domingo, 22 de março de 2020

Pre-emptive low cost social distancing and enhanced hygiene implemented before local COVID-19 transmission could decrease the number and severity of cases. Dalton CB1, Corbett SJ2, Katelaris AL3. 1

Low cost Hygiene and Social Distancing Interventions

Box 1. Notes: *“Ill” person refers to someone with an undiagnosed respiratory illness or fever, who is not yet under investigation for COVID-19 but nevertheless could be an unrecognised case. ** This could be costly unless used judiciously while awaiting exclusion of COVID-19 in the case and should be introduced based on likelihood of local transmission. *** Evidence that low temperature and low humidity in air conditioned environments may enhance the survival of coronaviruses such as SARS.15 **** Sites such as the CDC travel risk assessment site may be useful https://www.cdc.gov/coronavirus/2019-ncov/travelers/index.html

Box 1. Workplace Interventions  No handshaking policy   Promote cough and sneeze etiquette (but focus is on excluding ill staff)  Videoconferencing as default for meetings  Defer large meetings  Enforced sanitisation of hands at entrance  Regular hand sanitation schedule reminders via email  Lunch at desk rather than in lunch room  Gamifying hygiene rules e.g. to discourage touching face   Ill* people stay at home and ill workers immediately isolated  Hold necessary meetings outside in open air if possible  Staff with ill household contacts should stay at home**  Disinfect high touch surfaces regularly and between users  Work from home where possible and consider staggering of staff where there is no loss of productivity from remote work  Consider opening windows and adjusting air conditioning***  Limit food handling and sharing of food in the workplace  Assess staff business travel risks****   Enhance hygiene and screening for illness among food preparation (canteen) staff and their close contacts.  Analyse the root cause of crowding events on site and prevent through rescheduling, staggering, cancelling.

Box 2. School Interventions  Supervised sanitisation of hands at entrance and at regular intervals  Defer activities that lead to mixing between classes and years.   Promote cough and sneeze etiquette (but focus on excluding ill persons)   Strict stay at home policy if ill  Gamifying hygiene rules e.g. to discourage touching face   Regular handwashing schedule  Disinfect high touch surfaces regularly and between users  Outdoor lessons where possible  Consider opening windows and adjusting conditioning   Enhance hygiene and screening for illness among food preparation (canteen) staff and their close contacts  Review after-school care arrangements that lead to mixing of children from multiple classes and ages


Box 4. Commercial/entertainment/transport setting Interventions  Sanitisation of hands at building entrance encouraged  Tap and pay preferred to limit handling of money.  Disinfect high touch surfaces regularly  Avoiding crowding through booking and scheduling, online prepurchasing, limiting attendance numbers.  Enhance hygiene and screening for illness among food preparation staff and their close contacts.  Enhance airflow and adjust air conditioning  Public transport workers/taxi/ride share – vehicle windows opened where possible, increased air flow

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