OSHA

National – The Occupational Safety and Health Administration (OSHA) developed this COVID-19 planning guidance based on traditional infection prevention and industrial hygiene practices. It focuses on the need for employers to implement engineering, administrative, and work practice controls and personal protective equipment  (PPE), as well as considerations for doing so. This guidance is intended for planning purposes and is not a standard or regulation.

List N: Disinfectants for Use Against SARS-CoV-2

Other COVID-19 Resources

• EPA’s Coronavirus Site
• CDC’s Coronavirus Disease  2019 Site
• CDC’s Cleaning and Disinfection Recommendations for COVID-19
• NPIC ‘s COVID-19 Virus Factsheet

List N includes products that meet EPA’s criteria for use against SARS-CoV-2, the novel coronavirus that causes the disease COVID-19.

When purchasing a product, check if its EPA registration number is included on this list. If it is, you have a match and the product can be used against SARS-CoV-2. You can find this number on the product label – just look for the EPA Reg. No. These products may be marketed and sold under different brand names, but if they have the same EPA registration number, they are the same product.

Note: Inclusion on this list does not constitute an endorsement by EPA. There may be additional disinfectants that meet the criteria for use against SARS-CoV-2. EPA will update this list with additional products as needed.

Visit https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2 to find a current list of products that meet EPA’s criteria for use against SARS-CoC-2, the cause of COVID-19.

Clean & Disinfect

Interim Recommendations for US Households with Suspected/Confirmed Coronavirus Disease 2019

Background

There is much to learn about the novel coronavirus that causes coronavirus disease 2019 (COVID-19). Based on what is currently known about the novel coronavirus and similar coronaviruses that cause SARS and MERS, spread from person-to-person with these viruses happens most frequently among close contacts (within about 6 feet). This type of transmission occurs via respiratory droplets. On the other hand, transmission of novel coronavirus to persons from surfaces contaminated with the virus has not been documented. Transmission of coronavirus occurs much more commonly through respiratory droplets than through fomites. Current evidence suggests that novel coronavirus may remain viable for hours to days on surfaces made from a variety of materials. Cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19 and other viral respiratory illnesses in households and community settings.

Purpose

This guidance provides recommendations on the cleaning and disinfection of households where persons under investigation (PUI) or those with confirmed COVID-19 reside or may be in self-isolation. It is aimed at limiting the survival of the virus in the environments. These recommendations will be updated if additional information becomes available.

These guidelines are focused on household settings and are meant for the general public.

• Cleaning refers to the removal of germs, dirt, and impurities from surfaces. Cleaning does not kill germs, but by removing them, it lowers their numbers and the risk of spreading infection.
• Disinfecting refers to using chemicals to kill germs on surfaces. This process does not necessarily clean dirty surfaces or remove germs, but by killing germs on a surface after cleaning, it can further lower the risk of spreading infection.

General Recommendations for Routine Cleaning and Disinfection of Households

Community members can practice routine cleaning of frequently touched surfaces (for example: tables, doorknobs, light switches, handles, desks, toilets, faucets, sinks) with household cleaners and EPA-registered disinfectants that are appropriate for the surface, following label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.

General Recommendations for Cleaning and Disinfection of Households with People Isolated in Home Care (e.g. Suspected/Confirmed to have COVID-19)

• Household members should educate themselves about COVID-19 symptoms and preventing the spread of COVID-19 in homes.
• Clean and disinfect high-touch surfaces daily in household common areas (e.g. tables, hard-backed chairs, doorknobs, light switches, remotes, handles, desks, toilets, sinks)
  • In the bedroom/bathroom dedicated for an ill person: consider reducing cleaning frequency to as-needed (e.g., soiled items and surfaces) to avoid unnecessary contact with the ill person.
    • As much as possible, an ill person should stay in a specific room and away from other people in their home, following home care guidance.
    • The caregiver can provide personal cleaning supplies for an ill person’s room and bathroom, unless the room is occupied by child or another person for whom such supplies would not be appropriate. These supplies include tissues, paper towels, cleaners and EPA-registered disinfectants (examples at this linkpdf iconexternal icon).
    • If a separate bathroom is not available, the bathroom should be cleaned and disinfected after each use by an ill person. If this is not possible, the caregiver should wait as long as practical after use by an ill person to clean and disinfect the high-touch surfaces.
• Household members should follow home care guidance when interacting with persons with suspected/confirmed COVID-19 and their isolation rooms/bathrooms.

How to clean and disinfect:

Surfaces

• Wear disposable gloves when cleaning and disinfecting surfaces. Gloves should be discarded after each cleaning. If reusable gloves are used, those gloves should be dedicated for cleaning and disinfection of surfaces for COVID-19 and should not be used for other purposes. Consult the manufacturer’s instructions for cleaning and disinfection products used. Clean hands immediately after gloves are removed.
• If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection.
• For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.
  • Diluted household bleach solutions can be used if appropriate for the surface. Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.
    • Prepare a bleach solution by mixing:
      • 5 tablespoons (1/3^rd cup) bleach per gallon of water or
      • 4 teaspoons bleach per quart of water
  • Products with EPA-approved emerging viral pathogens claimspdf iconexternal icon are expected to be effective against COVID-19 based on data for harder to kill viruses. Follow the manufacturer’s instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
• For soft (porous) surfaces such as carpeted floor, rugs, and drapes, remove visible contamination if present and clean with appropriate cleaners indicated for use on these surfaces. After cleaning:
  • Launder items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely, or
    Use products with the EPA-approved emerging viral pathogens claims (examples at this linkpdf iconexternal icon) that are suitable for porous surfaces.

 Clothing, towels, linens and other items that go in the laundry

• Wear disposable gloves when handling dirty laundry from an ill person and then discard after each use. If using reusable gloves, those gloves should be dedicated for cleaning and disinfection of surfaces for COVID-19 and should not be used for other household purposes. Clean hands immediately after gloves are removed.
  • If no gloves are used when handling dirty laundry, be sure to wash hands afterwards.
  • If possible, do not shake dirty laundry. This will minimize the possibility of dispersing virus through the air.
  • Launder items as appropriate in accordance with the manufacturer’s instructions. If possible, launder items using the warmest appropriate water setting for the items and dry items completely. Dirty laundry from an ill person can be washed with other people’s items.
  • Clean and disinfect clothes hampers according to guidance above for surfaces. If possible, consider placing a bag liner that is either disposable (can be thrown away) or can be laundered.

Hand hygiene and other preventive measures

• Household members should clean hands often, including immediately after removing gloves and after contact with an ill person, by washing hands with soap and water for 20 seconds. If soap and water are not available and hands are not visibly dirty, an alcohol-based hand sanitizer that contains at least 60% alcohol may be used. However, if hands are visibly dirty, always wash hands with soap and water.
• Household members should follow normal preventive actions while at work and home including recommended hand hygiene and avoiding touching eyes, nose, or mouth with unwashed hands.
  • Additional key times to clean hands include:
    • After blowing one’s nose, coughing, or sneezing
    • After using the restroom
    • Before eating or preparing food
    • After contact with animals or pets
    • Before and after providing routine care for another person who needs assistance (e.g. a child)

Other considerations

• The ill person should eat/be fed in their room if possible. Non-disposable food service items used should be handled with gloves and washed with hot water or in a dishwasher. Clean hands after handling used food service items.
• If possible, dedicate a lined trash can for the ill person. Use gloves when removing garbage bags, handling, and disposing of trash. Wash hands after handling or disposing of trash.
• Consider consulting with your local health department about trash disposal guidance if available.

 

No, You Do Not Need Face Masks To Prevent Coronavirus—They Might Increase Your Infection Risk

Community transmission of COVID-19, the disease caused by the new coronavirus, has officially begun in the U.S., with two cases in California and one in Oregon of unknown origin. The first COVID death was reported Saturday, Feb. 29, in Seattle. The natural human response to a strange, new disease making its way to a neighborhood near you is to feel anxiety and want to DO SOMETHING. That’s why many people have been buying up and stockpiling masks. But even if you could buy any in the midst of global shortages, should you? 

No. 

And if you already have masks, should you wear them when you’re out? 

No. 

Even if there are COVID cases in your community?

Today In: Healthcare

Even if there are cases next door, the answer is no, you do NOT need to get or wear any face masks—surgical masks, “N95 masks,” respirator masks, or anything else—to protect yourself against the coronavirus. Not only do you not need them, you shouldn’t wear them, according to infection prevention specialist Eli Perencevich, MD, a professor of medicine and epidemiology at the University of Iowa’s College of Medicine. 

“The average healthy person does not need to have a mask, and they shouldn’t be wearing masks,” Dr. Perencevich said. “There’s no evidence that wearing masks on healthy people will protect them. They wear them incorrectly, and they can increase the risk of infection because they’re touching their face more often.” 

PROMOTED

But even if you know what you’re doing and you tie your hands behind your back, you still don’t need to wear a mask. 

Only Wear A Mask If You’re Sick

First of all, most people buying masks are not getting one that stops the virus from reaching their mouth or nose anyway. The coronavirus is transmitted through droplets, not through the air. That means you cannot randomly breathe it in, but it also means the standard surgical mask you see people wearing will not help. Those masks are designed to keep droplets in—not to keep them out—and are intended to keep the wearer from getting others sick. 

“The one time you would want a mask is if you’re sick and you have to leave the house,” Dr. Perencevich said. “If you have the flu or think you have COVID, that’s when you’d put on a mask to protect others. In your house, if you feel like you’re sick, you should wear a mask to protect your family members.” 

ETA 3/1/20: If you are caring for someone with COVID in your home, it is wise to wear a mask when in close proximity to that person, who should also wear a mask, Dr. Perencevich said. Consult a healthcare provider for the correct way to wear and dispose of the mask, or consult this excellent explainer from the World Health Organization. For those concerned about being able to get a mask if you or a household member becomes ill with COVID, the emergency department or clinic where you are diagnosed should provide them them to you. The sick individual should ask for one immediately upon arriving at the healthcare facility.

[ETA 3/1/20: There has been some question about whether this coronavirus is “airborne” and what that means. The virus is not airborne using the scientific definition used for pathogens such as tuberculosis or measles. Droplets might become aerosolized for some viruses, but there is not yet evidence showing that this coronavirus can be breathed in when a nearby infected individual exhales. Most research into this question focuses on influenza, such as this 2018 study suggesting the flu virus can be aerosolized in exhalations without coughing or sneezing. This evidence is preliminary, and it remains an open scientific question whether (and which) droplet-based respiratory viruses are transmitted this way. So far, all documented transmission for COVID cases has involved droplets. ]

What Does Keep The Virus Out?

The type of face covering that reduces exposure to airborne particles—including protecting the wearer from viruses and bacteria—is called a respirator. The type of personal protection equipment (PPE) that healthcare workers wear when treating someone with a serious contagious disease is a medical respirator.

As 3M, a major manufacturer of masks and respirators, explains, medical respirators do both: they protect the wearer from getting sick and protect the patient from the wearer’s germs. That’s where the confusion in terms—using “mask” and “respirator” interchangeably—often comes from. From here on in this article, assume “mask” refers to a respirator.

These medical respirators/masks must have an efficiency rating of “N95,” “FFP2,” or a similar rating that refers to how many particles—and of what size—can’t get through. The CDC has a webpage listing all the approved respirators for personal protection.

Disposable medical respirators can resemble standard surgical masks but must be thrown away after one use because they become contaminated with the particles they’re filtering out. Reusable respirators, which use replaceable filters, are the ones that make you look like a giant insect.

So Why Shouldn’t I Get An N95 Medical Respirator? 

The people who wear medical respirators have received training in how to wear them to protect themselves, such as ensuring the mask forms an airtight seal with their face. 

But even then, “no matter how well a respirator seals to the face and how efficient the filter media is, wearers should expect a small amount of leakage inside any respirators,” 3M notes. “No respirator will eliminate exposures entirely.” 

Not using—or disposing of—a respirator mask correctly can increase infection risk because it is literally trapping all the stuff in the air you’re trying to avoid, and many people end up touching their face absent-mindedly.

“Wearing a mask is tricky because it can create a false sense of security,” Dr. Perencevich said. “If you don’t wash your hands before you take off the mask and after you take off your mask, you could increase your risk.”

Even if you believe you will be careful enough to wear, use, and dispose of the mask properly, buying these masks in the midst of existing shortages makes it harder for hospitals and healthcare workers who actually need them to get them. 

“The most concerning thing is if our healthcare workers are sick and have to stay home, then we lose the doctors and nurses we need to get through this outbreak,” said Dr. Perencevich, who recently tweeted concerns about the “potential crisis” of N95 respirator scarcity.

US Surgeon General Jerome Adams, MD, has even pleaded on Twitter, “Seriously people-STOP BUYING MASKS!” Aside from their ineffectiveness in protecting the general public, he said, “if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk!”

Disturbingly, Dr. Perencevich has even heard from colleagues who saw people walking out of hospitals with boxes of masks.  

“We really need to get the message out not to take the masks from the hospitals,” he said. “We’ve got to protect our healthcare workers because they’re the ones who are going to take care of us if we get sick.” 

Here’s How To Actually Protect Yourself From COVID-19

You’ve heard it over and over, already, but the best way to protect yourself from the coronavirus really, truly, honestly is to regularly wash your hands with soap and water. Karen Fleming, PhD, a professor in biophysics at Johns Hopkins University, explained on Twitter why: “Coronavirus is an ‘enveloped’ virus, which means that it has an outer lipid membrane layer,” an outer layer of fat. “Washing your hands with soap and water has the ability to ‘dissolve’ this greasy fatty layer and kill the virus,” she said.

Wash your hands before and after eating and try to train yourself not to touch your face, “especially your mouth and nose,” Dr. Perencevich said. Also carry around hand sanitizer in case you can’t get to soap and water after touching your face or another germ-laden surface (like doorknobs).

“Just because it’s a respiratory virus doesn’t mean it gets into your body through breathing,” he said. “It can enter when your contaminated hands touch your mouth or face. So wash your hands, and don’t touch your mouth or face without washing your hands first.”

You can also protect yourself through social distancing: If you see someone coughing or sneezing or otherwise looking sick, stay at least three feet away from them since that’s as far as most droplets will travel. 

What If I’m Immune-Compromised Or Traveling To Infected Areas?

If you are immune-compromised or otherwise at high risk for complications from coronavirus—which means you’re already at high risk for flu complications—you need to talk to your doctor about whether it’s necessary to wear a medical respirator in public, Dr. Perencevich said. Similarly, if you’re traveling to an area with known widespread transmission, consult a travel clinic. Even in these cases, however, social distancing and washing your hands frequently are your most important and effective protection tools.  

Here’s What You SHOULD Do To Prepare For COVID-19 

So you shouldn’t be buying masks, but there are things you can do to prepare for an outbreak in your city. First, make sure you have at least 3-4 weeks’ worth of any medications you need “so you don’t have to run out and get it at a certain time,” Dr. Perencevich said.

Similarly, have enough necessities, including food and anything you cannot live without, on hand if school is cancelled for several weeks and the kids are at home. You don’t have to stockpile food, but being prepared for any kind of emergency—not just a disease outbreak but also unexpected severe weather and similar events—means having enough food and water (one gallon per person per day) on hand for three days along with supplies to use in the case of power outages. 

A helpful disaster emergency kit list is available online from the Department of Homeland Security, and Kent State epidemiologist Tara C. Smith, PhD, offers great tips on preparing for COVID-19 at Self. 

Where Can I Learn More About Medical Respirators And Masks? 

For the technical or science-minded folks out there, it’s certainly possible to jump down a rabbit hole and learn all about the manufacturing and technical specifications of personal protection equipment. Aside from the CDC page already mentioned, super geeks will want to read all the links at 3M’s Worker Health & Safety page on the Novel Coronavirus Outbreak. While 3M is not the only manufacturer, they are a major one with a great deal of helpful, easy-to-read information on the risk of products shipped from China (there isn’t much of one), healthcare alternatives to surgical N95 respirators, an FAQ for those in healthcare and the general public, and how to spot counterfeit products (though this will vary by manufacturer).