Employer Information Covid-1916/03/2020
Medmark Advice for Employers regarding COVID-19
We are living in unprecedented times with a global threat from this new pandemic with the Covid-19 virus. This is already impacting on forwarding planning in terms of how we structure our working lives and our way of life. The impact of this virus is being keenly felt across the entire country with the impact most severe on those over 70 years of age. No one will however be immune from contracting this virus and understandably people are becoming increasingly anxious as the messaging becomes more urgent. The information we are providing is in the context of the current COVID-19 outbreak. The HSE (Health Services Executive) and the HPSC (Health Protection Surveillance Centre), are issuing guidance on a daily basis for the national management of COVID-19. We recommend monitoring these websites which are updated daily. The medical advice is changing continuously as the infection spreads and we are all under pressure to keep abreast of this advice as the situation evolves: www.hpsc.ie/coronavirus
Remember: Every measure we take on advice by health care professionals is aimed at reducing the risk of very accelerated transmission of this virus in our community and mitigating the risk of overwhelming our health care systems and their ability to cope. We are urgently trying to buy time now to allow us to urgently upscale and equip our emergency services to ensure we have sufficient resources to deal with all of those who may become very ill.
Businesses are already facing stress on very many levels and employees are understandably anxious as cases mount and as business moves to reorganise itself to cope with uncertainty. In light of the decision to close schools, universities and childcare facilities, employers are already experiencing significant disruption to normal business practices and being faced with the need to accelerate flexible working from home options and flexible start finish times to enable employees to travel to work on public transport off peak times. Levels of absenteeism amongst the workforce will increase significantly as a result of a number of factors including; employees becoming ill with Covid-19, employees being advised to self-isolate as a result of a close contact with Covid-19, school and child care facility closures and potential future disruptions to public transport. We encourage all employers to prepare for these potential disruptions now.
Medmark as an occupational health provider is there to support you with evidence-based information to help support your organisation through this period of uncertainty. We are also there to support your employees with employee telemedicine assessments to offer advice, information and ongoing support.
Now is the time to advise all employees to register with a local GP so that they can avail of their support through illness. GP’s can now request Covid 19 testing on line, if clinically indicated for patients from March 16th. Now is the time to ensure you have an employee assistance programme (EAP) to support employees who may become overtly anxious about the risk Covid 19 poses to themselves or their loved ones or to support employees through the bereavements which may occur over the coming months.
What we now know about Covid-19
It is a novel or new Virus and we are still learning day to day about how it affects patients. There is as yet no cure and no vaccine, but the scientific community is hard at work exploring the use of anti-viral medication against the virus and working to develop a vaccine. These options are likely to be some time away and many estimate that it could be over a year or more before we have a suitable vaccine. The Chinese may well lead the way having been affected so early by this virus. There is little doubt that cases in Ireland are likely to increase over the next 3-4 months.
It is highly infectious and transmitted by droplet spread during normal conversations or coughing, sneezing – that is why keeping at a safe distance from others and the use of regular hand hygiene can reduce the risk of spread if we regularly wash hands and avoid touching our face/mouth/nose/eyes. It generally takes 15 minutes of close personal contact (less than 3 feet) to contract the virus from a patient.
Remember: It is not possible to eliminate completely the risk of person to person transmission of this virus – it is however possible to reduce the risk of transmission and minimise the risk of harm – Employers collectively and employees by their individual effort can work together to protect the health and safety of everyone in their workplace.
Symptoms usually begin from day 6-12 after we have been exposed. Symptoms can commence as early as day 2-3 and as late as day 14. It is believed we are infectious for at least 48 hours before we develop symptoms, while we are ill, and for about 48 hours after we have completely recovered and no longer have symptoms. Patients may become slightly/vaguely unwell after 2-3 days but may become clinically unwell from day 5-6. They remain unwell for 2 weeks or more and then make a full recovery. This appears to be the picture in over 80% of cases. Unfortunately, It has a higher mortality rate averaging 2-4% compared to influenza at 1%. Mortality rates are especially high in the elderly and in particular for those over 80 years of age. Complications are also more likely to affect those with pre-existing chronic illnesses - respiratory, cardiac, kidney, cancer and those who may be immunosuppressed as a result or illness or medication. The symptoms include fever, a cough usually dry, shortness of breath, aches and pains and fatigue. The main concerning complication of this virus is respiratory (affecting the lungs) and some patients very quickly become very distressed with marked breathing difficulties. These patients need urgent medical care and sometimes ventilatory support. There is for some a risk of enduring lung damage.
People are naturally worried about how long the virus could pose a risk to them on surfaces. The consensus is that it typically survives for a number of hours up to at least 3-5 days or more on some porous surfaces paper, wood, cardboard, fabric and up to 9 days on non-porous surfaces glass, plastics, varnished wood and metal objects. Some researchers have indicated it can last over a week on some surfaces such as door handles, glass, steel. Hence the advice to wash your hands frequently and often and the advice to ensure such surfaces are thoroughly and frequently cleaned. The virus can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within one minute.
Medmark as an occupational health provider is there to support you and any employees who may have a chronic illness, be immunosuppressed or pregnant with timely advice, information and support at this difficult time. In some health care environments where the risk of exposure to Covid-19 is much higher we do recommend alternative duties, removal from the front line and other restrictions to mitigate the risk of exposure for employees. There is currently no strong medical evidence or consensus that supports restricting employees from working in non-health care environments.
Practical measure to put in place:
General workplace hygiene measures for all places of employment
- Environmental cleaning: Surfaces (e.g. desks and tables) and objects (e.g. telephones, keyboards) need to be wiped with disinfectant regularly
- Promote regular and thorough handwashing by employees, contractors and customers. Place sanitising hand rub dispensers in prominent places around the workplace. Make sure these dispensers are regularly refilled. Display posters promoting hand-washing and good hygiene
- Promote good respiratory hygiene in the workplace with posters.
The following measures should be strongly considered by all employers:
- Illness: There should be a notice issued to every employee and contractor advising them not to attend work or enter the workplace if feeling unwell nor attempt to enter the workplace. Any employee who presents work with a fever, cough, respiratory symptoms, flu like illness should be advised to leave the premises, make contact with their local GP for guidance, @HSELive for information or HSE help line 1850241850 Anyone with even mild symptoms e.g. cough, fever, respiratory or flu like symptoms should stay home (or work from home if that is possible) Keep communicating and promoting the message that staff and contractors need to stay at home even if they have mild respiratory or flu like symptoms and must adhere to guidance provided if diagnosed with Covid-19 Display posters with this message in your workplace. Medmark can also arrange to follow up, provide information and support to any employee who are referred to us while absent and we will arrange telephone review to certify when they may be fit to resume work or re-enter the place of work.
- Workplace measures to reduce the risk of transmission:
- Reduce gatherings - virtual meetings teleconferencing should become the new norm
- Explore opportunities to work from home
- Cancel social events
- Respectfully request employees do not travel to areas at high risk of transmission
- Reduce any requirement for employee travel
- Stagger breaks and lunch times to reduce numbers in the canteen
- Adopt flexible start and finish times
- Restrict entry to your workplace
- Encourage social distancing
- Replace bins with no touch foot operated bins
- Provide no touch or elbow operated soap dispensers in bathrooms
- No hand towels in bathrooms
Encourage physical distancing measures within the workspace and increased use of email and teleconferences/skype to reduce close contacts
Ideally, workers should stay 2 metres apart from each other while working and while using shared facilities, such as the canteen.
- Encourage reduced contact between employees and customers and between employees
- Adoption of flexible leave policies
Business continuity planning:
Move to identify critical business functions and essential employees.
Consider the following:
- Set up alternate pods of employees (e.g. Team A & Team B) who can be deployed to different work schedules (e.g. Team A working in the office at alternate weeks, while Team B telecommutes). The teams should be physically segregated to avoid the risk of cross infection between teams
- Cross-train employees and establish covering arrangements to minimise disruptions
HYGIENE, HYGIENE, HYGIENE - ADVISE EMPLOYEES ON HOW TO PROTECT THEMSELVES AND ENSURE THE WORK ENVIRONMENT IS CLEANED REGULARLY THOROUGHLY
- Wash your hands frequently with soap and water or use an alcohol-based hand rub if your hands are not visibly dirty
- Wash your hands after coughing or sneezing, after toilet use, before eating, before and after preparing food, if you are in contact with a sick person, especially those with respiratory symptoms, if your hands are dirty, and if you have handled animals or animal waste
- Practice good respiratory hygiene, such as when coughing and sneezing, cover your mouth and nose with flexed elbow or tissue– discard tissue immediately into a closed bin and clean your hands with alcohol-based hand rub or soap and water
- Maintain social distancing where possible, that is, leave at least 1 metre (3 feet) distance between yourself and other people, particularly those who are coughing, sneezing and have a fever
- Avoid touching your eyes, nose and mouth, as if you touch your eyes, nose or mouth with contaminated hands, you can transfer the virus from the surface to yourself
- Provide Alcohol Gel outside main toilets, outside canteen facilities, receptions, every office, all toilet facilities
Posters detailing information on how Covid-19 spreads, how to protect yourself and what steps to take if a person thinks they are at risk are available can be found via the link below.
Case Management relevant to your employees
1. What to do if an employee contacts the manager to report
- Symptoms prior to commencing work
- Recent travel to one of the current areas of ongoing community transmission
- Contact with a confirmed or suspected case of Covid-19
Advise the employee to remain at home, to self-isolate and telephone their GP or GP out of hours service or HSE Live for information or HSE 1850 24 1850
Medmark can also arrange to provide information and support to any employee who is referred to us while absent and we will arrange telephone review to certify when they may be fit to resume work or re-enter the place of work.
2. What to do if an employee is living with someone who has returned from an area of ongoing community transmission but has not had any known contact with a confirmed case of Covid-19 or attended a healthcare facility where patients were being treated for Covid-19:
If the person they are living with is well, there are no specific work restrictions required unless symptoms present
Medmark can provide information and support to HR in managing these situations and can provide information and support to any employee
3. What to do if an employee informs you that they have been in contact with a person diagnosed with Covid-19 or who is being tested for Covid-19?
Employees fulfilling the above criteria should be advised to self-isolate at home and must contact their GP or GP out of hours service or HSE Live for information or 1850 241850 in an emergency
Medmark will arrange to provide advice, information and support to any employee who is referred to us in this situation and we will arrange telephone review to certify when they may be fit to resume work or re-enter the place of work.
4. What to do if an employee presents for work unwell OR becomes unwell while at work with symptoms AND has a history of recent travel to one of the current identified affected areas
We would advise every employer to prepare a suitable room in your place of work as suitable for employee isolation: make sure it has a window that can be opened to ventilate, stock with tissues, alcohol gel and a lidded bin - ideally it should be beside a bathroom that can be marked for isolation use in the event of this situation arising in your work place
- The unwell person should be kept at least 2 metres away from other people
- Accompany them at a safe distance to the allocated room - where they can be isolated behind a closed door
- Ask them to open a window to ventilate the room
- If they need to go to the bathroom, they should use a separate bathroom if available. This bathroom should not be used by any other staff member until appropriate cleaning has been arranged.
- Advise them to cover their mouth and nose with a disposable tissue when they cough or sneeze and put the tissue in the bin promptly
Advise them to avoid touching things and do not touch anything that they touch
If the individual appears very unwell or with any breathing difficulty - contact NAS (National ambulance service) immediately and seek their advice on hospital transfer
If the individual is unwell fever/cough/flu symptoms but in no distress, they should be advised to go home, they should not use public transport and they should be advised to self-isolate and call their GP or 1850 24 1850
Arrange for the room and bathroom to be cleaned after any use in this scenario
Medmark will arrange to provide information and support to any employee who is referred to us while absent and we will arrange telephone review to certify when they may be fit to resume work or re-enter the place of work.
5. What steps should be taken in the event that one of your employees is confirmed as a case of COVID-19.
In the event that an employee is confirmed as a case of Covid-19, Public Health is contacted to arrange contact tracing and to assess the risk to other employees. This will commence once the employee is confirmed as a case of Covid-19.
Medmark will arrange to provide information and support to HR as required in such a situation
Medmark will arrange to provide information and support to any employee who is referred to us after this diagnosis and we can arrange telephone support and reviews to certify when they may be fit to safely resume work or re-enter the place of work
Websites resources for business continuity planning and preparing your workplace for Covid-19:
1. Enterprise Singapore: Guide on Business Continuity Planning for 2019 novel coronavirus:
2. WHO: Getting your workplace ready for Covid-19
3. Centre for Disease Control and Prevention (CDC): Interim Guidance for businesses and Employers
4. Centre for Infectious Disease Research and Policy (CIDRAP) COVID-19 Information for Employers, Business
FURTHER PRACTICAL ADVICE YOU CAN GIVE EMPLOYEES ABOUT COVID 19 AND THE WORKPLACE:
What to do if you develop suspicious symptoms?
- As per the HSE guidelines if you are feeling unwell/think you may have symptoms of COIVD-19 you should not come into work and you should call your GP only by phone.
- Symptoms typically include cough, fever, shortness of breath, breathing difficulties
We will refer your case details to our occupational health providers Medmark who will contact you around Day 1 to provide with advice and support and again on Day 14 to certify when you are fit to safely resume work
What should I know about Travel?
- Be travel aware - it is your duty as an employee to be mindful of your health and safety and the health and safety of others with whom you may come in contact
- Be informed about Category 1 affected countries where virus transmission risks are high: https://www.hpsc.ie/a-z/respiratory/coronavirus/novelcoronavirus/traveladvice/
- IF you are returning from any of the category 1 affected countries - you should stay at home AND self-quarantine for 14 days.
- Consult the HSE/HPSC websites daily as these Category 1 Countries are subject to ongoing changes
We will refer your case details to our occupational health providers Medmark who will contact you around Day 1 to provide with advice and support and again on Day 14 to certify when you are fit to safely resume work after returning from travel to an at risk Country.
What does it mean to be a “Close contact” of a COVID-19 case?
Definition: A close contact is anyone who has had one of the following contacts with a confirmed case while the case is considered infectious:
- living in the same household or household-like setting (e.g., in a hostel) as a COVID-19 case – confirmed case or awaiting the result of a test to confirm the diagnosis
- having spent two hours or longer in the same room, bus, Luas or train as a COVID-19 case
- having been seated within two rows either side of a COVID-19 case on a flight for two hours or longer
- having been face-to-face within one metre or less of the case for more than 15 minutes in any other setting not listed above
What you should do?
Actions you must take if you have close contact as defined above or if you have reason to believe you have had close contact with a confirmed case
a. Do not come to work - likely to be a minimum period of 14 days
b. Please limit your movements and interactions with others as much as possible immediately
c. Avoid contact with the elderly, pregnant, immunocompromised or other vulnerable individuals with long term illnesses
d. Do not attend large social gatherings, workplace, health care settings, childcare or school settings.
e. Reschedule any non-urgent medical appointments.
f. Cancel or defer any travel arrangements outside of Ireland for 14 days and link with Public Health if travel becomes essential for advice
g. Other members of your household do not need to restrict their activities
h. Ensure that you are readily contactable by phone
i. Do not donate blood for at least 28 days after your last known exposure
j. Avoid the use of medication that might mask the onset of flu type symptoms while being monitored i.e. paracetamol/nurofen, aspirin, ibuprofen
Who will monitor me?
Call your GP who can now arrange Covid-19 testing
Your GP may also alert Public Health who may call you – please be available on your phone
- They will discuss and advise you about what the next steps you need to take are.
- They will provide you with advice about hand hygiene and respiratory etiquettes.
- They will discuss passive or active follow up with you and contact tracing.
Passive follow up:
Will include providing you with advice about self-monitoring yourself for symptoms for 14 days with advice to contact public health should you develop symptoms
May be agreed in some cases by phone/text/email as agreed - for up to 14 days after your last possible exposure to a confirmed case
You will be advised to contact your GP or Public Health again if you develop any symptoms – management will usually then include arranging testing for the novel coronavirus.
If you develop symptoms you must move to completely isolate yourself from others and stay in a different room from other family members with the door closed
In the very unlikely event that you are unable to contact Public health doctors or nurses, call your GP or phone your nearest hospital Emergency Department and clearly say that you are a contact with exposure to Novel Coronavirus and tell them your symptoms.
Do not attend your local Emergency Department unless told to do so by the Emergency Department, Public Health or your GP.
Do not attend your GP, including their out-of-hours/on-call service unless told to do so
Hygiene: You should always engage in regular hand washing and cover your mouth and nose with a tissue or the bend of your elbow when coughing and sneezing to prevent the spread of infection.
We will refer your case details to our occupational health providers Medmark who will contact you around Day 1 with advice and support and Day 14 and will certify when you are fit to safely resume work
What does it mean to be a “casual contact” of a COVID-19 case?
- Any individual who has shared a closed space with a confirmed case for less than 2 hours
- Passengers on an aircraft sitting beyond two seats in any direction of a confirmed case
- Any individual who has shared a closed space with a confirmed case for longer than 2 hours but following a risk assessment by Public Health does not meet the definition of a close contact.
What you should do
- Contact your GP or Public Health for advice
- No restriction on movement or interactions with others at work is advised – There is no requirement to remain at home
- No restriction on travel is advised
- Self-monitor for the development of any symptoms of Covid-19
- Do not donate blood for at least 28 days after your last known casual exposure
- Avoid the use of medication that might mask the onset of flu type symptoms i.e. paracetamol/nurofen, aspirin, ibuprofen
If you develop any symptoms you must immediately move to self-isolate and contact your GP or failing this your local Public Health Department who will initiate screening
We will refer your case details to our occupational health providers Medmark who will contact you around Day 1 with advice, support and general information
MEDMARK REFERRAL PROCESS FOR COVID 19 CASE MANAGEMENT
HR to complete the Medmark on line employer referral form: www.medmark.ie/employer referral form /complete and submit form/select nurse case management in the drop down menu – add Covid 19 to issues to be addressed within the form – submit to commence telephone support
Medmark will issue reports as appropriate after case management reviews
Employee should be advised not to return to work until Medmark give clearance to do so
IMPORTANT CONTACT INFORMATION
PUBLIC HEALTH - Medical Officers:
HSE East: 01 635 2145
HSE Midlands: 057 935 9891
HSE Midlands West: 061 483 338
HSE North East: 046 907 6412
HSE North West: 071 985 2900
HSE South East: 056 778 4142
HSE South: 021 492 7601
HSE EMERGENCY HELP LINE: 1850241850
NATIONAL AMBULANCE SERVICE: 999/111
Follow HSE updates on twitter: @HSELive
Follow ECDC updates on twitter (European centre for disease control) @Eurosurveillance
MEDMARK – Working to support and protect the health and safety of all your employees
Medmark Support Services:
Covid-19 Query Form:
If you have any queries you would like to put to our experts please refer to our Covid-19 query form If you have any further questions you can fill our enquiry form here »
COVID-19 Case Management – Isolation Monitoring:
If an employee has been advised to self-isolate, then a call from a Medmark clinician can be set up on day 1 and day 14 of the isolation period. The Day 1 call will include advice on self-isolation; symptom identification and answer any concerns the employee may have. The Day 14 call will assess if employee is fit to return to work or indeed if it is necessary to extend the period of isolation. Following each consultation, a report will be issued to the employer.
If an employee is in self isolation or has a concern about visiting a clinic while the outbreak is ongoing, we can conduct a remote assessment by telephone, Skype, or Facetime.
- You should complete the employer referral form as normal and send an email to firstname.lastname@example.org requesting a remote consultation.
- Our admin team will respond to your email with an appointment time.
COVID-19 Monitoring - Questionnaire / Telephone
If an employer has concerns about an employee with an underlying medical condition, Medmark can issue a COVID-19 risk assessment questionnaire to the employee which is then reviewed by an occupational health adviser. This can result in one of the following outcomes; employee confirmed fit to stay in work; or employee contacted by a physician and risk assessed over the phone and appropriate recommendations made.
Requests for this service can be directed to email@example.com
In order to protect our capacity to provide continuity of service we may have to cease to operate our phones and all communications should then be directed to firstname.lastname@example.org