This article provides safety and health guidance for those “Essential Employees” who must go to work even under these uncertain conditions of an unknown and invisible enemy, COVID-19. This article also speaks to the general premise and precautionary measures one can take to safeguard against COVID-19 while knowing well that real protection is only in Allah’s hands. Prayers to the Al-Hafeez (The Preserver, The Protector, The Guardian) are a mandatory part of these protective measures.
Coronavirus Disease 2019 (COVID-19) is a respiratory disease caused by the SARS-CoV-2 virus (1). It is now a pandemic spread across the world, including the United States. Depending on the severity of COVID-19’s global impacts, outbreak conditions can affect all aspects of daily life, including travel, trade, tourism, food supplies, and financial markets.
To reduce the impact of COVID-19 outbreak conditions on businesses, workers, customers, and the public, all employers need to plan for continuity of their operations. This means that some essential employees will continue to have to attend to the business of their assigned duties. Many of us are classified as “Essential Workers” and expected to work in the COVID-19 environment when staying-at-home (isolation) is perhaps the safest place to be. Those who have the option to telework should do so, thereby minimizing risk to their families and themselves.
While the right amount of workplace safety responsibilities falls on employers’ shoulders, employees should be well versed in their protection and take appropriate steps to protect themselves. After all, it is precious human life. In the United States, the Occupational Safety and Health Administration (OSHA), the Centers for Disease Control (CDC), the National Institute for Occupational Safety and Health (NIOSH), and the National Institute of Health (NIH) are leading authorities in developing and providing safety guidance to workers. The commercial sector also has a strong cadre of consensus-building organizations, such as the American Medical Association (AMA). These organizations provide COVID-19 planning guidance based on traditional infection prevention and industrial hygiene practices. It focuses on the need for employers to implement engineering, administrative, and work practice controls, as well as providing personal protective equipment (PPE).
Although the SARS-CoV-2 virus can spread from both infected people and animals, the virus is thought to spread mainly from person-to-person contact with one another (about 6 feet) and through droplets of an infected person’s coughs, sneezes, or even conversation. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled. It may be possible that a person can get COVID-19 by touching a surface or object that has SARS-CoV-2 on it and then touching their mouth, nose, or eyes, but this is not thought to be the primary way the virus spreads. While people are most contagious when most symptomatic, some spread might be possible before people show symptoms (asymptomatic).
Infection with SARS-CoV-2 can cause illness ranging from mild to severe and, in some cases, can be fatal. Symptoms typically include fever, cough, and shortness of breath. Some people infected with the virus have reported experiencing other non-respiratory symptoms, and others remain asymptomatic. COVID-19 symptoms may appear in as few as two days or as long as 14 days after exposure.
Advice for workers is that they should conform to employers’ guidance, as the employers are bound by the law to protect their employees. That being said, one should also take responsibility for their own well-being. For this article, we dwell on what actions workers can take to protect themselves.
Control of hazards in the workplace is best achieved by using a systemic framework called the “Hierarchy of Controls.” (2) This approach allows the danger to be systematically removed from the workplace, rather than relying on workers to reduce their exposure. The best way of controlling a hazard is to:
- engineer the risk out (called Engineering Control)
- develop administrative guidelines for control (Administrative Control), and
- using personal protective equipment (PPE), in that order.
Engineering controls require no effort by the worker, while administrative and PPE controls require an exceeding amount of effort. For example, installing a clear plastic sneeze guard at a receptionist’s counter, instead of telling people to stand 6 feet away, versus everyone being required to wear a respirator. The use of PPE is often considered to be the least effective hazard control techniques. In most cases, a combination of control measures will be necessary to protect workers from exposure to SARS-CoV-2.
Hierarchy of Controls
Other examples of Engineering Controls include installing high-efficiency air filters, increasing ventilation rates in the workspaces, installing physical barriers, installing a drive-through window for customer service, or specialized negative pressure ventilation in some settings.
As engineering controls are not often in an employee’s control, a combination of administrative and PPE control will perhaps be more beneficial for the readers of this article. SARS-CoV-2 administrative controls include:
- Encouraging sick workers to stay at home. Minimizing contact among workers, clients, and customers by replacing face-to-face meetings with virtual communications and implementing telework if feasible.
- Establishing alternating days or extra shifts that reduce the total number of employees in a facility at a given time.
- Discontinuing non-essential travel to locations with ongoing COVID-19 outbreaks. Training workers in the use of PPE and clothing.
- Practice improved personal hygiene by washing hands, using tissues, no-touch trash cans, 60 % alcohol-based hand rubs, disinfectants, and disposable towels for cleaning.
Personal Protective Equipment (PPE): While engineering and administrative controls are considered more effective in minimizing exposure to SARS-CoV-2, PPE may also be needed to prevent individual exposures. Examples of PPE include gloves, goggles, face shields, facemasks, and respiratory protection, when appropriate. Remember that some PPE already required for your job might already be protective enough, and in some cases, protection level will need to be enhanced to incorporate considerations for COVID-19. All types of PPE must be selected based upon the hazard, adequately fitted, regularly inspected, maintained, cleaned, stored and replaced, to avoid contamination of self, others, or the environment.
Special Considerations for Healthcare Workers: Healthcare and other workers, those who work within 6 feet of patients known or suspected of being, infected with SARS-CoV-2 and those performing aerosol-generating procedures, need to use NIOSH-approved, N95 filtering face-piece respirators, or better. These workers need to be medically qualified, fit-tested, and trained in the use and maintenance of the respirators, as per OSHA’s requirements (3).
When disposable N95 [or KN95]filtering face-piece respirators are not available, consider using other respirators that provide better protection and improve worker comfort. These include R/P95, N/R/P99, or N/R/P100 filtering face-piece respirator; an air-purifying elastomeric (e.g., half-face or full-face) respirator with appropriate filters or cartridges; powered air-purifying respirator (PAPR) with high-efficiency particulate air (HEPA) filter; or supplied-air respirator (SAR). Consider using PAPRs or SARs, which are more protective than filtering face-piece respirators, for any work operations or procedures likely to generate aerosols (e.g., cough induction procedures, some dental procedures, invasive specimen collection, blowing out pipettes, shaking or vortexing tubes, filling a syringe, centrifugation). Face shields may also be worn on top of a respirator to prevent extensive contamination of the respirator.
In summary, the following general prevention guidelines must be adhered to protect self and others (4):
- Wash hands with soap and water for at least 20 seconds. If soap and water are not available, use an alcohol-based hand sanitizer.
- Avoid touching your eyes, nose, and mouth with unwashed hands.
- Practice social distancing by maintaining a separation of at least six feet (6’) from others.
- Stay home when you are sick or if an immediate member of your household is symptomatic or has been tested for or diagnosed with the COVID-19 virus.
- Cover your cough or sneeze with tissue on the front side of the elbow, then throw the tissue in the trash. Wash or disinfect your hands afterwards.
- Clean and disinfect frequently touched objects, tools, equipment, and surfaces. Minimize transferring paper; use electronic means (scanning, emails, etc.) instead.
- If you choose to handle others’ paperwork, disinfect your hands and workstation.
- Do not eat or drink when doing these additional risky maneuvers.
- Disinfect your hands after using refrigerators, microwave, copier, three-hole punch, etc.
We hope and pray for everyone’s protection through the Grace and Mercy of Almighty Allah.
This article appears in our Summer 2020 print edition.
1. Occupational Safety and Health Administration, https://www.osha.gov/SLTC/covid-19 [Accessed June 7, 2020]
2. https://www.cdc.gov/niosh/topics/hierarchy/default.html [Accessed June 7, 2020]
3. OSHA, https://www.osha.gov/SLTC/covid-19/healthcare-workers.html [Accessed June 7, 2020]
4. NIOSH, https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html [Accessed June 7, 2020]
Last modified: February 2022