The COVID-19 pandemic has had a devastating impact throughout much of the world and has had a significant effect on our country, state and our community. At Valley Medical Center we are extraordinarily grateful to the entire community for their support. Our Occupational Health Services Clinic recognizes that COVID-19 has had a profound effect on our local business and their workforces. We want to do our best to help our community, families and companies get back to work safely and address questions you may have to the best of our ability.

We realize that many businesses, employers and employees have questions and concerns about COVID-19 and many employers are wrestling with questions about how to keep their employees safe. To help with this we have put together this list of frequently asked questions that we hope you will find useful. In the event you have additional follow up questions please do not hesitate to reach out to Maria Dakan, clinic manager, at 425.690.3140, email maria_dakan@valleymed.org or myself by email louis_lim@valleymed.org.

For a downloadable, printable pdf of the FAQs below with all of the links embedded, please click here.

 COVID-19 Town Hall FAQ Header Sm

 FREQUENTLY ASKED QUESTIONS

  1. When can I safely reopen the business/company again?
    We recommend adhering to the orders and guidance issued by Governor Inslee and our state Health Department which maintains a COVID-19 Data Dashboard providing data on COVID-19 cases in our state. Our state also maintains a COVID-19 Risk Assessment Dashboard which outlines the trajectory and risks of COVID-19 in each county. King County is currently in Phase 2 of the reopening plan. Please carefully review the phases and what businesses are permitted to open in each of the phases. Please note that businesses deemed essential are allowed to continue operations.
  2. What do I need to do to keep my employees safe when my business reopens?
    1. CDC recommendations for business include:
      1. Reducing transmission among employees by:
        1. Encouraging sick employees to stay home and follow CDC recommendations on when to return to work.
        2. Identifying sick employees when symptomatic or through screening and keep sick employees at home.
        3. Identifying where and how workers might get exposed at work to COVID-19 and develop mitigation strategies.
        4. Educating employees on steps they can take to reduce the spread of COVID-19 (please see section on “Educate employees about how they can reduce the spread of COVID-19).
        5. Disinfecting frequently touched objects at work and increasing environmental cleaning.
        6. Enable social distancing while at work to maintain 6 feet distance between employees whenever possible.
        7. Use a face mask or surgical mask.
        8. Use hand sanitizer and/or wash hands regularly.
         
      2. Maintain or implement business policies that support keeping COVID-19 from the workplace.
        1. Provide sick leave to enable sick employees to stay home for the duration of their illness.
        2. Allow employees who have known close contact with a COVID-19 positive individual (in their immediate family or at work for example) to self-quarantine away from work for 14 days.
        3. Do not require a positive COVID-19 test result or healthcare provider’s note to validate a sick employee’s illness. Currently not all individuals who are ill with COVID-19 symptoms are able to get tested. Others are having difficulty seeing their healthcare provider.
        4. Establish policies and practices that support the social distancing recommendations. This would include telework, flexible work hours, providing adequate physical space etc.
         
      3. Maintain a healthy work environment.
        1. Increase frequency of sanitization procedures in the workplace.
        2. Provide adequate hand sanitizer, gloves, face masks and other protective equipment as appropriate.
        3. Implement engineering controls such as increasing ventilation rates of the HVAC and/or increasing outdoor air that circulates.
        4. Implement administrative controls such as limiting the number of workers in a particular location, scheduling shifts and breaks to minimize crowding of workplaces and cafeterias.
        5. The CDC also provides detailed information on cleaning and disinfecting as well as preventive steps for grocery and food retail workers.
         
                                    
    2. The CDC also has recommendations for small business. In addition, Occupational Safety and Health Administration (OSHA) has also issued guidance on preparing workplaces for COVID-19.
    3. An excellent, easy-to-read and well organized downloadable resources for COVID-19 safety best practices for all types of industries and businesses can be found at the AIHA (American Industrial Hygiene Association) website backtoworksafely.org.
    4. Washington state has a comprehensive web page that provides links to specific reopening guidance for various types of industries and business grouped by the phase of reopening outlined in the Governor’s Safe Start Washington plan.
    5. The Johns Hopkins Bloomberg School of Public Health Center for Health Security has developed an Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19 which includes a Business Risk Worksheet and Assessment Calculator.
     
  3. What about face masks? Do I need to use an N-95 mask?
    In most settings, it is believed that surgical grade masks provide adequate protection against droplets that might contain the COVID-19 virus. In certain circumstances, especially when specific medical procedures are performed on a COVID-19 positive individual, the virus may be aerosolized (stays suspended in air for a certain amount of time) and in this situation an N-95 mask is recommended. This is believed to rarely occur in the general workplace. The CDC currently recommends the use of cloth face masks with all interactions and this would include most workplaces.

    The state of Washington has mandated that individuals wear a face mask or face cloth covering effective June 26 in indoor public spaces and also when an individual is unable to stay 6 feet apart from other people, whether indoors or outdoors. This applies to work places as well and employers are required to provide facial coverings for their employees. There are some exceptions. Please review the order and guidance carefully.

    If you have questions specific to your workplace about possible aerosolization and need for additional respiratory protection, please do not hesitate to reach out. We will be happy to provide an initial assessment and if further in-depth evaluation is needed, we will be glad to provide guidance and direction.
  4. What should I do if one of my employees is exposed to COVID-19 either at home, in the community or in the workplace?
    The recommendations currently from the CDC for individuals who have been exposed to COVID-19 is to stay home until 14 days after last exposure and maintain social distancing (6 feet) and self-monitor for symptoms. Assuming that the individual remains asymptomatic, he or she can return after 14 days.

    If the employee becomes ill with COVID-19 or in the absence of testing a COVID-19 like illness, there are additional criteria issued by the CDC on returning to work as discussed below in Question 6.

    The CDC has additional guidance that varies from their general recommendations for an exposed employee for critical infrastructure workers and healthcare workers who have had exposure to an individual with suspected or confirmed COVID-19.
  5. What do I need to do in my workplace if an employee found to have COVID-19 was working there prior to being taken off work?
    The CDC has recommendations for addressing possible workplace contamination and reducing risk of exposure in the workplace under their Frequently Asked Questions for General Business. In particular, please review the questions “What should I do if an employee is suspected or confirmed to have COVID-19?” and What should I do if I find out several days later that they were diagnosed with COVID-19?”
  6. How do I know if an employee who has contracted COVID-19 is safe to return to work?
    For COVID positive employees who are planning to return to work who were symptomatic and who are in a non-essential job, the CDC recommends that at least 10 days have passed since the individual’s symptoms first appeared AND the individual has had no fever for at least 72 hours without the use of medicines AND other symptoms such as cough and shortness of breath have improved. If the employee is being tested, the CDC has separate criteria. The CDC also has specific recommendations for healthcare workers who are returning to work after being infected with COVID-19. It is strongly recommended that the employee follow the guidance of the healthcare professional (physician or advanced practice clinician) who is providing care to him/her/them for the COVID-19 infection. We recognize that trying to make return to work determinations can be challenging in the absence of the complete medical picture, we will be glad to perform a fitness for duty assessment of an employee to help with the determination if they are safe to return to work and whether any additional precautions will need to be taken.
  7. Should I be screening all my employees for COVID-19 using an antibody (serology) test?
    We do not recommend antibody/serology testing for COVID-19 at this time unless it is recommended by the health department. It is important to know that the antibody test should NOT be used to try to determine if an individual is acutely ill with COVID-19. An antibody test can be negative when an individual is acutely ill with COVID-19. For acute illness the gold standard is the widely used RT-PCR test for SARS-CoV-2 RNA. The University of Washington Department of Laboratory Medicine has a very good FAQ web page that provides more detail about these two types of tests.
  8. Wouldn’t it be helpful to know which of my employees might have already been infected with COVID-19 using the COVID-19 antibody test? Won’t they be immune to COVID-19?
    It may be helpful to know who might have previously been infected. But we do not have enough information right now to know how to use the antibody test effectively. As an example, we do not know yet if the presence of antibodies to COVID-19 confers complete or even incomplete immunity. In many other diseases, the presence of antibodies does usually provide some degree of immunity though there are notable exceptions. This is a rapidly evolving area of clinical study and more should be known in a matter of weeks or months. It is also important to ensure that the manufacturer of the antibody test is reputable and has independent verification of the sensitivity (positive test is truly positive) and specificity (negative test is truly negative). If you determine this test is needed for your employees, we have the ability to order a highly sensitive and specific COVID-19 antibody test.
  9. If the COVID-19 antibody test is not that helpful, what about the PCR assay test for COVID-19?
    The COVID-19 PCR test (also known as the SARS-CoV-2 RT-PCR test) is highly sensitive and specific for the COVID-19 virus. It is a very good test to determine if someone is acutely ill with the virus. It is used to accurately diagnose the presence of an infection. However, it is important to be aware that there have been instances where the first PCR test of an ill patient was negative only to turn positive when retested later. Hence a negative test should always be interpreted within the context of the clinical presentation. We will be glad to assist with the ordering of the COVID-19 PCR test and assessment of an employee who is suspected of being infected with COVID-19. 

Throughout this FAQ we have included links to respected and authoritative primary sources of information such as the CDC. Our scientific and clinical understanding of the virus that causes COVID-19 is rapidly evolving and advancing each day and we will continue to update this page as new information becomes available. If in doubt, please rely on the authoritative links/references we have embedded in this FAQ to provide you the most up-to-date guidance. 

To conclude we are committed to helping all members of our community, including our businesses and workers during this challenging time. Please do not hesitate to reach out to the OHS Clinic Manager, Maria Dakan, or myself if we can be of service.

Thank you,

Louis Lim, MD, MPH, FACOEM, FACP
Medical Director, Occupational Health Services
UW Medicine | Valley Medical Center
louis_lim@valleymed.org

 

 

 WEB PAGE LINKS

 

Orders and guidance issued by the State of Washington –
coronavirus.wa.gov/what-you-need-know/whats-open-and-closed

Washington State COVID-19 Data Dashboard –  
doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID19/DataDashboard

Washington State COVID-19 Risk Assessment Dashboard –
coronavirus.wa.gov/what-you-need-know/covid-19-risk-assessment-dashboard

Washington State information on Phase 2 –
coronavirus.wa.gov/what-you-need-know/safe-start/whats-open-each-phase#Phase2

Washington State information on the various Phases of Reopening –
coronavirus.wa.gov/what-you-need-know/safe-start/whats-open-each-phase

Essential business definition and information –
coronavirus.wa.gov/what-you-need-know/whats-open-and-closed/essential-business

CDC guidance for business –
cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

CDC recommendations on when to return to work –
cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

Symptoms of COVID-19 –
cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html?CDC_AA_refVal=https%3A%2F%2Fcdc.gov%2Fcoronavirus%2F2019-ncov%2Fabout%2Fsymptoms.html

Steps employees can take to reduce the spread of COVID-19 –
cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html

CDC guidance on cleaning and disinfecting and preventive steps for grocery and food retail workers –
cdc.gov/coronavirus/2019-ncov/community/organizations/businesses-employers.html

CDC guidance for small business –
cdc.gov/coronavirus/2019-ncov/community/guidance-small-business.html

OSHA Guidance on Preparing Workplaces for COVID-19 –
osha.gov/Publications/OSHA3990.pdf

Washington State official guidance on reopening businesses –
governor.wa.gov/issues/issues/covid-19-resources/covid-19-reopening-guidance-businesses-and-workers

Washington State Safe Start plan –
governor.wa.gov/sites/default/files/SafeStartWA_4May20_1pm.pdf

AIHA (American Industrial Hygiene Association) resource on COVID-19 safety best practices for all types of industries and businesses
backtoworksafely.org

Johns Hopkins Bloomberg School of Public Health Center for Health Security –
centerforhealthsecurity.org/

JHSPH Center for Health Security COVID-19 Operational Toolkit –
centerforhealthsecurity.org/our-work/publications/operational-toolkit-for-businesses-considering-reopening-or-expanding-operations-in-covid-19

CDC recommendations on use of cloth face coverings –
cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html#:~:text=In%20light%20of%20this%20new,community%2Dbased%20transmission

Washington State order regarding use of a face covering or mask –
coronavirus.wa.gov/information-for/you-and-your-family/face-masks-or-cloth-face-covering

CDC recommendations for an individual who has had a community related exposure to COVID-19 –
cdc.gov/coronavirus/2019-ncov/community/organizations/businesses-employers.html

CDC recommendations for Critical Infrastructure Workers who have been exposed to COVID-19 –
cdc.gov/coronavirus/2019-ncov/community/critical-workers/implementing-safety-practices.html

CDC recommendations for healthcare workers who have been exposed to COVID-19 in the healthcare setting –
cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

CDC Frequently Asked Questions for Business –
cdc.gov/coronavirus/2019-ncov/community/general-business-faq.html#Suspected-or-Confirmed-Cases-of-COVID-19-in-the-Workplace

CDC recommendations for what to do if an individual is sick with COVID-19 or suspected COVID-19 including when to discontinue isolation (and by implication return to work) –
cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html

CDC recommendations for healthcare workers returning to work after COVID-19 infection –
cdc.gov/coronavirus/2019-ncov/hcp/return-to-work.html?CDC_AA_refVal=https%3A%2F%2Fcdc.gov%2Fcoronavirus%2F2019-ncov%2Fhealthcare-facilities%2Fhcp-return-work.html

UW Medicine Department of Laboratory Medicine –
testguide.labmed.uw.edu/public/guideline/covid_faq

 

Reviewed 6.25.2020