This Briefing Note was completed by the Research, Analysis, and Evaluation Branch (Ministry of Health).
Purpose
This briefing note provides a summary of recommended interventions that may prevent or control the spread of COVID-19 in workplaces across jurisdictions.
*The full version of the Briefing Note including the Appendix and References can be accessed in the PDF file at the top of the page*
Key Findings and Implications
11 workplace interventions are identified in Canada (British Columbia, Alberta, Manitoba, Ontario, Quebec), Europe (United Kingdom [UK]), and the United States (US). Less commonly referenced interventions include COVID-19 organizational leadership, infectious disease preparedness plans, COVID-19 screening, triaging of suspected COVID-19 cases, and heating, ventilation and air conditioning. Most commonly recommended interventions are as follows:
- Education on and Awareness of COVID-19 Workplace Interventions: Education, training, and awareness is recommended on topics such as workplace sick leave, personal protective equipment (PPE), hand hygiene, and public health measure communication and information in the workplace.
- Interventions Outside the Workplace: Employers can offer incentives encouraging their employees to use different forms of transportation that minimize close contact with others (e.g., biking, carpooling), and allow shifting in worker hours to commute during less busy times.
- Physical Distancing: Interventions recommended to increase physical distancing in the workplace include: flexible worksites (i.e., telecommuting); flexible work hours (i.e., staggered shifts); limiting use of other workers’ equipment; increase physical space between workers; using signs, tape marks, plexi shields, or other visual cues to indicate where to stand when physical barriers are not possible; close or limit access to common areas where employees congregate; deliver services or meetings remotely (i.e., phone, video); stagger lunch breaks, and offer paid sick leave.
- Hand Hygiene: Frequent and thorough hand washing is recommended in the workplace through hand washing and sanitizing stations.
- Disinfection and Sanitizing: Disinfection and sanitization interventions include routine cleaning and disinfecting of commonly used surfaces and equipment in the workplace using cleaning detergent followed by disinfection with an approved disinfectant product.
- PPE: PPE is recommended in essential and non-essential workplaces (i.e., schools, childcare, LTC, food industry, and general worksites) to prevent the spread of COVID-19. Face masks must be worn by workers in the workplace settings noted above, along with face shields, medical grade masks, and/or disposable gloves where required.
Analysis of Ontario
- Recommended Interventions: To reduce the spread of COVID-19, it is recommended to restrict staff members to one work site and avoid the use public transportation through carpooling or using company vans.
- Implemented Interventions: PPE interventions have been implemented in essential workplaces across Ontario.
- Schools: All staff in schools must wear masks, with reasonable exceptions for medical conditions. Medical masks and eye protection (i.e., face shields) for teachers and school board staff should be supplied.
- Child Care: Child care staff, home child care providers, home child care visitors, and early childhood education students are required to wear a medical mask and eye protection (e.g., face shields, safety glasses, and goggles) while inside in the child care premises, including in hallways and staff rooms.
Supporting Evidence
This section summarizes jurisdictional experiences on recommended interventions preventing or controlling the spread of COVID-19 in workplaces. In terms of jurisdictional experience, information is presented on Canada (British Columbia, Alberta, Manitoba, Ontario, Quebec), Europe (EU [UK]), and the US. No scientific evidence was identified.
International Scan
- Education on and Awareness of COVID-19 Workplace Interventions: Education, training, and awareness is recommended on topics such as workplace sick leave (US), personal protective equipment (PPE) (US), hand hygiene (US), and public health measure communication and information in the workplace (US, EU).
- Organizational Leadership: Identifying a COVID-19 workplace coordinator can help identify, deal, and resolve COVID-19 issues (US).
- Interventions Outside the Workplace: Employers who have employees who commute to work using public transportation should consider offering employees: incentives to use different forms of transportation that minimize close contact with others (i.e., biking, walking, driving, or riding by care alone or with household members); allow shifting in hours to commute during less busy times; and requesting hand washing or sanitizing after commuting (US).
- Physical Distancing: The following interventions are recommended to increase physical distancing in the workplace:
- Flexible worksites (i.e., telecommuting) (EU, UK, US);
- Flexible work hours (i.e., staggered shifts) (UK, US);
- Limiting use of other workers’ phones, desks, offices, or other work tools and equipment, when possible (EU, UK, US);
- Increase physical space between employers at the worksite by modifying the workspace (EU, UK, US);
- Increase physical space between employees and customers (i.e., drive through service, physical barriers) (EU, UK, US);
- Use of signs, tape marks, or other visual cues to indicate where to stand when physical barriers are not possible (EU, UK, US);
- Close or limit access to common areas where employees congregate (UK, US);
- Prohibit handshaking or physical contact (EU, US); and
- Deliver services or meetings remotely (i.e., phone, video) (EU, US).
- Hand Hygiene: Frequent and thorough hand washing is recommended in the workplace through the following interventions:
- A designated space for workers to regularly and thoroughly wash their hands with soap and water (EU, UK, US);
- If soap and running water are not immediately available, provide alcohol-based hand rubs containing at least 60% alcohol placed in prominent locations (EU, UK, US); and
- Placing information and communication promoting hand hygiene throughout the workplace (EU).
- Disinfection and Sanitizing: The following disinfection and sanitization interventions are recommended:
- Maintaining regular housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the work environment (US);
- Disinfecting high-touch surfaces (i.e., commonly used areas, door and window handles, light switches, kitchen and food preparation areas) (EU, UK, US);
- Cleaning using soap or a neutral detergent, water using a mechanical action (i.e., brushing, scrubbing). After the cleaning process is completed, disinfection should be used to inactivate pathogens and other microorganisms on surfaces (EU);
- The selection of disinfectants should align with the local authorities’ requirements for market approval, including any regulations applicable to specific sectors (EU, US); and
- Waiting 24 hours before cleaning and disinfecting areas exposed to a sick employee to minimize potential of respiratory droplet exposure to other employees. During this waiting period, outside doors and windows should be opened to increase air circulation in these areas (US).
- Personal Protective Equipment (PPE): PPE is recommended in essential and nonessential workplaces to prevent the spread of COVID-19:
- School: Mandatory face covering is required when inside a building whenever it is not feasible to maintain six feet of physical distancing (US); and
- General Workplace: PPE is required based on the workplace and hazard to the worker, and if required it must be fitted, periodically refitted, regularly inspected, maintained, replaced and properly removed to avoid contamination of self, others, or the environment (US).
- Infectious Disease Preparedness Plans: Infectious disease preparedness and response plans help guide protective actions against COVID-19. Plans should consider and address the level(s) of risk associated with various worksites and job tasks workers perform at those sites (EU, US). Various steps in preparedness plans can include: initial testing of all workers before entering a workplace; periodic testing of workers at regular intervals; targeted testing for new workers or those returning from a prolonged absence; and identifying what work activity or situations might cause transmission of the virus (US). Other considerations include: considering individuals that could be at risk; deciding how likely a worker could be exposed; and acting to control the risk (EU, UK).
- Triaging of Suspected or Confirmed COVID-19 Infection: Sick employees should report their symptoms to their employer, be encouraged to self-isolate, and stay at home. It is recommended that employers have sick leave policies that are flexible, non-punitive, and supportive (EU, US).
- COVID-19 Screening: The purpose of a workplace screening process is to verify employees’ symptoms and temperature prior to them entering a workplace setting. The screening process may consist of a screener who wears PPE (i.e., face mask, eye protection) and stands behind a physical barriers/partition (EU, US).
- Heating, Ventilation, Air Conditioning: Ventilation reduces the concentration of the virus in the air and therefore reduces the risks from airborne transmission. Some HVAC COVID-19 measures include turning off demand-controlled ventilation, considering the use of portable high-efficiency particulate air (HEPA) fan/filtration systems to help enhance air cleaning, and using ultraviolet germicidal irradiation (UVGI) as a supplement to help inactivate SARS-CoV-2 (US). In addition, it is recommended it to generally air out rooms or increase outdoor ventilation (UK, US).
Canadian Scan
- Education on and Awareness of COVID-19 Workplace Interventions: Education, training, and awareness is recommended on topics such as hand hygiene and workplace COVID-19 symptoms which are delivered in various languages (Canada).
- Organizational Leadership: In long-term care settings, it is recommended to have an infection prevention and control (IPC) lead, particularly in large, high risk facilities where outbreaks have occurred. An IPC lead can ensure accountability, enhance operations and communication, and facilitate interactions with public health (Canada).
- Interventions Outside the Workplace: Strategies outside the workplace that can help control COVID-19 within the workplace include restricting staff members to one worksite and avoiding public transportation through encouraging the use of carpooling or company vans (British Columbia, Alberta).
- Physical Distancing: The following interventions are recommended to increase physical distancing in the workplace (Canada):
- Plexi-shields separating employees from patrons;
- Spacing out workstations;
- Staggering work shifts to limit the number of employees in a workplace at a given time;
- Staggering lunch breaks, and organizing employees into work groups to minimize interaction; and
- Implementing paid leaves and/or other means of ensuring job security if employees are symptomatic or asymptomatic with COVID-19.
- Hand Hygiene: Hand washing and alcohol-based hand sanitizing stations (i.e., containing at least 60% alcohol) should be readily and easily available throughout the workplace.
- Disinfection and Sanitizing: When a COVID-19 case is identified at a workplace, all surfaces the infected person encountered must be cleaned, which is in addition to routine cleaning of high-traffic areas. The products, timing, and processes for cleaning differ based on the outbreak site, with hospitals and LTC facilities having different requirements (Canada).
- Personal Protective Equipment (PPE): PPE is recommended in essential workplaces to prevent the spread of COVID-19 (Canada).
- Homeless Shelter: Staff who are not dealing directly with clients and who are not within six feet should cover their face with a covering. For staff who are doing client temperature screening at intake, a physical barrier (i.e., plastic partition) is recommended. However, if the physical barrier is not available, then a medical facemask (not a cloth mask), eye protection, and disposable gloves should be used. For medical staff providing care, a N95 respirator, eye protection, gowns, and gloves should be used.
- Food Industry: For food businesses, PPE such as face masks, hair nets, disposable gloves, clean overalls, and slip reduction work shoes should be supplied for staff.
- Schools: Staff members must wear a face covering at all times when moving around the school. In schools located in red and orange zones, wearing a procedural mask is mandatory for all school staff at all times in common areas, in rooms used by staff, and on school grounds (Quebec). Wearing masks in school is mandatory for all students in grades four to 12 students and all staff, and is optional for students in kindergarten to grade three. In September 2020, teachers and students were provided with two reusable masks from the Alberta government. Should a teacher prefer a different face mask (i.e., higher quality) than what is provided or choose to wear a face shield in addition to a face mask, this would be at the teacher’s expense (Alberta).
Ontario Scan
- Interventions Outside the Workplace: Strategies outside the workplace that can help control COVID-19 within the workplace include restricting staff members to one worksite and avoiding public transportation through encouraging the use of carpooling or company vans.
- Personal Protective Equipment (PPE):
- Schools: All staff in schools must wear masks, with reasonable exceptions for medical conditions. Medical masks and eye protection, such as face shields, for all teachers and other school board staff are supplied. School staff who are regularly in close contact with students will be provided with all appropriate PPE.
- Child Care: Child care staff, home child care providers, home child care visitors, and early childhood education students are required to wear a medical mask and eye protection (e.g., face shields, safety glasses, and goggles) while inside the child care premises, including in hallways and staff rooms (unless eating, but time with masks off should be limited and physical distance should be maintained).