IIPP Addendum-COVID-19 Training

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Cal/OSHA requires employers in California to develop and maintain an Injury and Illness Prevention Program. This is codified in Title 8 of the California Code of Regulations section 3203. Cal/OSHA also requires that employers address COVID-19 in their Injury and Illness Prevention Program. In addition to having COVID-19 addressed in the written program, employers have to provide training to their employees regarding COVID-19. This training can be conducted in-person, online, or by prerecorded video. The following presentation is intended to satisfy the COVID-19 IIPP training requirement.


COVID-19 is caused by a novel coronavirus. There are many types of human coronaviruses including some that commonly cause simply mild respiratory tract infections. COVID-19 is a new disease caused by a novel, or new, coronavirus that was not previously seen in humans. COVID-19 is spread through person-to-person contact by respiratory droplets that are produced when the infected person coughs, sneezes, or even simply talks.

Symptoms for COVID-19 generally appear two to 14 days after the initial exposure, five days for onset of symptoms appears to be the average. Symptoms include high fever, chills, cough, fatigue, pain or pressure in the chest, headache, confusion, sore throat, congestion, nausea or vomiting, diarrhea, difficulty breathing. The symptoms highlighted on this slide in yellow require immediate medical attention.

The primary route of transmission for COVID-19 is airborne. The disease is spread from person-to-person whenever someone coughs, talks, sneezes, by droplet nuclei. These are very small respiratory droplets that go airborne and another person can inhale them and become infected with COVID-19. There's also the possibility that a person could contract the virus from surface contamination, although this is considered unlikely now.


Some people infected with COVID-19 may be asymptomatic, that is exhibit no symptoms or extremely mild symptoms that could be mistaken for a cold or allergies. Even though this person is asymptomatic, they can still infect other people with COVID-19.


What to do if you have symptoms? Well, the first thing to do is stay home. Do not go to work. Do not go around other people. Stay home. Call your manager or supervisor and let them know, and then contact your doctor. If you have symptoms of COVID-19, you should get tested. A viral test tells you if you have a current infection. An antibody test tells you if you had a past infection. An antibody test might not show if you have a current infection because it can take one to three weeks after the infection for your body to make antibodies. Keep in mind that about 80% of people who develop COVID-19 recover without needing any special treatment or hospitalization.


Now we'll give you some statistics about the corona. As you can see here, we're talking about incredibly small diameters. A coronavirus is typically about 0.15 microns in diameter. For comparison, a single human hair is approximately 75 microns in diameter, and the smallest visible respiratory droplets whenever someone speaks, coughs, or sneezes are about 50 microns in diameter.


The yellow dots you see on this photo micrograph are the coronavirus infecting a single human cell. This graph illustrates COVID-19 mortality rates by age groups. And you can see, by about age 50, mortality rates take a big jump. Currently in California, COVID-19 cases, not deaths, are currently in people 49 years of age and younger.


Obviously, the way to prevent contracting COVID-19 is to avoid being exposed by the virus. So let's take a minute and talk about what actions can help prevent the spread of COVID-19. Antibiotics don't work against viruses, including the coronavirus. Antibiotics are only effective against bacterial infections. The good news is currently, there are about 23 vaccines being tested.


In epidemiology, the basic reproduction number sometimes referred to as R naught, or R0, of an infection can be thought of as the expected number of cases directly generated by one case of the infectious disease in a population where all the individuals are susceptible to the infection. The basic reproductive number is used to determine the spread of an emerging infectious disease, such as COVID-19, in an unvaccinated population. If the R naught number is above one, that indicates that the disease is going to continue to spread. If that number is below one, that indicates that the disease is going to die out on its own.


Currently, the basic reproductive number for COVID-19 is approximately 2.65 to 3.25, meaning that one infected individual with COVID-19 will generate two to three new cases of COVID-19, and those individuals will go and generate two to three new cases on their own also.


The best way to protect yourself and others from contracting COVID-19 is clean your hands often, preferably with soap and water, for at least 20 seconds, or a hand sanitizer that contains at least 60% alcohol. Avoid close contact with people who are sick. Put distance between yourself and other people, at least six feet, that's the social distancing component. Cover your mouth and nose with a cloth face cover when you're around other people. Cover your cough or sneeze with a tissue, then throw the tissue in the trash and wash your hands. Clean and disinfect frequently touched objects and surfaces regularly.

The CDC recommends that people wear cloth face coverings in any public setting and when around people outside of their household, especially when other social distancing measures are difficult to maintain. Cloth face coverings help prevent people who have COVID-19 from spreading the virus to other people.


You can reduce the spread of COVID-19 through social distancing and prevention hygiene that includes frequently washing your hands with soap and water and wearing facial coverings. The virus that causes COVID-19 can be destroyed if you use the right products. The U.S. Environmental Protection Agency has compiled a list of disinfectant products that can be used against COVID-19. These include ready-to-use sprays, concentrates, and wipes. Each of these products has been shown to be effective against viruses that are more difficult to destroy than viruses like the one that causes COVID-19.


Whenever you're using any of these cleaning or disinfection products, you wanna be sure to wear skin protection and consider eye protection for potential splash hazards. You want to ensure adequate ventilation and use no more than the amount recommended on the label. Use water at room temperature for dilution, avoid mixing chemical products, label diluted chemical cleaning solutions, and store unused chemicals out of the reach of children and pets.


EPA has six steps for safe and effective disinfectant use. Step one is check to make sure your product is EPA-approved. You find the EPA registration number on the product label, then check to see if it's on EPA's list of approved disinfectants. Step two, always read the directions. Follow the product's directions, check use sites and surface types to see where you can use the product, and always read the precautionary statements. Preclean the surface, make sure to wash the surface with soap and water if the directions reference pre-cleaning or if the surface is visibly dirty.


Step four, follow the contact time. Sometimes, this is called dwell time. This is the amount of time that the surface has to remain visibly wet with the product to ensure that it's effective. Step five, you want to always wear gloves, disposable gloves, and discard them after each cleaning, and then wash your hands. And step number six, lock it up. Lock up the products to keep it out of the reach of children.


And here's the link to the U.S. EPA's list of approved disinfectants for COVID-19 cleaning. Something else you should know is that research has revealed that exposure to sunlight, when the virus is exposed to sunlight for approximately six minutes, it's deactivated. Also, warmer temperatures reduce the time that the virus survives on surfaces and objects.


On this slide, we're talking about disposable masks, such as surgical masks that you see a lot of people wearing now. Before you put the mask on, you wanna wash your hands either with a hand sanitizer or preferably, with soap and water for at least 20 seconds. You wanna make sure your mouth and nose are covered by the mask and make sure that it is pressed firmly against your face. You do not want to touch the mask while you're wearing it. If you do touch the outside of the mask, you have to wash your hands again or use an alcohol-based hand disinfectant. You wanna replace the mask as soon as it gets wet and obviously, if it's a disposable mask, don't reuse the mask, just dispose of it, throw it away.


You wanna remove the mask from behind while not touching the front or outside of the mask and throw it away in a closed container, and then wash your hands. Reusable cloth masks, as many people wear, can be laundered and reused. Something to keep in mind that masks and facial coverings are not considered personal protective equipment.


Here we have, obviously, a cloth face covering and an N95 respirator. The face coverings are really intended to prevent the wearer from spreading the virus, from spreading COVID-19. An N95 respirator, and it is a true respirator, is intended to reduce the wearer's exposure to airborne particles, including aerosol droplets. N95 respirators are tight-fitting respirators that filter out at least 95% of particles in the air. Now not everyone's able to wear a respirator due to medical conditions, such as maybe asthma, a heart condition, or some other respiratory condition.


And something to keep in mind, if an employee is using an N95 respirator, Federal OSHA and Cal/OSHA require that the employer have a written respiratory protection program in place that the employee wearing the N95 is medically cleared by a healthcare professional, a physician's assistant, doctor, nurse practitioner, or someone like that, that they are fit-tested to make sure the respirator provides an adequate fit to their face and that they received training in the use of the respirator. The fit testing requirement and the training requirement have to be redone every year that the respirators are used.


This photograph's kind of interesting. This is actually from the 1918 flu pandemic, sometimes referred to as the Spanish flu. Even then, you can see, people were wearing masks and facial coverings.


As we mentioned earlier, COVID-19 is spread via respiratory droplets whenever someone coughs, sneezes, or even simply talks. Some recent COVID-19 outbreaks have occurred in crowded indoor settings, such as restaurants, night clubs, churches, places like that. This suggests that the virus can be suspended in the air long enough to potentially infect others if social distancing measures aren't strictly enforced. There are some studies that indicate when someone sneezes that, that sneeze and those respiratory droplets that can contain the COVID-19 virus can spread up to 26 feet and remain airborne from eight to 14 minutes.


Initially, when the pandemic started, there was a lot of concern that the primary route of exposure was from surface contamination, surfaces like, doorknobs, light switches, desktops, countertops, things like that. That appears to be unlikely now. You can contract the virus from surface contamination, but it appears that the primary route of exposure is through respiratory droplets that are airborne.


This slide is kind of interesting. It was an experiment conducted using a bacteria but the same dynamics would apply with a virus because we're talking about being spread by respiratory droplets. On the left, you can see the Petri dishes with the growth media that's with the mask on when the person coughs and talks and sings and sneezes. And the right group of Petri dishes on the right side are with no mask. So you can see, there's a huge difference, that this is just a disposable surgical mask that this person's wearing. So you can see that there's a huge difference when you're even just speaking it makes a big difference if you're in a mask.


This is pretty interesting. This is a newly constructed air flow imaging system to show air flow patterns. It's called a qualitative real-time shadow graph. What it does illustrates is it shows the potential transmission of airborne infection while coughing and sneezing and also just talking. These two individuals are about a meter apart. They're roughly 39 inches apart, and if you click the play button on the screen [in the PowerPoint File] you'll see that just from normal speaking, you'll see the amount of respiratory particles that are exhaled by both of these individuals.


This is the SoCo COVID-19 mobile app that was developed by IBM for Sonoma County to prevent and mitigate the spread of the novel coronavirus. There was an employee and employer portion to the app. Each day, the employees, before starting work, would complete a 30-second self-assessment for COVID-19 related symptoms and possible exposures to the coronavirus. The employer portion of the app ask that employers verify that employees do not have temperatures over 100 degrees Fahrenheit and are wearing the appropriate facial coverings. Use of this app is currently not required in Sonoma County.


Currently, in Sonoma County, facial coverings and masks must be worn by staff following California Department of Public Health guidelines, unless the person is medically exempted. Hands should be washed for 20 seconds frequently throughout the day. You should also wash your hands after coughing or sneezing into tissues. There should be adequate supplies to support healthy hygiene behaviors such as soap, tissues, no-touch trash cans, facial coverings, and hand sanitizers. The hand sanitizers need to contain, at a minimum, 60% ethyl alcohol. Physical distancing or social distancing should be maintained because that's critical to preventing the spread of COVID-19.


As of the recording of this presentation, which is July 31st, 2020 tele-work is being provided where possible and virtual learning platforms are also being used. All meetings should be conducted virtually, such as on an online platform, like Zoom. Of course, you should monitor daily symptoms for all the staff and surfaces should be cleaned and disinfected frequently, especially frequently touched surfaces in classrooms and offices and on school buses.


Frequently touched surfaces include items such as door handles, light switches, sink handles, bathroom surfaces, tables, desks, chairs, telephone receivers, anything like that. When you choose products to disinfect, you want to use approved products by the U.S. Environmental Protection Agency. These are found on List N.


To reduce exposure risks when using these disinfecting products, you want products that contain such active ingredients, as hydrogen peroxide, citric acid, or lactic acid. Remember that custodial staff and any workers that do any cleaning or disinfecting at a school site have to be outfitted with proper personal protective equipment, that would be gloves, eye protection, respiratory protection, anything else that's called for by the product that they're using. It's very important that they are trained in the Cal/OSHA Hazard Communication Standard which teaches how to safely handle and work with chemicals. And of course, all chemicals and cleaning products need to be kept out of the reach of children. Whenever possible, introduce as much fresh outdoor air as possible into the occupied spaces.


That concludes this presentation. The following slides are frequently asked questions regarding COVID-19. The health and safety of students and staff continues to be the first priority around the novel coronavirus situation in Sonoma County. RESIG encourages our school community to follow the science and closely monitor the state and local information. Stay safe and well. Thank you.