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Course 638 Preparing Workplaces for COVID-19

Safety guides and audits to make your job as a safety professional easier

Infectious Disease Prevention and Planning

As a result of infectious disease outbreaks and pandemics throughout the recent past, OSHA has developed infectious disease preparedness and response planning guidance. The guidance is based on traditional infection prevention and industrial hygiene practices and focuses on the design, development, and deployment of an Infectious Disease Prevention and Response (IDPR) Plan.

Click on the button below to see information on a variety of recent infectious disease outbreaks and pandemics.

Recent Events Involving Infectious Diseases

Ebola Virus Disease (EVD) - One of the deadliest viral diseases, Ebola was discovered in 1976 when two consecutive outbreaks of fatal hemorrhagic fever occurred in different parts of Central Africa. The first outbreak occurred in the Democratic Republic of Congo (formerly Zaire) in a village near the Ebola River, which gave the virus its name. The second outbreak occurred in what is now South Sudan, approximately 500 miles (850 km) away. More information on Ebola.

Middle East Respiratory Syndrome (MERS) - Middle East Respiratory Syndrome (MERS) is an illness caused by a virus (more specifically, a coronavirus) called Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Most MERS patients developed severe respiratory illness with symptoms of fever, cough and shortness of breath. About 3 or 4 out of every 10 patients reported with MERS have died. More information on MERS.

Norovirus Illness - Norovirus is the leading cause of foodborne illness in the United States. It causes 58% of foodborne illnesses and is the leading cause of vomiting and diarrhea from acute gastroenteritis (inflammation of the stomach and intestines) among people of all ages. It is the leading cause of acute gastroenteritis among U.S. children less than 5 years of age who seek medical care. Norovirus is responsible for nearly 1 million pediatric medical care visits annually. More information on Norovirus Norovirus Toolkit.

Severe Acute Respiratory Syndrome (SARS) - Severe acute respiratory syndrome (SARS) is an emerging, sometimes fatal, respiratory illness. The first identified cases occurred in China in late 2002, and the disease has now spread throughout the world. Although SARS is believed to be caused by a virus, the specific agent has not been identified, and there is not yet any laboratory or other test that can definitively identify cases. Suspected SARS cases in the United States have involved individuals returning from travel to Asia and health care workers and other contacts of those patients. More information on SARS

Swine Influenza - Swine Flu is a respiratory disease of pigs caused by type A influenza viruses that regularly cause outbreaks of influenza in pigs. Influenza viruses that commonly circulate in swine are called “swine influenza viruses” or “swine flu viruses.” Like human influenza viruses, there are different subtypes and strains of swine influenza viruses. The main swine influenza viruses circulating in U.S. pigs in recent years have been, swine triple reassortant (tr) H1N1 influenza virus, trH3N2 virus, and trH1N2 virus. More information on Swine Influenza. Information on Past Influenza Pandemics.

Tuberculosis (TB) - According to the Centers for Disease Control and Prevention (CDC) in 2008, nearly one-third of the world's population is infected with Tuberculosis (TB), which kills almost 1.6 million people per year. TB is now the second most common cause of death from infectious disease in the world after human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS). More information on Tuberculosis.

Masked employee.
Plan for the next outbreak.
Click to enlarge.

COVID-19 Pandemic

Note: Although we are emphasizing preparedness and response to the COVID-19 pandemic, the information in this course may also be valuable in preparing and responding to other infectious disease outbreaks, epidemics, and pandemics.

What Employers Must Do

To reduce the long-term impact of infectious disease outbreak conditions on businesses, workers, customers, and the public, it is important for all employers to implement an Infectious Disease Preparedness and Response (IDPR) Plan.

  • For employers who have already planned for influenza pandemics, planning for COVID-19 may involve updating plans to address the specific exposure risks, sources of exposure, routes of transmission, and other unique characteristics of SARS-CoV-2.
  • Employers who have not prepared for pandemic events should prepare themselves and their workers as far in advance as possible of potentially worsening outbreak conditions.

Lack of continuity planning can result in a cascade of failures as employers attempt to address challenges of COVID-19 with insufficient resources and workers who might not be adequately trained for jobs they may have to perform under pandemic conditions.

Click on the button below to a list of links to more resources on COVID-19.

  1. FREE OSHA Coronavirus Resources
  2. The latest Covid-19 Updates from the CDC
  3. Ten Steps All Workplaces Can Take to Reduce Risk of Exposure to Coronavirus
  4. National Pandemic Influenza Plans
  5. HHS Pandemic Influenza Plan 2017 Update
  6. Utah Dept. of Health Infectious Disease Emergency Response Plan
  7. Infectious Disease Emergency Response Plan - SFDPH
  8. Univ. of Texas Emergency Operations Plan Annex I - Infectious Disease
  9. SOG Sample Infectious Disease Exposure Control Plan
  10. Sample Policy for Emergent Infectious Diseases for Skilled Nursing Care Centers
  11. OSHA COVID-19 Overview
  12. Guidance on Preparing Workplaces for COVID-19
  13. NIOSH Exposure Control Plan
  14. OSHA Infectious Diseases Page
  15. CDC Hand Hygiene in Healthcare Settings
  16. OSHA Training Requirements
  17. Guide to Infection Prevention for Outpatient Settings
  18. Guidelines for Environmental Infection Control in Health-Care Facilities
  19. COVID-19 Guidance for Restaurants & Beverage Vendors Offering Takeout or Curbside Pickup (Spanish). (May 1, 2020).
  20. COVID-19 Guidance for the Construction Workforce (Spanish). (April 21, 2020).
  21. COVID-19 Guidance for the Manufacturing Industry Workforce (Spanish). (April 16, 2020).
  22. COVID-19 Guidance for the Package Delivery Workforce (Spanish). (April 13, 2020).
  23. COVID-19 Guidance for Retail Workers (Spanish). (April 8, 2020).
  24. Prevent Worker Exposure to Coronavirus (COVID-19) (Spanish). (March 2020).
  25. COVID-19 Guidance for Dentistry Workers and Employers
  26. Ten Steps All Workplaces Can Take to Reduce Risk of Exposure to Coronavirus | Spanish
  27. CDC Guidelines for Schools and Child Care Program

Click on the buttons below to see a video giving you an overview of COVID-19 and a short video on prevention methods.

Read the material in each section to find the correct answers to each of the questions. After answering all questions, click the "Check Quiz Answers" button to see your score and a list of missed questions. To correct a question, return to the question, review the material, change your answer, and return to the last section page. Click the "Check Quiz Answers" again to recheck the results.

Do not refresh these pages or you'll have to answer all questions again.

Note: Videos and exercises in our courses are for information only and not required to view. Final exam questions will not be derived from the videos. OSHAcademy is not responsible for video content.

1. To mitigate the long-term negative impact of an infectious disease outbreak, employers should _____.

a. send workers home if they get sick
b. move the company to a rural location
c. develop and deploy a IDPR Plan
d. close the business until the outbreak is over

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What is COVID-19?

COVID-19 morphology
Ultrastructural morphology of COVID-19.
Click to enlarge.

"COVID-19" is shorthand for COronaVIrus Disease 2019. It is a respiratory disease caused by the SARS-CoV-2 virus. It has spread from China to many other countries around the world, including the United States. Because COVID-19 has reached the level of world-wide pandemic, it can affect all aspects of daily life, including travel, trade, tourism, food supplies, and financial markets.

Symptoms of COVID-19

Infection with SARS-CoV-2, the virus that causes COVID-19, can cause illness ranging from mild to severe and, in some cases, can be fatal.

  • Most people experience symptoms such as fever (the most common symptom), dry cough, shortness of breath, and general aches and pains.
  • Others may also experience sputum production, headache, spitting up blood, or diarrhea. Some people infected with the virus have reported experiencing other non-respiratory symptoms. Other people, referred to as asymptomatic cases, have experienced no symptoms at all.

According to the CDC, symptoms of COVID-19 may appear in as few as 2 days or as long as 14 days after exposure.

Click on the buttons below to learn more about the symptoms of COVID-19.

2. COVID-19 is caused by _____.

a. any one of several common flu viruses
b. a wide family of coronaviruses
c. the SARS-CoV-2 virus
d. a specific MERS-19 zootic virus

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How COVID-19 Spreads

How coronavirus is transmitted
How COVID-19 spreads.
Click for more information.

Basically, COVID-19 spreads like the flu. Although the first human cases of COVID-19 likely resulted from exposure to infected animals, infected people can spread SARS-CoV-2 to other people.

The virus is thought to spread mainly from person- to-person, including:

  • Between people who are in close physical contact with one another (within about 6 feet).
  • Through respiratory droplets produced when an infected person coughs or sneezes. These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs.

It may be possible that a person can get COVID-19 by touching a surface or object infected with SARS-CoV-2. However, the CDC does not consider this a primary transmission route. Risk assessment studies estimate the risk of surface transmission is less than 1 in 10,000. Using soap or detergent is considered acceptable in reducing risk unless confirmed cases of COVID-19 was present within the past 24 hours. In such cases, the CDC recommends disinfection.

People are thought to be most contagious when they are most symptomatic (i.e., experiencing fever, cough, and/or shortness of breath). Some spread might be possible before people show symptoms; there have been reports of this type of asymptomatic transmission with this new coronavirus, but this is also not thought to be the main way the virus spreads.

Although the United States has implemented public health measures to limit the spread of the virus, it is likely that some person-to-person transmission will continue to occur.

This CDC website provides the latest information about COVID-19.

Click on the button below to see videos on the spread of COVID-19 and related topics.

3. The coronavirus is thought to spread mainly from person-to-person _____.

a. who contact fecal matter
b. if they share food or drink
c. through sexual contact
d. who are in close physical contact

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How COVID-19 Affects the Workplace

COVID-19 morphology
The pandemic can affect the economy.
Click to Enlarge.

Similar to viral infections, COVID-19 has the potential to cause extensive outbreaks. Under conditions associated with widespread person-to- person spread, multiple areas of the United States and other countries may see impacts at the same time. In the absence of a vaccine, an outbreak may also be an extended event. As a result, workplaces may experience:

  • Absenteeism: Workers could be absent because they are sick; are caregivers for sick family members; are caregivers for children if schools or daycare centers are closed; have at-risk people at home, such as immunocompromised family members; or are afraid to come to work because of fear of possible exposure.
  • Change in patterns of commerce: Consumer demand for items related to infection prevention (e.g., respirators) is likely to increase significantly, while consumer interest in other goods may decline. Consumers may also change shopping patterns because of a COVID-19 outbreak. Consumers may try to shop at off-peak hours to reduce contact with other people, show increased interest in internet and home delivery services, or prefer other options, such as drive- through service, to reduce person-to-person contact.
  • Interrupted supply/delivery: Shipments of items from geographic areas severely affected by COVID-19 may be delayed or canceled with or without notification.

Click on the button below to see a video about COVID-19 good hygiene practices.

4. Which of the following is an example of a change in patterns of commerce due to COVID-19?

a. Increased internet and home delivery services
b. Employees are afraid to go to work
c. Schools and day care centers close
d. Workers are absent because they are sick

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Infectious Disease Preparedness and Response Plan

A cranes outrigging supported in muddy conditions.
The IDPR Plan is only one component in the Business Continuity Plan.
Click for more information.

This section describes basic steps that every employer can take to reduce the risk of worker exposure to SARS-CoV-2, the virus that causes COVID-19, in their workplace. Later sections of this guidance—including those focusing on jobs classified as having low, medium, high, and very high exposure risks— provide specific recommendations for employers and workers within specific risk categories.

Develop an Infectious Disease Preparedness and Response (IDPR) Plan

The IDPR Plan is an important component of a company's Business Continuity Plan. If your company does not yet have an IDPR Plan, don't wait: develop a plan that can help guide protective actions against COVID-19 and other infectious diseases.

Stay abreast of guidance from federal, state, local, tribal, and/or territorial health agencies, and consider how to incorporate those recommendations and resources into workplace-specific plans.

Plans should consider and address the level(s) of risk associated with various worksites and job tasks workers perform at those sites.

Click on the button below to see the considerations when developing the IDPR Plan.

  1. Where, how, and to what sources of SARS-CoV-2 might workers be exposed, including:
    • The general public, customers, and coworkers; and
    • Sick individuals or those at particularly high risk of infection (e.g., international travelers who have visited locations with widespread sustained (ongoing) COVID-19 transmission, healthcare workers who have had unprotected exposures to people known to have, or suspected of having, COVID-19).
  2. Non-occupational risk factors at home and in community settings.
  3. Workers' individual risk factors (e.g., older age; presence of chronic medical conditions, including immunocompromising conditions; pregnancy).
  4. Controls necessary to address those risks.

Follow federal and state, local, tribal, and/or territorial (SLTT) recommendations regarding development of contingency plans for situations that may arise as a result of outbreaks, such as:

  • Increased rates of worker absenteeism.
  • The need for social distancing, staggered work shifts, downsizing operations, delivering services remotely, and other exposure-reducing measures.
  • Options for conducting essential operations with a reduced workforce, including cross-training workers across different jobs in order to continue operations or deliver surge services.
  • Interrupted supply chains or delayed deliveries.

Plans should also consider and address the other steps that employers can take to reduce the risk of worker exposure to SARS-CoV-2 in their workplace, described in the following sections.

5. Infectious Disease Preparedness & Response Plans should consider and address _____.

a. warning signage to identify infected employees
b. scheduling consolidated work shifts
c. the costs associated with control measures
d. the levels of risk associated with worksites and tasks

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Infectious Disease Preparedness and Response Plan (Continued)

Cutting concrete creating dust
Washing hands often helps prevent infection.
Click to enlarge.

Prepare to Implement Basic Infection Prevention Measures

When developing the IDPR Plan, develop policies and procedures that emphasize basic infection prevention measures. As appropriate, all employers should give information and training on good hygiene and infection control practices, including:

  • Personal Hygiene: Promote frequent and thorough hand washing, including by providing workers, customers, and worksite visitors with a place to wash their hands. If soap and running water are not immediately available, provide alcohol-based hand rubs containing at least 60% alcohol.
  • Flexible work scheduling: Employers should explore establishing policies and practices, such as flexible worksites (e.g., telecommuting) and flexible work hours (e.g., staggered shifts). Require workers to stay home if they are sick. Encourage work at home when possible.
  • Respiratory etiquette: Encourage properly covering coughs and sneezes.
  • Waste containment: Provide customers and the public with tissues and trash receptacles.
  • Social distancing: This measure and hand washing are the two most effective measures to prevent infection. Increase the physical distance to at least 6 feet among employees and between employees and others, both on and off work, and do not shake hands.
  • Sharing items: Discourage workers from using other workers' phones, desks, offices, or other work tools and equipment, when possible.
  • Housekeeping: Maintain good housekeeping practices, including routine cleaning and disinfecting of surfaces, equipment, and other elements of the work environment. When choosing cleaning chemicals, employers should consult information on Environmental Protection Agency (EPA) -approved disinfectant labels with claims against emerging viral pathogens. Products with EPA-approved emerging viral pathogens claims are expected to be effective against SARS-CoV-2 based on data for harder to kill viruses.

Click the button to watch an interesting video on the transmission and control of infectious diseases.

6. Which of the following are the two of the most important infection control practices to stress in the IDPR Plan?

a. Respiratory etiquette and work policies
b. Social distancing and personal hygiene
c. Flexible work schedules and cleaning surfaces
d. Not sharing items and waste containment

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Infectious Disease Preparedness and Response Plan (Continued)

Develop Policies and Procedures

Sick worker at home
To isolate workers, send them home.
Click to enlarge.

Develop effective policies and procedures to identify and isolate employees and others who may be infected and showing symptoms. Policies and procedures include the following:

  • Identification: Prompt identification and isolation of potentially infectious individuals is a critical step in protecting workers, customers, visitors, and others at a worksite.
  • Self-monitoring: Employers should inform and encourage employees to self-monitor for signs and symptoms of COVID-19 if they suspect possible exposure.
  • Reporting symptoms: Employers should develop policies and procedures for employees to report when they are sick or experiencing symptoms of COVID-19.
  • Isolation: Where appropriate, employers should immediately isolate people who have signs and/or symptoms of COVID-19. Move potentially infectious people to a location away from workers, customers, and other visitors to prevent further transmission—particularly in worksites where medical screening, triage, or healthcare activities occur, using either permanent (e.g., wall/different room) or temporary barrier (e.g., plastic sheeting).
  • Limiting the spread: Take steps to limit spread of the respiratory secretions of a person who may have COVID-19. Provide a face mask, if feasible and available, and ask the person to wear it, if tolerated. Note: A face mask (also called a surgical mask, procedure mask, or other similar terms) on a patient or other sick person should not be confused with PPE for a worker; the mask acts to contain potentially infectious respiratory secretions at the source (i.e., the person’s nose and mouth).
  • Restricted entry: Restrict the number of personnel entering isolation areas.
  • Exposure controls: Protect workers in close contact with (i.e., within 6 feet) a sick person or who have prolonged/repeated contact with such persons by using additional engineering and administrative controls, safe work practices, and PPE. Workers whose activities involve close or prolonged/ repeated contact with sick people are addressed further in later sections covering workplaces classified at medium and very high or high exposure risk.

Click on the buttons below to see a video on protective policies in the workplace.

7. What is the best policy if an employee self-identifies and reports symptoms of COVID-19 at work?

a. End of day reporting
b. Isolating the employee
c. Encourage safe practices
d. Restricted movement

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Infectious Disease Preparedness and Response Plan (Continued)

Classroom training.
Inform everyone about policies.
Click to enlarge.

Develop Flexibility in the Plan

Develop flexible IDPR Plan policies for employees. Include the following:

  • During an outbreak, require sick employees to stay at home.
  • Ensure that sick leave policies are flexible and that employees are aware of these policies.
  • Talk with temporary employee providers about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
  • Do not require a healthcare provider's note for employees who are sick with acute respiratory illness to validate their illness or to return to work.
  • Maintain flexible policies that permit employees to stay home to care for a sick family member.
  • Recognize that workers with ill family members may need to stay home to care for them.
  • Be aware of workers' concerns about pay, leave, safety, health, and other issues. Provide adequate information and training about business-essential job functions, proper hygiene practices, and the use of any exposure controls.
  • Work with insurance companies and public health agencies to provide information to workers and customers about medical care in the event of an outbreak.

Once the Plan is Developed

After the IDPR Plan has been developed, the work is not yet done. You can help make sure the plan is effective by taking the following actions:

  • Ensure the plan is flexible and involve your employees in developing and reviewing your plan.
  • Conduct an exercise to discover ahead of time if the plan has gaps or problems that need to be corrected.
  • Prepare a checklist containing all essential steps, actions, and responsible persons.
  • Tell employees what human resources policies, workplace and leave flexibilities, and pay and benefits will be available to them.
  • Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce, and associations to improve community response efforts.

Click on the buttons below to see links to Sample Plans and a video to learn about preventive measures.

8. What is recommended to make sure gaps in the IDPR Plan are discovered before an actual infectious disease outbreak occurs?

a. Prepare a checklist
b. Compare the plan with others
c. Submit the plan to OSHA for review
d. Exercise the plan

Next Section

OSHA Recordkeeping

Classroom training.
OSHA may conduct no-notice COVID-19 inspections.

The U.S. Department of Labor’s Occupational Safety and Health Administration (OSHA) has adopted policies for enforcing OSHA's requirements with respect to coronavirus as economies reopen in states throughout the country.

Under OSHA's recordkeeping requirements, COVID-19 is a recordable illness, and thus employers are responsible for recording cases of COVID-19, if:

  1. The case is a confirmed case of COVID-19, as defined by the Centers for Disease Control and Prevention (CDC);
  2. The case is work-related as defined by 29 CFR § 1904.5; and
  3. The case involves one or more of the general recording criteria set forth in 29 CFR § 1904.7.

As states begin reopening their economies, OSHA and CDC have issued interim guidance to ensure employers are taking action to protect their employees. Due to the ever-changing nature of the OSHA and CDC guidance, please refer to the following links for updated recordkeeping and reporting information:

9. A coronavirus illness is recordable if the case meets each of the following conditions EXCEPT _____.

a. it is work-related
b. it became symptomatic on a regular work day
c. it is a confirmed COVID-19 case
d. it involves one or more general recording criteria

Check your Work

Read the material in each section to find the correct answer to each quiz question. After answering all the questions, click on the "Check Quiz Answers" button to grade your quiz and see your score. You will receive a message if you forgot to answer one of the questions. After clicking the button, the questions you missed will be listed below. You can correct any missed questions and check your answers again.

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