Novel Coronavirus: What South African employers needs to know

The 2019 Novel Coronavirus – officially named COVID-19 on February 11– has caused the global outbreak of a fast-spreading, often fatal respiratory illness. Currently, no one in South Africa has contracted COVID-19. “Now is the time to prepare for COVID-19. Simple precautions and planning can make a big difference. Action now will help protect your employees and your business,” says Dr Noluthando Nematswerani, Discovery Health Head of the Centre for Clinical Excellence. “As concern about the 2019 Novel Coronavirus grows worldwide, local employers must ensure that managers are equipped to handle any suspected cases in the workplace.”

• Read the World Health Organization’s (WHO) Q and A on coronaviruses
• Read the WHO’s document on Getting your Workplace ready for COVID-19
• Read on leading your business through the coronavirus crises.

COVID-19 is a highly transmissible disease. “That means the virus spreads very quickly. It is thought to be transmitted mainly via respiratory droplets produced when a person who has acquired COVID-19 coughs or sneezes, in a manner similar to how influenza and other respiratory infections spread. This sort of situation is particularly relevant in our places of work where people are in close proximity to each other for many hours each day,” says Dr Nematswerani.

As the Novel Coronavirus was recently identified, there is limited information regarding its mode/s of transmission, clinical features, and the severity of disease it causes. “There is also, currently, no vaccine available to provide protection from COVID-19. The best way to prevent contracting COVID-19 is to avoid being exposed to this virus. Managers must be equipped to ensure particular safety measures are in place to prevent or limit exposure. They also need to know how to respond in the event that a staff member contracts COVID-19.”

What do we know about human coronaviruses?

Coronaviruses are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). Human coronaviruses most commonly spread through:

• one meter of a person who has the illness, by breathing in droplets coughed out or exhaled by the ill person
• close personal contact, such as when shaking hands or touching others
• touching an object or surface on which the virus is found (after an ill person coughs or exhales close to these objects or surfaces such as desks, tables or telephones), then - before washing the hands - touching the mouth, nose, or eyes
• rarely, fecal contamination

Symptoms of COVID-19 can include:

• Fever
• Cough
• Shortness of breath

In confirmed cases of COVID-19, reported illnesses have ranged widely. Most persons (over 80%) infected with COVID-19 experience mild symptoms and recover. However, some go on to experience more serious illness (up to 5%) and may require hospital care and some cases result in death (up to 2%). Risk of serious illness rises with age: people over 40 seem to be more vulnerable than those under 40. People with weakened immune systems and people with conditions such as diabetes, heart and lung disease are also more vulnerable to serious illness.

It’s important to note that people who have the Novel Coronavirus may take anywhere from one to 14 days to develop symptoms following exposure. Currently, there is no medication available that can be given to combat the virus during the asymptomatic period.

Not all cases of fever, cough and shortness of breath are due to contracting COVID-19. These symptoms may also be linked to an influenza or common cold virus. However, the same precautionary measures listed below should apply when these symptoms present, to prevent the spread of any viral infection.

Managers play a key role in preventing the spread of infection

All sections of our society – including businesses and employers – must play a role if we are to stop the spread of this disease. “Employers should let staff know that their line managers are equipped to handle any cases of COVID-19,” says Dr Nematswerani. “Employees must also be encouraged to report a recent history that may indicate exposure to the COVID-19, or any symptoms that indicate that they may have contracted this illness, to their line managers.”

“Managers must understand that they play a critical role in preventing the spread of the virus that causes coronavirus disease 2019. They must ensure that they are familiar with the guidelines around dealing with cases of people who may have, or are confirmed to have COVID-19.” Overall:

• Make sure that staff, contractors and customers have access to places where they can wash their hands with soap and water
• Put sanitizing hand rub dispensers in prominent places around the workplace. Make sure these dispensers are regularly refilled
• Display posters promoting hand-washing and respiratory hygiene
• Combine this with other communication measures such as offering guidance from occupational health and safety officers, briefing at meetings and information on the intranet etc.
• Ensure that face masks and/or paper tissues are available at your workplaces, for those who develop a runny nose or cough at work, along with closed bins for hygienically disposing of them

More information on getting work place ready for COVID-19.

Course of action in the case of a suspected or confirmed COVID-19 illness

• Precautionary measures and steps to be taken by a line manager in the event of a possible case of COVID-19, in the absence of symptoms:
• The manager must ask the staff member to see their healthcare provider as soon as possible. The staff member should be allowed to stay at home until they have been cleared to return to work by their healthcare provider
• Asymptomatic staff members who have a possible infection, can still come to work but their symptoms must be closely monitored
• Symptoms must also be monitored in all staff who may have come into contact with any staff member suspected to have contracted coronavirus. If symptoms present then these individuals must see their healthcare provider for clearance to return to work. These individuals must be allowed to work from home if they are not very sick or take sick leave if they are too sick, and unable to work from home
• As there is no medication or vaccine available in the asymptomatic period, it is critical that safety precautions be reinforced to other members of the team and the workplace as a whole. These include the following low-cost measures which help to prevent the spread of infection in the workplace (including colds, flu, stomach bugs and COVID-19):
  • Washing of hands with soap and water for at least 20 seconds.
    • An excellent way to ensure the right amount of time is spent washing hands is to simultaneously hum the “Happy Birthday” song from beginning to end, twice. If soap and water are not available, make use of an alcohol-based hand sanitizer for hand washing
  • Avoiding touching the eyes, nose, and mouth with unwashed hands
  • When coughing or sneezing, covering the mouth and nose with a flexed elbow or tissue, throwing tissues away immediately and washing the hands
  • Cleaning and disinfecting of frequently touched objects and surfaces - including the office space that may have been contaminated
  • Avoiding close contact with the staff member who has possibly acquired COVID-19 infection.
• Precautionary measures and steps to be taken by a line manager when staff members present with symptoms of COVID-19:
• The manager must ask the staff member to seek medical care as soon as possible and to work from home during the period in which there is a risk of infecting others.
• The staff member must tell their health care provider about their recent travel history and any history of known contact with a person who is may have or is confirmed to have COVID-19.
• Employees confirmed to have acquired COVID-19, should follow the medical advice to remain at home for 14 days or get clearance from their treating healthcare providers before coming back to work.
• When coughing or sneezing, the sick person must cover their mouth and nose with a flexed elbow or tissue, throw tissues away immediately and wash their hands.
• Managers must ensure regular cleaning and disinfecting of any frequently touched objects or surfaces that the sick staff member may have come into contact and the person’s office space.

Precautionary measures and guidelines for Health and Safety personnel in dealing with a suspected or confirmed case of COVID-19:

• Follow the standard triage protocols for ambulance services
• Follow standard precautions for hand and respiratory hygiene and ensure the use of appropriate Personal Protective Equipment (PPE):
  • Wear disposable gloves and a surgical mask if there is need to touch or move the staff member.
  • Refrain from touching the eyes, nose or mouth with potentially contaminated gloves or bare hands.
• Ensure that the following respiratory hygiene measures are adhered to:
  • Ensure that the patient covers their nose and mouth with a tissue or their elbow when coughing or sneezing. Throw the tissue away immediately
  • Have the patient use a medical mask, especially while they are in waiting/public areas
    • Read this WHO brief on when and how to use medical masks.
  • Perform hand hygiene (washing hands with soap and water or cleaning with alcohol-based hand rubs for 20 seconds) after contact with respiratory secretions
• Disinfect all equipment used on the patient immediately after use (thermometer, BP machine etc.)
• Limit the number of persons present in the room/area in which the staff member is located, or attending to the staff member
• Avoid moving and transporting patients out of their room/area unless medically necessary
• Where necessary, use predetermined transport routes to minimize exposure for staff
• Maintain a record of all staff who come into contact with the patient
• After the staff member suspected or confirmed to have COVID-19 has left their workspace or been removed from the building, inform building services to come and disinfect the surfaces using water and detergent and to apply commonly-used hospital level disinfectants (such as sodium hypochlorite).

Stay safe while travelling

In the event that you or your staff have to travel for business or other reasons, here’s what you need to know (from the WHO advisory):

Before travelling

• Make sure your organization and its employees have the latest information on areas where COVID-19 is spreading to
• Based on the latest information, your organization should assess the benefits and risks related to upcoming travel plans
• Avoid sending employees who may be at higher risk of serious illness (e.g. older employees and those with medical conditions such as diabetes, heart and lung disease) to areas where COVID-19 is spreading
• Make sure all persons travelling to locations reporting COVID-19 are briefed by a qualified professional (e.g. staff health services or health care provider) 
• Consider issuing employees who are about to travel with small bottles of alcohol-based hand rub, to facilitate regular handwashing.

While travelling

Ensure that your employees comply with instructions from local authorities where they are traveling. If they are told by local authorities not to go somewhere they should comply with this. Your employees should comply with any local restrictions on travel, movement or large gatherings.

Ensure that employees know to:

• Frequently clean hands with soap and water or alcohol-based hand rub
• Avoid touching eyes, nose or mouth with unclean hands while travelling, especially when using public transport
• If they choose to wear a face mask be sure to cover mouth and nose and avoid touching the mask once it’s on. The WHO explains when and how to use medical masks
• Immediately discard single-used masks after each use and wash hands after removing the mask
• Avoid close contact with people suffering from fever and cough - stay at least one meter away
• Eat only well-cooked food
• Avoid contact with sick animals
• Avoid markets where live animals are sold. If staff do visit animal markets in areas currently experiencing cases of COVID-19, avoid direct unprotected contact with live animals and surfaces in contact with animals.
• Avoid contract with stray animals, waste and fluids in roads and markets.

When you or your employees return from travelling

• Employees who have returned from an area where COVID-19 is spreading should monitor themselves for symptoms for 14 days and take their temperature twice a day. If they develop even a mild cough or low-grade fever (i.e. a temperature of 37.3 C or more) they should stay at home and self-isolate. This means avoiding close contact (one meter or nearer) with other people, including family members. They should also telephone their healthcare provider or the local public health department, giving them details of their recent travel and symptoms.
• You can watch a video on, or read about, the WHO’s advice to people travelling here.

Avoid travel if you have symptoms of COVID-19

All individuals with symptoms of COVID-19 must avoid travelling via shared transport. If these symptoms develop while travelling, they should inform the transport staff/crew and seek medical care as soon as possible.

Prevent the spread of social stigma around COVID-19 in the workplace

For most people COVID-19 is a disease that can be overcome. What is important is that we talk positively and emphasise the effectiveness of prevention and treatment measures. We must encourage the sharing of facts and prevent the spread of misinformation that stigmatises people who acquire COVID-19, as this might

• Cause people to hide their illness to avoid discrimination

• Prevent people from seeking healthcare immediately if symptoms arise
• Discourage people from adopting healthy behaviours that prevent the spread of COVID-19

Read the WHO and UNICEF’s document on Social Stigma associated with COVID-19.

Develop a contingency and business continuity plan

The WHO advises that businesses plan ahead of a COVID-19 case in the communities where they operate. The plan should address how to keep your business running even if a significant number of employees, contractors and suppliers cannot come to your place of business - either due to local restrictions on travel or because they are ill. Communicate to your employees and contractors about the plan and make sure they are aware of what they need to do – or not do – under the plan. Emphasize key points such as the importance of staying away from work even if they have only mild symptoms or have had to take simple medications (e.g. paracetamol, ibuprofen) which may mask the symptoms. Be sure your plan addresses the mental health and social consequences of a case of COVID-19 in the workplace or in the community and offer information and support.

For more information and support: 

• Read the WHO’s Q&A on coronaviruses here.
• The WHO provides rolling updates on COVID-19
• The WHO busts myths about COVID-19 and treatments for the virus