MUSCATINE, Iowa—Trinity Muscatine Public Health, in coordination with the Iowa Department of Public Health, released new guidance for essential businesses operating during the COVID-19 pandemic. 

Preventing Outbreaks

• Implement measures to enable social distancing as much as possible.
• Consider staggering shifts to reduce worker population at any given time.
• Stagger breaks to reduce staff interactions.
• Identify ways to increase the physical separation of staff.
• Prioritize hand hygiene and respiratory etiquette among employees.
• Provide or allow employees to wear cloth face-masks.
• Provide hand sanitizer or hand-washing opportunities frequently.

Detecting Outbreaks

• Screen all employees by taking their temperature and assessing for cough, sore throat, difficulty breathing or other respiratory symptoms at the beginning and end of each shift. For a screening algorithm visit: https://idph.iowa.gov/Portals/1/userfiles/7/bscreening%20algorithm%2003222020.pdf.
• Exclude all employees reporting fever or respiratory symptoms (direct them to stay home and isolate themselves from other people and animals in the home) until they:
  • Have had no fever for at least 72 hours (three full days of no fever without the use of medicine that reduces fevers) and
  • Other symptoms have improved (for example, when cough or shortness of breath have improved) and
  • At least seven days have passed since symptoms first appeared.
• Follow exclusion criteria with all symptomatic employees, regardless of whether they undergo testing (even if the employee tests negative for COVID-19 infection).
• Report to the Iowa Department of Public Health when 10% or more of employees show COVID-19 symptoms (including fever, cough, sore throat, difficulty breathing, or other respiratory symptoms). Report to public health by filling out the survey at this link: https://redcap.idph.state.ia.us/surveys/?s=NRJ4FDMDPN

Managing Outbreaks

• Coordinate with your occupational health provider to define a pathway to test symptomatic employees.
• Public health will approve State Hygienic Laboratory testing for symptomatic employees during outbreaks.
• The occupational health provider or employees’ personal health providers take the nasopharyngeal swab for testing and following-up for medical care as needed.
• When employees test positive for COVID-19 infection, public health and occupational health will work jointly to investigate cases and identify the following contacts:
  • household contacts.
  • rideshare partners.
  • co-workers with prolonged contact (within six feet of the case for at  least 30 minutes).
• All of these contacts must stay at home and isolate themselves from other people and  animals in the home for 14 days after the last known exposure to a person with COVID-19.
• Businesses should consider excluding high-risk employees when outbreaks are ongoing. High-risk employees include the following:
  • People aged 65 years and older.
  • People of all ages with underlying medical conditions, particularly if not well controlled, including:
  • People with chronic lung disease or moderate to severe asthma.
  • People who have serious heart conditions.
  • People who are immunocompromised. Many conditions can cause a  person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies,  poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications.
  • People with severe obesity (body mass index of 40 or more).
  • People with diabetes.
  • People with chronic kidney disease undergoing dialysis.
  • People with liver disease.

Businesses should make decisions to close based upon workforce availability and the ability to follow the recommended measures outlined above.

• Outbreaks are defined as greater than 10% of employees ill with COVID-19 symptoms (fever, cough, sore throat, difficulty breathing, or other respiratory symptoms).