WORKPLACE READINESS FOR COVID-19 INTERIM GUIDE PART 3 as of MAY 26, 2020 PHILIPPINE COLLEGE OF OCCUPATIONAL MEDICINE, INC. TABLE OF CONTENTS NEW CLASSIFICATION OF INDIVIDUALS FOR COVID-19 ....................................................................... 2 WORKER EXPOSURE RISK TO COVID-19 ................................................................................................ 3 DUTIES OF THE OCCUPATIONAL HEALTH PHYSICIAN ......................................................................... 4 DUTIES OF THE OCCUPATIONAL HEALTH NURSE ................................................................................ 4 DUTIES OF THE FIRST AIDER .................................................................................................................... 4 DUTIES OF THE OCCUPATIONAL HEALTH PRACTITIONER ................................................................. 4 DUTIES OF THE HEALTH AND SAFETY COMMITTEE ............................................................................. 5 DUTIES OF THE EMPLOYERS .................................................................................................................... 5 SHARED ACCOUNTABILITY ....................................................................................................................... 5 HIERACHY OF CONTROLS ......................................................................................................................... 6 HAZARD IDENTIFICATION, RISK ASSESSMENT AND DETERMINATION OF CONTROL (HIRADC) 10 EQUALITY IN THE WORKPLACE ............................................................................................................. 18 MANAGING VISITORS, CLIENTS ETC. .................................................................................................... 18 CLEANING THE WORKPLACE ................................................................................................................. 18 SHIFT PATTERNS AND WORKING GROUPS .......................................................................................... 19 WORK-RELATED TRAVEL ........................................................................................................................ 19 COMMUNICATION AND TRAININGS ........................................................................................................ 20 INCREASE PHYSICAL AND MENTAL RESILIENCE ............................................................................... 20 RETURN TO WORK .................................................................................................................................... 21 RAPID ANTIBODY TESTING ..................................................................................................................... 29 ADVISORIES AND ISSUANCES ................................................................................................................ 30 RESOURCES: ............................................................................................................................................. 35 Philippine College of Occupational Medicine, Inc. 1 NEW CLASSIFICATION OF INDIVIDUALS FOR COVID -19 The following are the new DOH case definitions for notification which transitions the reporting of PUI and PUM to Suspect, Probable, and Confirmed COVID-19 cases. These definitions are consistent with the latest WHO Global Surveillance for COVID-19 disease interim guidance (as of March 20, 2020). Thus, the COVID-19 Surveillance System, through the DOH Epidemiology Bureau, will capture and detect cases through the enhanced influenza-like illness (ILI) and expanded severe acute respiratory infection (SARI) sentinel surveillance systems, notification from hospital and laboratory facilities, and event-based surveillance and response. SUSPECT CASE is a person who is presenting with any of the conditions below: a. All SARI cases where NO other etiology fully explains the clinical presentation. b. Individuals with influenza-like illness (ILI): a. With no other etiology that fully explains the clinical presentation AND history of travel to or residence in an area that reported local transmission of COVID-19 disease during the 14 days prior to symptom onset OR b. With contact* to a confirmed or probable case of COVID-19 disease during the 14 days prior to the onset of symptoms c. Individuals with fever or cough or shortness of breath or other respiratory signs or symptoms and under any of the following conditions: (i) aged 60 years and above, (ii) with a comorbidity, (iii) assessed as having high-risk pregnancy, or (iv) a health worker. PROBABLE CASE A. Suspect case whom testing for COVID-19 is inconclusive B. Suspect case who tested positive for COVID-19 but whose test was not conducted in a national or subnational reference laboratory, or an officially accredited laboratory CONFIRMED CASE A. Any individual irrespective of the presence of clinical signs and symptoms who was laboratory- confirmed for COVID-19 in a test conducted at the national reference laboratory or subnational reference laboratory, or a DOH-certified laboratory testing facility *Contact as defined by the WHO Global Surveillance for COVID-19 disease interim guidance (as of March 20, 2020) is a person who experienced any one of the following exposures during the 2 days before and the 14 days after the onset of symptoms of a probable or confirmed case: 1. Face-to-face contact with a probable or confirmed case within 1 meter and for more than 15 minutes; 2. Direct physical contact with a probable or confirmed case; 3. Direct care for a patient with probable or confirmed COVID-19 disease without using proper PPE; OR 4. Other situations as indicated by local risk assessments Note: For confirmed asymptomatic cases, the period of contact is measured as the 2 days before through the 14 days after the date on which the sample was taken which led to confirmation. Philippine College of Occupational Medicine, Inc. 2 WORKER EXPOSURE RISK TO COVID-19 LOW EXPOSURE RISK • Individuals that are only in contact for a brief period of time (≦ 2minutes) • Jobs that do not require contact with people known to be or suspected of being infected. Workers have minimal occupational contact with the public and other coworkers. • Practice physical distancing at all times *Follow applicable engineering, administrative and PPE controls in your workplaces MEDIUM EXPOSURE RISK • Individuals are in contact for a longer period of time and are fairly distant from each other. • Jobs that require frequent/close contact with people who may be infected, but who are not known or suspected patients or close contacts of the same. Workers may have contact with the general public (e.g. restaurants, high-population-density work environments, some high-volume retail settings) including individuals returning from locations with widespread COVID-19 transmission. • Practice physical distancing at all times *Follow applicable engineering, administrative and PPE controls in your workplaces HIGH EXPOSURE RISK • Individuals are in prolonged close (more than 15 minutes) contact and may not be able to practice physical distancing at all times. Large group of individuals in a given time (inmates) • Jobs with a high potential for exposure to known or suspected sources of COVID-19. Healthcare delivery, healthcare support, medical transport, and mortuary workers exposed to known or suspected COVID-19 patients or bodies of people known to have, or suspected of having, COVID-19 at the time of death. *Follow applicable engineering, administrative and PPE controls in your workplaces VERY HIGH EXPOSURE RISK • Healthcare workers, morgue workers, performing aerosol-generating procedures on or collecting / handling specimens from potentially infectious patients or bodies of people known to have, or suspected of having, COVID-19 at the time of death. *Follow applicable engineering, administrative and PPE controls in your workplaces Philippine College of Occupational Medicine, Inc. 3 DUTIES OF THE OCCUPATIONAL HEALTH PHYSICIAN The Occupational Health Physician, whether part-time or full-time, who shall be responsible for promoting and maintaining the health and well-being of the workers, shall have the following duties and functions: 1. Organize, administer and maintain an occupational health service program integrating therein an occupational safety program; 2. Continually monitor the work environment for health hazards through periodic inspection of the workplace; 3. Prevent diseases or injury in the workplace by establishing proper medical supervision over substances used, processes, and work environment; 4. Conserve the health of the workers through physical examinations, proper advice for placement and health education; 5. Provide medical and surgical care to restore health and earning capacity of injured workers; 6. Maintain and analyze records of all medical cases and to prepare and submit to the employer annual medical reports, using form DOLE/BWC/OH-47, as required by this Standards; 7. Conduct studies on occupational health within his means and resources; 8. Act as adviser to management and labor on all health matters; 9. And report directly to top management in order to be effective. DUTIES OF THE OCCUPATIONAL HEALTH NURSE The duties and functions of the Occupational Health Nurse are: 1. In the absence of a physician, to organize and administer a health service program integrating occupational safety, otherwise, these activities of the nurse shall be in accordance with the physician; 2. Provide nursing care to