Dr Deb Mills MBBS MPHTM

11^thMarch 2020

As COVID19 heads for Australia, we need to  plan for the worst but hope for the best. Go to the Australian Govt website  for latest information. 

People say “oh its just a flu” . This is why it is not  “just a flu”.

Here are a few thoughts for  how to prepare for when the main wave hits your community.

Firstly this is what the World Health Organisation says is the role of the public in this situation

from WHO joint mission to China on COVID19

It is important to remember that some persons with COVID-19 may spread the disease without feeling sick.  Most sufferers (80%) have only mild symptoms. High risk persons develop a severe pneumonia which can sometimes be fatal. Any staff or contractors who are over 60 and especially over 80 years of age, or who have pre-existing medical problems are particularly at risk of more severe pneumonia from this virus.

Controlling the virus is a team effort but ideally one nominated staff member in each workplace needs to coordinate planning for COVID-19 preparations.

It maybe useful to think of the process for managing this virus in stages and plan your activities for each stage.

Phase	Trigger	Activities
Phase 1	Cases overseas	Education and Infection Control systems in place
Phase 2	More cases in Australia and some community spread begins	Active monitoring of staff and home isolation if  fever or respiratory symptoms
Phase 3	Community spread in your region: closure of school, cinemas, gyms  etc	Many Business shut down
Phase 4	Community spread has been halted	Businesses reopen

Working from home?

This may be necessary at times. If this is an option in your business, think about how you would manage this, and what would be needed by staff to facilitate this. Organise this now.

Limiting face to face meetings?

During the peak of the wave, to slow transmission, it may be necessary to have business meetings over the internet eg via Zoom or phone. What preparations may this require? Conferences or travel may need to be restricted. How can you plan for this?

Overseas Travel?

Any staff member who needs to travel overseas needs to get appropriate specialised travel medicine advice.  Persons returning from overseas may need to self isolate for 14 days. COVID-19 is spread most easily in a household setting so the travel history of household members may be important as well.

Sickness in Staff?

Really the most important strategy in this whole saga is that those who are sick with any respiratory symptoms mut stay home.

Staff should ensure they have a thermometer at home so they can monitor their temperature. It may be necessary to have a thermometer at work – one that can be cleaned between uses.

Centre for Disease Control in USA  says

Employees who have symptoms of acute respiratory illness are recommended to stay home and not come to work until they are free of fever – (37.8° ) or greater using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours, without the use of fever-reducing or other symptom-altering medicines (e.g. cough suppressants). Employees should notify their supervisor and stay home if they are sick.

Usually the nature of someone’s illness or reason for time off is quite confidential. Due to the nature of this outbreak, employers may sometimes need to have information on the nature of staff symptoms if they are respiratory in nature. To decrease the load on the medical system, it is recommended that workplaces do  NOT require a note from a  doctor. A statutory declaration by the sufferer maybe sufficient to satisfy HR documentation.

Some staff may also need to stay home to care for sick family members.

CDC recommends that employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the dayshould be separated from other employees and be sent home immediately. Sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).

Perhaps put a sign or poster in the Tearoom, for example.

Sickness in Suppliers?

Suppliers must be notified nowin preparation for the arrival of the COVID-19 that anyone with respiratory symptoms at their workplace should be sent home and not work and that we expect them to screen delivery personnel to ensure delivery staff have no respiratory symptoms when they deliver our goods

Notify cleaners and give them a copy of the guidelines so there are no sick cleaners in the office after hours potentially leaving viral particles on surfaces. Make sure they are using chemicals effective against COVID-19 – eg bleach. WHO guidelines on this.

Sickness in visitors to the business?

Depending on the nature of the business, it may be possible to limit the number of sick visitors – more difficult in a retail environment but in a business environment this may be easier. Reception staff need to advise visitors that if they have respiratory symptoms they must not come in – they must stay home.

Visitors who demonstrate respiratory symptoms should be isolated immediately and given a mask (if available), tissues, hand sanitiser and assisted to leave ASAP.

Perhaps designate a room to use as the isolation room with supplies and a bin for disposal.

• WHO[ii]recommends

Employees, contractors and customers that if COVID-19 starts spreading in your community anyone with even a mild cough or low-grade fever (37.3 C or more) needs to stay at home. They should also stay home (or work from home) if they have had to take simple medications, such as paracetamol/acetaminophen, ibuprofen or aspirin, which may mask symptoms of infection

Enhanced infection control in the workplace?

From World Health Organisation

It is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment).

If you think a surface may be infected, clean it with simple disinfectant to kill the virus and protect yourself and others. Clean your hands with an alcohol-based hand rub or wash them with soap and water. Avoid touching your eyes, mouth, or nose.

Place a sign in entrance, perhaps on the reception desk near hand sanitiser that says : “Your safety is our priority.  Please clean your hands on arrival.”

Remove magazines from reception area in case they serve as a reservoir for fomite transmission.  Maybe place a sign in reception area that says: “We are currently not providing  magazines  to minimise the potential transmission of COVID19  which may persist on surfaces for hours or days. Thank you for your understanding.”

Are there pens or items used by visitors that need to be cleaned and not used by multiple people?  Do you need to take notices, business cards  and decorations off the front desk to allow enhanced cleaning? Are tissues and hand sanitiser are available throughout workplace plus bins for no-touch disposal of tissues.

Receptionists may need to  wear dispoable gloves and wipe bench through the day with disinfectant as required depending on volume of visitors.

Handwashing

Ensure supplies of soap and towels if relevant for handwashing if you have basins Order extra handwash and towels to ensure rooms with basins are well stocked.

Place sanitiser in tea room, at lunch table, on each desk, on reception desk, etc.

Dont forget cleaning of mobile phones for example

Other – ? decreased demand for your services

This is beyond the scope of the article but most business will bounce back once the crisis is past and you need to plan how to weather the storm so when things settle you are ready.

Check your stock levels

Do you have enough

• Hand sanitiser
• Soap
• Towels for hands
• Bench wiping disinfectant
• Thermometers to check temperature
• Gloves

More information?

If you wish more information or medical assistance with planning contact corp@thetraveldoctor.com.au to arrange a phone consultation with Dr Deb Mills. If your work is asking for clearance to work, please see this page.

It is important to be prepared for the coming wave of COVID19 – both at work and at home.  Hope for the best but prepare for the worst.