COVID-19: A Guide for Direct Care Workers

Note: A similar version of this content was first published on March 20, 2020 as the 30-minute class COVID-19: A Guide for Direct Care Workers. The current version of the content, published on July 06, 2020, is a 60-minute self-study class that contains expanded guidance about face coverings, PPE, and household cleaning and disinfecting.

CareAcademy's FREE COVID-19 Certification Class prepares direct care workers to perform critical frontline work during today's challenging times. With this self-study class, gain relevant, reliable information about the virus and learn how to care for yourself and your care recipients amidst the COVID-19 pandemic. At the end of the class, claim your certificate and let your agency and care recipients know that you're COVID-19 Certified through CareAcademy.

Note to CareAcademy Customers: Assign the class, Overview of COVID-19, to your caregivers via your CareAcademy dashboard to take advantage of automated reporting.

Learning Objectives

Describe COVID-19, its symptoms, the people most at risk of serious illness from it, and how it is transmitted.

Identify reliable sources of information about COVID-19.

Apply strategies for reducing the spread of the COVID-19 virus.

Describe tactics for providing care to someone who has COVID-19.

Explain why cleaning and disinfection is important during the COVID-19 pandemic.

Suggest strategies for self-care for direct care workers during the COVID-19 global pandemic.

Contents

Understanding COVID-19

The information about the coronavirus disease 2019 (COVID-19) situation continues to change. As a direct care worker, you are on the front lines, so it is vital that you stay informed.



This class offers a brief overview of what we know about COVID-19, how it spreads, strategies for preventing the spread, and how to care for someone who has the virus.

Try to Keep Calm

We are still learning more and more about the COVID-19 virus, including the mortality (death) rate. It’s important to stay calm and think clearly, as there is a lot of inaccurate information available regarding the virus.

Why Is COVID-19 Important?

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic. A global pandemic is a new disease that has spread around the world. This means fully stopping the spread of the virus is not the goal (because it is already everywhere)—instead, we must focus on reducing how fast it spreads and how sick it makes people.1

Staying Up to Date



The COVID-19 situation continues to evolve. To stay informed with the latest information, consult the websites for the:

Your state and local health departments will have the latest information relevant to where you live. Use the resources below to locate the state and local health department websites:

You are expected to follow your agency’s policies and procedures and comply with all state and federal laws and regulations at all times.

There is a lot we are still learning about COVID-19. New information is continuously developing, including guidance for direct care workers. Contact your agency, supervisor, or care team for specific guidance about how the COVID-19 pandemic impacts your responsibilities.

What Is COVID-19 (Novel Coronavirus)?



COVID-19

A new virus was detected in late 2019 in Wuhan, China. On February 11, 2020, WHO announced an official name for the disease that is causing the current coronavirus outbreak. The name of the disease is coronavirus disease 2019 (COVID-19).2 This novel (new) coronavirus causes a respiratory (lung) infection. It has not previously been seen in humans.

Coronaviruses are not new. In fact, the common cold is a type of coronavirus. Some other coronaviruses, like SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome), can cause serious illnesses.3

Symptoms of COVID-19

Symptoms of COVID-19 may appear 2 - 14 days after exposure to the virus.

A wide range of symptoms has been reported. Some individuals have no symptoms at all and others may have mild symptoms. Symptoms may begin gradually but become very serious. If a person becomes very sick, they can develop pneumonia. People with these symptoms or combinations of symptoms may have COVID-19:

Fever

Cough

Shortness of breath or difficulty breathing

Chills

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

These are not the only possible symptoms. If a care recipient has any other symptoms that seem serious, contact your supervisor.

Emergency Warning Signs

If a care recipient has any of these emergency warning signs for COVID-19, call 911 immediately:

Trouble breathing

Persistent (continuing) pain or pressure in the chest

New confusion

Inability to wake or stay awake

Blush lips or face4

Vulnerable Populations

We are learning more about COVID-19 every day. What we do know is that older adults are most at risk of getting the sickest and dying from COVID-19; the older a person is, the higher their risk of death. Adults are at increased risk of severe illness or death if they are severely obese (body mass index [BMI] of 40 or higher), or have a chronic comorbid (existing and unrelated) illness such as heart disease or diabetes.5

These groups are also most likely to get more sick more quickly. If you have a care recipient in one of these groups, be extra vigilant (alert) for any changes in their medical status. If you observe any changes in your care recipient’s status, notify your supervisor immediately. If the care recipient has emergency symptoms, call 911.

Treatment for COVID-19

There are no vaccines yet to prevent COVID-19 or medicines to treat it. People who think they might have the virus should call their health care provider for advice on what to do next.

COVID-19 Mortality (Death) Rate

We don’t know yet how deadly COVID-19 is. The CDC estimates that 0.4% of people (or 4 in 1000) who show symptoms of Covid-19 will die, making it up to 10 times more deadly than influenza. The chance of dying is much higher as individuals get older, and if they have comorbid conditions.

Related to COVID-19’s mortality rate, is the number of patients who need to be admitted to hospitals and need ventilation to help support their breathing.The CDC’s best estimate is that 3.4% of people with Covid-19 symptoms will require hospitalization, rising to 7.4% for people 65 and older.6

How COVID-19 Spreads

Community Spread

COVID-19 is spread through respiratory secretions (droplets from coughs and sneezes). The virus is transmitted from person to person in the community, and not just from people who have traveled to specific countries (such as China and Italy).

Since COVID-19 was first detected in Wuhan, China, many areas are seeing “community spread” of the virus. Community spread means people have been infected with the virus in a geographic area, including some people who are not sure how or where they became infected.7

How Contagious is COVID-19?

COVID-19 is more contagious than seasonal flu. If one person has the flu, they are likely to pass it on to at least one other person. If one person has COVID-19, they are likely to pass it on to at least two to three other people. So COVID-19 is more than twice as contagious as seasonal flu. By comparison, if one person has measles (a highly contagious disease), they are likely to pass it on to at least 18 others. It is still unknown when infected people can spread COVID-19. The most challenging aspect of COVID-19 is that it may be caught from people who have no symptoms.8

Ways to Reduce the Spread of COVID-19

By slowing the spread of the virus, we increase the chance that everyone who needs care can get the care they need, and fewer people might end up becoming really sick or dying. We really don’t know how widespread the virus is, because there has not been widespread testing across the country. Even though the same number of people may become infected, we will be better able to take care of them if everyone avoids unnecessary contact,practices good hygiene, and wears face coverings in public.

Travel Recommendations and Restrictions

Travel increases the chance of getting and spreading COVID-19. Cases have been reported in all states, and around the world. To prevent the virus from spreading, many countries have implemented restrictions on travel.

The CDC maintains a list of general travel recommendations and international travel restrictions to help reduce the spread of COVID-19. Visit the CDC’s website for up-to-date information.

Social Distancing

Social distancing (also known as “physical distancing”) means deliberately (carefully) increasing the physical space between people to avoid spreading illness. This means avoiding places where people meet or gather; avoiding local public transportation (such as buses, the subway, taxis, and rideshares), if possible; and maintaining distance (approximately 6 feet or 2 meters) from others.9

Since COVID-19 may be caught from people who have no symptoms, social distancing is especially important for reducing the spread of COVID-19.10



The expectation is that by practicing social distancing, we can reduce the daily number of cases of COVID-19. That is why the authorities have closed schools and houses of worship, and canceled public events, unnecessary travel, and visits to nursing homes. The danger is that, without social distancing, the health care system will have more patients at one time than can be taken care of reasonably and safely.

Please contact your agency for guidance on limiting physical contact with care recipients during the current COVID-19 pandemic.

Quarantine and Isolation

In addition to social distancing, public health experts recommend other tactics to limit the spread of infectious diseases. These tools are quarantine and isolation.

Quarantine

Quarantine separates and restricts the movement of well people who were exposed to a contagious disease to see if they become sick.

Self-quarantine is appropriate for people who have been exposed to the new coronavirus and who are at risk for coming down with COVID-19. Health experts recommend self-quarantine for 14 days.

Self-quarantine is recommended for people who knowingly been exposed to an infected person or who have recently returned from traveling to a part of the world where COVID-19 is spreading rapidly.

Self-quarantine involves:

Using good hygiene and washing hands frequently

Not sharing things like towels and utensils

Staying at home

Not having visitors

Staying at least 6 feet away from other people in the household

If a person has no symptoms at the end of the self-quarantine period, they should follow their health care provider’s instructions on how to return to a normal routine.11

Isolation

Isolation is used to separate ill persons who have a communicable disease from those who are healthy.12 For people who are confirmed to have COVID-19, isolation is appropriate. Isolation is a health care term that means keeping people who are infected with a contagious illness away from those who are not infected. Isolation can take place at home or at a hospital or care facility.13

Good Hygiene

Everyday preventive actions will help reduce the spread of COVID-19.

Hand Hygiene

Practice appropriate hand hygiene on a regular basis. This means washing hands frequently, with soap and water, for at least 20 seconds. When soap and running water are unavailable, use a hand sanitizer with at least 60% alcohol. Always wash hands before and after providing personal care.

View the video to learn the appropriate technique for washing your hands.

Additional Hygiene Practices

These measures will also help prevent the spread of COVID-19:

Avoid touching your eyes, nose, and mouth.

Cover your cough or sneeze with a tissue (then throw the tissue in the trash) or use the inside of your elbow. Wash your hands immediately after you cough or sneeze.

Avoid touching “high-touch” surfaces in public places. Use a tissue or your sleeve to cover your hand or finger if you must touch something.

Avoid handshaking with people.

Wash your hands after touching surfaces in public places.

Wear Face Coverings in Public

The CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies). Face coverings prevent people who may have the virus and do not know it from transmitting it to others. Homemade face coverings are not as effective as medical (surgical) masks and do not protect the wearer from catching the virus.14

Cleaning and Disinfecting

The COVID-19 virus can stay in the air for multiple hours and on surfaces for days.15



Clean and disinfect frequently touched surfaces and objects routinely. This includes tables, doorknobs, light switches, countertops, handles, desks, cell phones, keyboards, toilets, faucets, and sinks. If a surface is dirty, clean it first with detergent or soap and water. Then disinfect it.



Wear disposable gloves when cleaning and disinfecting surfaces. Discard gloves after each cleaning. Wash your hands immediately after gloves are removed.

Caring for Someone Infected with COVID-19

You should always follow your agency’s policies when providing care. Your agency should be keeping up to date with the latest information with federal, state, and local public health authorities. If you have any questions about how to care for someone who has COVID-19, you should contact your supervisor.

As a direct care worker in a non-health care setting, you may have close contact with a person undergoing testing for the virus or who has tested positive for COVID-19. As the number of people with the virus increases, individuals who have only mild illness and do not require hospitalization need to be cared for in the home.

Close Contact

Close contact means:

Being within approximately 6 feet (2 meters) of a person with COVID-19, or

Having direct contact with the infectious secretions of a person with COVID-19 (for example, being coughed on).

Close contact can occur while caring for, living with, visiting, or sharing a health care waiting area or room with a person with a diagnosed case of COVID-19.16

Precautions When Caring for Someone with the Virus

All health care professionals, including direct care workers, are at a higher risk of getting COVID-19 because of the older and sicker population you care for. It is important to take preventive measures to avoid contracting the virus while you care for someone who has COVID-19.

Monitor Your Own Health

Call your health care provider right away if you develop symptoms suggestive of COVID-19 (such as fever or cough). Call your supervisor and do NOT go to work.17

Practice Infection Control

The most important thing you can do when caring for someone with COVID-19 is to practice good general infection control measures:

Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry.

Avoid touching your eyes, nose, and mouth with unwashed hands.

Clean and disinfect surfaces frequently.

Wear a facemask when in close contact with the care recipient.

Wear a disposable facemask and gloves when you touch or have contact with the care recipient’s blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, and urine. Ideally, put the mask on before entering the care recipient’s home. Use of Personal Protective Equipment (PPE) When providing care for someone with suspected or known COVID-19, it is particularly important to wear appropriate PPE, including any recommended eye protection, masks, gowns, and gloves. The CDC and state and local health officials continue to update recommendations as PPE supplies change, and more is learned about the virus. Use of Gloves Always wear single, disposable gloves when: Touching blood or bodily fluids

You or the care recipient has broken areas of skin

Assisting with personal care, such as bathing, oral care, and toileting

Handling soiled clothing or linens

Cleaning and disinfecting surfaces Immediately clean your hands with soap and water or alcohol-based hand sanitizer after removing gloves. Throw out disposable gloves after using them. Do not reuse them. Place used disposable gloves in a lined container before disposing of them with other household waste.18 Use of Facemasks Follow your agency’s policies at all times for the use of masks and other PPE. Here are some best practices for the use of masks:

Wear a disposable facemask when you touch or have contact with the care recipient's blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, and urine. Ideally, put the mask on before entering the care home, and ideally, remove the mask after leaving the care recipient's home and dispose of it in the outdoor trash bin.

when you touch or have contact with the care recipient's blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, and urine. Ideally, put the mask on before entering the care home, and ideally, remove the mask after leaving the care recipient's home and dispose of it in the outdoor trash bin. Use an N95 respirator when performing aerosol-generating procedures with care recipients who have or may have COVID-19. An aerosol-generating procedure is one that sends particles into the air, such as the use of a nebulizer or a CPAP machine.

Remove a mask that is damaged or soiled , or if breathing through the mask becomes difficult. Discard it safely, and replace it with a new one.

, or if breathing through the mask becomes difficult. Discard it safely, and replace it with a new one. Dispose of used masks in a lined container.

in a lined container. Consider reuse. Under normal circumstances, masks should also not be reused. However, currently, there may not be not enough masks available to follow standard practices of throwing away masks after they are used. Because of the limited supply of masks, you may have to reuse them. You can check the CDC's website to learn more about the evolving situation, and defer to your agency for specific policies and procedures around reusing masks and other PPE.19 Check with your agency for guidance on whether you should wear a homemade face covering when caring for clients if surgical masks are unavailable. Encourage the Care Recipient to Clean Their Hands Frequently Make sure the care recipient washes their hands often with soap and water for at least 20 seconds. Handwashing is especially important after they blow their nose, cough, sneeze, or go to the bathroom, and before they or prepare food. If soap and water are not readily available, they can use an alcohol-based hand sanitizer with at least 60% alcohol. Make sure they cover all surfaces of their hands and rub them together until they are dry. Remind the care recipient to avoid touching their eyes, nose, and mouth with unwashed hands. Care recipients should cover their mouth and nose with a tissue when they cough or sneeze and immediately wash their hands afterward. Make sure they throw used tissues in a lined trash can.20 Have the Care Recipient Wear a Facemask Whenever a care recipient with COVID-19 is around others, including you and other direct care workers, they should wear a facemask. This includes when they are in the same room or vehicle. Tips for Caring for a Care Recipient with COVID-19 View the video to learn some strategies for caring for a client with the virus. Keep the Care Recipient Isolated and Limit Contact If you are caring for someone with COVID-19 who can be cared for at home, they should stay in home isolation as recommended by their health care provider, unless they need medical assistance. If they need to see a health care provider, be sure to call first before arriving in person. If there are other people living in the home, the care recipient should stay in a separate room and apart. The care recipient should also use a separate bathroom, if one is available. If a separate bathroom is not available, after each use by the care recipient, you should clean and disinfect the bathroom wearing a mask and gloves. Make sure that shared spaces in the home have good airflow, such as by an air conditioner or an opened window, weather permitting. Prohibit visitors who do not have an essential need to be in the home. The care recipient should remain in home isolation until they are no longer at risk of transmitting the virus to others. This decision should be made by their health care provider, possibly in consultation with state and local health departments. You should help the care recipient with basic needs in the home and provide support for getting groceries, prescriptions, and other personal needs.21 Avoid Sharing Household Items No one in the home should share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with the care recipient. After the care recipient uses these items, you should wash them thoroughly with soap and water.22 Electronics (like cell phones and tablets) should not be shared. Take Precautions When Providing Food Provide food (or feed) the care recipient in their room, if there are other people in the household. Handle dishes, glasses, and utensils with gloves, and wash them with hot water or in a dishwasher. Wash your hands after touching any items used by the care recipient. Perform Only Essential Cleaning If the care recipient is isolated in a bedroom, try to limit your contact with them by reducing the amount of cleaning you do to only soiled items and surfaces on an as-needed basis. Always use appropriate PPE when entering the client’s room, and handling soiled materials and disinfectants. Avoid bringing supplies in and out of a care recipient's room. Keep a supply of cleaning materials in their bedroom and bathroom, including tissues, paper towels, cleaners, and an EPA-registered disinfectant. If they feel up to it, the care recipient can clean their own space. Cleaning and Disinfecting Protect yourself and others in the home by disinfecting frequently touched surfaces and objects regularly. This includes tables, doorknobs, light switches, countertops, handles, desks, cell phones, keyboards, toilets, faucets, and sinks. Also, clean and disinfect any surfaces that may have blood, stool, or body fluids on them.23 If a surface is dirty, clean it first with detergent or soap and water. Then disinfect it.



Wear disposable gloves when cleaning and disinfecting surfaces. Discard gloves after each cleaning. Wash your hands immediately after gloves are removed. Provide a lined trash can for the client. Use gloves when removing garbage bags, handling, and disposing of trash. Wash hands after handling or disposing of trash. Disinfectants for COVID-19 Use a household bleach solution, an alcohol solution with at least 70% alcohol, hydrogen peroxide, or an Environmental Protection Agency (EPA)-registered household disinfectant to eliminate COVID-19 from surfaces. Always follow the manufacturer’s instructions for products, including how much product to use, how to apply it, and the “contact time.” Contact time (also known as “dwell time,” “wet time,” or “kill time”) is the amount of time a product needs to remain in contact with a surface to be sure it kills all the germs. Bleach Bleach is a strong and effective disinfectant against the virus that causes COVID-19, and is recommended for use on hard surfaces. To make a bleach solution, mix: 5 tablespoons (1/3 cup) bleach per 1 gallon of water or 4 teaspoons bleach per 1 quart of water Alcohol A solution of 70% alcohol, such as rubbing alcohol, is an effective disinfectant against the coronavirus on hard surfaces. Alcohol should be left on surfaces for 30 seconds. Alcohol is generally safe for all surfaces but can discolor some plastics.24 Hydrogen Peroxide If bleach or alcohol is unavailable, hydrogen peroxide may be effective on coronavirus. Use it undiluted in a spray bottle and spray it on the surface to be cleaned. Let it sit on the surface for at least 1 minute. Hydrogen peroxide can be used on metal surfaces but it can discolor fabrics.25 Disinfecting Wipes Use disinfecting wipes recommended by the EPA on electronic items that are touched often, such as phones and computers. Pay close attention to the directions for using disinfecting wipes. It may be necessary to use more than one wipe to keep the surface wet for the stated length of contact time. Make sure that the electronics can withstand the use of liquids for cleaning and disinfecting. EPA-Recommended Disinfectants The EPA’s website has a list of disinfectants that are effective against the COVID-19 virus.



When using an EPA-registered disinfectant (or any disinfectant), follow the label directions for safe, effective use. Make sure to follow the contact time.



If you can’t find a product on the EPA list, look at the product's label to confirm it has an EPA registration number and that human coronavirus is listed as a target pathogen.26 Avoid Unauthorized Products The following items should NOT be used as disinfectants because they do NOT kill the virus that causes COVID-19: Vinegar

Vodka

Tea tree oil

Lemon juice

Baking soda Wash Laundry Thoroughly Take precautions to prevent infections when doing laundry for a care recipient: Avoid shaking dirty laundry to reduce the chance of spreading the virus through the air.

Place a disposable bag liner in the clothes hamper.

If clothes or bedding have blood, stool, or bodily fluids on them, they should be removed and washed immediately.

Wear disposable gloves while handling items soiled with blood, stool, and other bodily fluids and keep soiled items away from your body. After removing your gloves, wash your hands or use an alcohol-based hand sanitizer.

Read and follow directions on labels of laundry or clothing items and detergent. Use a normal laundry detergent according to washing machine instructions.

Dry laundry completely, on as hot a temperature as possible. Take care to read clothing labels. Some materials shrink at warmer temperatures.

Wash hands after putting items in the washing machine and after putting items in the dryer.

Disinfect surfaces in the laundry area, (such as the knobs and the latch on the washing machine or dryer) after using the machines. Clean and disinfect clothes hampers and laundry baskets like other hard surfaces. Wash hands afterwards.27 If the care recipient has known or suspected COVID-19: Laundry from a person with COVID-19 can be washed with items of a person who does not have the virus. Avoid shaking dirty laundry to reduce the chance of spreading the virus through the air. Take Precautions When Bringing items Into the Home Groceries While the coronavirus can live on some surfaces for as long as 2-3 days, there is no evidence that food or food packaging has been linked to getting sick from COVID-19. Here are some precautions you can take when handling groceries: Wash your hands after handling food packaging, after removing food from the packaging, before you prepare food, and before you serve food to the care recipient. 28

After unpacking groceries, use disinfectants to wipe surfaces on which bags or items were placed.

Rinse fruits and vegetables with water before cooking them or serving them to a care recipient. Do NOT use bleach or other disinfectant products on fresh fruits or vegetables.29 Mail, Packages, and Newspapers Although the COVID-19 virus can survive for a short period on some surfaces, it is unlikely to be spread from mail or packages at regular temperatures.30 In addition, postal service employees are taking additional precautions to use facemasks, gloves, and cleaning supplies.31 If you are assisting a care recipient with mail, packages, and newspapers: Let items sit for 24 hours after delivery before handling them.

Dispose of packaging, and wash your hands or use a hand sanitizer after opening newspapers or collecting mail. Shoes Shoes are not generally a common source of infection, but they can carry bacteria and viruses. Cleaning the soles of shoes is more likely to spread infection than eliminate it. Instead of cleaning the soles of shoes, you can take these precautions: Remove your shoes and those of the care recipient when entering the household. (When your care recipient is indoors, make sure they wear slippers or indoor shoes with non-skid soles.)

Wash hands after handling shoes. Personal Items It is also important to take precautions with any personal items you bring into the care recipient's home, for their protection and yours. Bring as few items as possible into your care recipient's home. This helps prevent bringing germs into the home with you and from taking them out with you.

Find a place near the entrance to the care recipient’s home where you can leave your personal items.

Find a place near the entrance to your home where you can leave the items you need for work and where they won’t be touched by others. Protect Health Care Professionals and Others in the Community Emergency Personnel: If the care recipient has a medical emergency and you need to call 911, notify the dispatcher that the care recipient has, or is being evaluated for, COVID-19. If possible, put a facemask on the care recipient before emergency medical services arrive.32 Health Care Providers, Office Staff, and Other Patients: When visiting a health care provider, the care recipient should put on a facemask before entering the building to protect the other people in the office or waiting room from getting infected or exposed to COVID-19.33 Nursing Home Staff and Residents: Many facilities, such as nursing homes and assisted living facilities, have had significant outbreaks of COVID-19. They limit visits from families and others to prevent the spread of the virus. If you are permitted to enter the building, you will likely be screened at the entrance. For example, your temperature may be taken and you may be asked about any recent respiratory symptoms.



You will be expected to wear a facemask or cloth face covering at all times, perform frequent hand hygiene, and be restricted to only the patient’s room or other area designated by the facility.34 Pets and Other Animals: It is recommended that people with COVID-19 limit contact with animals until more information is known about the virus, although there is currently no evidence that pets or other companion animals spread the COVID-19 virus.



When possible, a caregiver or another member of the household should care for any animals while the care recipient is sick. If the care recipient must care for the pet while they are sick, they should wear a facemask, and wash their hands before and after they interact with pets.35 Protecting Yourself and Your Loved Ones You cannot take care of your care recipients or your loved ones if you do not take care of yourself. Ways to protect yourself and others are discussed below. Monitor Your Health

Call your health care provider right away if you develop symptoms suggestive of COVID-19 . Call your supervisor and do NOT go to work. If you have tested positive for COVID-19 or suspect you have been infected, check with your agency. It is possible that you will not be able to return to work until you’ve been without a fever for at least 72 hours, and at least 7 days since your first symptoms appeared. 36



If you have had close contact (within 6 feet) for more than 20 minutes with a person with known or suspected COVID-19, and neither of you was wearing a mask, or if you have had contact with the secretions of a person with COVID-19, check with your agency. It is possible they will recommend you self-quarantine for 7-14 days.

Practice Preventative Hygiene

Practice good hygiene, regular cleaning and disinfecting, and the other preventative measures discussed earlier. Taking these preventative actions both when you are at work and at home will help reduce your chance of catching and spreading COVID-19.

Practice Social Distancing Take appropriate precautions when you are at work, at home, and as you move around your community to help prevent catching and spreading the virus. Remember, the actions you take in your personal encounters can also impact your clients. Wear Face Coverings in Public Wear face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies).

Share the Facts

Make sure that you keep informed of the latest updates on the virus by consulting reliable sources on a regular basis. Help debunk myths and rumors by sharing factual information from sources like the CDC.