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An epidemiologist on what steps to take if you are preparing to reopen your business

Balance an awareness of your community’s conditions alongside the the needs of your employees. From there, break down the specifics of each precaution to make sure you are being as thorough as possible to protect every individual’s health.

An epidemiologist on what steps to take if you are preparing to reopen your business
Brick House Salon co-owner Jenni Morgan cleans up as she prepares to open for business later this week on April 28, 2020 in Greeley, Colorado. [Photo: Michael Ciaglo/Getty Images]

In the past week, many states took the first steps to reopen their economies. For some other locations, the reopening of their businesses may still be months away.

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But regardless of timing, it is a good idea for businesses to start planning for the circumstances of a reopening in order to keep their employees and customers safe. As we’ve already learned in this pandemic, it never hurts to plan ahead.

As part of this planning, it’s important to remember that pandemics typically come in waves, and we are likely to see resurgence at some point. This means we need to monitor illness vigilantly, and if we see a rise in cases, we may need to return to a state of more stringent physical distancing. Therefore, businesses need to have plans in place covering a few essential steps, which include monitoring employee illness and absenteeism, quickly identifying and isolating ill employees, and setting thresholds for the return of stringent physical distancing measures.

Community considerations

No matter where your workplace is situated, each community should practice situational awareness.

First and foremost, a community really should not reopen unless we are seeing, not just a flattening of the curve, but a downward trend in the number of cases. In addition, to prevent a large resurgence in illness and death, a community should aim to rapidly test, track, and terminate transmission prior to an economic reopening. Here what each of these transmission steps entail.

  • Test. Ideally, the community would have the capability to rapidly test a large percentage of the population and first send back to work those who are immune or recovered from the virus (and who do not fall into a high risk category). In addition they would need to be able to test quickly to identify any new cases that emerge. So the availability and accessibility of testing in a given location will be a key consideration in the timing of reopening.
  • Track. The community would also hopefully have an enhanced ability to identify and track people who developed illness, and trace their contacts. This is traditionally a function conducted by local and state health departments, but we are starting to see private sector apps and other mechanisms to assist with this function.
  • Terminate. Finally, there would need to be the ability to rapidly disrupt transmission, by ensuring individuals who are newly infected with the virus, and their contacts, are kept away from others, so it does not spread further and rapidly. This will require strong public health guidelines and communication channels between local or state health departments and employers, as well as preparations to reintroduce more stringent physical distancing policies if needed.

Situational awareness will be key. Businesses should incorporate mechanisms into their planning to keep abreast of what is happening in communities where their offices are located. Consider designating a COVID-19 coordinator at each location to monitor the local news, healthcare websites, and social media channels to keep you updated on the situation.

Employer considerations

  • Occupation types. The type of work your employees do is arguably one of the most important initial considerations. If they must work in close proximity to others due to the nature of their work, you will need to consider the types of personal protective equipment they may need.  If they interact with the public, you may need to install plastic sneeze guards or require cloth face coverings for both customers and workers.
  • Location. Review the rate of illness according to your business’s state and county. Take a look at whether the curve in your area is climbing, flattening, or following a downward slope. Stay abreast of changes in local shelter-in-place mandates and the availability of public transportation, if that is a major method of employee commute. In addition, check whether area childcare centers are reopening, as this may affect the ability of parents to return to work.
  • Lab testing. Ensure that you have a solid understanding of the availability of lab testing in the communities where your employees are located and the quality of the tests being offered. If you have the capability of offering testing to your employees, this can help reduce the risk of a widespread outbreak spreading quickly among your employees. Be sure to consider how you will get your employees access to this testing as well.
  • Symptom monitoring. One of the key factors for successfully continuing business operations while keeping employees and customers safe is to rapidly detect new cases of illness and prevent further spread in the workplace. This may involve asking employees to use a symptom checker daily, prior to arriving to work, so they stay home if they are experiencing cough, loss of smell, shortness of breath, fever, or other symptoms. Temperature screenings at workplace entry can offer an additional layer of protection against viral spread. If an employee is identified as being ill, their close contacts at the workplace will need to be notified and quarantined in accordance with the latest CDC guidelines.
  • Infection control. If possible, increase the frequency of environmental cleaning and consider engineering controls that may reduce viral spread, like, markers indicating six feet of distance, sneeze guards, or HVAC upgrades. Provide basic infection control training for employees prior to their return to work (for instance, on how to properly wear a cloth face covering, wash hands, and gauge six feet of distance.) Train supervisors and HR teams on symptom reporting and protocols for sending ill employees home.
  • Communications. Provide clear, concise messaging in and around your workplace before reopening. Signage at entry points, such as near elevators, doors, bathrooms, and common areas regarding physical distancing, mask usage, temperature requirements, handwashing, and environmental cleaning should be highly visible. Consider setting up regular employee communication channels, through virtual town halls or Q&A sessions with clinical experts to calm fears and dispel myths. And make sure clinical guidance is readily available to your employees, through access to telehealth providers or clinician hotlines.
  • Legal. Are you following the latest guidelines from the EEOC, OSHA, CDC, and others, as it pertains to pandemic situations? Ensure your legal team has briefed you on each of these and is actively monitoring what will likely be constantly evolving guidelines.

Thinking through these considerations, as well as maintaining situational awareness of the communities in which your business operates, will be the key to successfully reopening. Also, having clear access to clinical and epidemiologic expertise may be critical in navigating the clinical uncertainties in the road ahead. Look to bolster your access to healthcare experts and medical help as our country moves into next phases of the pandemic.

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Dr. Tista Ghosh is the senior medical director and epidemiologist for Grand Rounds. Trained in both internal and preventive medicine, Dr. Ghosh previously served as Colorado’s chief medical officer and as a member of the CDC’s preventive services task force.

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