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Author: COVID-19 NEWS

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The bottom line: COVID-19 vaccines protect people against severe illness, including disease caused by Delta and other variants circulating in the U.S.
COVID-19 vaccines protect people from getting infected and severely ill, and significantly reduce the likelihood of hospitalization and death.
The best way to slow the spread of COVID-19 and to prevent infection by Delta or other variants is to get vaccinated.
For people who are vaccinated and still get infected (i.e., “breakthrough infections”), there is a risk of transmission to others.
That is why, if you are vaccinated or unvaccinated and live or work in an area with substantial or high transmission of COVID-19, you – as well as your family and community – will be better protected if you wear a mask when you are in indoor public places.
People who are immunocompromised may not always build adequate levels of protection after an initial 2-dose primary mRNA COVID-19 vaccine series. They should continue to take all precautions recommended for unvaccinated people, until advised otherwise by their healthcare provider.  Further,  CDC recommends that moderately to severely immunocompromised people receive an additional dose.

COVID-19 vaccines are effective at preventing infection, serious illness, and death. Most people who get COVID-19 are unvaccinated. However, since vaccines are not 100% effective at preventing infection, some people who are fully vaccinated will still get COVID-19. An infection of a fully vaccinated person is referred to as a “breakthrough infection.”What We Know about Vaccine Breakthrough Infections

Breakthrough infections are expected. COVID-19 vaccines are effective at preventing most infections. However, like most vaccines, they are not 100% effective.
Fully vaccinated people with a breakthrough infection are less likely to develop serious illness than those who are unvaccinated and get COVID-19.
Even when fully vaccinated people develop symptoms, they tend to be less severe symptoms than in unvaccinated people. This means they are much less likely to be hospitalized or die than people who are not vaccinated.
People who get vaccine breakthrough infections can be contagious.

CDC is collecting data on vaccine breakthrough infections and closely monitors the safety and effectiveness of all Food and Drug Administration (FDA)-authorized COVID-19 vaccines. Because vaccines are not 100% effective, as the number of people who are fully vaccinated goes up, the number of breakthrough infections will also increase. However, the risk of infection remains much higher for unvaccinated than vaccinated people. Vaccines remain effective in protecting most people from COVID-19 infection and its complications.
Vaccine Breakthroughs and Variants
CDC continues to actively monitor vaccine safety and effectiveness against new and emerging variants for all FDA-authorized COVID-19 vaccines. Research shows that the FDA-authorized vaccines offer protection against severe disease, hospitalization, and death against currently circulating variants in the United States. However, some people who are fully vaccinated will get COVID-19.
The Delta variant is more contagious than previous variants of the virus that causes COVID-19. However, studies indicate that the vaccines used in the United States work well against the Delta variant, particularly in preventing severe disease and hospitalization. Overall, if there are more infections with SARS-CoV-2 (the virus that causes COVID-19) there will be more vaccine breakthrough infections. However, the risk of infection, hospitalization, and death are all much lower in vaccinated compared to unvaccinated people. Therefore, everyone aged 12 years and older should get vaccinated to protect themselves from severe disease and death.
How CDC Monitors Breakthrough Infections
CDC has multiple surveillance systems and ongoing research studies to monitor the performance of vaccines in preventing infection, disease, hospitalization, and death.  CDC also collects data on breakthrough infections through outbreak investigations. One important system that CDC uses to track breakthrough infections is COVID-NET (the Coronavirus Disease 2019 [COVID-19]-Associated Hospitalization Surveillance Network). This system provides the most complete data on vaccine breakthroughs in the general population. COVID-NET is a population-based surveillance system that collects reports of lab-confirmed COVID-19-related hospitalizations in 99 counties in 14 states. COVID-NET covers approximately 10% of the U.S. population. One recent COVID-NET publication assessed the effectiveness of COVID-19 vaccines in preventing hospitalization among adults ≥ 65 years. More information on COVID-NET vaccine breakthrough data will be published as it becomes available.

Racial and Ethnic Approaches to Community Health (REACH) – COVID-19 Supplemental Funding for COVID-19 and Flu Vaccination Program
Populations of focus: African American/Black, American Indian/Alaska Native, Asian American, Hispanic/Latinx, and Native Hawaiian/other Pacific Islander adults
Purpose: Build the evidence base of effective interventions for reducing racial and ethnic disparities in adult vaccination. To make an immediate impact on racial and ethnic disparities in COVID-19 and influenza vaccination rates by funding national organizations to implement tailored education, outreach, and access strategies
Partners: Alaska Native Tribal Health Consortium, Allegheny County, American Heart Association, California Department of Public Health, African American Health Equity Task Force, City of Hartford, City of Miami Gardens, City of San Antonio Metropolitan Health District, Latino Education Institute at Worcester State University, County of San Diego, Health and Human Services Agency, Public Health Services, Cuyahoga County District Board of Health, DeKalb County Board of Health, Eastern Michigan University, Health and Hospital Corporation of Marion County, Health Partners Initiative DBA Partnership for a Healthy Lincoln, Houston County Board of Health/North Central Health District, Mississippi Public Health Institute, Leadership Council for Healthy Communities, Lowell Community Health Center, Montgomery Area Community Wellness Coalition, Multnomah County Health Department, National Kidney Foundation of Michigan, Partners In Health, Penn State Health Milton S. Hershey Medical Center, REACH-NARTC, Presbyterian Healthcare Services, Public Health Advocates, RAO: Rosedale Assistance & Opportunities, Seattle-King County Public Health Department, Southern Connecticut State University, Southern Nevada Health District, The Institute for Family Health, University of Arkansas for Medical Sciences, and Young Men’s Christian Association of Coastal Georgia, Inc.

Racial and Ethnic Approaches to Community Health (REACH) – COVID-19 Supplemental Funding for COVID-19 and Flu Vaccination Program
Populations of focus: African American/Black, American Indian/Alaska Native, Asian American, Hispanic/Latinx, and Native Hawaiian/other Pacific Islander adults
Purpose: Build the evidence base of effective interventions for reducing racial and ethnic disparities in adult vaccination. To make an immediate impact on racial and ethnic disparities in COVID-19 and influenza vaccination rates by funding national organizations to implement tailored education, outreach, and access strategies
Partners: Alaska Native Tribal Health Consortium, Allegheny County, American Heart Association, California Department of Public Health, African American Health Equity Task Force, City of Hartford, City of Miami Gardens, City of San Antonio Metropolitan Health District, Latino Education Institute at Worcester State University, County of San Diego, Health and Human Services Agency, Public Health Services, Cuyahoga County District Board of Health, DeKalb County Board of Health, Eastern Michigan University, Health and Hospital Corporation of Marion County, Health Partners Initiative DBA Partnership for a Healthy Lincoln, Houston County Board of Health/North Central Health District, Mississippi Public Health Institute, Leadership Council for Healthy Communities, Lowell Community Health Center, Montgomery Area Community Wellness Coalition, Multnomah County Health Department, National Kidney Foundation of Michigan, Partners In Health, Penn State Health Milton S. Hershey Medical Center, REACH-NARTC, Presbyterian Healthcare Services, Public Health Advocates, RAO: Rosedale Assistance & Opportunities, Seattle-King County Public Health Department, Southern Connecticut State University, Southern Nevada Health District, The Institute for Family Health, University of Arkansas for Medical Sciences, and Young Men’s Christian Association of Coastal Georgia, Inc.

Neetu Abad (l.) and Lis Wilhelm (r.) in downtown Atlanta, where they set up a vaccine confidence art event in cooperation with the Georgia Department of Public Health.
The sun over Ghana’s capital Accra broiled Neetu Abad as she sat in the back of a taxi with no air conditioning for an hour. Then something happened that made her realize how much she could rely on her CDC colleague Lis Wilhelm.
“I didn’t have enough money with me to pay the fare, and the driver didn’t want to let me out to go get more,” Neetu says. “I was half a mile from our hotel, and I messaged Lis that I was melting in the cab. Five minutes later, she was running down the road to give me money.”
Bonding moments like this have turned the two into a tight-knit team. Together, Lis and Neetu travel around the world and throughout the United States to encourage vaccination, and they face similar hurdles wherever they go.
Lis is a health communicator and Neetu is a behavioral scientist. They’ve worked together since 2016 for CDC’s Global Immunization Division on vaccination campaigns for polio, measles-rubella, cholera, and more. When COVID-19 struck, the two led the vaccine confidence and demand team for CDC’s COVID-19 response in the US.
As they travel, Lis and Neetu collaborate with public health partners, healthcare providers, and people who need vaccines to research why some people are not getting vaccinated, despite ample vaccine supplies. The two use the findings to help partners develop strategies to get more people vaccinated.
Neetu and Lis have many stories to tell from places as diverse as Nigeria, Indonesia, and Alabama. But they’ve found everywhere that listening to what other people say makes the difference in helping people get vaccinated.
“We listen to people we serve to keep from making assumptions. We may assume, for example, that if we give people clear messages, they’ll make the choice to get vaccinated,” Lis says, “but have they even gotten your information about vaccines?”
Lis and Neetu often discover that many people haven’t received answers to their questions. Everywhere, the two hear similar reasons for not getting vaccinated. Often, it’s not vaccine hesitancy—an unwillingness to get vaccinated.
“We can use the word ‘hesitant’ too quickly. Sometimes the reason is not being able to get time off from work or to find someone to watch your children. You may not have access to a healthcare provider you trust to answer your questions about vaccines,” Lis says.
In 2017, when Lis and Neetu promoted measles vaccine confidence in Ghana, healthcare providers there spoke of being unaware that children needed more than one vaccine dose. The healthcare providers didn’t know what to do when parents brought older children in for a second dose.
Mothers spoke of hour-long trips down treacherous roads to take their children to a clinic. Some had thought about staying home and skipping the second dose.
Other times, vaccine hesitancy does play a role, especially when it’s boosted by misinformation and fear on social media. Rumors on chat apps damaged Lis and Neetu’s efforts in measles-rubella campaigns in India and Indonesia. In the US, floods of information have collided with misinformation, leaving some people confused and hesitant to get vaccinated against COVID-19.
In Sumter County, Alabama, Neetu saw a long line of people outside a funeral home, where many were making funeral arrangements for loved ones who died from COVID-19. There, a woman selling catfish from a food truck said she would get her mother vaccinated, but from what she heard about vaccines, she decided not to get one herself.
“We explain the science to help people get to know vaccines, so they’re less afraid of them. With mRNA vaccines, we help people see that this is a technology upgrade in health care.”
Some people are hesitant to get a COVID-19 vaccine because they feel that public health and health care have failed them before and could again. Sometimes this has to do with barriers to health care that are rooted in racial discrimination.
“People asked why we were there for COVID-19 vaccines but not for other healthcare issues they faced. And every single person we talked to in communities suffering heavily in the pandemic had lost a family member to COVID-19 or became sick themselves,” Lis says.
Community and religious leaders have helped Lis and Neetu build the trust people need to feel more confident about vaccines.
“I sat with imams in northwest Nigeria who used Koran verses to help worshippers understand the importance of protecting yourself, your children, and your neighbors,” Neetu says.
In April 2021, she sat with pastors in Albany, Georgia, who held funerals for people who died from COVID-19. The pastors wanted to know how to get their congregations to trust the science.
“One pastor had a radio station and put us on air. He asked simple questions about mRNA vaccines. He told us that our answers made things very understandable. The show may have reached more people who needed our information than if we talked to a major TV network,” Neetu says.
Neetu and Lis are taking what they’ve learned in the US back to the Global Immunization Division to get more people vaccinated against COVID-19 around the world.
“People are experts in their own lives and want to be heard. If you start there, you may find a solution, like informing healthcare providers or getting vaccines closer to where people live,” Neetu says.

Summary of Recent Changes

Added mask guidance for staff who are fully vaccinated and in areas of substantial or high transmission
Added public health laboratories to guidance audience

Updated face covering  to face mask
Added guidance for staff who are fully vaccinated and staff who are not fully vaccinated
Added links to the “General Guidance” and “Face Masks” sections
Deleted the “Physical Distancing” section
Added links to the “Additional Resources” section

Key Points

General Guidance
This guidance is to address the general safety concerns of laboratory personnel during the COVID-19 pandemic. All laboratories should perform site- and activity-specific risk assessments to determine the most appropriate safety measures to implement for particular circumstances. In addition, facilities should adhere to local policies and procedures as well as all applicable federal, state, and local regulations and public health guidelines.
Risk assessments should include the following considerations:

Fully vaccinated staff should wear a face mask when in an area with potential risk of substantial or high transmission of COVID-19.This helps protect staff from the Delta variant and prevents spreading it to others.

If staff are unvaccinated or not fully vaccinated, they should

Wear face masks.
Physically distance at least 6 feet apart from others.
Analyze the number of people that the laboratory space can realistically and safely accommodate.
Assess the flow of personnel traffic. Where possible, design one-way paths for staff to walk through the laboratory space.

To ensure clean surfaces and equipment for all users, assess procedures for cleaning and sanitizing commonly shared equipment and areas (for example, counters, benchtops, and desks).
Review emergency communication and operational plans, including how to protect staff at higher risk for severe illness from COVID-19.

Every institution should have a COVID-19 health and safety plan to protect employees. This plan should be shared with all staff. Ideally, this plan would:

Describe steps to help prevent the spread of COVID-19 if an employee is sick.
Instruct sick employees to stay home and not return to work until the criteria to discontinue home isolation are met in consultation with healthcare providers and state and local health departments.
Provide information on whom employees should contact if they become sick.
Implement flexible sick leave and supportive policies and practices. If sick leave is not offered to some or all employees, the institution should consider implementing emergency sick leave policies.
Designate someone to be responsible for responding to employees’ COVID-19 concerns. Employees should know who this person is and how to contact this person at all times.
Provide employees with accurate information about COVID-19, how it spreads, and the risk of exposure.
Reinforce training on proper handwashing practices and other routine infection control precautions to help prevent the spread of many diseases, including COVID-19.

Ensure that employees have access to personal protective equipment (PPE); disinfectant products that meet the EPA’s criteria for use against SARS-CoV-2external icon; and soap, clean running water, and drying materials for handwashing, or alcohol-based hand sanitizers that contain at least 60% ethanol or 70% isopropanol.
Face Masks
Staff who are fully vaccinated
Fully vaccinated staff should wear face masks when in an area of substantial or high transmission of COVID-19. This helps protect staff from the Delta variant and prevents spreading it to others. Fully vaccinated staff might choose to wear a mask regardless of the level of transmission, particularly if they are immunocompromised or at increased risk for severe disease from COVID-19. They may also choose to wear a mask if they have someone in their household who is immunocompromised, at increased risk of severe disease, or not fully vaccinated. Staff should continue to wear a mask where required by laws, rules, regulations, or local guidance.
Staff who are not fully vaccinated
CDC recommends staff who are unvaccinated or not fully vaccinated wear face masks and physically distance, especially when indoors around people who don’t live in your household. This includes office spaces, computer workstations, and break rooms. However, wearing a mask is not a substitute for physical distancing. In general, employees who are not fully vaccinated should wear a face mask in laboratory spaces that do not have requirements for respiratory PPE and where other physical distancing measures are difficult to maintain.
Any face mask worn inside a laboratory area where personnel works with potentially infectious material should subsequently not be worn outside of that laboratory area. Laboratory PPE are critical supplies, and employees should refrain from removing them from the laboratory for general use. Site- and activity-specific risk assessments, as well as available resources, should determine where specific facial protection, such as disposable masks, should be used and how to dispose of them. These face masks should not be used in place of recommended personal protective equipment (PPE).

Face masks are not intended to protect those who wear them from any biological or chemical agent handled in the laboratory and are not considered laboratory PPE.
All staff should follow established PPE requirements for working in laboratory spaces.

Staff should wash their hands before putting on face masks and minimize mask removal while in the laboratory. The guidance below describes how to remove a face mask and replace it with a clean face mask:

Remove the face mask carefully.
Be careful not to touch eyes, nose, or mouth when removing the face mask.
Untie the strings behind the head or stretch the ear loops.
Handle only by the ear loops or ties.
Place reusable cloth masks in a bag, and close the bag until it can be washed.
Wash cloth face masks frequently.
Wash hands immediately after removing.

Depending on the facility’s design or configuration, additional physical barriers, such as a face shield, plexiglass, partition, or plastic barriers, may be needed to achieve physical distancing goals in settings with unvaccinated staff or staff who are not fully vaccinated.
Personal Hygiene and Disinfection
As more workers return to the laboratory, extra measures may be needed to ensure a clean and appropriate environment. Reevaluate current protocols for cleaning, use of PPE, and handwashing. High-touch surfaces and equipment present a higher probability of contamination in the work area and should be disinfected frequently. Increasing the number of available cleaning supplies and distributing them throughout the laboratory can encourage staff to clean surfaces and equipment more frequently.
Use visual reminders, such as posters displayed throughout the laboratory environment, common areas, and restrooms to emphasize the importance of hand hygiene and to encourage frequent handwashing. Hands should be washed regularly with soap and water for at least 20 seconds. An alcohol-based hand sanitizer containing at least 60% ethanol or 70% isopropanol can be used when soap and water are unavailable. For more information, see CDC’s Hand Hygiene Recommendations.
For additional information, refer to the following:
OSHA information for all employers and workers:

CDC COVID-19 resources:

CDC Laboratory Safety Resources

If You Need a Second Shot
If you receive an mRNA COVID-19 vaccine (Pfizer-BioNTech COVID-19 vaccine or Moderna COVID-19 vaccine), you will need 2 shots to be fully protected. COVID-19 vaccines are not interchangeable. If you received a Pfizer-BioNTech or Moderna COVID-19 vaccine, you should get the same product (or brand) for your second shot.  You should get your second shot even if you have side effects after the first shot, unless a vaccination provider or your doctor tells you not to get it.
If you receive the viral vector COVID-19 vaccine, Johnson & Johnson’s Janssen (J&J/Janssen) COVID-19 Vaccine, you will only need 1 shot.
Learn more about getting your second shot.

People with moderately to severely compromised immune systems should receive an additional dose of mRNA COVID-19 vaccine after the initial 2 doses.

Learn more about Booster Shots.

As of August 9, 2021, more than 147 thousand v-safe participants have indicated they were pregnant at the time they received COVID-19 vaccination. CDC is currently enrolling eligible participants and analyzing data to better understand how COVID-19 vaccination affects pregnant people. As CDC learns more about the effects of vaccination during pregnancy, data will be presented at the Advisory Committee on Immunization Practices (ACIP) meetings, which are open to the public, and in published reports.* The large difference between the number of people who self-identified as pregnant in v-safe and the number of people enrolled in the v-safe pregnancy registry is due to a number of factors. 1) There was a delay between rollout of COVID-19 vaccination and the launch of the v-safe pregnancy registry.  2) It takes time for registry staff to contact people who self-identify as pregnant in v-safe. 3) Not everyone who identified as pregnant in v-safe meets criteria to be in the registry. 4) The registry will only need to enroll a certain number of people who are vaccinated at different time points during pregnancy
**Recommendations for routine use of vaccines in children, adolescents, and adults are developed by the Advisory Committee on Immunization Practices (ACIP). ACIP is a federal advisory committee to provide expert external advice and guidance to the CDC Director on the use of vaccines and related agents for the control of vaccine-preventable diseases in the civilian population of the United States.
V-safe and the V-safe COVID-19 Vaccine Pregnancy Registry: What’s the Difference?
v-safe is a smartphone-based tool that uses text messaging and web surveys to provide personalized health check-ins after you receive a COVID-19 vaccine. The v-safe COVID-19 Vaccine Pregnancy Registry is for v-safe participants who self-identify as pregnant at the time of vaccination or shortly thereafter (within 30 days of vaccination). The registry activities are in addition to the v-safe after vaccination health check-ins that participants receive via text message. Pregnant participants in the registry will be contacted to answer questions about their pregnancy and medical history. Participants will also be asked for permission to contact their healthcare provider(s).
Note: Participants are not paid for their participation, and not all people reporting pregnancy will be contacted to participate. Participation is completely voluntary, and you can opt out at any time. However, in general, many people feel good about participating in activities to help answer critical scientific questions, which can help inform recommendations for the public.
How CDC Is Using the Information
The information you provide will be combined with information from other participants in the registry. Together, this information will be evaluated and used to educate the public about how COVID-19 vaccination might affect pregnancy. In addition, this information will be used by CDC and the Food and Drug Administration (FDA) to guide recommendations on COVID-19 vaccination during pregnancy.
Specific health effects that scientists will be looking at include:

Pregnancy outcomes, like miscarriage and stillbirth
Pregnancy complications, like preeclampsia and gestational diabetes
Problems with the newborn, like preterm delivery, poor growth, or birth defects

Your name and any identifying information will not be included in any reports. Your responses and personal information will be protected to the full extent allowed by law. Data for the registry are kept on a CDC system that employs strict security measures to keep personally identifiable information private.
CDC May Need Permission to Contact Your Healthcare Provider
Having information on details, like medications or clinical laboratory results, can help provide a more complete picture of your pregnancy. Your healthcare provider(s) can help provide this information, which is important as we try to understand any potential effects of COVID-19 vaccination during pregnancy. If you choose not to give your permission for CDC to access medical records, you can still participate in the registry.
Vaccine Safety Monitoring in People Who Are Breastfeeding
Based on how these vaccines work in the body, the authorized COVID-19 vaccines are not thought to be a risk to lactating people or their breastfeeding babies. Although this project is not looking at potential effects during breastfeeding, other researchers across the nation are working to better understand the effects of COVID-19 vaccination in people who are breastfeeding.
CDC Is Using Data from the Registry
CDC released the first U.S. dataexternal icon on the safety of mRNA COVID-19 vaccines administered during pregnancy based on analyses of data from three vaccine safety-related databases, including the v-safe pregnancy registry. The analyses did not identify any safety concerns for pregnant people who were vaccinated or for their babies. Additional follow-up is needed, particularly among those vaccinated in the first or second trimesters of pregnancy; however, these preliminary findings are reassuring. Thanks to the participation of thousands of people, information gathered through the v-safe COVID-19 Vaccine Pregnancy Registry is helping to build the evidence base about the safety of COVID-19 vaccination during pregnancy.
Data collected from the registry will also be regularly presented at the ACIP meetings, which are open to the public, and in published reports. However, gathering data on potential effects of COVID-19 vaccination during pregnancy is expected to take some time. People are being vaccinated at different times during their pregnancies. Given the natural length of pregnancy, it takes time to follow pregnancies and learn about any potential effects on babies. CDC is committed to sharing information learned about potential effects of COVID-19 vaccination during pregnancy as soon as possible.
How to Report Adverse Events
You or your medical provider can report any adverse eventsexternal icon or health problems after COVID-19 vaccination to the Vaccine Adverse Event Reporting System (VAERS) by filling out a form that can be found on the VAERS websiteexternal icon. FDA requires healthcare providers to report certain adverse eventsexternal icon that occur after administering COVID-19 vaccine, but anyone can submit a report to VAERS. Reports to VAERS are invaluable to understanding the safety of COVID-19 vaccines as more people receive them over time. If you need further assistance with reporting to VAERS, please email info@VAERS.org or call 1-800-822-7967.

Travel Requirements:All air passengers coming to the United States, including U.S. citizens, are required to have a negative COVID-19 test result or documentation of recovery from COVID-19 before they board a flight to the United States. See the Frequently Asked Questions for more information.
Wearing a mask over your nose and mouth is required on planes, buses, trains, and other forms of public transportation traveling into, within, or out of the United States and while indoors at U.S. transportation hubs such as airports and stations. Travelers are not required to wear a mask in outdoor areas of a conveyance (like on open deck areas of a ferry or the uncovered top deck of a bus). CDC recommends that travelers who are not fully vaccinated continue to wear a mask and maintain physical distance when traveling.

Develop a Staffing PlanStaff are used primarily to ensure the orderly functioning of the CIC and to triage patients. The number of staff will depend on available resources, the size of the facility, and the intended number of patients. A staffing plan for a CIC should include patient care and, where applicable, administrative, cleaning, security, and food preparation staff. Having patient care staff with at least some medical training (e.g., nurses, nursing assistants, or community health workers) on site to assess patients may be beneficial. If care staff are not available, consider training community volunteers.
Staffing plans should include:

Encouraging staff and healthcare workers to become vaccinated against COVID-19 to reduce the risk of infection or hospitalization from COVID-19 exposure in higher-risk settings.
At least one person with infection prevention and control (IPC) training who is regularly available to answer questions, listen to concerns, and train staff.
Monitoring for infectious diseases and providing regular cleaning and disinfection of the facility.
Having one or two staff members available at the CIC 24 hours per day, 7 days a week, to monitor patient intake, ensure patient safety, and keep unauthorized people from entering the facility.

Considering children’s physical safety and mental and emotional health and hiring staff who have experience dealing with children.
Employing a full-time security guard, if feasible, to ensure the safety of patients and staff.

Flexible and nonpunitive sick leave policies for staff will ensure people do not work while ill, helping to maintain the health of the overall workforce. Be sure there is a process in place for reporting staff exposure and infections to the authority responsible for operating the CIC and the Ministry of Health. Develop a written protocol or log for identifying, monitoring, and reporting COVID-19 among staff.
All staff must self-assess daily for COVID-19 symptoms. If staff exhibit signs of fever or respiratory symptoms, staff should:

Remotely report this information to their supervisor.
Be given an immediate medical assessment and follow-up actions.
Determine with the supervisor whether they should report to work, depending on whether they are in contact with only confirmed cases, how ill they are, and whether they feel comfortable going to work.

Develop best practices for monitoring and managing ill and exposed healthcare workers.

Cloth face coverings in manufacturing work
CDC recommends wearing cloth face coverings as a protective measure in addition to social distancing (i.e., staying at least 6 feet away from others). Cloth face coverings may be especially important when social distancing is not possible or feasible based on working conditions. A cloth face covering may reduce the amount of large respiratory droplets that a person spreads when talking, sneezing, or coughing. Cloth face coverings may prevent people who do not know they have the virus that causes COVID-19 from spreading it to others. Cloth face coverings are intended to protect other people—not the wearer.
Cloth face coverings are not PPE. They are not appropriate substitutes for PPE such as respirators (like N95 respirators) or medical facemasks (like surgical masks) in workplaces where respirators or facemasks are recommended or required to protect the wearer.
While wearing cloth face coverings is a public health measure intended to reduce the spread of COVID-19 in communities, wearing a single cloth face covering for the full duration of a work shift (e.g., eight or more hours) in a manufacturing facility may not be practical if the face covering becomes wet, soiled, or otherwise visibly contaminated during the work shift. If cloth face coverings are worn in these facilities, employers should provide readily available clean cloth face coverings (or disposable facemask options) for workers to use when the coverings become wet, soiled, or otherwise visibly contaminated.
Employers who determine that cloth face coverings should be worn in the workplace, including to comply with state or local requirements for their use, should ensure the cloth face coverings:

fit over the nose and mouth and fit snugly but comfortably against the side of the face;
are secured with ties or ear loops;
include multiple layers of fabric;
allow for breathing without restriction;
can be laundered using the warmest appropriate water setting and machine dried daily after the shift, without damage or change to shape (a clean cloth face covering should be used each day);
are not used if they become wet or contaminated;
are replaced with clean replacements, provided by the employer, as needed.
are handled as little as possible to prevent transferring infectious materials to or from the cloth; and
are not worn with or instead of respiratory protection when respirators are needed.

Educate and train workers and supervisors about how they can reduce the spread of COVID-19Supplement workers’ normal and required job training (e.g., training required under OSHA standards) with additional training and information about COVID-19, including recognizing signs and symptoms of infection and ways to prevent exposure to the virus. Training should include information about how to implement the various infection prevention and control measures recommended here and included in any infection prevention and control or COVID-19 response plan that an employer develops. OSHA provides additional informationexternal icon about training on its COVID-19 webpage.
All communication and training should be easy to understand and should (1) be provided in languages appropriate to the preferred languages spoken or read by the workers, if possible; (2) be at the appropriate literacy level; and (3) include accurate and timely information about:

Signs and symptoms of COVID-19, risks for workplace exposures, the spread of the virus, and how workers can protect themselves;
Proper handwashing practices and use of hand sanitizer stations;
Cough and sneeze etiquette; and
Other routine infection control precautions (e.g., signs and symptoms of COVID-19, putting on or taking off masks or cloth face coverings and social distancing measures).

Employers should place simple posters in all of the languages that are common in the worker population that encourage staying home when sick (or after testing positive for the virus that causes COVID-19), cough and sneeze etiquette, and proper hand hygiene practices. They should place these posters at the entrance to the workplace and in break areas, locker rooms, and other workplace areas where they are likely to be seen.
CDC has free, simple posters available to download and print, some of which are translated into different languages. The Stop the Spread of Germs poster pdf icon[441 KB, 1 Page] is available in Amharic pdf icon[444 KB, 1 Page], Arabic pdf icon[475 KB, 1 Page], Burmese pdf icon[459 KB, 1 Page], Dari pdf icon[493 KB, 1 Page], Farsi pdf icon[460 KB, 1 Page], French pdf icon[443 KB, 1 Page], Haitian Creole pdf icon[437 KB, 1 Page], Kinyarwanda pdf icon[435 KB, 1 Page], Karen pdf icon[807 KB, 1 Page], Korean pdf icon[511 KB, 1 Page], Nepali pdf icon[450 KB, 1 Page], Pashto pdf icon[478 KB, 1 Page], Portuguese pdf icon[438 KB, 1 Page], Russian pdf icon[434 KB, 1 Page], Simplified Chinese pdf icon[595 KB, 1 Page], Somali pdf icon[437 KB, 1 Page], Spanish pdf icon[438 KB, 1 Page], Swahili pdf icon[437 KB, 1 Page], Tigriyna pdf icon[420 KB, 1 Page], Ukrainian pdf icon[441 KB, 1 Page], and Vietnamese pdf icon[441 KB, 1 Page].
Employers should post signs that you can read from a far distance (or use portable, electronic reader boards) that inform visitors and workers of social distancing practices.
Employers should provide alternative training for workers who cannot read written materials or who require other reasonable accommodations.
OSHA understands that some employers may face difficulties complying with OSHA standards due to the ongoing health emergency, including those standards that require certain types of worker training. OSHA is providing enforcement discretionexternal icon around the completion of training and other provisions in its various standards. OSHA has instructed its Compliance Safety and Health Officers (CSHOs) to evaluate whether an employer has made a good faith effort to comply with applicable OSHA standards and, in situations where compliance was not possible given the ongoing pandemic, to ensure that employees were not exposed to hazards from tasks, processes, or equipment for which they were not prepared or trained.
Cleaning and disinfection in manufacturing
For tool-intensive operations, employers should ensure tools are regularly cleaned and disinfected, including at least as often as workers change workstations or move to a new set of tools. Refer to List Nexternal icon on the EPA website for EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against SARS-CoV-2.
Establish protocols and provide supplies to increase the frequency of sanitization in work and common spaces. Disinfect frequently touched surfaces in workspaces and break rooms (e.g., microwave and refrigerator handles, vending machine touchpads, knobs, levels, and sink handles) at least once per shift, if possible. For example, wipe down tools or other equipment at least as often as workers change workstations. Frequently clean push bars and handles on any doors that do not open automatically and handrails on stairs or along walkways. If physical barriers are being used, then these should be cleaned frequently.
Workers who perform cleaning and disinfection tasks may require additional PPE and other controls to protect them from chemical hazards posed by disinfectants. Note: Employers must ensure their written hazard communication programexternal icon is up to date and training is up to date for all employees. (Also, see OSHA’s enforcement discretion memorandumexternal icon on this topic.) Employers may need to adapt guidance from this section, the Environmental Services Workers and Employersexternal icon section, and the Interim Guidance for Workers and Employers of Workers at Increased Risk of Occupational Exposureexternal icon, to fully protect workers performing cleaning and disinfection activities in manufacturing workplaces.
Screening[1] and monitoring workers
Workplaces, particularly in areas where community transmission of COVID-19 is occurring, should consider developing and implementing a comprehensive screening and monitoring strategy aimed at preventing the introduction of COVID-19 into the work site. Consider a program of screening workers before entry into the workplace, criteria for exclusion of sick workers, including asymptomatic workers who have tested positive for COVID-19; and criteria for return to work of exposed and recovered (those who have had signs or symptoms of COVID-19 but have gotten better).. This type of program should be coordinated to the extent possible with local public health authorities and could consist of the following activities:
Screening of workers for COVID-19
Screening manufacturing workers for COVID-19 symptoms (such as temperature checks) is an optional strategy that employers can use. If implemented for all workers, policies and procedures for screening workers should be developed in consultation with state and local health officials and occupational medicine professionals. Options to screen workers for COVID-19 symptoms include:

Screen before entry into the facility.
Provide verbal screening in appropriate language(s) to determine whether workers have had symptoms including a cough or shortness of breath, or at least two of these: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell. in the past 24 hours.
Check temperatures of workers at the start of each shift to identify anyone with a fever of 100.4°F or greater (or reported feelings of feverishness). Ensure that screeners:

Are trained to use temperature monitors and monitors are accurate under conditions of use (such as cold temperatures); and
Wear appropriate PPE.

Do not let employees enter the workplace if they have a fever of 100.4°F or greater (or reported feelings of feverishness), or if screening results indicate that the worker is suspected of having COVID-19.

Encourage workers to self-isolate and contact a healthcare provider;
Provide information on the facility’s return-to-work policies and procedures; and
Inform human resources, employer health unit (if in place), and supervisor (so the worker can be moved off schedule during illness and a replacement can be assigned, if needed).

Ensure that personnel performing screening activities, including temperature checks, are appropriately protected from exposure to potentially infectious workers entering the facility:

Implement engineering controls, such as physical barriers or dividers or rope and stanchion systems, to maintain at least 6 feet of distance between screeners and workers being screened.
If screeners need to be within 6 feet of workers, provide them with appropriate PPE based on the repeated close contact the screeners have with other workers.

Such PPE may include gloves, a gown, a face shield, and, at a minimum, a face mask.
N95 filtering facepiece respirators (or more protective) may be appropriate for workers performing screening duties and necessary for workers managing a sick employee in the work environment (see below) if that employee has signs or symptoms of COVID-19. If respirators are needed, they must be used in the context of a comprehensive respiratory protection program that includes medical exams, fit testing, and training in accordance with OSHA’s Respiratory Protection standardexternal icon (29 CFR 1910.134).

Managing sick workers
Workers who appear to have symptoms including a cough or shortness of breath, or at least two of these: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, or new loss of taste or smell upon arrival at work or who become sick during the day should immediately be separated from others at the workplace and sent home.
Ensure that personnel managing sick employees are appropriately protected from exposure. When personnel need to be within 6 feet of a sick colleague, appropriate PPE may include gloves, a gown, a face shield and, at a minimum, a face mask. N95 filtering facepiece respirators (or more protective) may be appropriate for workers managing a sick employee if that employee has signs or symptoms of COVID-19. If respirators are needed, they must be used in the context of a comprehensive respiratory protection program that includes medical exams, fit testing, and training in accordance with OSHA’s Respiratory Protection standardexternal icon (29 CFR 1910.134).
If a worker is confirmed to have COVID-19 (regardless of whether that has had symptoms of COVID-19), employers should inform anyone they have come into contact with (including fellow workers, inspectors, graders, etc.) of their possible exposure to COVID-19 in the workplace, but should maintain confidentiality as required by the Americans with Disabilities Act (ADA). The employer should instruct fellow workers about how to proceed based on the CDC Public Health Recommendations for Community-Related Exposure.
If a worker becomes or reports being sick, or testing positive for COVID-19,  disinfect the workstation used and any tools handled by the worker.
Employers should work with state, local, tribal, and/or territorial health officials to facilitate the identification of other exposed and potentially exposed individuals, such as coworkers in a plant.
On-site healthcare personnel, such as facility nurses or emergency medical technicians, should follow appropriate CDC and OSHAexternal icon guidance for healthcare and emergency response personnel.
Addressing return to work

Critical infrastructure employers have an obligation to manage the continuation of work and return to work of their workers in ways that best protect the health of workers, their coworkers, and the general public. Employers should consider providing screening and ongoing medical monitoring of these workers, ensuring they wear an appropriate source control device (e.g cloth face covering and/or face shield) in accordance with CDC and OSHA guidance and any state or local requirements, and implementing social distancing to minimize the chances of workers exposing one another.
Critical infrastructure employers should continue to minimize the number of workers present at work sites, balancing the need to protect workers with support for continuing critical operations.
Reintegration (bringing back) of exposed, asymptomatic workers to on-site operations should follow the CDC Critical Infrastructure Guidance. The guidance advises that employers may permit workers who have been exposed to COVID-19, but remain without symptoms, to continue to work, provided they adhere to additional safety precautions. This option should be used as a last resort and only in limited circumstances, such as when cessation of operation of a facility may cause serious harm or danger to public health or safety. Consultation with an occupational health provider and state and local health officials will help employers develop the most appropriate plan.
Reintegration of workers with COVID-19 (COVID-19 positive), including those workers who have remained asymptomatic, to on-site operations should follow the CDC interim guidance, “Discontinuation of Isolation for Persons with COVID-19 Not in Healthcare Settings.” As noted above, consultation with an occupational health provider and state and local health officials will help employers develop the most appropriate plan.

As employers move forward with continuing essential work, they should implement strategies to prioritize positions without which critical work would stop. This prioritization should include an analysis of work tasks, workforce availability at specific work sites, and assessment of hazards associated with the tasks and work site. Employers may be able to cross-train workers to perform critical duties at a work site to minimize the total number of workers needed to continue operations.
For workers who have had signs/symptoms of COVID-19
Both workers with COVID-19 who have symptoms and those that have tested positive for COVID-19and have stayed home (home isolated) should not return to work until they have met the criteria to discontinue home isolation, and have consulted with their healthcare providers and state and local health departments.
The situation is constantly changing, so employers of critical infrastructure workers will need to continue to reassess the virus’s transmission levels in their area and follow recommendations from local, state, and federal officials. This guidance does not replace state and local directives for businesses.
Personal protective equipment
Employers must conduct a hazard assessment to determine if hazards for which workers need PPE are present, or are likely to be present. OSHA’s PPE standardsexternal icon (29 CFR 1910 Subpart I) require employers to select and provide appropriate PPE to protect workers from hazards identified in the hazard assessment. The results of that assessment will be the basis of workplace controls (including PPE) needed to protect workers.
Employers should:

Face shields may serve as both PPE and source control:

If helmets are being used, use face shields designed to attach to helmets.
Face shields can provide additional protection from both potential process-related splashes and potential person-to-person droplet spread.

Safety glasses may fog up when used in combination with masks or cloth face coverings.
Only some face shields are acceptable substitutions for eye protection (such as safety glasses) that are used for impact protection; facilities should consult with an occupational safety and health professional concerning the use of face shields.

Face shields can help minimize contamination of masks and cloth face coverings.
If used, face shields should be cleaned and decontaminated after each shift, and when not in use they should be kept in a clean location at the work facility.
If used, face shields should also wrap around the sides of the wearer’s face and extend to below the chin.

Employers should stress hand hygiene before and after handling all PPE. Employers in manufacturing industries should continue to stay up to date on the most current guidance concerning PPE.
As part of their hazard assessments, employers must always consider whether PPE is necessary to protect workers. Specifically, when engineering and administrative controls are difficult to maintain and there may be exposure to other workplace hazards, such disinfectants used for facility cleaning, PPE should be considered.
During the COVID-19 pandemic, manufacturing employers should consider allowing voluntary use of filtering facepiece respirators (such as an N95, if available) for their workers, even if respirators are not normally required. Employers who permit voluntary use of respirators must comply with applicable provisions of OSHA’s Respiratory Protection standardexternal icon (29 CFR 1910.134), including proving a copy of Appendix D – Information for Employees Using Respirators When Not Required Under Standardexternal icon to employees who use such equipment.
In addition to face shields as noted above, workers in manufacturing facilities may need PPE such as gloves, face and eye protection, and other types of PPE when cleaning and disinfecting manufacturing plants (including frequently touched surfaces), tools, and equipment.
When PPE is needed, employers should consider additional hazards created by poorly fitting PPE (e.g., mask ties that dangle or catch, PPE that is loose and requires frequent adjustment or tends to fall off), including hazards resulting from use of such PPE in a particular work environment (e.g., where workers are around machinery in which PPE could get caught).
Workers’ rights
Section 11(c)external icon of the Occupational Safety and Health Act of 1970external icon (29 USC 660(c)) prohibits employers from retaliating against workers for raising concerns about safety and health conditions. Additionally, OSHA’s Whistleblower Protection Programexternal icon enforces the provisions of more than 20 industry-specific federal laws protecting employees from retaliation for raising or reporting concerns about hazards or violations of various airline, commercial motor carrier, consumer product, environmental, financial reform, food safety, health insurance reform, motor vehicle safety, nuclear, pipeline, public transportation agency, railroad, maritime, securities, and tax laws. OSHA encourages workers who suffer such retaliation to submit a complaint to OSHAexternal icon as soon as possible in order to file their complaint within the legal time limits, some of which may be as short as 30 days from the date they learned of or experienced retaliation. An employee can file a complaint with OSHA by visiting or calling his or her local OSHA office; sending a written complaint via fax, mail, or email to the closest OSHA office; or filing a complaint onlineexternal icon. No particular form is required, and complaints may be submitted in any language.
OSHA provides recommendations intended to assist employers in creating workplaces that are free of retaliation and guidance to employers on how to properly respond to workers who may complain about workplace hazards or potential violations of federal laws. OSHA urges employers to review its publication Recommended Practices for Anti-Retaliation Programs pdf icon[569 KB, 12 Pages]external icon.
[1] Employers should evaluate the burdens and benefits of recording workers’ temperatures or asking them to complete written questionnaires. These types of written products become records that must be retained for the duration of the workers’ employment plus 30 years. See OSHA’s Access to Employee Exposure and Medical Records standard (29 CFR 1910.1020external icon).
Quick reference guides for manufacturing facility employees and employers
CDC has also developed three one-page flyers with recommendations and strategies for preventing the spread of COVID-19 in manufacturing facilities and when carpooling to and from work. These include: