General Business Frequently Asked Questions
Suspected or Confirmed Cases of COVID-19 in the Workplace
When should an employee suspected or confirmed to have COVID-19 return to work?
Sick employees should follow steps to prevent the spread of COVID-19 if you
are sick.
Employees should not return to work until they meet the criteria to
discontinue home isolation and have consulted with a healthcare provider and state or
local health department.
Employers should not require sick employee to provide a negative COVID-19 test
result or healthcare provider’s note to return to work. Employees with
COVID-19 who have stayed home can stop home isolation and return to work when
they have met one of the following sets of criteria:

Option 1: If, in consultation with a healthcare provider and local public health authorities knowledgeable about locally available testing resources, it is determined an employee will not have a test to determine if they are still contagious, the employee can leave home and return to work after these three conditions have been met:

The employee has had no fever for at least 72 hours (that is, 3 full days of no fever without the use medicine that reduces fevers)
AND

respiratory symptoms have improved (for example, cough or shortness of breath have improved)
AND

at least 10 days have passed since their symptoms first appeared

Option 2: If, in consultation with a healthcare provider and local public health authorities knowledgeable about locally available testing resources, it is determined the employee will be tested to determine if the employee is still contagious, the employee can leave home after these three conditions have been met:

The employee no longer has a fever (without the use of medicine that reduces fevers)
AND

respiratory symptoms have improved (for example, cough or shortness of breath have improved)
AND

they received two negative tests in a row, at least 24 hours apart. Their doctor should follow CDC guidelines.


General Business Frequently Asked Questions
Reducing the Spread of COVID-19 in Workplaces
How do I handle personal protective equipment (PPE) waste?
Discard PPE into a trash can. There is no evidence to suggest that facility
waste needs any additional disinfection.


General Business Frequently Asked Questions
Healthy Business Operations
What is social distancing and how can my workplace do that?
Social distancing means avoiding large
gatherings and maintaining distance (at least 6 feet or 2
meters) from others when possible. Strategies that businesses could use
include:

Allowing flexible worksites (such as telework)
Allowing flexible work hours (such as staggered shifts)
Increasing physical space between employees at the worksite
Increasing physical space between employees and customers (such as a drive-through and partitions)
Implementing flexible meeting and travel options (such as postponing non-essential meetings or events)
Downsizing operations
Delivering services remotely (e.g., phone, video, or web)
Delivering products through curbside pick-up or delivery


General Business Frequently Asked Questions
Suspected or Confirmed Cases of COVID-19 in the Workplace
What should I do if I find out several days later, after an employee worked, that they were diagnosed with COVID-19?

If it has been less than 7 days since the sick employee used the facility, clean and disinfect all areas used by the sick employee following the CDC cleaning and disinfection recommendations.
If it has been 7 days or more since the sick employee used the facility, additional cleaning and disinfection is not necessary. Continue routinely cleaning and disinfecting all high-touch surfaces in the facility.
Other employees may have been exposed to the virus if they were in “close contact” (within approximately 6 feet or 2 meters) of the sick employee for a prolonged period of time.
Those who have symptoms should self-isolate and follow CDC recommended steps.
In most workplaces, those potentially exposed but with no symptoms should remain at home or in a comparable setting and practice social distancing for 14 days.
Critical infrastructure workers should follow Implementing Safety Practices for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19. A critical infrastructure worker who is symptom-free and returns to work should wear a face mask at all times while in the workplace for 14 days after last exposure. Employers can issue facemasks or can approve employees’ supplied cloth face coverings in the event of shortages.

Employees not considered exposed should self-monitor for symptoms such as fever, cough, or shortness of breath. If they develop symptoms, they should notify their supervisor and stay home.


General Business Frequently Asked Questions
Suspected or Confirmed Cases of COVID-19 in the Workplace
Are allergy symptoms considered an acute respiratory illness?
No. Allergy symptoms are not considered an acute respiratory illness.


General Business Frequently Asked Questions
Reducing the Spread of COVID-19 in Workplaces
Do my employees need to wear cloth face coverings or personal protective equipment (PPE) (such as N95 respirators, gloves) to protect themselves while working?
CDC recommends wearing cloth face coverings in public settings where other
social distancing measures are difficult to maintain, especially in areas of
significant community transmission. Cloth face coverings may prevent people
who don’t know they have the virus from transmitting it to others. These face
coverings are not surgical masks or respirators and are not appropriate
substitutes for them in workplaces where masks or respirators are recommended
or required.
Employees should continue to follow their routine policies and procedures for
PPE (if any) that they would ordinarily use for their job tasks. When cleaning
and disinfecting, employees should always wear gloves and gowns appropriate
for the chemicals being used. Additional personal protective equipment (PPE)
may be needed based on setting and product.
CDC does not recommend the use of PPE in workplaces where it is not routinely
recommended. Facilities can use the hierarchy of
controls, such as administrative, and engineering
controls – these strategies are even more effective at preventing exposures
than wearing PPE.


General Business Frequently Asked Questions
Reducing the Spread of COVID-19 in Workplaces
What can I tell my employees about reducing the spread of COVID-19 at work?
Employees should take the following steps to protect
themselves at
work:

Follow the policies and procedures of the employer related to illness, cleaning and disinfecting, and work meetings and travel.
Stay home if sick, except to get medical care.
Maintain a distance of at least 6 ft. from all other persons
Understand that no one with symptoms should be present at the workplace. Employees should inform their supervisor if they or their colleagues develop symptoms at work, especially fever, cough, or shortness of breath.
Wash hands often with soap and water for at least 20 seconds, especially after blowing noses, coughing, or sneezing, or having been in a public place.
Use hand sanitizer that contains at least 60% alcohol if soap and water are not available.

Avoid touching eyes, nose, and mouth.
To the extent possible, avoid touching high-touch surfaces in public places – elevator buttons, door handles, handrails, handshaking with people, etc.
Minimize handling cash, credit cards, and mobile or electronic devices when possible.
Practice social distancing by keeping at least 6 feet away from fellow co-workers, customers, and visitors when possible.
Avoid all non-essential travel.


General Business Frequently Asked Questions
Reducing the Spread of COVID-19 in Workplaces
How do I keep employees who interact with customers safe?
To keep your employees safe, you should:

Consider options to increase physical space between employees and customers such as opening a drive- through, erecting partitions, and marking floors to guide spacing at least six feet apart.
At least once a day clean and disinfect surfaces frequently touched by multiple people. This includes door handles, desks, phones, light switches, and faucets,
Consider assigning a person to rotate throughout the workplace to clean and disinfect surfaces.
Consider scheduling handwashing breaks so employees can wash their hands with soap and water for at least 20 seconds. Use hand sanitizer that contains at least 60% alcohol if soap and water are not available.
Consider scheduling a relief person to give cashiers and service desk workers an opportunity to wash their hands.


General Business Frequently Asked Questions
Reducing the Spread of COVID-19 in Workplaces
Should we be screening employees for COVID-19 symptoms (such as temperature checks)? What is the best way to do that?
Screening employees is an optional strategy that employers may use. There are
several methods that employers can use to protect the employee conducting the
temperature screening. The most protective methods incorporate social
distancing (maintaining a distance of 6 feet from others), or physical
barriers to eliminate or minimize the screener’s exposures due to close
contact with a person who has symptoms during screening. Examples to consider
that incorporate these types of controls for temperature screening include:

Reliance on Social Distancing : Ask employees to take their own temperature either before coming to the workplace or upon arrival at the workplace. Upon their arrival, stand at least 6 feet away from the employee and:
Ask the employee to confirm that their temperature is less than 100.4o F (38.0o C), and confirm that they are not experiencing coughing or shortness of breath.
Make a visual inspection of the employee for signs of illness, which could include flushed cheeks or fatigue.
Screening staff do not need to wear personal protective equipment (PPE) if they can maintain a distance of 6 feet.

Reliance on Barrier/Partition Controls : During screening, the screener stands behind a physical barrier, such as a glass or plastic window or partition, that can protect the screener’s face and mucous membranes from respiratory droplets that may be produced when the employee sneezes, coughs, or talks. Upon arrival, the screener should wash hands with soap and water for at least 20 seconds or, if soap and water are not available, use hand sanitizer with at least 60% alcohol. Then:
Make a visual inspection of the employee for signs of illness, which could include flushed cheeks or fatigue.
Conduct temperature and symptom screening using this protocol:
Put on disposable gloves.
Check the employee’s temperature, reaching around the partition or through the window. Make sure the screener’s face stays behind the barrier at all times during the screening.
If performing a temperature check on multiple individuals, make sure that you use a clean pair of gloves for each employee and that the thermometer has been thoroughly cleaned in between each check. If disposable or non-contact thermometers are used and you did not have physical contact with an individual, you do not need to change gloves before the next check. If non-contact thermometers are used, clean and disinfect them according to manufacturer’s instructions and facility policies.
Remove and discard PPE (gloves), and wash hands with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer with at least 60% alcohol.

If social distance or barrier controls cannot be implemented during screening,
PPE can be used when the screener is within 6 feet of an employee during
screening. However, reliance on PPE alone is a less effective control and more
difficult to implement given PPE shortages and training requirements.

Reliance on Personal Protective Equipment (PPE) : Upon arrival, the screener should wash their hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol, put on a facemask, eye protection (goggles or disposable face shield that fully covers the front and sides of the face), and a single pair of disposable gloves. A gown could be considered if extensive contact with an employee is anticipated. Then:
Make a visual inspection of the employee for signs of illness, which could include flushed cheeks or fatigue, and confirm that the employee is not experiencing coughing or shortness of breath.
Take the employee’s temperature.
If performing a temperature check on multiple individuals, make sure that you use a clean pair of gloves for each employee and that the thermometer has been thoroughly cleaned in between each check. If disposable or non-contact thermometers are used and you did not have physical contact with an individual, you do not need to change gloves before the next check. If non-contact thermometers are used, you should clean and disinfect them according to manufacturer’s instructions and facility policies.
After each screening, remove and discard PPE and wash hands with soap and water for at least 20 seconds or use hand sanitizer with at least 60% alcohol.


General Business Frequently Asked Questions
Cleaning and Disinfection in the Workplace
In addition to cleaning and disinfecting, what can I do to decrease the spread of disease in my workplace?
Employers can also:

Provide tissues and no-touch disposal receptacles.
Provide soap and water in the workplace. If soap and water are not readily available, use alcohol-based hand sanitizer that contains at least 60% alcohol. If hands are visibly dirty, soap and water should be chosen over hand sanitizer.
Place hand sanitizer in multiple locations to encourage good hand hygiene practices.
Place posters that encourage staying home when sick, the importance of hand hygiene, and coughing and sneezing etiquette at the entrance to your workplace and in other workplace areas where employees are likely to see them.
Discourage handshaking


General Business Frequently Asked Questions
Healthy Business Operations
Should I require employees to provide a doctor’s note or positive COVID-19 test result?
Employers should not require sick employees to provide a COVID-19 test result
or a healthcare provider’s note to validate their illness, qualify for sick
leave, or to return to work. Healthcare provider offices and medical
facilities may be extremely busy and not able to provide such documentation in
a timely manner.


General Business Frequently Asked Questions
Cleaning and Disinfection in the Workplace
Should I adjust my ventilation system?
The risk of spreading the virus that causes COVID-19 through ventilation
systems has not been studied, but is likely low. Routine HVAC maintenance is
recommended. Although it is never the first line of prevention, consider
general ventilation adjustments in your workplace, such as increasing
ventilation and increasing the amount of outdoor air used by the system.
Maintain the indoor air temperature and humidity at comfortable levels for
building occupants.


General Business Frequently Asked Questions
Suspected or Confirmed Cases of COVID-19 in the Workplace
What should I do if an employee has a respiratory illness?
Employees who appear to have COVID-19 symptoms, such as fever, cough, or
shortness of breath, upon arrival to work or become sick during the day with
COVID-19 symptoms should immediately be separated from other employees,
customers, and visitors and sent home.
CDC has a symptom self-checker chatbot called Clara that employers and employees may
find helpful. It has a series of questions and recommends what level of
medical care, if any, the user should seek. It is not intended to provide
diagnosis or treatment.


General Business Frequently Asked Questions
Critical Infrastructure
How do I know if my business is considered critical?
The Department of Homeland Security developed a listexternal iconexternal
icon of essential critical infrastructure workers to help state and local
officials as they work to protect their communities, while ensuring continuity
of functions critical to public health and safety as well as economic and
national security. State and local officials make the final determinations for
their jurisdictions about critical infrastructure workers.


Healthcare Infection Prevention and Control FAQs for COVID-19
What personal protective equipment (PPE) should be worn by individuals transporting patients who are confirmed with or under investigation for COVID-19 within a healthcare facility? For example, what PPE should be worn when transporting a patient to radiology for imaging that cannot be performed in the patient room?
In general, transport and movement of the patient outside of their room should
be limited to medically essential purposes. If being transported outside of
the room, such as to radiology, healthcare personnel (HCP) in the receiving
area should be notified in advance of transporting the patient. For transport,
the patient should wear a facemask or cloth face covering to contain
secretions and be covered with a clean sheet.
If transport personnel must prepare the patient for transport (e.g., transfer
them to the wheelchair or gurney), transport personnel should wear all
recommended PPE (gloves, a gown, respiratory protection that is at least
as protective as a fit tested NIOSH-certified disposable N95 filtering
facepiece respirator or facemask—if a respirator is not available—and eye
protection [i.e., goggles or disposable face shield that covers the front and
sides of the face]). This recommendation is needed because these interactions
typically involve close, often face-to-face, contact with the patient in an
enclosed space (e.g., patient room). Once the patient has been transferred to
the wheelchair or gurney (and prior to exiting the room), transporters should
remove their gown, gloves, and eye protection and perform hand hygiene.
If the patient is wearing a facemask or cloth face covering, no recommendation
for PPE is made typically for HCP transporting patients with a respiratory
infection from the patient’s room to the destination. However, given current
limitations in knowledge regarding COVID-19 and following the currently
cautious approach for risk stratification and monitoring of healthcare
personnel caring for patients with
COVID-19, use of
a facemask by the transporter is recommended for anything more than brief
encounters with COVID-19 patients. Additional PPE should not be required
unless there is an anticipated need to provide medical assistance during
transport (e.g., helping the patient replace a dislodged facemask).
After arrival at their destination, receiving personnel (e.g., in radiology)
and the transporter (if assisting with transfer) should perform hand hygiene
and wear all recommended PPE. If still wearing their original respirator or facemask,
the transporter should take care to avoid self-contamination when donning the
remainder of the recommended PPE. This cautious approach will be refined and
updated as more information becomes available and as response needs change in
the United States.
Interim guidance for EMS personnel transporting patients with confirmed or
suspected COVID-19 is available here. EMS personnel should wear all recommended PPE because they are
providing direct medical care and in close contact with the patient for longer
periods of time.


Healthcare Infection Prevention and Control FAQs for COVID-19
Why does CDC continue to recommend respiratory protection equivalent or higher to the level provided by an N95 disposable filtering facepiece respirator for care of patients with known or suspected COVID-19?
CDC’s guidance to use NIOSH-approved N95 disposable filtering facepiece or
higher level respirators when providing care for patients with suspected or
known COVID-19 is based on the current understanding of SARS-CoV-2 and related
respiratory viruses.
Current data suggest that close-range aerosol transmission by droplet and
inhalation, and contact followed by self-delivery to the eyes, nose, or mouth
are likely routes of transmission. Long-range aerosol transmission, such as is
seen with measles, has not been a feature of SARS-CoV-2.
Potential routes of close-range transmission include splashes and sprays of
infectious material onto mucous membranes and inhalation of infectious virions
exhaled by an infected person. The relative contribution of each of these is
not known for SARS-Co-V-2.
Facemasks commonly used during surgical procedures will provide barrier
protection against droplet sprays contacting mucous membranes of the nose and
mouth, but they are not designed to protect wearers from inhaling small
particles. N95 and higher level respirators, such as other disposable
filtering facepiece respirators, powered air-purifying respirators (PAPRs),
and elastomeric respirators, provide both barrier and respiratory protection
because of their tight fit and filtration characteristics.
Respirators should be used as part of a respiratory protection program that
provides staff with medical evaluations, training, and fit testing.
Although facemasks are routinely used for the care of patients with common
viral respiratory infections, N95 or higher level respirators are routinely
recommended for emerging pathogens like SARS CoV-2, which have the potential
for transmission via small particles, the ability to cause severe infections,
and no specific treatments or vaccines.
CDC recommendations acknowledge the current challenges with limited supplies
of N95s and other respirators. Facilities that do not have sufficient supplies
of N95s and other respirators for all patient care should prioritize their use
for activities and procedures that pose high risks of generating infectious
aerosols and use facemasks for care that does not involve those activities or
procedures. Detailed strategies for optimizing the supply of N95
respirators are
available on the CDC website. Once availability of supplies is reestablished,
the guidance states that the use of N95 and higher level respirators should
resume.


Healthcare Infection Prevention and Control FAQs for COVID-19
Which procedures are considered aerosol generating procedures in healthcare settings?
Some procedures performed on patients are more likely to generate higher
concentrations of infectious respiratory aerosols than coughing, sneezing,
talking, or breathing. These aerosol generating procedures (AGPs) potentially
put healthcare personnel and others at an increased risk for pathogen exposure
and infection.
Development of a comprehensive list of AGPs for healthcare settings has not
been possible, due to limitations in available data on which procedures may
generate potentially infectious aerosols and the challenges in determining if
reported transmissions during AGPs are due to aerosols or other exposures.
There is neither expert consensus, nor sufficient supporting data, to create a
definitive and comprehensive list of AGPs for healthcare settings.
Commonly performed medical procedures that are often considered AGPs, or that
create uncontrolled respiratory secretions, include:

open suctioning of airways
sputum induction
cardiopulmonary resuscitation
endotracheal intubation and extubation
non-invasive ventilation (e.g., BiPAP, CPAP)
bronchoscopy
manual ventilation

Based on limited available data, it is uncertain whether aerosols generated
from some procedures may be infectious, such as:

nebulizer administration*
high flow O2 delivery

*Aerosols generated by nebulizers are derived from medication in the nebulizer. It is uncertain whether potential associations between performing this common procedure and increased risk of infection might be due to aerosols generated by the procedure or due to increased contact between those administering the nebulized medication and infected patients.
References related to aerosol generating procedures:
Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J (2012) Aerosol Generating
Procedures and Risk of Transmission of Acute Respiratory Infections to
Healthcare Workers: A Systematic Review. PLoS ONE 7(4);
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3338532/#!po=72.2222external
iconexternal
icon).


Healthcare Infection Prevention and Control FAQs for COVID-19
My hospital is experiencing a shortage of isolation gowns. To preserve our supply, can we stop using gowns for the care of patients with methicillin-resistant Staphylococcus aureus (MRSA) and other endemic multidrug-resistant organisms (MDROs), and Clostridioides difficile?
CDC has released information about strategies to optimize the supply of
isolation gowns. Healthcare facilities should refer to that guidance and implement
the recommended strategies to optimize their current supply of gowns. This
includes shifting toward the use of washable cloth gowns, if feasible.
The use of gowns as part of Contact Precautions in the context of MDROs has
been implemented primarily to reduce the risk of transmission to other
patients rather than to protect healthcare personnel (HCP). Facilities with
shortages could consider suspending the use of gowns for the care of patients
with endemic MDROs, such as MRSA, VRE, and ESBL-producing Gram-negative
bacilli except as required for Standard
Precautions. Facilities
should assess their local epidemiology to determine which MDROs are considered
endemic. Regardless of the use of gowns, HCP at facilities should continue to
wear gloves for contact with these patients and their environment. Hand
hygiene should continue to be emphasized. Facilities should also attempt to
place patients colonized or infected with an MDRO in a private room, if
available.

Caring for patients who have highly resistant Gram-negative organisms (e.g., carbapenem-resistant Enterobacteriacae) and other MDROs (e.g., Candida auris ) that are not considered endemic: Rather than gowns being donned for every room entry, they should be reserved for use as part of Standard Precautions and also prioritized for high-contact patient care activities that pose highest risk for transfer of pathogens from the patient to HCP. Examples of such high-contact care activities include dressing, bathing/showering, transferring, providing hygiene, changing linens, changing briefs or assisting with toileting, device care or use (central line, urinary catheter, feeding tube, tracheostomy/ventilator), and wound care. To further preserve gowns, HCP are recommended to bundle high-contact care activities as part of individual care encounters. Regardless of the use of gowns, HCP at facilities should continue to wear gloves for contact with these patients and their environment. Hand hygiene should continue to be emphasized. Facilities should also attempt to place patients colonized or infected with an MDRO in a private room, if available.
Caring for patients with Clostridioides difficile infections (CDI): Facilities should continue using Contact Precautions (putting on a gown and gloves upon entry into the patient’s room and placing the patient in a private room) for the care of symptomatic patients with CDI. As part of a supplemental strategy to prevent transmission of CDI, some facilities have implemented Contact Precautions for the care of patients at high risk for CDI who have asymptomatic carriage of Clostridioides difficile. There are limited data about the role of asymptomatic carriage in transmission of CDI. In this setting of a critical national shortage of gowns, facilities should consider suspending this approach until the shortage is addressed. Gowns should still be used as part of Standard Precautions.


Healthcare Infection Prevention and Control FAQs for COVID-19
Given the potential for asymptomatic transmission of SARS-CoV-2, what personal protective equipment (PPE) should be worn by healthcare personnel (HCP) providing care to patients who are not suspected to have COVID-19?
The potential for asymptomatic SARS-CoV-2 transmission underscores the
importance of applying prevention practices to all patients, including social
distancing, hand hygiene, surface decontamination, and having patients wear a
cloth face covering or facemask (for source control) while in a healthcare
facility. To protect patients and co-workers, HCP should wear a facemask at
all times while they are in a healthcare facility (i.e., practice source
control). Use of a facemask, instead of a cloth face covering, is recommended
for HCP, because a facemask offers both source control and protection from
exposure to splashes and sprays of infectious material from others.

HCP caring for patients with suspected or confirmed COVID-19 should continue to wear gloves, a gown, respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering facepiece respirator (or facemask if respirators are not available), and eye protection (i.e., goggles or disposable face shield that covers the front and sides of the face).

HCP working in facilities located in areas with moderate to substantial community transmission are more likely to encounter asymptomatic patients with COVID-19. If COVID-19 is not suspected in a patient presenting for care (based on symptom and exposure history), HCP should follow Standard Precautions (and Transmission-Based Precautions if required based on the suspected diagnosis). They should also:

Wear eye protection in addition to their facemask to ensure the eyes, nose, and mouth are all protected from splashes and sprays of infectious material from others.
Wear an N95 or higher-level respirator, instead of a facemask, for:
Aerosol-generating procedures (See Which procedures are considered aerosol generating procedures in healthcare settings FAQ) and
Surgical procedures that might pose higher risk for transmission if the patient has COVID-19 (e.g., that generate potentially infectious aerosols or involving anatomic regions where viral loads might be higher, such as the nose and throat, oropharynx, respiratory tract) (see Surgical FAQ below).
Respirators with exhalation valves are not recommended for source control and should not be used during surgical procedures as unfiltered exhaled breath would compromise the sterile field

For HCP working in areas with minimal to no community transmission, the universal eye protection and respirator recommendations (described above) for areas with moderate to substantial community transmission are optional. However, HCP should continue to use eye protection or an N95 or higher-level respirator whenever recommended for patient care as a part of Standard or Transmission-Based Precautions. Universal use of a facemask for source control is recommended for HCP.

Depending on testing availability and how rapidly results are available,
facilities can also consider implementing pre-admission or pre-procedure
testing for COVID-19. Testing results might inform decisions for universal use
of eye protection and respirators as described above, especially if there are
PPE shortages. Limitations of using this testing strategy include obtaining
negative results in patients during their incubation period who later become
infectious and false negative test results, depending on the test method used.
Definitions:

Substantial community transmission: Large scale community transmission, including communal settings (e.g., schools, workplaces)
Minimal to moderate community transmission: Sustained transmission with high likelihood or confirmed exposure within communal settings and potential for rapid increase in cases
No to minimal community transmission: Evidence of isolated cases or limited community transmission, case investigations underway; no evidence of exposure in large communal setting


Healthcare Infection Prevention and Control FAQs for COVID-19
Do all patients with confirmed or suspected COVID-19 need to be placed in airborne infection isolation rooms?
No. Updated CDC Interim Infection Prevention and Control Recommendations for
Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in
Healthcare
Settings recommends placing patients in a regular
examination room with the door closed. Airborne infection isolation rooms
should be reserved for patients undergoing aerosol generating procedures or
for diagnoses such as active tuberculosis.


Healthcare Infection Prevention and Control FAQs for COVID-19
Where should nasopharyngeal swabs be performed on a known or suspected COVID-19 patient, and with what PPE?
The collection of nasopharyngeal (NP) swabs from patients with known or
suspected COVID-19 can be performed in a regular examination room with the
door closed. Use of an airborne infection isolation room for nasopharyngeal
specimen collection is not required. HCP in the room should wear an N95 or
higher-level respirator (or facemask if a respirator is not available), eye
protection, gloves, and a gown. If respirators are not readily available, they
should be prioritized for other procedures at higher risk for producing
infectious aerosols (e.g., intubation), instead of for collecting NP swabs.


Healthcare Infection Prevention and Control FAQs for COVID-19
Is a negative test for SARS-CoV-2, the virus that causes COVID-19, required before a hospitalized patient can be discharged to a nursing home?
No. For patients hospitalized with COVID-19, decisions about discharge
from the hospital should be based on their clinical status and the ability
of the accepting facility to meet their care needs and adhere to recommended
infection prevention and control practices. Decisions about hospital discharge
are distinct from decisions about discontinuation of Transmission-Based
Precautions.
For patients with suspected or confirmed COVID-19, decisions about
discontinuing Transmission-Based Precautions should be based on the
strategies outlined here. The test-based strategy is NOT REQUIRED and
might not be possible due to limitations on availability of testing.
If a patient with suspected or confirmed COVID-19 has not met criteria for
discontinuing Transmission-Based Precautions, they should be transferred to a
facility with the ability to adhere to infection prevention and control
recommendations for the care
of residents with COVID-19, including placement in a unit or area of the
facility designated to care for residents with COVID-19 and provision of
recommended personal protective equipment to healthcare personnel.
If the patient with suspected or confirmed COVID-19 has met the criteria
for discontinuing Transmission-Based Precautions but has persistent
symptoms (e.g., persistent cough), they should ideally be placed in a single
room, be restricted to their room to the extent possible, and wear a facemask
(if tolerated) during care activities until all symptoms are completely
resolved or at baseline. If the patient has met the criteria for
discontinuing Transmission-Based Precautions and does not have persistent
symptoms, they do not require additional restrictions.
A patient hospitalized for non-COVID-related illnesses whose COVID-19 status
is not known can be transferred to a nursing home without testing. However, to
ensure they are not infected, nursing homes should place them in
Transmission-based Precautions in a separate observation area or in a single-person room until 14
days have elapsed since admission.
As part of universal source control
measures,
all residents (including those described in the scenarios above) should wear a
cloth face covering or facemask (if tolerated) whenever they leave their room.


Healthcare Infection Prevention and Control FAQs for COVID-19
During the COVID-19 pandemic, are there special considerations for surgical and other procedural care settings, including performance of aerosol-generating procedures (AGPs)?
As part of routine practices, healthcare personnel (HCP) should be applying
Standard Precautions. HCP
should always deliberately assess potential risks of exposure to infectious
material before engaging in activities and procedures in healthcare delivery.
Based on their risk assessment, safe work practices, including engineering
controls that reduce the release of infectious material, administrative
controls, and use of personal protective equipment (PPE) should be implemented
at the point of care according to CDC guidelines and standards of practice for
the activity performed.
To reduce SARS-CoV-2 exposure during the COVID-19 pandemic, CDC recommends
that facilities:

consider nonoperative approaches when feasible;
minimize the use of procedures or techniques that might produce infectious aerosols when feasible;
minimize the number of people in the operating or procedure room to reduce exposures;
use the extent of community transmission and an assessment of the likelihood for patient harm if care is delayed to make decisions about cancelling or postponing elective surgeries and procedures; and
implement universal source control measures, which includes having patients wear a cloth face covering (as tolerated) and having HCP wear a facemask at all times while they are in the healthcare facility.

If surgery or procedures cannot be postponed, HCP caring for patients with
suspected or confirmed COVID-19 should adhere to all recommended infection
prevention and control practices for
COVID-19.
This includes:

Using all recommended PPE: an N95 or higher-level respirator (or facemask if respirators are not available), eye protection, gloves, and a gown.
Respirators with exhalation valves should not be used during surgical procedures as unfiltered exhaled breath would compromise the sterile field.
If shortages exist, N95 or higher-level respirators should be prioritized for procedures involving higher risk techniques (e.g., that generate potentially infectious aerosols) or that involve anatomic regions where viral loads might be higher (e.g., nose and throat, oropharynx, respiratory tract).

As part of routine practice, HCP should also be using additional engineering controls for source control, when applicable (e.g., smoke evacuation devices).

Because COVID-19 can be transmitted asymptomatically, some infected
individuals will not be identified based on clinical signs and symptoms. HCP
providing surgical or procedural care to patients not suspected of having
COVID-19 should use a tiered approach based on the level of community
transmission to inform the need for universal eye protection and respirator
use (see FAQ addressing recommended PPE when caring for asymptomatic patients
who are not suspected to have COVID-19). HCP should continue to use eye
protection or an N95 or higher-level respirator whenever recommended for
patient care as a part of Standard or Transmission-Based Precautions.


Healthcare Infection Prevention and Control FAQs for COVID-19
How long does an examination room need to remain vacant after being occupied by a patient with confirmed or suspected COVID-19?
Although spread of SARS-CoV-2 is believed to be primarily via respiratory
droplets, the contribution of small respirable particles to close proximity
transmission is currently uncertain. Airborne transmission from person-to-
person over long distances is unlikely.
The amount of time that the air inside an examination room remains potentially
infectious is not known and may depend on a number of factors including the
size of the room, the number of air changes per hour, how long the patient was
in the room, if the patient was coughing or sneezing, and if an aerosol-
generating procedure was performed. Facilities will need to consider these
factors when deciding when the vacated room can be entered by someone who is
not wearing PPE.
For a patient who was not coughing or sneezing, did not undergo an aerosol-
generating procedure, and occupied the room for a short period of time (e.g.,
a few minutes), any risk to HCP and subsequent patients likely dissipates over
a matter of minutes. However, for a patient who was coughing and remained in
the room for a longer period of time or underwent an aerosol-generating
procedure, the risk period is likely longer.
For these higher risk scenarios, it is reasonable to apply a similar time
period as that used for pathogens spread by the airborne route (e.g., measles,
tuberculosis) and to restrict HCP and patients without PPE from entering the
room until sufficient time has elapsed for enough air changes to remove
potentially infectious particles.
General guidance on clearance rates under differing ventilation
conditions
is available.
In addition to ensuring sufficient time for enough air changes to remove
potentially infectious particles, HCP should clean and disinfect environmental
surfaces and shared equipment before the room is used for another patient.


Healthcare Infection Prevention and Control FAQs for COVID-19
Do CDC’s interim infection prevention and control recommendations for COVID-19 apply to psychiatric hospitals or other behavioral health facilities?
Yes. To keep patients and healthcare personnel (HCP) healthy and safe, CDC’s
infection prevention and control guidance applies to all settings where
healthcare is delivered. However, as with any guidance, facilities can tailor
certain recommendations to their setting. For example, inpatient psychiatric
care includes communal experiences and group activities that may need to
continue. If so, these activities might need to be adapted to align with
social distancing recommendations. Other recommended infection control measures
(for example, ensuring access to alcohol-based hand sanitizer, cohorting
patients with COVID-19 and assigning dedicated staff, or implementing
universal source control measures) might not be safe or appropriate to
implement in all locations or for all patients due to security and behavioral
concerns.
Challenges and potential solutions specific to behavioral health settings
might include:

Cohorting
Challenge: To prevent transmission, it is generally recommended that patients with COVID-19 be transferred to a separate area of the facility where they can be cared for by dedicated HCP. Because of security concerns or specialized care needs, it might not be possible to cohort certain patients together or change HCP assigned to their care.
Potential Solutions: When cohorting is not possible, implement measures to maintain social distancing (at least 6 feet) between patients with COVID-19 and others on the unit. Ideally, this would include a separate bathroom for COVID-19 patients. Ensure HCP wear all recommended personal protective equipment (PPE) when caring for patients with suspected or confirmed COVID-19.

Group Therapy Sessions
Challenge : Group counseling, therapy, and discussion sessions are a critical component of psychiatric treatment and care plans, but the traditional set-up for these activities is not compatible with social distancing recommendations.
Potential Solutions : When possible, use virtual methods, or decrease group size so social distancing can be maintained. In the event that COVID-19 is transmitted in the facility, sessions should stop or move to a video discussion forum until additional infection prevention measures are in place to stop the spread.

Cloth Face Coverings
Challenge: For some patients, the use of cloth face coverings or facemasks might pose an additional danger or may cause distress. Some patients may be unable or unwilling to use them as intended. Elastic and cloth straps can be used for strangling oneself or others, and metal nasal bridges can be used for self-harm or as a weapon.
Potential Solutions: Consider allowing patients at low risk for misuse to wear cloth face coverings or facemasks, with a preference for those with short ear-loops rather than longer ties. Consider use of cloth face coverings or facemasks during supervised group activities. Ensure that HCP interacting with patients who cannot wear a cloth face covering or facemask are wearing eye protection and a facemask (or a respirator if the patient is suspected to have COVID-19 and respirators are available).

Alcohol-based Hand Sanitizer
Challenge : While alcohol-based hand sanitizer (ABHS) containing 60-95% alcohol is an important tool to increase adherence to hand hygiene recommendations, ABHS must be used carefully in psychiatric facilities to ensure it is not ingested by patients.
Potential Solutions : Consider not placing ABHS in patients’ rooms in psychiatric facilities, nor in locations where the patients have unsupervised access. Encourage frequent hand washing with soap and water for patients and HCP. Consider providing personal, pocket-sized ABHS dispensers for HCP.

Dining
Challenge : As part of social distancing, communal dining is generally not recommended. However, eating needs to remain supervised due to the potential for self-harm with eating utensils and because commonly used psychiatric medications may cause side effects (e.g., tardive dyskinesia, dysphagia, hypo- and hypersalivation) that increase choking risk for patients.
Potential Solutions : One option is to position staff in patients’ rooms to monitor their dining. Another option is to allow communal dining in shifts so that staff can monitor patients while ensuring they remain at least 6 feet apart. A third option is to have patients sit in appropriately spaced chairs in the hallway outside their rooms so they can be monitored while they eat.

Smoking
Challenge: A higher proportion of psychiatric patients smoke cigarettes compared to the general population. Patients might congregate in outdoor smoking spaces without practicing appropriate social distancing.
Potential Solutions: Limit the number of patients allowed to access smoking spacesat the same time, and position staff to observe and ensure patients are practicing appropriate physical distancing.


Healthcare Infection Prevention and Control FAQs for COVID-19
If a long-term care facility has a resident or staff member with suspected or confirmed COVID-19, how and to whom should this be communicated?
Facilities should follow the reporting requirements of their state or
jurisdiction. Those regulated by the Centers for Medicare and Medicaid
Services (CMS) (e.g., nursing homes) should also follow all CMS
requirementspdf iconexternal
icon, which are being
updated to include new requirements for reporting to CDC and to residents and
their representatives.
In addition, CDC recommends
that health departments be promptly notified
about:

Residents or healthcare personnel (HCP) with suspected or confirmed COVID-19,
Residents with severe respiratory infection resulting in hospitalization or death, and
≥ 3 residents or HCP with new-onset respiratory symptoms within 72 hours of each other.

These could signal an outbreak of COVID-19 or other respiratory disease in the
facility. The health department can provide important guidance to assist with
case finding and halting transmission.
The facility should also have a plan and mechanism to regularly communicate
with residents, family members, and HCP, including if cases of COVID-19 are
identified in the facility. Often, information in nursing homes is
communicated through town hall meetings and staff meetings, along with letters
or emails. However, during the COVID-19 pandemic, in-person gatherings should
not occur. Instead, communication should occur through virtual meetings over
phone or web platforms. These should be supplemented with written
communications that provide contact information for a staff member who can
respond to questions or concerns. Communications should include information
describing the current situation, plans for limiting spread within the
facility, and recommended actions they can take to protect themselves and
others. Facilities should make this information available in a timely manner
and offer periodic updates as the situation develops and more information
becomes available.


Healthcare Infection Prevention and Control FAQs for COVID-19
What personal protective equipment (PPE) should be worn by environmental services (EVS) personnel who clean and disinfect rooms of hospitalized patients with COVID-19?
In general, only essential personnel should enter the room of patients with
COVID-19. Healthcare facilities should consider assigning daily cleaning and
disinfection of high-touch surfaces to nursing personnel who will already be
in the room providing care to the patient. If this responsibility is assigned
to EVS personnel, they should wear all recommended
PPE when
in the room. PPE should be removed upon leaving the room, immediately followed
by performance of hand hygiene.
After discharge, terminal cleaning may be performed by EVS personnel. They
should delay entry into the room until a sufficient time has
elapsed
for enough air changes to remove potentially infectious particles. We do not
yet know how long SARS-CoV-2 remains infectious in the air. Regardless, EVS
personnel should refrain from entering the vacated room until sufficient time
has elapsed for enough air changes to remove potentially infectious particles
(more information on clearance rates under differing ventilation conditions
is
available).
After this time has elapsed, EVS personnel may enter the room and should wear
a gown and gloves when performing terminal cleaning. A facemask (if not
already wearing for source control) and eye protection should be added if
splashes or sprays during cleaning and disinfection activities are anticipated
or otherwise required based on the selected cleaning products. Shoe covers are
not recommended at this time for personnel caring for patients with COVID-19.


Homelessness and COVID-19 FAQs
Should homeless encampments be cleared?
Connecting people to stable housing should continue to be a priority. However,
if individual housing options are not available, allow people who are living
in encampments to remain where they are. Encourage people living in
encampments to increase space between people and provide hygiene resources in
accordance with the Interim Guidance for People Experiencing Unsheltered
Homelessness.


Homelessness and COVID-19 FAQs
Should homeless shelters screen clients?
Homeless shelters can screen clients for symptoms of respiratory infections.
Clients who have symptoms may or may not have COVID-19. Make sure they have a
separate place they can safely stay within the shelter or at an alternate site
in coordination with local health authorities. An on-site nurse or other
clinical staff can help with clinical assessments.

Provide anyone who presents with symptoms with a cloth face covering.
Facilitate access to non-urgent medical care as needed.
Use standard facility procedures to determine whether a client needs immediate medical attention. Emergency signs include:
Trouble breathing
Persistent pain or pressure in the chest
New confusion or inability to arouse
Bluish lips or face

Notify the designated medical facility and personnel to transfer clients that
the client might have COVID-19.


Homelessness and COVID-19 FAQs
What should a person who is experiencing homelessness do if they have symptoms consistent with COVID-19?
Any person experiencing homelessness with symptoms consistent with
COVID-19 (fever,
cough, or shortness of breath) should alert their service providers (such as
case managers, shelter staff, and other care providers). These staff will help
the individual understand how to isolate themselves and identify options for
medical care as needed.


Homelessness and COVID-19 FAQs
Where can people experiencing homelessness be tested for COVID-19?
If they meet criteria for testing, people experiencing homelessness will access COVID-19
testing through a healthcare provider. Local public health and healthcare
facilities need to determine the best location for this testing in
coordination with homeless healthcare clinics and street medicine clinics.


Homelessness and COVID-19 FAQs
Where should a person who is experiencing homelessness stay if they are suspected to have COVID-19 or if they have tested positive for COVID-19?
Those with suspected or confirmed COVID-19 should stay in a place where they
can best be isolated from other people to prevent spreading the infection.
Local health departments, housing authorities, homeless service systems and
healthcare facilities should plan to identify locations to isolate those with
known or suspected COVID-19 until they meet the criteria to end
isolation.
Isolation housing could be units designated by local authorities or shelters
determined to have capacity to sufficiently isolate these people. If no other
options are available, homeless service providers should plan for how they can
help people isolate themselves while efforts are underway to provide
additional support. Please see the Interim Guidance for Homeless Service
Providers and Interim Guidance for People Experiencing Unsheltered
Homelessness for more information.


Homelessness and COVID-19 FAQs
Can homeless service providers accept donations?
Homeless service providers can accept donations during community spread of
COVID-19, but general infection control precautions should be taken. Request
that donors not donate if they are sick. Set up donation drop-off points to
encourage social distancing between shelter workers and those donating.
According to usual procedures, launder donated clothing, sheets, towels, or
other fabrics on high heat settings, and disinfect items that are nonporous,
such as items made of plastic. Food donations should be shelf-stable, and
shelter staff should take usual food-related infection prevention precautions.
For more information about COVID-19 and food, see the Food and Drug
Administration’s website on Food Safety and COVID-19external
icon. For further information on cleaning and
disinfection, see
here.


Homelessness and COVID-19 FAQs
Are people experiencing homelessness at risk of COVID-19?
People who are homeless are at risk of COVID-19. Homeless services are often
provided in congregate settings, which could facilitate the spread of
infection. Because many people who are homeless are older adults or have
underlying medical conditions, they may also be at higher risk for severe disease than
the general population. Health departments and healthcare facilities should be
aware that people who are homeless are a particularly vulnerable group. If
possible, identifying non-congregate settings where those at highest risk can
stay may help protect them from COVID-19.


Homelessness and COVID-19 FAQs
How can people experiencing homelessness protect themselves when COVID-19 is spreading in their community?
Many of the recommendations to prevent
COVID-19 may be difficult for
a person experiencing homelessness to do. Although it may not be possible to
avoid certain crowded locations (such as shelters), people who are homeless
should try to avoid other crowded public settings and public transportation.
If possible, they should use take-away options for food. As is true for
everyone, they should maintain a distance of about 6 feet (two arms’ length)
from other people. They also should wash their hands with soap and water for
at least 20 seconds as often as possible, and cover their coughs and sneezes.


Homelessness and COVID-19 FAQs
Should homeless shelters close?
Homeless shelters serve a critical function in our communities. Shelters
should stay open unless homeless service providers, health departments, and
housing authorities have determined together that a shelter needs to close.


Institutes of Higher Education
Planning and Preparedness
What should we do if a student, staff or faculty member shows symptoms of COVID-19?
You should establish procedures for anyone who becomes sick or arrives sick on
campus. Sick students, staff and faculty should be separated from others,
given a mask to wear, if available and sent to their place or residence as
soon as possible. Sick residents of on-campus housing should avoid contact
with individuals who are healthy.


Institutes of Higher Education
Dismissals
How long should colleges or universities be dismissed?
It depends on the situation at your school and community. You may need to
temporarily dismiss school for 2-5 days, if someone with COVID-19 was on
campus. This initial short-term dismissal allows time for the local health
officials to gain a better understanding of the COVID-19 situation impacting
the school and for custodial staff to clean and disinfect the affected
facilities. The need for an extended dismissal will be made based on what
officials discover from contact tracing.
If there is substantial transmission in the local community, local health
officials may suggest extended school dismissals. This longer-term, and likely
broader-reaching, dismissal strategy is intended to slow transmission rates of
COVID-19 in the community.


Institutes of Higher Education
Planning and Preparedness
What can staff and students do to prevent the spread of COVID-19?
Encourage students and staff to take everyday preventive
actions to
prevent the spread of respiratory illnesses, such as staying home when sick;
appropriately covering coughs and sneezes; cleaning frequently touched
surfaces; and washing hands often with soap and water. If soap and water are
not readily available, use an alcohol-based hand sanitizer with at least 60%
alcohol. Always wash hands with soap and water if hands are visibly dirty.


Institutes of Higher Education
Dismissals
When should I suspend classes or cancel events/activities on campus?
Any decision about school dismissal or cancellation of events should be made
in coordination with your local health officials. Colleges and universities
are not expected to make decisions about dismissals on their own.
You may need to temporarily dismiss school for 2-5 days, if someone with
COVID-19 was on campus. COVID-19. This initial short-term dismissal allows
time for the local health officials to gain a better understanding of the
COVID-19 situation impacting the school and for custodial staff to clean and
disinfect the affected facilities. Work with the local health officials to
determine appropriate next steps, including whether an extended dismissal
duration is needed to stop or slow further spread of COVID-19.
If there is substantial transmission in the local community, local health
officials may suggest extended school dismissals. This longer-term, and likely
broader-reaching, dismissal strategy is intended to slow transmission rates of
COVID-19 in the community.


Institutes of Higher Education
Dismissals
Should we continue teaching and/or research activities if we decide to dismiss classes?
Yes, consider ways that your college/university can adapt or use alternative
teaching methods.

Review continuity plans, including plans for the continuity of teaching, learning, and research. Implement e-learning plans and distance learning options as feasible and appropriate.
Ensure continuity plans address how to temporarily postpone, limit, or adapt research-related activities (e.g., study recruitment or participation, access to labs) in a manner that protects the safety of researchers, participants, facilities, and equipment.
Consider the following approaches:
Use of existing infrastructure and services (e.g., Blackboard, Skype, Zoom) to support efficient transition of classes from in-person to distance-based formats. This may include using strategies such as faculty check-ins, recorded class meetings or lectures, and live class meetings.
Other student support services such as online library services, print materials available online, phone- or Internet-based counseling support, or study groups enabled through digital media.

Institutes of higher education should determine, in consultation with their university system:
How to convert face-to-face lessons into online lessons and how to train faculty to do so.
How to triage technical issues if faced with limited IT support and staff
How to deal with the potential lack of students’ access to computers and the Internet at home or in temporary housing.


Institutes of Higher Education
Planning and Preparedness
What should we do if we have a confirmed case of COVID-19 on campus or identify someone who was on campus?
Immediately notify local health officials. These officials will help
administrators determine a course of action for your college or university.
Administrators should work closely with their local health officials to
determine if a short-term closure (for 2-5 days) of all campus buildings and
facilities is needed. In some cases, you may only need to close buildings and
facilities that had been entered by the individual(s) with COVID-19. This
initial short-term class suspension and event and activity (e.g., club
meetings; on-campus sport, theater, and music events) cancellation allows time
for the local health officials to gain a better understanding of the COVID-19
situation and for custodial staff to clean and disinfect the affected
facilities. It also allows the local health officials and administrators to
determine appropriate next steps, including whether an extended duration is
needed to stop or slow further spread of COVID-19.


Institutes of Higher Education
Planning and Preparedness
What should I do if there is substantial community transmission?
If local health officials have determined there is substantial transmission of
COVID-19 within the community, they will provide guidance to administrators on
the best course of action for their college or university. Similar strategies
will extend across organizations (e.g., K-12 schools, business, community and
faith-based organizations) in a collective effort to stop the spread of
COVID-19.
Measures will likely include extended class suspension and event/activity
cancellations (e.g., suspension/cancellations for longer than two weeks). This
longer-term, and likely broader-reaching, strategy is intended to slow
transmission rates of COVID-19 in the community. During extended class
suspensions, cancel extracurricular group activities and large events.
Remember to implement strategies to ensure the continuity of education,
research, and housing as well as meal programs and other essential services
for students.


Institutes of Higher Education
Planning and Preparedness
How should my school prepare when there is minimal to moderate community transmission?
Work with your local health officials to determine a set of strategies
appropriate for your community’s situation. Continue using the preparedness
strategies implemented for no community transmission, and consider the
following social distancing strategies:

Cancel large gatherings
Cancel or modify courses where students are likely to be in very close contact.
Increase space between desks.
Reduce congestion in the health clinic.
Consider if and how existing dining services should be scaled back or adapted.


Institutes of Higher Education
Planning and Preparedness
What should I consider as I plan and prepare for COVID-19?
As you plan and prepare, you should reinforce healthy practices to everyone on
campus and prepare for a potential case of COVID-19, regardless of the level
of community transmission.
As you create and update your preparedness plans, work with your local health
officials to determine the most appropriate plan and action for your college
or university. Together, you will need to consider your local community
situation—whether you have local transmission in your community, and if so,
the level of transmission (none/minimal, minimal to moderate, substantial).
CDC has created guidance for the scenarios listed below, to help colleges,
universities and their partners understand how to help prevent the
transmission of COVID-19 within their campus, and to react quickly should a
case be identified. The administrators’ guidance includes information about
the following:

How to prepare if you have no community spread of COVID-19.
How to prepare if you have minimal to moderate community spread in your community.
How to prepare if you have substantial community spread in your community.
What to do if a person with COVID-19 has entered your school.

See CDC’s full interim guidance for more
details.


Institutes of Higher Education
Planning and Preparedness
What groups should I work with in our community to prepare?
Work with your local health department to develop/update your emergency
operations plan and information-sharing system. Institutional information
systems can be used to get accurate and up-to-date information, and day-to-day
absenteeism or changes in student health center traffic can help detect and
respond to an outbreak.


Institutes of Higher Education
Dismissals
Should we temporarily cancel extracurricular group activities and large events?
If your community has cases of COVID-19, work with your local public health
officials to determine if you should temporarily cancel
events.
If you decide to dismiss classes, you should also cancel extracurricular group
activities and large events, such as club meetings, performances, social
events, athletic team practices, and sporting events. You should also
discourage students, staff, and faculty from gathering or socializing
elsewhere.


Institutes of Higher Education
Planning and Preparedness
What should I include in my emergency operations plan?
Review and update your emergency operations plan in collaboration with your
local health departmentexternal icon. Focus on the components or annexes of
the plans that address infectious disease outbreaks.

Ensure the plan includes strategies to reduce the spread of a wide variety of infectious diseases (e.g., seasonal influenza). This includes strategies for social distancing and school dismissal that may be used to stop or slow the spread of infectious disease. The plan should also include strategies for continuing education, meal programs, and other related services in the event of school dismissal.
Ensure the plan emphasizes everyday preventive actions for students and staff. For example, emphasize actions such as staying home when sick; appropriately covering coughs and sneezes; cleaning frequently touched surfaces; and washing hands often.


Institutes of Higher Education
Recent Travel
What should we do if a student or staff member recently traveled to an area with COVID-19 or has a family member who has traveled to an area with COVID-19?
Review updatedCDC information for
travelers, including FAQ for
travelers, and consult with state
and local health officials. Health officials may use CDC’s Interim US
Guidance for Risk Assessment and Public Health Management of Persons with
Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-associated or
Community Settings to make recommendations. Individuals returning from travel
to areas with community spread of COVID-19 must follow guidance they have
received from health officials.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
What should I do when there is substantial community transmission?
If local health officials have determined there is substantial transmission of
COVID-19 within the community, they will provide guidance to administrators on
the best course of action for child care programs or schools. These strategies
are expected to extend across multiple programs, schools, or school districts
within the community.
You may need to consider extended school dismissals (e.g. dismissals for
longer than 2 weeks). This longer-term, and likely broader-reaching, dismissal
strategy is intended to slow transmission rates of COVID-19 in the community.
During extended school dismissals, also cancel extracurricular group
activities, school-based afterschool programs, and large events (e.g.,
assemblies, spirit nights, field trips, and sporting events). Remember to
implement strategies to ensure the continuity of education (e.g., distance
learning) as well as meal programs and other essential services for students.


K-12 Schools and Child Care Programs
Dismissals
If I make the decision for a school dismissal, what else should I consider?
In the event of a school dismissal, extracurricular group activities and large
events, such as performances, field trips, and sporting events should also be
cancelled. This may require close coordination with other partners and
organizations (e.g., high school athletics associations, music associations).
In addition, discourage students and staff from gathering or socializing
anywhere, like at a friend’s house, a favorite restaurant, or the local
shopping mall.
Ensure continuity of meal programs for your students. Consider ways to
distribute food to students who receive free or reduced cost meals. Check with
the US Department of Agriculture – Food and Nutrition Service for additional
information:
https://www.fns.usda.gov/disaster/USDAfoodsPandemicSchools.external
icon If there is
community spread of COVID-19, design strategies to avoid distribution in
settings where people might gather in a group or crowd. Consider options such
as “grab-and-go” bagged lunches or meal delivery.
Consider alternatives for providing essential medical and social services for
students. Continue providing necessary services for children with special
healthcare needs, or work with the state Title V Children and Youth with
Special Health Care Needs (CYSHCN) Program.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
How should my school prepare when there is no community transmission in our area?
The most important thing you can do now is to prepare. Schools need to be
ready if COVID-19 does appear in their communities. Here are some strategies:

Review, update, and implement emergency operations plans.
Develop information-sharing systems with partners.
Teach and reinforce health hygiene practices.
Intensify cleaning and disinfection efforts.
Monitor and plan for absenteeism.
Assess group gatherings and events. Follow current guidance about non-critical gatherings and events.
Require sick students and staff to stay home. Establish procedures for students and staff who are sick at school.
Create and test communications plans for use with the school community.
Review CDC’s guidance for business and employers.


K-12 Schools and Child Care Programs
Recent Travel
What should we do if a child, student, or staff member has recently traveled to an area with COVID-19 or has a family member who has traveled to an area with COVID-19?
Review updated CDC information for
travelers,
including FAQ for
travelers, and
consult with state and local health officials. Health officials may use CDC’s
Interim US Guidance for Risk Assessment and Public Health Management of
Persons with Potential Coronavirus Disease 2019 (COVID-19) Exposure in Travel-
associated or Community Settings to make recommendations. Individuals
returning from travel to areas with community spread of COVID-19 must follow
guidance they have received from health officials.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
If children with asthma use “breathing treatments” or peak flow meters, do schools need to be concerned about aerosolizing the virus that causes COVID-19?
First, students with symptoms of COVID-19 should not attend school. Symptoms
of asthma and COVID-19 may overlap, including cough and shortness of breath.
Therefore, students experiencing acute asthma attacks should not be attending
school without approval by a healthcare provider; if an asthma attack starts
at school, a student may need a bronchodilator treatment before being sent
home or before an ambulance arrives. The American Lung Association’s Model
Policy for School Districts: Stock Bronchodilatorspdf iconexternal
icon recommends using inhalers with disposable
spacers/mouthpieces and nebulizers with disposable tubing with
mask/mouthpieces. Inhalers and nebulizers should be used and cleaned according
to the manufacturer’s instructions.
During this COVID-19 pandemic, asthma treatments using inhalers with
spacers (with or without face mask,
according to each student’s individualized treatment plan) are preferred over
nebulizer treatments whenever possible. Based on limited data, use of asthma
inhalers (with or without spacers or face masks) is not considered an aerosol-
generating procedure.
Based on limited available data, it is uncertain whether aerosols generated
by nebulizer treatments are potentially
infectious. During this COVID-19 pandemic, nebulizer treatments at school
should be reserved for children who cannot use or do not have access to an
inhaler (with or without spacer or face mask).
Schools should obtain the appropriate personal protective equipment (PPE) for
staff who administer nebulizer treatments. PPE for use when administering
nebulizer treatments to students with asthma consists of gloves, medical grade
facemask and eye protection.
School staff should be trained on when to use PPE, what PPE is necessary,
where this PPE is stored, how to properly don (put on), use, and doff (take
off) PPE, and how to properly dispose of used PPE. CDC has
information on using PPE. Staff
should also be trained on how to administer nebulizer treatments.
During this COVID-19 pandemic, if a nebulizer treatment is necessary at school
for a student, the number of people present in the room should be limited to
the student and the staff member administering the treatment. If appropriate
based on the student’s age and level of maturity, the staff member could leave
the room and return when the treatment is finished. After the nebulizer
treatment, this room should undergo routine cleaning and disinfection. CDC has
information on how to clean and
disinfect and how to prevent asthma attacks triggered by cleaning and
disinfecting
activities.
Use of peak flow meters, including in the school setting, includes forceful
exhalation. Forceful exhalation is not considered an aerosol-generating
procedure associated with increased risk of transmitting the virus that causes
COVID-19. However, for some people with asthma, using a peak flow meter can
trigger cough.
People with moderate to severe asthma may be at higher risk of getting very sick from
COVID-19. CDC has more information on COVID-19 for
schools and healthcare
providers
(including school nurses).


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
What steps should my school take if a student or staff member shows symptoms of COVID-19?
You should establish procedures to ensure students and staff who become sick
at school or who arrive at school sick are sent home as soon as possible. Keep
anyone sick separate from well students and staff until the sick person can
be sent home.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
If each child has his or her own spacer, can a school’s metered dose inhaler be used by more than one student if the actuator is cleaned before use by another student?
CDC is not aware of data regarding practices to prevent transmission of the
virus that causes COVID-19 or other respiratory viruses, when multiple people
share one asthma inhaler.
Students should be permitted to use their personal inhaler, as needed, to the
extent permitted by state law and school policies. When students need to use
of the school’s stock inhaler, the inhaler should be used and cleaned
according to the manufacturer’s instructions. The American Lung Association’s
Model Policy for School Districts: Stock Bronchodilatorspdf iconexternal
icon recommends using inhalers with disposable
spacers/mouthpieces.
Additional strategies to further minimize cross-contamination include using
spacers with one-way valves and not allowing the student to touch the inhaler
(e.g., the student can touch the spacer, but only the school staff
administering the inhaler can touch the inhaler). Limited data from
healthcare settingspdf iconexternal
icon suggest
wiping all surfaces of an inhaler with an alcohol-based wipe containing at
least 70% alcohol after inhaler use, and then allowing these surfaces to air-
dry can prevent bacterial cross-contamination. CDC is not aware of data on
whether this has helped prevent viral infections or infections in the school
setting.
CDC is not aware of data regarding viral contamination of spacer devices. A
study evaluating the persistence of SARS-CoV-2external
icon (the virus that
causes COVID-19) on plastic, stainless steel, and cardboard surfaces showed
that the virus is able to remain viable for up to 72 hours. The American Lung
Association’s Model Policy for School Districts: Stock Bronchodilatorspdf
iconexternal
icon recommends using inhalers with disposable spacers
or disposable mouthpieces.
School staff who administer asthma medication to students should use good hand
hygiene, including washing hands
with soap and water for at least 20 seconds before and after administration.
If soap and water are not available and hands are not visibly dirty, staff
should use an alcohol-based hand sanitizer that contains at least 60% alcohol.
People with moderate to severe asthma may be at higher risk of getting very sick from
COVID-19. CDC has more information on COVID-19 for
schools and healthcare
providers
(including school nurses).
CDC has additional information about asthma (non-COVID related) for health
professionals and schools here: https://www.cdc.gov/asthma/info.html


K-12 Schools and Child Care Programs
Teachers
What can teachers do to protect themselves and their students?
Teachers and students are in close contact for much of the day, and schools
can become a place where respiratory diseases like COVID-19 can quickly
spread. Protect yourself and your students by practicing and promoting
healthy habits during the school year. You should also plan to say home
if you have symptoms of COVID-19 like fever, cough, or shortness of breath.
Encourage parents to keep students at home if they’re sick. Consider social
distancing strategies, such as modifying classes where students are likely to
be in very close contact; increasing space between desks; and allowing
students to eat meals in the classroom.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
What should I include in my emergency operations plan?
Review and update your emergency operations plan in collaboration with your
local health departmentexternal iconexternal
icon. Focus on the
components or annexes of the plans that address infectious disease outbreaks.

Ensure the plan includes strategies to reduce the spread of a wide variety of infectious diseases (e.g., seasonal influenza). This includes strategies for social distancing and school dismissal that may be used to stop or slow the spread of infectious disease. The plan should also include strategies for continuing education, meal programs, and other related services in the event of school dismissal.
Ensure the plan emphasizes everyday preventive actions for students and staff. For example, emphasize actions such as staying home when sick; appropriately covering coughs and sneezes; cleaning frequently touched surfaces; and washing hands often.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
What should I do if the suspected sick student or staff member is confirmed to have COVID-19?
Immediately notify local health officials. These officials will help
administrators determine a course of action for their child care programs or
schools.
You will likely dismiss students and most staff for 2-5 days. This initial
short-term dismissal allows time for the local health officials to gain a
better understanding of the COVID-19 situation impacting the school and for
custodial staff to clean and disinfect the affected facilities. Work with the
local health officials to determine appropriate next steps, including whether
an extended dismissal duration is needed to stop or slow further spread of
COVID-19.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
How should my school prepare when there is minimal to moderate community transmission in our area?
Work with your local health officials to determine a set of strategies
appropriate for your community’s situation. Continue using the preparedness
strategies implemented for no community transmission, and consider the
following social distancing strategies:

Cancel field trips, assemblies, and other large gatherings.
Cancel or modify classes where students are likely to be in very close contact.
Increase the space between desks to at least 6 feet.
Stagger arrival and/or dismissal times.
Reduce congestion in the health office.
Limit nonessential visitors.
Limit bringing in students from other schools for special programs (e.g., music, robotics, academic clubs)
Teach staff, students, and their families to maintain a safe distance (6 feet) from each other in the school.


K-12 Schools and Child Care Programs
Parents
How should parents talk to children about COVID-19?
As public conversations around COVID-19 increase, children may worry about
themselves, their family, and friends getting ill with COVID-19. Parents play
an important role in helping children make sense of what they hear in a way
that is honest, accurate, and minimizes anxiety or fear. CDC has created
guidance to help adults have conversations with children about
COVID-19 and ways they can avoid getting and spreading the disease.


K-12 Schools and Child Care Programs
Teachers
How should I talk to my students about COVID-19?
As public conversations around COVID-19 increase, children may worry about
themselves, their family, and friends getting ill with COVID-19. Teachers can
play an important role in helping children make sense of what they hear in a
way that is honest, accurate, and minimizes anxiety or fear. CDC has created
guidance to help adults have conversations with children about
COVID-19 and ways they can avoid getting and spreading the disease.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
What should I consider as I plan and prepare for COVID-19?
Administrators should always reinforce healthy practices among their staff and
students, as well as prepare for a potential case of COVID-19, regardless of
the current level of community transmission.
As you create and update your preparedness plans, work with your local health
officials to determine the most appropriate plan and actions for your school
or program. Together, you will need to consider your local community
situation—whether you have local transmission in your community, and if so,
the level of transmission (none/minimal, minimal to moderate, substantial).
CDC has created overall guidance, as well as guidance tailored for
transmission level in your area to help child care programs, schools, and
their partners understand how to help prevent COVID-19 and react quickly when
a case is identified. The guidance includes information about the following:

How to prepare if you have no community spread of COVID-19.
How to prepare if you have minimal to moderate community spread in your community.
How to prepare if you have substantial community spread in your community.
What to do if a person with COVID-19 has entered your school.

See CDC’s full interim guidance for more
details.


K-12 Schools and Child Care Programs
Dismissals
Are there ways for students to keep learning if we decide to dismiss schools?
Yes, consider implementing e-learning plans, including digital and distance
learning options as feasible and appropriate. Determine, in consultation with
school district officials or other relevant state or local partners:

If a waiver is needed for state requirements of a minimum number of in-person instructional hours or school days (seat time) as a condition for funding.
How to convert face-to-face lessons into online lessons and how to train teachers to do so.
How to triage technical issues if faced with limited IT support and staff.
How to encourage appropriate adult supervision while children are using distance learning approaches.
How to deal with the potential lack of students’ access to computers and the internet at home.


K-12 Schools and Child Care Programs
Dismissals
When should I dismiss our school/child care program?
Any decision about school dismissal or cancellation of school events should be
made in coordination with your local health officials. Schools are not
expected to make decisions about dismissals on their own.
You may need to temporarily dismiss school for 2-5 days, if a student or staff
member attended school before being confirmed as having COVID-19. This initial
short-term dismissal allows time for the local health officials to gain a
better understanding of the COVID-19 situation impacting the school and for
custodial staff to clean and disinfect the affected facilities. Work with the
local health officials to determine appropriate next steps, including whether
an extended dismissal duration is needed to stop or slow further spread of
COVID-19.
If there is substantial transmission in the local community, local health
officials may suggest extended school dismissalspdf iconpdf
icon (e.g., dismissals for longer than two weeks). This longer-
term, and likely broader-reaching, dismissal strategy is intended to slow
transmission rates of COVID-19 in the community.


K-12 Schools and Child Care Programs
Parents
How will I know if my child's school is closed?
Look out for information from your school district. Information may come via
phone, email, or website depending on your school’s communication plan. Local
media outlets may provide updates, since they often monitor this information.


K-12 Schools and Child Care Programs
Dismissals
If we dismiss school, what do we need to consider when re-opening the building to students?
CDC is currently working on additional guidance to help schools determine when
and how to re-open in an orderly manner. If you need immediate assistance with
this, consult local health officials for guidance. Stay in touch with your
local and state health department, as well as the Department of Education.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
What can staff and students do to prevent the spread of COVID-19?
Encourage students and staff to take everyday preventive
actions to prevent the spread of respiratory illnesses. These
actions include staying home when sick; appropriately covering coughs and
sneezes; cleaning and disinfecting frequently touched surfaces; and washing
hands often with soap and water. If soap and water are not readily available,
use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash
hands with soap and water if they are visibly dirty. Remember to supervise
young children when they use hand sanitizer to prevent swallowing alcohol.


K-12 Schools and Child Care Programs
Parents
What are schools doing to prepare for COVID-19?
Schools are advised to ensure adequate supplies are available to support
healthy hygiene practices, and to routinely clean and disinfect objects and
surfaces that are frequently touched.
They are also working closely with local health officials to review and update
their school emergency operation plans, and to determine if or when to dismiss
schools.


K-12 Schools and Child Care Programs
Parents
Are children more at-risk?
Information about COVID-19 in
children is somewhat
limited, but the information that is available suggests that children with
confirmed COVID-19 generally had mild symptoms. Person-to-person spread from
or to children, as among adults, is thought to occur mainly via respiratory
droplets produced when an infected person coughs, sneezes, or talks. Recent
studies indicate that people who are infected but do not have symptoms likely
also play a role in the spread of COVID-19.
However, a small percentage of children have been reported to have more severe
illness. People who have serious chronic medical conditions are believed to be
at higher risk. Despite lower risk of serious illness among most children,
children with COVID-19-like symptoms should avoid contact with others who
might be at higher risk, such as older adults and adults with serious chronic
medical conditions.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
What should I do if my school experiences increased rates of absenteeism?
If your school notices a substantial increase in the number of students or
staff missing school due to illness, report this to your local health
officials.


K-12 Schools and Child Care Programs
Administrators
Planning and Responding to COVID-19
Should my school screen students for COVID-19?
Schools and child care programs are not expected to screen children,
students, or staff to identify cases of COVID-19. If a community (or more
specifically, a school) has cases of COVID-19, local health officials will
help identify those individuals and follow up on next steps.


Personal Protective Equipment: Questions and Answers
Gowns
How do I put on (don) and take off (doff) my gown?

Check to see if your facility has guidance on how to don and doff PPE. The procedure to don and doff should be tailored to the specific type of PPE that you have available at your facility.
If your facility does not have specific guidance, the CDC has recommended sequences for donning and doffing of PPE.pdf icon
It is important for Health Care Providers (HCP) to perform hand hygiene before and after removing PPE. Hand hygiene should be performed by using alcohol-based hand sanitizer that contains 60-95% alcohol or washing hands with soap and water for at least 20 seconds. If hands are visibly soiled, soap and water should be used before returning to alcohol-based hand sanitizer.


Personal Protective Equipment: Questions and Answers
Gloves
What type of glove is recommended to care for suspected or confirmed COVID-19 patients in healthcare settings?
Nonsterile disposable patient examination gloves, which are used for routine
patient care in healthcare settings, are appropriate for the care of patients
with suspected or confirmed COVID-19.


Personal Protective Equipment: Questions and Answers
Gloves
How do I put on (don) or take off (doff) my gloves?

Check to see if your facility has guidance on how to don and doff PPE. The procedure to don and doff should be tailored to the specific type of PPE that you have available at your facility.
If your facility does not have specific guidance, the CDC has recommended sequences for donning and doffing of PPEpdf icon.
It is important for HCP to perform hand hygiene after removing PPE. Hand hygiene should be performed by using an alcohol-based hand sanitizer that contains 60-95% alcohol or washing hands with soap and water for at least 20 seconds. If hands are visibly soiled, soap and water should be used before returning to alcohol-based hand sanitizer.


Personal Protective Equipment: Questions and Answers
Respirators
What do I do with an expired respirator?
In times of increased demand and decreased supply, consideration can be made
to use N95 respirators past their intended shelf life. However, the potential
exists that the respirator will not perform to the requirements for which it
was certified. Over time, components such as the strap and nose bridge may
degrade, which can affect the quality of the fit and seal. Prior to use of N95
respirators, the HCP should inspect the respirator and perform a seal check.
Additionally, expired respirators may potentially no longer meet the
certification requirements set by NIOSH. For further guidance, visit Release
of Stockpiled N95 Filtering Facepiece Respirators Beyond the Manufacturer-
Designated Shelf Life: Considerations for the COVID-19
Response .


Personal Protective Equipment: Questions and Answers
Respirators
How do I know if my respirator is expired?
NIOSH does not require approved N95 filtering facepiece respirators (FFRs) be
marked with an expiration date. If an FFR does not have an assigned expiration
date, you should refer to the user instructions or seek guidance from the
specific manufacturer on whether time and storage conditions (such as
temperature or humidity) are expected to have an effect on the respirator’s
performance and if the respirators are nearing the end of their shelf life.


Personal Protective Equipment: Questions and Answers
Gowns
What testing and standards should I consider when looking for CDC-recommended protective clothing?

CDC’s guidance for Considerations for Selecting Protective Clothing used in Healthcare for Protection against Microorganisms in Blood and Body Fluids outlines the scientific evidence and information on national and international standards, test methods, and specifications for fluid-resistant and impermeable gowns and coveralls used in healthcare.
Many organizations have published guidelines for the use of personal protective equipment (PPE) in medical settings. The American National Standards Institute (ANSI) and the Association of the Advancement of Medical Instrumentation (AAMI): ANSI/AAMI PB70:2012pdf iconexternal icon describes the liquid barrier performance and a classification of surgical and isolation gowns for use in health care facilities.
As with any type of PPE, the key to proper selection and use of protective clothing is to understand the hazards and the risk of exposure. Some of the factors important to assessing the risk of exposure in health facilities include source, modes of transmission, pressures and types of contact, and duration and type of tasks to be performed by the user of the PPE. (Technical Information Report (TIR) 11pdf iconexternal icon[AAMI 2005]).
For gowns, it is important to have sufficient overlap of the fabric so that it wraps around the body to cover the back (ensuring that if the wearer squats or sits down, the gown still protects the back area of the body).


Personal Protective Equipment: Questions and Answers
Respirators
How can I tell if a respirator is NIOSH-approved?
The NIOSH approval number and approval
label
are key to identifying NIOSH-approved respirators. The NIOSH approval label
can be found on or within the packaging of the respirator or sometimes on the
respirator itself. The required labeling of NIOSH-Approved N95 filtering
facepiece respiratorspdf
icon includes the NIOSH name, the approval number, filter
designations, lot number, and model number to be printed on the respirator.
You can verify that your respirator approvals are valid by checking the NIOSH
Certified Equipment List
(CEL).


Personal Protective Equipment: Questions and Answers
Respirators
Should I wear a respirator in public?
Most often,
spread of
respiratory viruses from person-to-person happens among close
contacts
(within 6 feet). Recent studies indicate that people who are infected but do
not have symptoms likely also play a role in the spread of COVID-19. CDC
recommends everyday preventive actions to prevent the spread of respiratory
viruses, such as avoiding people who are sick, avoiding touching your eyes or
nose, and covering your cough or sneeze with a tissue. People who are sick
should stay home and not go into crowded public places or visit people in hospitals.
Workers who are sick should follow CDC guidelines and stay home when they are
sick.


Personal Protective Equipment: Questions and Answers
Gloves
Is double gloving necessary when caring for suspected or confirmed COVID-19 patients in healthcare settings?
CDC Guidance does not recommend double gloves when
providing care to suspected or confirmed 2019-COVID patients.


Personal Protective Equipment: Questions and Answers
Respirators
My N95 respirator has an exhalation valve, is that okay?
An N95 respirator with an exhalation valve does provide the same level of
protection to the wearer as one that does not have a valve. The presence of an
exhalation valve reduces exhalation resistance, which makes it easier to
breathe (exhale). Some users feel that a respirator with an exhalation valve
keeps the face cooler and reduces moisture build up inside the facepiece.
However, respirators with exhalation valves should not be used in situations
where a sterile field must be maintained (e.g., during an invasive procedure
in an operating or procedure room) because the exhalation valve allows
unfiltered exhaled air to escape into the sterile field.


Personal Protective Equipment: Questions and Answers
Gloves
Are extended length gloves necessary when caring for suspected or confirmed COVID-19 patients in healthcare settings?
According to CDC
Guidance, extended length gloves are not necessary when providing
care to suspected or confirmed COVID-19 patients. Extended length gloves can
be used, but CDC is not specifically recommending them at this time.


Personal Protective Equipment: Questions and Answers
Respirators
What is a respirator?
A respirator is a personal protective device that is worn on the face or head
and covers at least the nose and mouth. A respirator is used to reduce the
wearer’s risk of inhaling hazardous airborne particles (including infectious
agents), gases or vapors. Respirators, including those intended for use in
healthcare settings, are certified by the CDC/NIOSH.


Personal Protective Equipment: Questions and Answers
Respirators
How do I know if a respirator is falsely advertising NIOSH-approval?
When NIOSH becomes aware of counterfeit respirators or those misrepresenting
NIOSH approval on the market, these respirators are posted on the Counterfeit
Respirators / Misrepresentation of NIOSH-
Approval
webpage to alert users, purchasers, and manufacturers.


Personal Protective Equipment: Questions and Answers
Respirators
What makes N95 respirators different from facemasks (sometimes called a surgical mask)?

Infographic: Understanding the difference between surgical masks and N95 respiratorspdf icon
N95 respirators reduce the wearer’s exposure to airborne particles, from small particle aerosols to large droplets. N95 respirators are tight-fitting respirators that filter out at least 95% of particles in the air, including large and small particles.
Not everyone is able to wear a respirator due to medical conditions that may be made worse when breathing through a respirator. Before using a respirator or getting fit-tested, workers must have a medical evaluation to make sure that they are able to wear a respirator safely.
Achieving an adequate seal to the face is essential. United States regulations require that workers undergo an annual fit test and conduct a user seal check each time the respirator is used. Workers must pass a fit test to confirm a proper seal before using a respirator in the workplace.
When properly fitted and worn, minimal leakage occurs around edges of the respirator when the user inhales. This means almost all of the air is directed through the filter media.
Unlike NIOSH-approved N95s, facemasks are loose-fitting and provide only barrier protection against droplets, including large respiratory particles. No fit testing or seal check is necessary with facemasks. Most facemasks do not effectively filter small particles from the air and do not prevent leakage around the edge of the mask when the user inhales.
The role of facemasks is for patient source control, to prevent contamination of the surrounding area when a person coughs or sneezes. Patients with confirmed or suspected COVID-19 should wear a facemask until they are isolated in a hospital or at home. The patient does not need to wear a facemask while isolated.


Personal Protective Equipment: Questions and Answers
Gowns
What type of gown is recommended for patients with suspected or confirmed COVID-19?
Nonsterile, disposable patient isolation gowns, which are used for routine
patient care in healthcare settings, are appropriate for use by patients with
suspected or confirmed COVID-19.