2019 Novel Coronavirus (SARS-CoV-2/COVID-19)

As part of a strategy aimed to limited continued COVID-19 spread in US communities, the US government has recommended that all travelers stay home voluntarily for 14 days after traveling from countries with widespread ongoing transmission or on cruise ships or river cruises. DCHHS is contacting people who recently traveled to countries that are classified by CDC as level 3 travel health notice due to COVID-19. 

Guidance for Social Distancing

Due to your potential exposure to COVID-19 infection during travel, as much as possible: 

• Stay at home until 14 days after arrival, except to get essential medical care, as much as possible. Do not go to work or school and avoid public areas (e.g., shopping centers, movie theaters, stadiums, etc.) and public transportation, including rideshare and taxis.
• Call ahead before visiting your doctor and reschedule all non-essential medical appointments.
• Separate yourself from others in the home and maintain a distance of at least 6 feet (2 meters) from others.
• Avoid contact with people at higher risk for severe illness (unless they live in the same home and had same exposure)
• Cover your coughs and sneezes.
• Wash your hands and avoid touching your eyes, nose, and mouth.
• Avoid sharing household items like dishes, cups, eating utensils, and bedding.
• Postpone long-distance travel as you may be unable to return if you become symptomatic.
• Monitor your symptoms for 14 days after you were exposed. Watch for: fever (> 100.4°F; take your temperature twice a day), coughing, difficulty breathing or shortness of breath, body aches, sore throat, headache, diarrhea and/or vomiting

If you develop fever or any of the symptoms listed above AT ANY TIME:

1. Follow the CDC's recommendations for what to do if you are sick with COVID-19 or think you might have COVID-19.
2. Call your healthcare provider right away or visit one of our drive-thru testing locations.
   • If your symptoms are mild, you may want to use the CDC's Coronavirus Self-Checker to answer questions about your symptoms and receive guidance to help you make a decision on whether or not to seek medical care. 
3. Before going to your medical appointment, be sure to tell your healthcare provider about your travel or your close contact with someone who is confirmed to have, or being evaluated for, COVID-19 infection. This will help the healthcare provider’s office take steps to keep other people from getting infected.

Resources:

• 14-Day Symptom Monitoring Log (简体中文)
• What to do if you have symptoms of COVID-19 and have not been around anyone who has been diagnosed with COVID-19, updated 7/23/20 (DCHHS)
• What to do if you have confirmed or suspected COVID-19, updated 7/23/20 (DCHHS)
• What To Do If You Are Sick with COVID-19 Information Sheet (简体中文) (CDC)
• Please visit https://dshs.texas.gov/coronavirus/ for the most up-to-date and accurate information about COVID-19 in Dallas County.
• Please visit the CDC website for the most up-to-date information nationally.

If you need to seek medical care for other reasons, such as dialysis, call ahead to your doctor and tell them about your recent travel to an area with widespread or ongoing community spread of COVID-19.

Many parents and school officials have expressed concern about school closures due to COVID-19. If there was a case of COVID-19 at a school, we would work closely with that school to issue recommendations that are made with consideration to student and staff health and safety, how to continue learning, and impact on the community. 

What Schools Can Do

• FAQ Health Authority Order for Public and Private Schools
• School nurses: If a child presents symptoms of respiratory illness, they should be masked and sent home. 
• Implement your annual seasonal influenza plan.
  • Students and staff who are ill, especially with acute respiratory symptoms (not allergies or chronic conditions), should stay home. 
  • Review sick policies for staff; ensure staff can stay home when ill. 
• Ensure prescribed cleaning is happening at school facilities (routine disinfectants are appropriate).
  • Enhance cleaning of high touch surfaces like door knobs, toilet handles, and sink handles. 
  • Ensure that hand sanitizer, soap/paper towels and tissues are widely available in school facilities. 
  • Remind students to cover their coughs/sneezes with a tissue or their elbow. 
• Ensure parents/guardians have a plan to designate a caregiver for a sick child(ren) if parents/guardians can’t stay home. 
• Look for opportunities to address food insecurity for families who rely on schools for breakfast and/or lunch. 
• Identify at-home learning opportunities during student absences or school closures. 
• Identify how the school will communicate updates to parents/guardians. 

Guidance from the CDC

• Interim Guidance for Childcare Programs and K-12 Schools

• Childcare and Schools
  • Resources for K-12 Schools and Childcare Programs (CDC)
• Colleges and Universities
  • Resources for Institutes of Higher Education (CDC)

Public Health Resources

• DCHHS K-12 School Reopening Guidance, 9/11/20
• DCHHS COVID-19 Screening Tool for K-12 School Settings, 8/11/20
• DCHHS COVID-19 Case Report Form for Childcare Programs and K-12 Schools, 8/20/20
• DCHHS Interim Recommendations for Childcare Programs and Providers, 7/19/20
  
  

Countering Stigma and Bullying

• Fighting Stigma and Bullying (MCDPH)
• Stigma Related to COVID-19 (CDC)
• Share Facts, Not Fear (CDC)

Infographics and Helpful Resources

• Stop the Spread of Germs (CDC)
• Does your school's infection control plan stand up to COVID-19? (Texas Medical Association)
• Decision Tree Tool For School Nurses (Texas Medical Association)
• School Attendance, Asthma and COVID-19 (American Academy of Allergy Asthma & Immunology)

Planning Considerations

Businesses should review their Continuity of Operations Plan or Business Continuity Plan. 

A Continuity of Operations Plan (COOP) or Business Continuity Plan (BCP) outlines the job or service functions that are essential to keeping the business operational. Essential functions are often tied to public safety and health, job functions tied to laws or administrative codes and those functions that keep the business open. A healthy COOP or BCP plan will include:

• Details of the essential functions
• Key staff who perform the essential functions
• List of essential records, contracts and important information needed to keep the functions running
• Cross-trained personnel who can perform essential functions

Businesses should prepare for social distancing and absenteeism

Businesses should include ways to reduce interactions amongst employees. Explore whether you can establish policies and practices, such as flexible worksites, teleworking, flexible work hours (e.g., staggered shifts), to increase the physical distance among employees and between employees.

Be flexible with employees who become ill. It’s important that employees with signs of respiratory illness (fever and cough) stay home and seek medical care. Some employees with recent travel to a Level 3 Country may be placed under quarantine for 14 days.

DO NOT require proof of a negative COVID-19 test before employees return to work.  

For more guidance on COOP or BCP planning, visit ready.gov/business 

Response Considerations

Provide alcohol-based (60%) hand sanitizers for use for both employees and customers by placing them at convenient/accessible locations.

Actively encourage sick employees to stay home:

• Dallas County Health and Human Services recommends employees who have COVID-19 symptoms to follow the CDC guidelines for what to do if you are sick. This recommendation applies regardless of whether the individual has been tested for COVID-19 and is advised to reduce overall risk of transmission of flu-like symptoms before returning to work. Employees should notify their supervisor and stay home if they are sick.
• Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are aware of these policies.
• Talk with companies that provide your business with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
• Do NOT require a healthcare provider’s note for employees who are sick with acute respiratory illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and not able to provide such documentation in a timely way.
• Do NOT require a negative COVID-19 test for employees to return to work.
• Public Health WILL NOT contact every business to notify them of employees who are positive for COVID-19. Notification to businesses depends on case investigation information, potential exposure and whether the employee was in a high-risk job (e.g., healthcare).
• Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.
• Encourage sick staff to use telehealth if available.

Separate sick employees:

• CDC recommends that employees who appear to have acute respiratory illness symptoms (i.e. cough, shortness of breath) upon arrival to work or become sick during the day should be separated from other employees and be sent home immediately. While at work, sick employees should cover their noses and mouths with a tissue when coughing or sneezing (or an elbow or shoulder if no tissue is available).
• Have sick employees follow CDC guidelines for what to do if you are sick.

Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees:

• Place posters that encourage staying home when sick, cough and sneeze etiquette, and hand hygiene at the entrance to your workplace and in other workplace areas where they are likely to be seen.
• Provide tissues and no-touch disposal receptacles for use by employees.
• Instruct employees to clean their hands often with an alcohol-based hand sanitizer that contains at least 60-95% alcohol,or wash their hands with soap and water for at least 20 seconds. Soap and water should be used preferentially if hands are visibly dirty.
• Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. Place hand rubs in multiple locations or in conference rooms to encourage hand hygiene.
• Visit the coughing and sneezing etiquette and clean hands webpage for more information.

Perform routine environmental cleaning:

• Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
• Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.

Advise employees before traveling to take certain steps:

• Check the CDC’s Traveler’s Health Notices for the latest guidance and recommendations for each country to which you will travel. Specific travel information for travelers going to and returning from China, and information for aircrew, can be found at on the CDC website.
• Advise employees to check themselves for symptoms of acute respiratory illness before starting travel and notify their supervisor and stay home if they are sick.
• Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor and should promptly call a healthcare provider for advice if needed.
• If outside the United States, sick employees should follow your company’s policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas

• Interim Guidance for Businesses and Employers to Plan and Respond to 2019 Novel Coronavirus (SARS-CoV-2)
• CDC guidance for Travelers and Airline Crew provides interim recommendations for the commercial airline industry about the 2019 novel coronavirus (SARS-CoV-2)
• Environmental Cleaning and Disinfection Recommendations for U.S. Community Facilities with Suspected/Confirmed COVID-19 (CDC)

Please see the following CDC link for business/employer guidance and cleaning and disinfection recommendations: Resources for Businesses and Employers (CDC)

OSHA

• Occupational Health and Safety Administration (OSHA) and Centers for Disease Control and Prevention (CDC) have issued interim recommendations to help prevent workplace exposure and transmission of 2019 novel coronavirus (SARS-CoV-2)