This post was written in collaboration with Dr. Timothy Boardman, an Emergency Medicine Physician in RI who is currently working on the frontline battling this virus. In what feels like another life, Dr. Boardman was also one of my amazing undergraduate research students at UMass Dartmouth.
I have received many requests for help from essential employees on how they can minimize their chances of being exposed to and or bringing home this virus to their family. Each of you will have to adjust which of these techniques you employ based on your unique work situation. If you are in an office, with few people, you may be able to tone down your precautions. If you are working in grocery store, a pharmacy, a prison, or in another setting where there is considerable interaction with others, you may wish to do all the recommended actions. The goal is not to feel like you are going into battle, but you should develop a routine that suitably addresses the risks associated with performing your job.
In general, the safest thing to do is to operate under the premise that everything on your person at work and everything you bring outside of your home is potentially contaminated with the coronavirus. In the same vein, treat everything you touch as potentially contaminated.
With this in mind, you should try to bring as little as possible with you to work. This includes things like watches, jewelry, and basically anything you do not absolutely need with you.
By reducing the amount of things you bring back and forth with you to work, you reduce the number of things that can potentially become contaminated and reduce risk to yourself and to your family.
Two biggest things you can do; wash your hands regularly and stop touching your face.
Soap and water for at least 20 seconds or hand sanitizer. (we've covered this a lot)
Now that many states have recommended the use of face coverings while in public, special care should be taken to not touch the face covering and if you do, to perform hand hygiene immediately afterwards.
At your workstation You should wipe down your area with disinfecting wipes or disinfecting spray regularly throughout your day. At a minimum, this should be performed when you first get to work, halfway through your day, and before you leave work.
Many of us enjoy drinking coffee at our desks and try to stay hydrated throughout the day with some sort of water bottle. Unfortunately, having food and drink with you in your workspace increases the risk of infection. For many of us, taking a sip of our coffee, or reaching for our water when we are thirsty is almost reflexive and I would bet that you do not think of cleaning your hands before you touch your coffee mug or water bottle. By keeping food and drink out of your workspace, you are more likely to make the mental connection of performing hand hygiene before consuming.
Cell phones are the ultimate vector for disease. Most people use their cell phones regularly throughout the day and this makes it prone to contamination. The phones are then brought up to the face when answering and making phone calls and this can lead to infection. Cell phones have many cracks and crevices where viruses and bacteria can hide and because of that, are not easy to disinfect. My advice would be to keep your cell phone in a ziplock bag throughout the day. Most touchscreens will still function through the bag and even though the outside of the bag can still become contaminated, this smooth plastic surface is much easier to wipe down and disinfect.
Other items Depending on the occupation there are many other objects and items that need to be used at work. You should be cognizant of these items and make sure you wipe them down or disinfect them regularly. If possible, objects used at work should stay at work and should not be brought home.
Social Distancing You should maintain social distancing while at work if possible. This includes the obvious things like standing far apart during conversation and less obvious things like eating lunch at separate tables or at keeping distance between you and your coworkers at the same table.
If conversations need to happen, try to avoid speaking face-to-face. I know its seems strange, but in face-to-face conversations, respiratory droplets and other mouth projectiles will travel straight forward to the other person. Talk off-center, both talk facing the same direction (like you would if you were walking and talking), and above all maintain your distance.
In terms of eating and drinking, this should be done in a space away from the public such as a designated breakroom. Again, maintain your physical space.
Going home from work:
One of the biggest challenges universally faced by all essential employees is what to do with work clothes. How this is handled will vary depending on personal living situations and type of occupation.
For healthcare workers, many institutions are providing scrubs and have a centralized laundry for them. If this is the case, workers can pick one of two options. They can either wear “street clothes” to work and change into scrubs and then change back into “street clothes” just before leaving work, or they can wear scrubs into work, change into a clean pair at the end of the work day and wear the clean pair home and repeat this process. Either method prevents the worker from bringing home dirty scrubs and puts the onus of washing the scrubs on their workplace.
For other Essential Workers For workers not in healthcare or do not have access to workplace sponsored clothing, the issue is more complex. There are a few different strategies.
One strategy is to bring an extra set of clothing with you to work and change into your clean clothing before leaving work for the day. The dirty clothes should be placed in a laundry bag and when you get home, they should be placed immediately into the washing machine and washed with hot water. This includes the face covering you may or may not be wearing. These same clothes should be dried on a hot setting as well.
Some workers advocate for keeping a clean pair of clothing in their vehicles and changing inside their vehicles before going home for the day. This is a reasonable option, but just be aware that you are potentially contaminating your vehicle by choosing this method.
Another method used by some is to strip out of all dirty clothing in an area just outside of their home, or in a designated area inside the home. This area could be the laundry room, the garage, the shed, the basement if it has an outside entrance, or a mudroom. Whatever area you choose should be fairly off-limits to other family members and should be readily accessible from the outside. If you have to walk around inside your home in your work clothes then you risk contaminating surfaces inside your home and risk exposure to your family.
Footwear presents a separate issue as they cannot be washed as easily as clothing. If possible, you should have dedicated footwear for work and these should not be worn in the home. Ideally, work footwear should be left in the garage or another location outside of the living space. If you do not have that option, footwear should be kept at the door to the home and should be sprayed, or wiped down with disinfectant.
After the issue of work clothing is addressed, the issue of skin and hair contamination must be dealt with. Once you get home, you should immediately shower. Special attention should be taken to areas exposed at work such as the face, hands, arms, ankles, and hair.
You should not come within six feet of your family members, sit down, stop for a drink or snack, or touch any more household surfaces than absolutely necessary until you have showered. Once you have finished showering and decontaminating yourself, you should backtrack your steps and disinfect any door knobs, door handles, locks, or keys that you touched on your way to the shower. After all of this, you must wash your hands again and then it is okay for you to greet your family members.
Other items and objects that may become contaminated during your day-to-day include vehicle parts such as keys, door handles, the steering wheel, shifter handle, radio dials, seatbelt, and rearview mirror. Pay attention to what you touch during the course of your day and be sure to clean these areas regularly.
This is a comprehensive list, but not an exhaustive list. You should assess your personal risk at work, and then implement a strategy that matches your work-place risk. The more people that pass through your workplace, the more enclosed your workplace, the more diligent you need to be with your actions. Find a routine, implement a strategy, and after a few days it will just feel normal.
Many of you did not ask to be an essential employee but have found yourself in that situation. If you are keeping our lights on, stocking our grocery shelves, delivering the mail, building our schools, or you if you are on the frontline with patients.