MANILA, Philippines – The easing of quarantine restrictions means that more industries are allowed to resume full or partial operations.

Fears that a second wave of infection may occur have, however, also been raised as other nations relax lockdowns. The World Health Organization (WHO) warned these countries to boost public health responses and ensure proper case identification and contact tracing to avoid a major second wave.

As of Wednesday, May 20, the number of confirmed coronavirus cases in the Philippines has risen to 13,221, with a death toll of 842.

To minimize the risks of infection due to the increased number of people in workplaces, government agencies have released guidelines for businesses to follow before and when they reopen their workplaces.

International institutions have also made checklists of what business owners and workers need to know about mitigating the coronavirus threat in their establishments.

What should employers consider before reopening workplaces?

The WHO and the Centers for Disease Control and Prevention (CDC) in the United States advise executives to conduct workplace risk assessment and draw up control plans in consultation with employees.

Work-related exposure depends on the likelihood of close contact or frequent contact with suspected coronavirus carriers, as well as contact with contaminated surfaces and objects.

Business operation decisions must also be based on the status of disease transmission in the community as well as the employer’s readiness to protect employees and customers. Executives must then monitor the cases in their community and work out policies in the event that infection occurs in the company.

What should be done before reopening a workspace?

According to the CDC, if building operations have been stopped or reduced, reductions in normal water use may cause hazards for occupants who will return to work. Microbial hazards that should be addressed before reopening are mold and Legionella, which causes Legionnaires’ disease.

Moisture from leaks or condensation from roofs, windows, or pipes, or even from floods, may cause mold to grow. Before resuming operations, buildings should be checked for mold and excess moisture. This could be done by trained industrial hygienists. If dampness or mold is detected, the water entry source must first be addressed, then clean-up and remediation must be conducted. 

Heating, ventilating, and air conditioning systems in the building that have been inactive for a prolonged period must be operated for at least 48 to 72 hours before the staff returns. This “flush out” process must be continued until no odors are detected.

As for Legionella, stagnant or standing water in a plumbing system may be the cause for its growth and spread. To reduce this risk, managers must determine if draining the water heater is recommended after a prolonged period of disuse. Higher temperatures may also reduce the risk of Legionella growth. 

Hot and cold water must also be flushed through all points of use like showers and sink faucets so that the water inside building piping may be replaced with fresh water. Decorative water features, like fountains, must also be cleaned. Safety equipment – like fire sprinkler systems, eyewash stations, and safety showers – must also be regularly flushed, cleaned, and disinfected.

How should returning workers be screened?

Based on the guidelines of the Philippine Department of Health (DOH), returning employees must be screened for COVID-19 symptoms, including fever, cough, colds, and other respiratory symptoms. They must be checked for any relevant travel history or exposure within the last 14 days.

Exposure means that these events happened two days prior or within 14 days from the onset of symptoms for a confirmed or probable case: face-to-face contact with a confirmed case for over 15 minutes and within one meter, direct physical contact with a confirmed case, and direct care for a probable or confirmed COVID-19 patient without using personal protective equipment (PPE).

Symptomatic employees with travel or exposure history on the date of work resumption should not be allowed to physically come back to work.

Symptomatic employees with travel or exposure history within the last 14 days before work resumption should present a certificate of quarantine completion issued by the step-down care facility or local health office.

Asymptomatic employees within the last 14 days before work resumption may be cleared to return to work.

What safeguards must be in place when operations resume?

Apart from mitigating work-related exposure risks to COVID-19, employers must also implement measures to provide support to employees. These standards should be planned out and ready for implementation before work resumes.

The following measures were recommended by the Department of Trade and Industry, the Department of Labor and Employment (DOLE), the DOH, WHO, and CDC:

Engineering and administrative controls

• The employer must provide visual reminders about safety policies around the workplace.
• Alternative working arrangements may be adopted or continued, such as working-hour shifts, work from home, or rotational duties.
• Employers must advise workers to stay home if they are sick, and allow vulnerable and immunocompromised employees to work from home without reduction in wages or benefits.
• Information, education, and communication programs on COVID-19 should be provided to workers.
• Employers must establish appropriate policies on sick leave, pay allowance, and medical insurance coverage to cater to COVID-19 needs. 
• Employers are also advised to provide shuttle services and/or accommodation near the worksite to lessen travel and movement. According to Presidential Spokesperson Harry Roque, if a company cannot provide shuttle service or if employees do not have means of transportation, then a company should not reopen. Labor Secretary Silvestre Bello III also said that employers are not obliged to provide shuttle service, but if they are unable to do so, their employees cannot be blamed for not being able to go to work.
• There must be a COVID-19 hotline and call center to allow workers to report symptoms and to monitor suspected cases daily.

Health checkups

• Daily temperature checks and symptom monitoring and recording for personnel must be conducted.
• Workers must accomplish a health symptoms questionnaire daily. This must be submitted to the guard or designated safety officer before entering the workplace.
• Personnel with temperatures above 37.5 degrees centigrade or with responses to the questionnaire that need further evaluation must be isolated in a designated area and not be allowed to enter the workplace.
• Clinical staff tasked to assess isolated workers must be provided PPE sets, including face masks, goggles or face shields, and/or gloves.
• A referral network for symptomatic employees must be established.

Promotion of physical and mental resilience

• Employers must remind workers on daily actions to stay healthy, such as eating nutritious and well-cooked food, drinking plenty of fluids and avoiding alcoholic beverages, getting at least 8 hours of sleep every night, and exercising regularly.
• Businesses should provide free medicines and vitamins to personnel.
• A referral must be in place for workers with mental health concerns.

Hygiene promotion

• Masks should be worn at all times. Washable masks must be worn with additional filter material such as tissue paper.
• Washrooms and toilets must have sufficient clean water and soap.
• Corridors, conference areas, elevators, stairways, and other areas where workers pass should have sanitizers.
• Workers must spray alcohol or sanitizer to both hands before entering the workplace. They must also wash their hands or spray alcohol before starting work, before eating, after contact with people, after going to the bathroom, after contact with body fluids, and after contact with potentially contaminated objects.
• Disinfectant foot baths at the entrance may also be provided.
• Tissues must be disposed of properly.

Environmental cleaning and disinfection

• Tables and chairs should be cleaned or disinfected after every use, and prior to, and at the end of, the workday. Canteens and kitchens must undergo regular cleaning and disinfection. All wastes must be disposed of properly.
• Work areas and frequently-handled objects, like doorknobs and handles, must be cleaned and disinfected at least once every two hours.
• Equipment or vehicles entering the work area must be disinfected.

Physical distancing

• Eating should ideally be done in individual work areas. If this is not possible, physical distancing must be ensured, with one worker per table and one-meter distance between workers. Conversations with masks off during meal times are discouraged.
• Prolonged face-to-face interaction between workers as well as with clients is discouraged.
• Physical meetings, if needed, should be limited to as few people as possible and be held for a short duration only. Lengthy discussions must be conducted through videoconferencing.
• Office tables may be arranged to maintain physical distancing. Barriers between tables may also be installed.
• Aisles, corridors, or walkways should follow unidirectional movement. Workstations should be designed to facilitate this.
• The number of people in enclosed spaces – like rooms, stores, or halls – should be limited.
• For elevator use, the number of people must also be limited. The use of stairs is encouraged, and if more than two stairways are accessible, one may be used exclusively for going up and another may be used for going down.
• For clients who need assistance in offices, online systems are encouraged.
• Physical distancing and compliance with the minimum health protocols must be ensured by roving officers.

What costs should employers cover?

The expenses to acquire and implement prevention and control measures should be shouldered by the employer. According to DOLE’s advisory, these include the following:

• Disinfection facilities
• Hand sanitizers
• PPE sets
• Face masks
• Signages
• Proper orientation and training for workers regarding COVID-19 prevention and control

Meanwhile, for construction project contracts and security, janitorial, and other services, these prevention and control measures will be provided by the principals or clients of the construction or service contractor.

If returning employees will be tested, how should it be conducted?

Testing returning workers is the prerogative of the employer. If an employer decides to conduct testing, the DOH recommends testing a representative sample of those who have physically returned to work and have a high risk of contracting COVID-19 due to their line of work, such as frontliners.

Reverse transcription–polymerase chain reaction (RT–PCR) testing for these personnel may be conducted to look for evidence of asymptomatic transmitters.

Those who test positive should be isolated and referred for appropriate management. Close contacts will also be isolated and tested. Those who test negative may continue working under the minimum preventive measures.

If an employee initially tested negative but developed symptoms over time, he or she must be tested again. In the event of testing positive, close contacts should be isolated and tested.

Employers must then report results to the DOH.

Meanwhile, testing representative samples using rapid antibody tests may be conducted up to every 14 days.

IgM negative, IgG negative, or IgG positive employees may continue to work. If an employee tests IgM positive but IgG negative on the first test, he or she should be isolated for 14 days and be tested again on the 14th day.

If the results are the same, quarantine will be extended by 7-day increments with repeat testing. If the results remain IgM positive but IgG negative for two consecutive retesting after the first 14-day quarantine period, an employee may be false-positive and must confer with infectious disease specialists.

Employers must submit the results of the rapid antibody tests to hrtucovid19results@gmail.com using the format at https://bit.ly/RDTReportingForm. – Rappler.com