
The CDC advises the following cleaning and disinfecting procedures:
- If the area is visibly dirty, clean with soapy water prior to disinfecting.
- Disinfectants must meet the United States Environmental Protection Agency (EPA) criteria that is used against this particular virus. EPA has provided a list of qualified disinfectants that can be used to against COVID-19. There are key factors regarding the disinfectant solution that you need to understand. An example is “dwell time”, which refers to the amount of time needed for the disinfectant to remain on the surface to be effective.
- Follow guidelines of the disinfectant to utilize it safely. For those individuals using the product, make sure appropriate protective gear is worn to ensure safe handling methods.
Once you have disinfected the area, the next step is to determine who the infected employee has encountered, as this will require additional steps.
According to the CDC:
- If an employee is confirmed to have COVID-19, employers should inform other employees of their possible exposure to COVID-19.
- Employees who have a positive COVID-19 test should not work in person and remain home isolating if no hospitalization is required.
- The CDC recommends individuals to contact the local health department as needed in case certain employees require further precautions.
- Most workplaces should follow the “Public Health Recommendations for Community-Related Exposure.” Employers should direct staff to monitor symptoms and stay home for 14 days. If telework is a possibility, the recommendation is to instruct them to do so.
As a clinic director, you would need to consider finding appropriate therapist coverage for those patients that need to be seen, since the employee may be out of work for an extended period. According to the CDC, employees or patients that were considered in close contact (six feet from a person) are considered exposed; therefore, the CDC recommends those individuals who develop symptoms should isolate at home. Those individuals who were exposed, but do not yet have symptoms, should also remain at home and are directed to execute social distancing measures for 14 days.
Any other employees that did not come in close contact should monitor themselves for symptoms and ensure proper protective equipment is worn when outside of the home. If those individuals develop symptoms, direct them to notify you immediately.
This information may lead you to then ask, “when can the employee safely return to work?” The CDC outlines this in their Return-to-Work Guidelines.
Based on the CDC recommendations, the employee can return to work at least 10 days since symptoms first appeared and at least 24 hours since their last fever without any medication to help reduce the fever. This is also dependent on whether there are noted improvements in other symptoms. If a healthcare provider was asymptomatic during their infection, and do not have severe underlying conditions, or are not immunocompromised, the individual may return to work after 10 days from the date of their first positive test result.
With the increased availability of testing, many companies may require a negative test result prior to returning to work. Refer to your local state guidelines as states may vary in these requirements.
For those with severe conditions, the CDC advises to wait at least 20 days since symptoms first appeared, at least 24 hours without a fever, and improvement in other symptoms. The CDC advises in the use of a “symptom-based strategy” when ending the need for isolation measures.
In terms of handling how to manage contacting clients, you would need to contact the client if this person came within 6 feet of the infected therapist as they are considered exposed.
Further information can be found in the “Interim U.S. Guidance for Risk Assessment and Work Restrictions for Healthcare Personnel with Potential Exposure to COVID-19” which was most recently updated on December 14, 2020.
Your protocols and processes for Infection Control should mimic those outlined by the CDC. When analyzing your Infection Control policies, keep these key guidelines at the forefront of your guidance. Note: This guidance is not all inclusive. The main recommendation is to contact your local health department for specific instructional protocol.
If you need assistance navigating infection control, please feel free to reach out to LW Consulting, Inc. We have trained and certified Infection Preventionists that would be happy to partner with you.
For more information, contact Deborah Alexander at 717-213-3122 or email DAlexander@LW-Consult.com.