COSH MANUAL Rev.

02 2020

Appendix - COVID-19 Prevention and Control in the

Workplace
I. INTRODUCTION:

Coronavirus Disease 2019 (COVID-19) was first identified last December 2019 as a cluster
of pneumonia cases of unknown etiology. On 30 January 2020, the World Health
Organization declared the COVID-19 outbreak as a Public Health Emergency of
International Concern and eventually as a Global Pandemic by 11 March 2020.

To reduce the impact of COVID-19 outbreak conditions on businesses, workers,

customers, and the public, it is important for all employers to plan for COVID-19. For
employers who have already planned for influenza outbreaks involving many staff
members, planning for COVID-19 may involve updating plans to address the specific
exposure risks, sources of exposure, routes of transmission, and other unique
characteristics of SARS-CoV-2 (i.e., compared to influenza virus outbreaks). Lack of
continuity planning can result in a cascade of failures as employers attempt to address
challenges of COVID-19 with insufficient resources and workers who might not be
adequately trained for jobs they may have to perform under pandemic conditions.

This COVID-19 planning guidance was created in accordance to the DOH, DOLE, DTI,
DOTR and other department orders issued by the agencies. 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. Employers
and workers should use this planning guidance to help identify risk levels in workplace
settings and to determine any appropriate control measures to implement. Additional
guidance may be needed as COVID-19 outbreak conditions change. In the event that
new information about the virus, its transmission, and impact, becomes available you
may have to modify your plans accordingly.

II. WORKPLACE SAFETY AND HEALTH:

The following safety and health standards shall be implemented in all workplaces
aligned with the objectives of the minimum health standards of the Department of
Health.

Increase physical and mental resilience

1. Emphasize to all workers the everyday actions to stay healthy such as:

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a. Eat nutritious and well-cooked food;

b. Drink plenty of fluids and avoid alcoholic beverages;

c. Increase the body’s resistance by having adequate rest and at least eight (8)
hours of sleep; and

d. Exercise regularly;

2. Enjoin companies to provide free medicines and vitamins; and

3. Provide referral for workers needing counselling or presenting with mental health
concerns

Reducing Risk of Transmission:

1. Prior to entrance in buildings or workplaces

a. All employers and workers shall:

i. Wear face masks at all times and remove the same only when
eating/drinking. Employers shall provide the appropriate face masks for
workers. Should cloth masks be used, the washable type shall be worn but
additional filter material such as tissue papers inside the masks may be
added

ii. Accomplish daily the health symptoms questionnaire (see annex) and submit
to the guard or designated safety officer prior to entry;

iii. Have their temperature checked and recorded in the health symptoms
questionnaire. (see annex)

For any personnel with temperature > 37.50C, even after a 5 minutes’ rest, or
if their response in the questionnaire needs further evaluation by the clinic
staff, the person shall be isolated in an area identified by the company and
not allowed to enter the premises. The isolation area should be well
ventilated and must be disinfected frequently.

Clinic staff assigned to assess the workers held in the isolation area shall be
provided the appropriate medical grade PPEs by the establishment which
shall include but not limited to, face masks, goggles/face shields, and/or
gloves; and

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iv. Spray alcohol/sanitizers to both hands; and provide disinfectant foot baths at
the entrance if practicable.

b. Equipment or vehicle entering the hub operational area must go through a

disinfection process; and

c. If there will be a long queue outside the office or store premises, roving
officers should instill physical distancing of one meter.

d. Ensure access to basic hygiene facilities such as toilets, handwashing areas,

water, soap, alcohol/ sanitizer.

e. Clean and disinfect the environment regularly, every two hours for high
touch areas such as toilets, door knobs, switches, and at least once every
day for workstations and other surfaces.

2. Inside the workplace

a. All work areas and frequently handled objects such as door knobs and
handles, shall be cleaned and disinfected regularly, at least once every two
(2) hours;

b. All washrooms and toilets shall have sufficient clean water and soap, workers
are encouraged to wash their hands frequently and avoid touching their
eyes, nose and mouth;

c. Sanitizers shall be made available in corridors, conference areas, elevators,

stairways and areas where workers pass;

d. Workers, whether in office workstations or in operations area, shall always

practice physical distancing meaning at the minimum one (1) meter radius
space (side, back and front) between workers;

e. Eating in communal areas is discouraged. It is best to eat in individual work

area and all wastes shall be disposed properly. If eating in individual work
areas is not possible, the employer shall ensure that physical distancing is
maintained in dining areas with one worker per table and 1-meter distance
per worker. It is discouraged that workers engage in conversation with masks
off during meal times. Tables and chairs shall be cleaned or disinfected after
every use of the area, and before as well as at the end of the work day; and

f. Canteens and kitchens should be cleaned and disinfected regularly.

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Minimize Contact Rate

a. Alternative work arrangements, such as working-hour shifts, work from home

(WFH), where feasible and on rotation basis;

b. Prolonged face-to-face interaction between workers and with clients are

discouraged and masks shall be worn at all times and not removed. Meetings
needing physical presence shall be kept to a minimum number of participants
and with short duration. Videoconferencing shall be utilized for lengthy
discussions among workers;

c. Office tables should be arranged in order to maintain proper physical

distancing. Barriers may be provided between tables;

d. Workstation layout should be designed to allow for unidirectional movement

in aisles, corridors or walkways;

e. To maintain physical distancing, number of people inside an enclosed space

such as a room, store or hall shall be limited. Elevator use should consider
physical distancing and limit the number of persons in order to observe the 1-
meter physical distancing;

f. Use of stairs should be encouraged subject to physical distancing

requirements. If more than 2 stairways are accessible, one stairway may be
used exclusively for going up and another for going down;

g. Online system shall be highly encouraged to be utilized for clients needing

assistance from offices including the use of videoconferencing; and

h. Roving officers shall always ensure physical distancing and observance of

minimum health protocols.

Reducing the Risk of Infection from COVID-19

In the event that a worker is suspected as having COVID-19:

a. The worker shall immediately proceed to the isolation area designated in the
workplace and never remove his/her mask;

b. Clinic personnel attending to the workers should wear appropriate PPEs and if
needed should require the transport of the affected worker to the nearest
hospital. Company protocols for transport for suspect COVID-19 cases and for

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PCR testing, should be in place including providing for ambulance

conduction. Hospitals will report to the DOH for COVID-19 suspect; and

c. Decontamination of workplace (DOH DO 2020-0157)

i. Workplace shall be decontaminated with appropriate disinfectant (e.g.

chlorine bleaching solution and 1:100 phenol based disinfectant);

ii. After decontamination of the work area, work can resume after 24 hours;
and

iii. Workers present in the work area with the suspect COVID-19 worker shall
go on 14 days home quarantine with specific instructions from the clinic
staff on monitoring of symptoms and possible next steps. If suspect COVID-
19 worker has negative result, co-workers may be allowed to report back
to work.

In the event that a worker is sick or has fever but is not suspected to have
COVID-19 (ex., urinary infection, wound infection or any respiratory disease not
related to COVID-19) the employer must advise the worker to take prudent
measures to limit the spread of communicable diseases, as follows:

1. Stay at home and keep away from work or crowds;

2. Take adequate rest and take plenty of fluids;

3. Practice personal hygiene to prevent spread of disease; and

4. Seek appropriate medical care if there is persistent fever, when difficulty of

breathing has started, or when he/she becomes weak.

III. CLASSIFYING VULNERABLE GROUP AND WORKER’S EXPOSURE TO SARS-COV-2:

Worker risk of occupational exposure to SARS-CoV-2 (the virus that causes COVID-19)
during an outbreak may vary from Most at risk population (MARP) to high, medium, or
low risk. The level of risk depends in part on the industry type, need for contact within 1
meters of people known to be, or suspected of being infected with SARS-CoV-2, or
requirement for repeated or extended contact with persons known to be, or suspected
of being infected with SARS-CoV-2.

This is classified according to MARP’s, HIGH, MEDIUM and LOW RISK.

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Most at Risk Population (MARP):

Refers to population groups who have a higher risk of developing severe COVID-19
infection.

Workers in this category include:

• individuals aged 60 and above, pregnant, and those with underlying conditions
or comorbidity at risk of COVID-19 exacerbation regardless of age.

High Exposure Risk

High exposure risk jobs are those with high potential for exposure to known or suspected
sources of COVID-19.

Workers in this category include:

• Healthcare delivery, healthcare support, medical transport, and mortuary

workers exposed to known or suspected COVID-19 patients or bodies of people known
to have, or suspected of having, COVID-19 at the time of death.

Medium Exposure Risk

Jobs that require frequent/close contact with people who may be infected, but who
are not known or suspected patients. Workers in this category include:

• Those who may have contact with the general public (e.g., schools, some
high-volume retail settings), including individuals returning from locations with
widespread COVID-19 transmission.

Lower Exposure Risk

Jobs that do not require contact with people known to be, or suspected of being,
infected.

• Workers in this category have minimal occupational contact with the public
and other coworkers.

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IV. IMPLEMENTING WORKPLACE CONTROLS:

With COVID-19, it may not be possible to eliminate the hazard, the most effective
protection measures are (listed from most effective to least effective): engineering
controls, administrative controls, safe work practices (a type of administrative control),
and PPE. There are advantages and disadvantages to each type of control measure
when considering the ease of implementation, effectiveness and cost.

In addition to the types of workplace controls discussed below, the National Institute for
Communicable Diseases (NICD) provides fact sheets that guide specific workplaces
(employers and employees) in relation to recommended infection prevention strategies
to implement in workplaces.

1. Engineering Controls

Engineering controls involve isolating employees from work-related hazards. In

workplaces where they are appropriate, these types of controls reduce
exposure to hazards without relying solely on worker behaviour and can be the
most cost-effective solution to implement.

Engineering controls for SARS-CoV-2 include:

• Installing high-efficiency air filters (not to be relied on as the most

appropriate in isolation of other controls).

• Increasing ventilation rates in the work environment.

• Installing physical barriers such as face shields.

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2. Administrative Controls

Administrative controls require action by the employee and employer. Typically,

administrative controls are changes in work policy or procedures to reduce or
minimize exposure to a hazard. Examples of administrative controls for SARS-
CoV-2 include:

• Encouraging sick workers to stay at home.

• Minimizing contact among workers, clients, and customers by replacing

face-to-face meetings with virtual communications e.g. conference calls,
Skype, etc.

• Minimizing the number of workers on site at any given time e.g. rotation or
shift work.

• Discontinuing nonessential local and international travel. Regularly check

travel advice from a reliable source

• Developing emergency communications plans, including a task team for

answering workers’ concerns and internet-based communications, if
feasible.

• Providing workers with up-to-date education and training on COVID-19 risk

factors and protective behaviours (e.g. cough etiquette and care of PPE).

• Training workers who need to use protective clothing and equipment on

how to put it on, use/wear it and take it off correctly, including, in the
context of their current and potential duties. Training material should be
easy to understand and available in the appropriate language and literacy
level for all workers.

3. Safe Work Practices

• Safe work practices are types of administrative controls that include

procedures for safe and proper work used to reduce the duration,
frequency, or intensity of exposure to a hazard. Examples of safe work
practices for SARS-CoV-2 include:

• Providing resources and a work environment that promotes personal

hygiene. For example, no-touch refuse bins, hand soap, alcohol-based
hand rubs containing at least 70 percent alcohol, disinfectants, and
disposable towels for workers to clean their hands and their work surfaces.

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• Requiring regular hand washing or using of alcohol-based hand rubs.

Workers should always wash hands when they are visibly soiled and after
removing any PPE.

• Display handwashing signs in restrooms.

4. Personal Protective Equipment (PPE)

While engineering and administrative controls are considered more effective in

minimizing exposure to SARS-CoV-2, PPE may also be needed to prevent certain
exposures. While correctly using PPE can help prevent some exposures, it should
not take the place of other prevention strategies.

Examples of PPE include: gloves, goggles, face shields, face masks, gowns,
aprons, coats, overalls, hair and shoe covers and respiratory protection, when
appropriate. During an outbreak of an infectious disease, such as COVID-19,
recommendations for PPE specific to occupations or job tasks may change
depending on geographic location, updated risk assessments for workers, and
information on PPE effectiveness in preventing the spread of COVID-19.
Employers should check the NICD website regularly for updates about
recommended PPE.

All types of PPE must be:

• Selected based upon the hazard to the worker.

• Properly fitted (e.g., respirators).

• Consistently and properly worn when required.

• Regularly inspected, maintained, and replaced, as necessary.

• Properly removed, cleaned, and stored or disposed of, as applicable, to

avoid contamination of self, others, or the environment.

Employers are obligated to provide their workers with PPE needed to keep them
safe while performing their duties. The types of PPE required during a COVID-19
outbreak will be based on the risk of being infected with SARS-CoV-2 while
working and job tasks that may lead to exposure.

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Workers, including those who work within 2meters of patients known to be, or
suspected of being, infected with SARS-CoV-2 and those performing aerosol-
generating procedures, need to use respirators:

• Approved N95 filtering half face respirators as a minimum used in the context
of a comprehensive, written respiratory protection program that includes fit-
testing, training, and medical exams.

• The appropriate form of respirator will depend on the type of exposure and
on the transmission pattern of COVID-19.

The process of implanting the hierarchy of controls may be summarized in Figure

below. If the first step of the hierarchy is not applicable, the employer must move
to the next step.

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5. Duties of Employers and Workers

Employers shall:

a. Provide the necessary company policies for the prevention and control of
COVID-19 in consultation with workers. Advocacy and IEC programs should
be taken from DOH, WHO and reliable sources of information on COVID-19;

b. Provide resources and materials needed to keep the workers healthy and
the workplace safe, e.g., masks, soap, sanitizer, disinfectant, PPEs, including
COVID-19 testing kits, etc;

c. Designate the safety officer to monitor COVID-19 prevention and control

measures such as physical distancing, wearing of masks, regular disinfection,
compliance to thermal scanning and accomplishing health symptoms
questionnaire;

d. Enhance health insurance provision for workers;

e. Where feasible, provide shuttle services and/or decent accommodation on

near-site location to lessen travel and people movement;

f. Enjoin the hiring from the local community; and

g. Put up a COVID-19 Hotline and Call Center for employees to report if

symptomatic, and daily monitoring scheme of our “suspect” employee
condition.

Workers shall:

a. Comply with all workplace measures in place for the prevention and control
of COVID-19, such as, frequent hand washing, wearing of masks, observe
physical distancing always, etc;

b. Observe proper respiratory etiquette;

c. Coughing and sneezing into tissue or into shirt sleeve if tissue is not available.

d. Disposing used tissues properly; and

e. Disinfecting hands immediately through proper washing with soap and water
or alcohol-based sanitizer immediately after a cough or sneeze.

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6. COVID Testing

Under the “New Normal” for Businesses, employers are not required to test their
employees returning to work (DOH Department Memorandum No. 02-0220). Should
employers decide to conduct testing however, the costs thereof shall be for its
account (DOLE Labor Advisory No. 18, Series of 2020). Employers may also consider
the following:

• The test may be conducted in a representative sample of employees who have

returned to work physically and are at high risk of contracting COVID-19 owing to
the nature of their work.

• Using RT-PCR tests among representative samples may be conducted to look for
possible asymptomatic transmitters. Depending on the results, employers should
take the following actions:

o If tested positive, the employee will be isolated and referred for

appropriate management. All close contacts must be isolated and tested
accordingly.

o If tested negative, the employee can continue working but must still follow
the usual precautions. They should be given appropriate advised and
instructions once they develop any health complaints or symptoms. The
company OSH personnel shall continue to monitor all workers. (Ref. DTI
and DOLE’s Interim Guidelines on Workplace Prevention and Control of
COVID-19).

o If initially found negative but later developed symptoms, the employee

must be tested again and if found positive, all close contacts must be
isolated and tested.

• Testing using FDA-approved rapid antibody-based tests among representative

samples may also be conducted up to every 14 days as an alternative.

For employers utilizing the RT-PCR test, information on suspect, probable, and
confirmed COVID-19 cases should be recorded and reported within 24 hours to
the Regional Epidemiology Surveillance Unit using the COVID-19 Case
Investigation Form or CIF found in DOH Administrative Order No. 2020-0013.

Employers who use the rapid antibody-based tests on their employees must
submit the results to [email protected] using the format available in
https://bit.ly/RDTReportingForm.

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Clearing for Return to Work: NOTE: RAPID ANTIBODY-BASED

TEST
1 FOOTNOTES:
Exposure by Travel – Travel from a
WORKER PSMID, PCOM PAFP, and WHO all do
country/area where there is a
CONTEMPLATING not recommend Rapid Antibody –Based
sustained community level
RETURN TO WORK Test for asymptomatic individuals as
transmission to an area with no
clearance for work.
sustained community transmission.
2 FOOTNOTES:
PREVIOUS Y Exposure by Contact Exposure by Residence- Stays in
CASE OR 1. Providing direct care to suspect, locality where there is sustained
SUSPECT? probable, or confirmed COVID-19 community level transmission.
N 4 patients without using proper PPE
3 (i.e. healthcare workers). Vulnerable Workforce
EXPOSURE BY SECURE
CLOSE Y 2. Face to face contact with a - Health and safety committee,
CERTIFICATE OF 14-
CONTACT OR DAY QUARANTINE
probable or confirmed case within 1 human resources, line managers and
TRAVEL? COMPLETION meter and for more than 15 minutes. other key people to work together to
N 3. Direct physical contact with a address possible risks with
5 probable or confirmed case; OR engineering and administrative
EXPOSURE IS 4. Other situations as indicated by
Y controls.
BY local risk assessments - High risk pregnancy,60 y/o and
RESIDENCE?
above, any age with co-morbidities,
N 6 7 8 or pre-existing illness (hypertension.
LIVES IN AREA Y
CONSIDER diabetes, asthma, etc.)
VULNERABLE ALTERNATIVE - Medical clearance from attending
WITH NO
WORKFORCE WORKPLACE physician and/or Occupational Health
TRANSMISSION
ACCOMMODATION Physician when needed
N
9
SYMPTOMPS Y
IN THE LAST
14 DAYS?

N 10 11
FOOTNOTES: ISOLATE AND
TEMPERATURE Y REPEAT NON-
Alternative Workplace
Accommodation >37.5C? CONTACT SCAN
- Encourage work from home AFTER 5 MINS.
-Skeletal workforce N 12 13
- Shelter in place
- Shift work REPEAT Y STAY HOME UNTIL
TEMPERATURE ASYMPTOMATIC
Symptoms >37.5C? FOR 14 DAYS
Sore throat, body pains, headache, N
fever, including other flu-like 14 15
symptoms (Cough, colds, body
CLEAR FOR SEE FIGURE 1A FOR
malaise fatigue)
WORK CLASSIFICATION OF
CASES

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Sample Health Questionnaire:

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Disinfection Solution:

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Hand Hygiene Guidelines:

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NOTES:
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