General Information
Purpose
This is a resource packet designed to assist businesses to prepare for and stay informed about the coronavirus, the
virus that causes COVID-19 disease.
Due to the rapidly evolving nature of the outbreak, this document contains links to public health resources that are
updated regularly. In addition, guidelines for general infection control in the workplace and emergency preparedness
for businesses are included.
Description
Coronaviruses are a large family of viruses that can infect people and animals. Sometimes animal viruses can “jump”
hosts and spread to people. Once this happens, transmission from person to person can occur and spread rapidly.
This was the case with the SARS coronavirus (SARS-COV) that spread in 2003, and most recently, the coronavirus
that is causing COVID-19 (SARS-CoV-2). The virus can cause severe respiratory illness, multi-organ failure and death.
An outbreak was first discovered in Wuhan (Hubei Province), China in December 2019 and has since spread to many
countries in the world.

Symptoms, Clinical Presentation and Course of Illness

The most frequently reported signs and symptoms of COVID-19 include:
• Fever
• Cough
• Shortness of breath
• Muscle aches
• Fatigue
The emergency warning signs that require immediate medical attention are:
• Difficulty breathing or shortness of breath
• Persistent pain or pressure in the chest
• New onset of confusion or inability to arouse
• Bluish lips or face
Less commonly reported symptoms and signs are:
• Sore throat
• Headache
• Cough with mucous or blood
COVID-19 – INFORMATION FOR
BUSINESSES AND PERSONNEL
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Transmission
• Symptoms may appear 2-14 days after exposure. The period between exposure and the onset of symptoms is
called the incubation period.
• An infected person may still be contagious during the incubation period, even if he or she has not developed
symptoms. People with mild symptoms can still infect others.
• Early reports suggest that the infection is spread through close contact (within 3-6 feet) with a person infected
with COVID-19.
• The route of transmission (how the infection is spread) appears to be through respiratory droplets.
o Droplets are expelled into the air when an infected person talks, laughs, coughs or sneezes.
o Droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the
 lungs of those within close proximity.
o Droplets may also land on surfaces and remain infectious for prolonged periods.
• It is not clear if the virus is spread in smaller particles that can be inhaled (aerosols or droplet nuclei) but currently, airborne transmission from person-to-person over long distances is thought to be unlikely.
For updates on the outbreak, please see: https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html
Workplace Infection Prevention and Control Measures
Encourage Proper Hand and Respiratory Hygiene
Provide basic training and bulletins to remind personnel, customers and others to:
Wash their hands often with soap and water for at least 20 seconds
Use hand sanitizer that contains at least 60% alcohol If soap and water are not readily available.
• Avoid touching eyes, nose, and mouth with unwashed hands.
Cover mouth and nose with a tissue when coughing or sneezing; use the inside of elbow to cover mouth if tissues are unavailable. Throw used tissues in the trash and wash hands immediately.
See hand hygiene steps here: https://www.cdc.gov/healthywater/hygiene/hand/handwashing.html
See respiratory etiquette guidelines here:
https://www.cdc.gov/healthywater/hygiene/etiquette/coughing_sneezing.html
Provide Needed Supplies
On order to promote a work environment that supports personal hygiene, make sure that the supplies and resources
are on hand, including:
• Soap, water, paper towels and hand washing sinks
• Alcohol-based hand sanitizer
• Disinfectants
• Tissues
• No-touch trash receptacles
• Signs reminding personnel and customers to wash their hands and practice respiratory hygiene
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Practice In-Office Social Distancing
Ask personnel to comply with social distancing policies while in the office, including refraining from visiting cubicles
or desks, shaking hands, using other people’s office equipment or borrowing supplies (pens, staplers, etc.). In addition
to in-office distancing, some companies may stagger schedules or offer work from home options in order to increase
physical distance among employees.
Screen Employees for Risk Factors
Some individuals are at higher risk for developing serious illness from SAR-CoV-2 infection. Older adults, people
with chronic health conditions and those with compromised immune systems may need to be reassigned so that
they can maintain at least a six-foot distance from other workers, visitors and customers.
 See: https://www.cdc.gov/ coronavirus/2019-ncov/specific-groups/high-risk-complications.html for information about high risk groups. 
Screen Personnel for Signs and Symptoms of Illness
The practice of screening all employees for signs or symptoms of respiratory illness may help prevent the spread of
SAR-CoV-2 in the workplace. These measures involve:
• Educating all personnel about risk factors, signs and symptoms of infection;
• Requesting self-monitoring and reporting of symptoms, even if mild;
• Encouraging symptomatic and/or ill personnel to stay at home and self-isolate 
(see https://www.cdc.gov/ coronavirus/2019-ncov/hcp/disposition-in-home-patients.html) for return to work criteria 
• Provide temperature screening checkpoints at the beginning of shifts.
Restrict Travel
Discontinue all non-essential travel.
Disinfect the Environment
Assign a person (or persons) to oversee and document daily cleaning and disinfection of the work environment.
Surfaces that should be cleaned and disinfected multiple times a day recommended include:
• Tables
• Desks
• Handles and doorknobs
• Light switches and fixtures
• Keyboards
• Phones and keypads
• Bathrooms
• Kitchen areas
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Workplace Practices
Understand Your Business Vulnerabilities
Aside from the safety concerns of individual workers, business should prepare for systemic burdens related to the
COVID-19 outbreak, including:
Absenteeism – this can be a results of illness, caring for ill family members, caring for children who are not in
school, or due to fear of exposure.
Changes in commerce patters – customers may request off-peak hours to avoid crowds, increase demands on
e-commerce, or suspend any non-essential purchases.
Supply chain or delivery interruptions – shipments from areas severely affected by the virus may be delayed
or cancelled.
Inventory vulnerabilities – depending on the goods or services sold, companies may have inventory that
is perishable or time-sensitive, while others may be unable to keep up with surges in demand. Purchasing,
logistics (such as manufacturing schedules and shipping), and inventory needs may change dramatically over
weeks or months.
Provide Information
Establish a central contact point of contact so that personnel know where to go for updated information specific to
your company. Some suggestions:
• Circulate daily, company-wide emails
• Provide a telephone number with a voice recording of the current situation
• Post revised policies and procedures as soon as they are available
• Share the Emergency Plan with essential personnel as soon as it is finalized
• Establish a COVID-19 landing site on the company intranet
• Establish a phone tree for critical personnel
Disinfectants
Use disinfectants appropriate for the surface. If surfaces are dirty, clean then using detergent or soap and water prior to
disinfection. The following solutions are considered effective against hard to kill viruses:
Diluted household bleach
To make a bleach solution, mix: 5 tablespoons (1/3rd cup) bleach per gallon of water OR 4 teaspoons bleach per quart of water.
Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration
date. Never mix household bleach with ammonia or any other cleanser.
Alcohol solutions
Ensure solution has at least 70% alcohol.
Other common EPA-registered household disinfectants
The products and ingredients listed in the links below are expected to be effective against COVID-19. Follow the manufacturer
instructions for all cleaning and disinfection products (e.g., concentration, application method and contact time, etc.).
https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2 and
https://www.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf
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Assess the Risk Level of Each Job Task
OSHA has divided job tasks into four exposure risk levels. The level represents the occupational risk of exposure to
SARS-COV-2. The following table represents the risk levels:
Very high exposure risk jobs are those with high potential for exposure to known or suspected sources of
COVID-19 during specific medical, postmortem, or laboratory procedures.
o Healthcare workers performing aerosol-generating procedures on known or suspected COVID-19 patients
o Healthcare or laboratory personnel collecting or handling specimens from known or suspected COVID-19
patients.
o Morgue workers performing autopsies on the bodies of people who were known to or suspected of having
COVID-19 at the time of their death.
High exposure risk jobs are those with high potential for exposure to known or suspected sources of COVID-19.
o Healthcare delivery and support staff (e.g., doctors, nurses, and other hospital staff who must enter patients’
rooms) exposed to known or suspected COVID-19 patients.
o Medical transport workers (e.g., ambulance vehicle operators) moving known or suspected COVID-19 patients in
enclosed vehicles.
o Mortuary workers involved in preparing (e.g., for burial or cremation) the bodies of people who are known to
have, or suspected of having, COVID-19 at the time of their death.
Medium exposure risk jobs include those that require frequent and/or close contact with (i.e., within 6 feet of)
people who may be infected with SARS-CoV-2, but who are not known or suspected COVID-19 patients.
o In areas without ongoing community transmission, this may include people who have frequent contact with
travelers who have been in locations with widespread COVID-19 transmission (e.g., airport personnel).
o In areas with ongoing community transmission, this category includes anyone who has to be in contact with the
general public (e.g., high-volume retail stores).
Lower exposure risk jobs are those that do not require contact with people known to be, or suspected of
being, infected with SARS-Cov-2, nor frequent close contact (within 6 feet) of the general public.
Utilize Engineering and Administrative Controls Appropriate for the Situation
and Task
Low exposure risk jobs:
• Follow general guidelines for infection prevention and control.
• Personal protective equipment (masks, gloves, gowns, etc.) are not required.
• Engineering controls for SARS-CoV-2 (i.e., special ventilation, barriers. Etc.) are not required.
• Monitor public health communications and communicate with personnel as the situation develops.
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Medium exposure risk jobs:
• Follow general guidelines for infection prevention and control.
• Install physical barriers (.g., plastic sneeze guards) where feasible or indicated
• If possible, provide face masks to ill personnel and customers to contain respiratory secretions until they can
leave the workplace.
• Keep customers informed about symptoms of COVID-19 and ask sick customers to minimize contact with workers until healthy again, such as by posting signs about COVID-19 in stores where sick customers may visit.
• Where appropriate, limit customers’ and the public’s access to the worksite, or restrict access to only certain
workplace areas.
• Consider strategies to minimize face-to-face contact (e.g., drive-through windows, phone-based communications, e-commerce, etc.).
• Workers with medium exposure risk may need to wear some combination of gloves, a gown, a face mask, and/
or a face shield or goggles. PPE ensembles for workers in the medium exposure risk category will vary by work
task, the results of the employer’s hazard assessment, and the types of exposures workers have on the job.
High or very high risk exposure jobs:
• Follow general guidelines for infection prevention and control.
• Ensure appropriate air-handling systems are installed and maintained in healthcare facilities. See www.cdc.
gov/mmwr/preview/mmwrhtml/rr5210a1.htm.
• Place patients with known or suspected COVID-19 (i.e., person under investigation) in an airborne infection
isolation room (AIIR), if available.
• Use isolation rooms when available for performing aerosol-generating procedures on patients with known or
suspected COVID-19. For postmortem activities, use autopsy suites or other similar isolation facilities when
performing aerosol-generating procedures on the bodies of people who are known to have, or suspected of
having, COVID-19 at the time of their death. See www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-postmortem-specimens.html
• Use special precautions associated with Biosafety Level 3 when handling specimens from known or suspected
COVID-19 patients. See www.cdc.gov/biosafety/publications/bmbl5
• Develop and implement policies that reduce exposure, such as cohorting (i.e., grouping) COVID-19 patients
when single rooms are not available.
• Post signs requesting patients and family members to immediately report symptoms of respiratory illness on
arrival at the healthcare facility and use disposable face masks.
• Consider offering enhanced medical monitoring of workers during COVID-19 outbreaks.
• See also, https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html for guidance on
healthcare personnel with potential exposure to COVID-19.
• Provide all workers with job-specific education and training on preventing transmission of COVID-19, including
initial and routine/refresher training.
• Ensure that psychological and behavioral support is available to address employee stress.
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Manage Sick Personnel
• Promptly identify and separate sick personnel (See Screening Personnel for Signs and Symptoms of Illness)
• Instruct personnel to notify their supervisor immediately if symptoms develop at work.
• Instruct personnel to stay at home if symptoms develop at home, and to notify their supervisor if someone in
their household becomes sick.
• Institute flexible sick leave policies and emergency sick pay, if feasible.
• Refer symptomatic employees to the local health department or their healthcare provider for possible testing.
• Implement return to work practices based on current guidelines. https://www.cdc.gov/coronavirus/2019-ncov/
hcp/disposition-in-home-patients.html
Communicate with Local Public Health Authorities
State Epidemiologists: https://www.cste.org/page/StateEpi
Local Health Departments: https://www.naccho.org/membership/lhd-directory
Plan for Shelter-in-Place Orders
Many states have issued stay at home or more restrictive shelter in place orders for individuals, and have allowed only
essential businesses to remain open. The definition of “essential business” varies from state to state but most agree
that the following types of businesses are essential for everyday lives:
• Supermarkets and grocery stores
• Big-box stores
• Pharmacies
• Convenience stores and discount stores
• Garbage collection
• Healthcare operations
• Daycare centers
• Hardware stores
• Gas stations and auto-repair shops
• Banks
Recording Workplace Exposures to COVID-19
OSHA recordkeeping requirements at 29 CFR Part 1904 mandate covered employers record certain work-related injuries and
illnesses on their OSHA 300 log (https://www.osha.gov/recordkeeping/RKforms.html).
COVID-19 can be a recordable illness if a worker is infected as a result of performing their work-related duties. However, employers
are only responsible for recording cases of COVID-19 if all of the following are met:
• The case is a confirmed case of COVID-19 (see CDC information on persons under investigation and presumptive positive
and laboratory-confirmed cases of COVID-19);
• The case is work-related, as defined by https://www.osha.gov/laws-regs/regulations/standardnumber/1904/1904.5; and
• The case involves one or more of the general recording criteria set forth in https://www.osha.gov/laws-regs/regulations/
standardnumber/1904/1904.7.
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• Post offices and shipping businesses
• Veterinary clinics and pet stores
• Farmers’ markets and food banks
• Businesses that provide necessities to shelters and economically disadvantaged people
• Educational institutions, for the purposes of facilitating distance learning
• Agriculture and food processing
• Warehousing, storage, and distribution
• Transportation, including airlines, taxis, ride share programs, and vehicle rentals
• Businesses that allow essential businesses to operate
Employees associated with critical infrastructure, including utilities, law enforcement, transportation, public works,
public health, food and agriculture are also exempt from mandatory shelter-in-place orders.
Establish a Continuity of Operations Plan (COOP)
Pandemics and widespread infectious disease outbreaks demand continuity of operations planning considerations
specific to infectious disease outbreaks particularly as it relates to the impact on personnel. In general, a COOP
provides detail and guidance so that organizations continue to perform essential services during a disruption of
normal operations. It should include provisions for:
• Maintaining essential functions of the operation
• Establishing delegations of authority and orders of succession
• Managing communications
• Supporting information systems and network capacity
• Ensuring essential records access and management
Organizations are encouraged to consider the utilizing a Continuity of Operations Plan Template (see FEMA Continuity
Plan [non-federal] Template at: https://www.fema.gov/continuity-resource-toolkit) to assist with medium-to long
range planning during emergencies.
Activate the Incident Command System
Organizations that have an Emergency Response Plan based on the National Incident Management System (NIMS)
will have an Incident Command System in place and should activate it when indicated by the local situation. The local
or regional emergency management office will provide guidance and serve as a network for further information and
resource sharing.
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Further Resources
Current Situation
For current coronavirus disease (COVID-19) cases in the US see:
https://www.cdc.gov/coronavirus/2019-ncov/cases-in-us.html
For global case numbers reported by the World Health Organization, see:
https://www.cdc.gov/coronavirus/2019-ncov/locations-confirmed-cases.html#map
For a current CDC Situation summary, see:
https://www.cdc.gov/coronavirus/2019-ncov/cases-updates/summary.html?CDC_AA_refVal=https%3A%2F%2Fwww.
cdc.gov%2Fcoronavirus%2F2019-ncov%2Fsummary.html
Testing
To contact a state health department for a testing sites:
https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html
See CDC Evaluating and Testing Persons for Coronavirus Disease 2019 (COVID-19) at:
https://www.cdc.gov/coronavirus/2019-nCoV/hcp/clinical-criteria.html
Government and Public Health Resources
Centers for Disease Control and Prevention Coronavirus Disease 2019:
https://www.cdc.gov/coronavirus/2019-ncov/about/index.html
Centers for Disease Control and Prevention – Implementation of Mitigation Strategies for Communities with Local
COVID-19 Transmission:
https://www.cdc.gov/coronavirus/2019-ncov/downloads/community-mitigation-strategy.pdf
Centers for Medicare and Medicaid Services: Coronavirus Emergency Updates:
https://www.cms.gov/About-CMS/Agency-Information/Emergency/EPRO/Current-Emergencies/Current-Emergenciespage
Federal Emergency Management Agency Continuity Resource Toolkit:
https://www.fema.gov/media-library-data/1536859210230-a1cc6e2fbae089261fccf7f8ee1693a8/non_federal_
continuity_plan_template_508_083118.pdf
Federal Government Coronavirus COVID-19:
www.usa.gov/coronavirus
State and Local Health Department Directory:
https://www.cdc.gov/publichealthgateway/healthdirectories/healthdepartments.html
Occupational Safety and Health Administration
https://www.osha.gov/SLTC/covid-19/standards.html
World Health Organization Coronavirus Disease Outbreak:
https://www.who.int/emergencies/diseases/novel-coronavirus-2019
See EPA List N: Disinfectants for Use against SARS-CoV-2:
https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2