COVID-19 working environment tips

In order to keep yourself, your colleagues and your patients safe we have compiled a list of procedures and precautionary measures that you can implement.

Disinfection/Sterilisation

There are three principal modes of virus spread:

  • airborne spread—owing to exposure to bodily fluids and generated droplets, spatter and aerosols;
  • contact spread—owing to contact with bodily fluids, patient materials
  • surface spread—since coronaviruses can persist on various surfaces for a prolonged time (depending on the type of surface).

Disinfect the working space
Effective and strict disinfection measures in both work areas and public areas should be rolled out. The workplace should be cleaned and disinfected regularly in accordance with current safety protocols, as should the public areas and appliances, including door handles, chairs, desks and pens.

Patient/Self-evaluation

Due to the very fact that patients are ill, it is advisable to screen if they have had confirmed contact with persons with Covid-19. Regular staff self-screening is also encouraged to prevent spread of SARS CoV-2 in the early stages of infection. Visitor’s to laboratories like service engineers are required to adhere to the facility policies and should also be screened before entering the premises. Use a standardised structured questionnaire, also including the measurement of body temperature and then taking adequate steps to address the results. It is strongly recommended that a contact-free infra-red forehead thermometer be used.

The following set of screening questions can help identify potential infection. This list is not exhaustive, and should be adapted to suit your needs, in keeping with current research and guidelines:

  • Do you have a fever, or have you experienced a fever within the past 14 days?
  • Have you experienced a recent onset of respiratory problems, such as a cough or difficulty in breathing, within the past 14 days?
  • Have you, within the past 14 days, travelled to areas with documented COVID-19 cases?
  • Have you come into contact with a patient with confirmed COVID-19 infection within the past 14 days?
  • Have you come into contact with people who had recent fever or respiratory problems within the past 14 days?
  • Have you recently participated in any gathering, meetings, or had close contact with many unacquainted people?

Following the screening questionnaire:

  • If the person replies yes to any of the screening questions, and the body temperature is below 37.3°C, you can postpone the treatment until 14 days after the exposure event.
  • If the person replies yes to any of the screening questions, and the body temperature is 37.3°C or higher, then the patient should be advised on immediate quarantine, and you should report the case to the Coved Infection Officer or the local health department. The method and place of quarantine should be as per the current guidelines mandated by the government.
  • If the person replies no to all the screening questions, but his or her body temperature is 37.3°C or higher, the person should be directed to the nearest appropriate facility for further medical care.
Hand Hygiene

Regular handwashing with soap is advised. Alcohol-based hand sanitizers may also be used to augment the hand hygiene regimes. Before and after working with any patients, hands must be washed/sanitized.

NOTE: Everyone should take extra care to avoid touching their own eyes, mouths and noses.

Personal Protective Measures

The following protective measures are recommended:

  • Standard protection in the clinical settings: Disposable working caps, surgical masks and working clothes, protective goggles or face shields, and disposable latex or nitrile gloves as per risk assessment.
  • Advanced protection based on duties:  Additional disposable isolation clothing or surgical clothes overworking clothes in addition to standard protection.
  • Strengthened protection for being in contact with patients with suspected or confirmed COVID-19.
Medical waste

Waste, including disposable PPE, should be regarded as infectious medical waste and should be appropriately and timeously discarded. Refer to the Department of Health Practical Manual for Implementation of the National Infection Prevention and Control Strategic Framework.

Ventilation

The laboratory, workspaces, procedure rooms and other facilities, such as waiting rooms, should be adequately ventilated. Whilst the use of air conditioning is discouraged, but should they be a necessity then approved hospital-quality multi filtration systems (a filtration system that includes a prefilter, true HEPA filter, carbon filter and a UV-C light) should be sourced and regularly changed.

Emotional Support

At all times, medical personnel are to work in a safe and ethical manner. Extend confidentiality to fellow co-workers as far as possible to prevent the emotional trauma of stigmatization and isolation. The Lockdown, due to Covid-19, has had a major financial impact on many people as well as anxiety-inducing fears. If the employer does not have a Wellness programme any person may make use of the below resources:

  • The South African Depression and Anxiety Group.
  • The National Department of Health’s COVID-19 portal.
  • Whilst the Board acknowledges that none of these precautions can prevent or resolve COVID-19 on their own, all of them can contribute to keeping the pathology workplace, staff and patients safer and healthier—whether there is an ongoing viral epidemic or not.