Pennsylvania issued a directive requiring essential workers to wear masks when working. The issue for controlling aerosols from those who may have the virus.
"A business that is authorized to maintain in-person operations, other than health care providers, pursuant to the Orders that the Governor and I issued on March 19, 2020, as subsequently amended, shall implement, as applicable, the following social distancing, mitigation, and cleaning protocols:
(10) provide masks for employees to wear during their time at the business, and make it a mandatory requirement to wear masks while on the work site, except to the extent an employee is using break time to eat or drink, in accordance with the guidance from the Department of Health and the CDC. Employers may approve masks obtained or made by employees in accordance with Department of Health guidance;
There are other requirements including cleaning, maintaining limits on people to maintain spacing, etc.
While many may question the need for this. A study from Western details how aerosols travel through the air. while the work was done in a chamber, there is recognition that other factors will influence speed and loft.
The study details how a cough puts aerosols into the air. At peak velocity, aerosols are moving at 1.2 m/sec (4 ft /sec) and 10% of the particles stay suspended after 4 seconds. So as suggested by the article, a 6 foot physical separation may not be enough in itself.
Click on the article link for viewing aerosol ejection from the mouth.
Pennsylvania Department of Health
file:///C:/Users/mwb124/AppData/Local/Microsoft/Windows/INetCache/Content.Outlook/8XX8W1BK/20200415-SOH-worker-safety-order%20(2).pdf
Order of the Secretary of the Pennsylvania Department of Health Directing Public Health Safety Measures for Businesses Permitted to Maintain In-person Operations
The 2019 novel coronavirus (COVID-19) is a contagious disease that is rapidly spreading from person to person in the Commonwealth of Pennsylvania. COVID-19 can be transmitted from people who are infected with the virus even if they are asymptomatic or their symptoms are mild, such as a cough. Additionally, exposure is possible by touching a surface or object that has the virus on it and then touching one’s mouth, nose, or eyes.
COVID-19 is a threat to the public’s health, for which the Secretary of Health may order general control measures, including, but not limited to, closure, isolation, and quarantine. This authority is granted to the Secretary of Health pursuant to Pennsylvania law. See Section 5 of the Disease Prevention and Control Law, 35 P.S. §§ 521.1, 521.5; sections 2102 and 2106 of the Administrative Code of 1929, 71 P.S. §§ 532, 536; and the Department of Health’s (Department’s) regulations at 28 Pa. Code §§ 27.60-27.68 (relating to disease control measures; isolation; quarantine; movement of persons subject to isolation or quarantine; and release from isolation and quarantine). Particularly, the Secretary has the authority to take any disease control measure appropriate to protect the public from the spread of infectious disease. See 35 P.S. § 521.5; 71 P.S. §§ 532(a), 1402(a); 28 Pa. Code § 28.60.
Recognizing that certain life-sustaining businesses in the Commonwealth must remain open despite the need for strong mitigation to slow the spread of the virus, I am ordering certain actions to be taken by employers and their employees to protect their health and lives, the health and lives of their families, and the health and lives of the residents of the Commonwealth who depend upon their services. Special consideration is required to protect not only customers, but the workers needed to run and operate these establishments.
As cleaning, disinfecting, and other maintenance and security services performed by building service employees are critical to protecting the public health by reducing COVID-19 infection in the Commonwealth, I previously directed building safety measures in an Order that went into effect at 12:01 a.m. on April 6, 2020. Similarly, based upon the manner of COVID-19's continued and extensive spread in the Commonwealth and in the world, and its danger to Pennsylvanians, I have determined that an additional appropriate disease control measure is the further direction of safety measures for all employees and visitors at life-sustaining businesses that have remained open during the COVID-19 disaster emergency.
Accordingly, on this date, April 15, 2020, to protect the public from the spread of COVID-19, I hereby order:
A. A business that is authorized to maintain in-person operations, other than health care providers, pursuant to the Orders that the Governor and I issued on March 19, 2020, as subsequently amended, shall implement, as applicable, the following social distancing, mitigation, and cleaning protocols:
(1) in addition to maintaining pre-existing cleaning protocols established in the business, as specified in paragraph (2) below, clean and disinfect hightouch areas routinely in accordance with guidelines issued by the Centers for Disease Control and Prevention (CDC), in spaces that are accessible to customers, tenants, or other individuals;
(2) maintain pre-existing cleaning protocols established by the business for all other areas of the building;
(3) establish protocols for execution upon discovery that the business has been exposed to a person who is a probable or confirmed case of COVID19, including:
a. close off areas visited by the person who is a probable or confirmed case of COVID-19. Open outside doors and windows and use ventilation fans to increase air circulation in the area. Wait a minimum of 24 hours, or as long as practical, before beginning cleaning and disinfection. Cleaning staff should clean and disinfect all areas such as offices, bathrooms, common areas including but not limited to employee break rooms, conference or training rooms and dining facilities, shared electronic equipment like tablets, touch screens, keyboards, remote controls, and ATM machines used by the ill person, focusing especially on frequently touched areas;
b. identify employees that were in close contact (within about 6 feet for about 10 minutes) with a person with a probable or confirmed case of COVID-19 from the period 48 hours before symptom onset to the time at which the patient isolated;
i. If the employee remains asymptomatic, the person should adhere to the practices set out by the CDC in its April 8, 2020 Interim Guidance for Implementing Safety Practice for Critical Infrastructure Workers Who May Have Had Exposure to a Person with Suspected or Confirmed COVID-19;
ii. If the employee becomes sick during the work day, the person should be sent home immediately. Surfaces in the employee’s workspace should be cleaned and disinfected. Information on other employees who had contact with the ill employee during the time the employee had symptoms
and 48 hours prior to symptoms should be compiled. Others at the workplace with close contact within 6 feet of the employee during this time would be considered exposed;
iii. Promptly notify employees who were close contacts of any known exposure to COVID-19 at the business premises, consistent with applicable confidentiality laws;
iv. ensure that the business has a sufficient number of employees to perform the above protocols effectively and timely;
c. implement temperature screening before an employee enters the business, prior to the start of each shift or, for employees who do not work shifts, before the employee starts work, and send employees home that have an elevated temperature or fever of 100.4 degrees Fahrenheit or higher. Ensure employees practice social distancing while waiting to have temperatures screened;
d. employees who have symptoms (i.e., fever, cough, or shortness of breath) should notify their supervisor and stay home;
e. sick employees should follow CDC-recommended steps. Employees should not return to work until the CDC criteria to discontinue home isolation are met, in consultation with healthcare providers and state and local health departments. Employers are encouraged to implement liberal paid time off for employees who do not return to work as set forth above.
(4) stagger work start and stop times for employees when practicable to prevent gatherings of large groups entering or leaving the premises at the same time;
(5) provide sufficient amount of space for employees to have breaks and meals while maintaining a social distance of 6 feet, while arranging seating to have employees facing forward and not across from each other in eating and break settings;
(6) stagger employee break times to reduce the number of employees on break at any given time so that appropriate social distancing of at least 6 feet may be followed;
(7) limit persons in employee common areas (such as locker or break rooms, dining facilities, training or conference rooms) at any one time to the number of employees that can maintain a social distance of 6 feet;
(8) conduct meetings and trainings virtually (i.e., by phone or through the internet). If a meeting must be held in person, limit the meeting to the fewest number of employees possible, not to exceed 10 employees at one time, and maintain a social distance of 6 feet;
(9) provide employees access to regular handwashing with soap, hand sanitizer, and disinfectant wipes and ensure that common areas (including but not limited to break rooms, locker rooms, dining facilities, rest rooms, conference or training rooms) are cleaned on a regular basis, including between any shifts;
(10) provide masks for employees to wear during their time at the business, and make it a mandatory requirement to wear masks while on the work site, except to the extent an employee is using break time to eat or drink, in accordance with the guidance from the Department of Health and the CDC. Employers may approve masks obtained or made by employees in accordance with Department of Health guidance;
(11) ensure that the facility has a sufficient number of employees to perform all measures listed effectively and in a manner that ensures the safety of the public and employees;
(12) ensure that the facility has a sufficient number of personnel to control access, maintain order, and enforce social distancing of at least 6 feet;
(13) prohibit non-essential visitors from entering the premises of the business; and
(14) ensure that all employees are made aware of these required procedures by communicating them, either orally or in writing, in their native or preferred language, as well as in English or by a methodology that allows them to understand.
B. In addition to the above, the following measures apply to businesses, other than health care providers, that serve the public within a building or a defined area:
(1) where feasible, businesses should conduct business with the public by appointment only and to the extent that this is not feasible, businesses must limit occupancy to no greater than 50% of the number stated on the applicable certificate of occupancy at any given time, as necessary to reduce crowding in the business, and must maintain a social distance of 6 feet at check-out and counter lines, and must place signage throughout each site to mandate social distancing for both customers and employees;
(2) based on the building size and number of employees, alter hours of business so that the business has sufficient time to clean or to restock or both;
(3) install shields or other barriers at registers and check-out areas to physically separate cashiers and customers or take other measures to ensure social distancing of customers from check-out personnel, or close lines to maintain a social distance between of 6 feet between lines;
(4) encourage use of online ordering by providing delivery or pick-up options;
(5) designate a specific time for high-risk and elderly persons to use the business at least once every week if there is a continuing in-person customer-facing component;
(6) require all customers to wear masks while on premises, and deny entry to individuals not wearing masks, unless the business is providing medication, medical supplies, or food, in which case the business must provide alternative methods of pick-up or delivery of such goods; however, individuals who cannot wear a mask due to a medical condition (including children under the age of 2 years per CDC guidance) may enter the premises and are not required to provide documentation of such medical condition;
(7) in businesses with multiple check-out lines, only use every other register, or fewer. After every hour, rotate customers and employees to the previously closed registers. Clean the previously open registers and the surrounding area, including credit card machines, following each rotation;
(8) schedule handwashing breaks for employees at least every hour; and
(9) where carts and handbaskets are available for customers’ use, assign an employee to wipe down carts and handbaskets before they become available to each customer entering the premises.
This Order shall take effect immediately and be enforceable as of 8:00 p.m. on April 19, 2020.
Western News
https://news.westernu.ca/2020/04/cough-chamber-shows-six-feet-not-far-enough/
‘Cough chamber’ shows six-feet not far enough
April 14, 2020 By Paul Mayne
A recent Western-led study says two meters might not be far enough away if someone lets an uncovered cough loose in your direction – meaning sneeze and cough etiquette is more than a simple social nicety, but a key to stopping the spread of diseases like COVID-19.
“It’s pretty hard to avoid a cough,” said Mechanical and Materials Engineering professor Eric Savory. “By the time you react, it’s reached you.”
Teaming up with virologists at Sunnybrook Hospital, Savory recently explored cough airflows produced by human subjects naturally infected with seasonal influenza in order to better understand how the environmental conditions affect the physical transmission of the infection.
“If you’re a couple metres away from someone who coughs unobstructively, then within about three seconds or so, their cough has reached you – and is still moving,” Savory explained. “Even when you’re two-and-a-half metres away, the airflow in the cough can still be moving at 200mm a second.”
In fact, the study showed that as much as 10 per cent of the fine droplets from the cough remain suspended in the air even after four seconds.
Health Canada, joining with health agencies around the globe, has advised people to cough and sneeze into their elbows, not their hands. While breaking a long-held habit for many, the shift prevents infection from being transmitted to frequently touched surfaces, like doorknobs, ATMs or touch screens.
Savory’s findings add to calls for these efforts in combination with social-distancing measures during the COVID-19 pandemic.
Savory is now transitioning his findings specifically to COVID-19.
Collaborating with Eric Arts from the Schulich School of Medicine & Dentistry and Franco Berruti from the Department of Chemical and Biochemical Engineering, the interdisciplinary research team intends to examine the pathways of COVID-19 droplets through the air and analyze different material surfaces in order to verify its survivability under different temperature and humidity conditions.
This further investigation will be conducted in Western’s ImPaKT containment laboratory where Arts and his collaborators are actively developing an effective COVID-19 vaccine.
Savory’s study, Experimental investigation of far field human cough airflows from healthy and influenza-infected subjects, was accepted earlier this week by the journal Indoor Air.
The “big question” out of this study for virologists, Savory said, is to figure out the required dosage needed to cause an infection. “It’s going depend on the droplet size, as well as the viral content of those droplets. Clearly, the further away you are from someone the less likely you are to be infected, should they cough or sneeze.”
Previous studies around cough airflow have measured directly in front of the mouth – “right at the source.” That is irrelevant to getting the best data, Savory argued, as he and his team measured at a distance instead, for the first time.
In order to come up with evidence “people would believe,” Savory also didn’t use a cough simulator, such as a mannequin, used in other studies.
In 2018, Savory created a ‘cough chamber’ conduct 77 experiments with 58 different subjects, including 21 who presented influenza-like illness and, of those, 12 had laboratory-confirmed respiratory infections or a seasonal virus.
The cough chamber was a specially constructed two-metre enclosed cube with a hole and chin rest in one end, where participants coughed. Savory used a high-speed camera and laser light to determine the velocity of the expelled particles. He then tracked the movement of fine particles as the air moved.
At peak velocity, observed at the cough jet centre, the speed was 1.2 metres per second.
“These droplets are still being transported quite quickly – even at that safe separation distance,” Savory explained.
“There is no real logical reason for saying that two metres is somehow safe, but it’s much better than one metre or closer. We’re not saying you’re going to get infected; we’re just saying there is a risk there. Obviously, it decreases the further you are away.”
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