General advices for daily life in pandemic situation COVID-19 (in Spain).

“The aim is to have the correct and useful information spreading faster than coronavirus infection “.

COVID-19: is the disease that causes the type of coronavirus (SARS-CoV-2)  COronaVIrus Disease, discovered in 2019.

Life has changed us. Many of these exceptional measures will have to be done on a daily basis.

We will have to educate ourselves and educate our own. Especially to children.

How Does Coronavirus Spread?

• Droplets: less than 2 meters from the infected when the contaminated particles of a person are deposited in mucosa such as the mouth, nose and eyes, which are not protected.
• Airborne: 4 meters. So far, the WHO has no evidence that it is transmitted by the outside air we breathe. It could be transmitted in an environment “loaded” with particles of the coronavirus (air that has the virus floating in it), since there are many contaminated people living in it or in the hospital areas where infected patients are, when the healthcare provider must perform special maneuvers, so they must work very protected .
• Surfaces: when we touch and drag coronavirus particles deposited on contaminated surfaces and then move them to the mucous membranes like the mouth, nose and eyes, which are not protected.

 

We must act as individuals and as a family or collective group and we must also act as a employed in our job enviroment.

 

The main objectives are:

• PROTECT the weakest people against the COVID-19 disease
• AVOID contagion between people (droplets/airborne)
• DISINFECT contact surfaces to avoid contagion

First! You have to make a family plan.

a) Identify family members at risk.

Today, graphically we can stratify our family members according to the risk of suffering major clinical complications based on a traffic light (4-lights)
They are based on published epidemiological data, but this does not mean that a person who is not “at risk” cannot suffer a clinical complication.

 

With people in red or in orange we would have, these days, to push security measures to the limit.

b) People in red or orange. Act with restrictive contact measures, such as:

• Safety distance of 2 meters.
• Wear mask.
• Si las personas son dependientes, para atenderlos deberemos lavarnos las manos con agua y jabón (30-40 segundos), lavar entre los dedo If people are dependent, to attend to them we must wash our hands with soap and water, lasting (30-40 seconds). Remember that we must wash our hands also between the fingers.
• People in red/orange must have their own crockery, towells, handkerchief and napkin.
• If possible, do not go outside to buy. If there is no other choice, use a mask and disposable gloves.

Second! You have to carry out an individual routine.

a) Mask and gloves.

Given the need to ration the use of masks. Its priority and necessary use is aimed at:

• Health personnel.
• Personnel of state security forces that care for people.
• Workers exposed to the public.
• If two people are traveling inside a vehicle (alarm state).
• Patients who go to hospital services.
• People with flu symptoms or symptoms compatible with COVID-19 (whether they are catarrhal or not) who live with others.
• Patients diagnosed with COVID-19 who live with others.
• Caregivers of patients suspected of having COVID-19 or patients in red or orange.

Its use is recommended in the following situations:

• When going to places where it is expected that there will be a crowded group of people (supermarket).
• To interact with other people who are exposed to the public (dispatching clients).
• Closed community areas (elevator).
• Public transport.

The Protection that wearing a mask gives us can be summed up by preventing our hand from going to our face the great number of times that we accidentally touch ourselves.

The protection we provide to others when wearing a mask is to “stop” our secretions as much as possible.

The “dangers of wearing a mask”:

• It should not be used more than 2-3 days in a row (inside it will be wet with our secretions).
• Masks should never be exchanged.
• Its use could give us “false security” we cannot touch the mask with our hands on the outside.
• They cannot be used on both sides, do not flip.
• Homemade mask, is the least safe for an infected patient (they should not be used in this situation).

Masks are classified according to “Filtering face piece” (FFP), their filtering capacity.

• FFP 3: 98% minimum filtration efficiency, 2% leakage to the outside. It is effective against bacteria, viruses and fungal spores. For high risk activities.
• FFP 2: 92% minimum filtration efficiency, 8% leakage to the outside. It prevents us from inhaling toxic fluids from dust, aerosols, and fumes. For activities with low or moderate risk.
• FFP 1: “Surgical mask” 78% minimum filtration efficiency, 22% leakage to the outside. Protects from non-toxic and non-fibrogenic residues from dust or aerosols. It prevents inhaling these and annoying odors.

The goal: the higher the risk of exposure, the better type of mask.

The WHO recommends for the correct use of a mask:

1. Before putting on a mask, we have to wash our hands with an alcohol-based disinfectant or soap and wáter.
2. Cover the mouth and nose with the mask, to make sure there are no gaps between your face and the mask.
3. Avoid touching the mask while wearing; if we touch it outside, we have to wash our hands with an alcohol-based disinfectant or with soap and wáter.
4. Change mask as soon as it is wet and do not reuse single-use ones.
5. To remove the mask: remove it from behind (do not touch the front of the mask); immediately throw it in a closed container; and wash your hands with an alcohol-based disinfectant or soap and wáter.

About the use of gloves.

There are many materials, the most recommended are vinyl or nitrile, since they are not usually allergenic, a phenomenon that can occur with latex gloves.

They do not need to be sterile.

Its use is necessary:

• For caring a COVID-19 patient and the disinfection of their areas of use. For the handling and removal of your waste.
• For handling products in a supermarket.
• For contact with people in red.
• For contact with community surfaces.

The mainly thing in the use of gloves is knowing how to take them off without contaminating us.

b) At home: disinfection and understanding eachother.

• Declare a “dirty area” and a “clean area” in the home. Street shoes and possibly contaminated clothing will remain in the dirty area (hall).
• If we live with dependent people (red), to attend to them we must wash our hands with soap and water (30-40 seconds), wash between the fingers.

· Wash your hands (WHO):

• Before handling cooked or ready-to-eat food.
• Before and after handling or preparing raw food.
• After handling packaged or packaged food.
• After handling waste.
• After cleaning tasks.
• Before and after using the bathroom.
• After blowing your nose, sneezing, or coughing.
• Before and after eating or drinking.
• After handling money, coins, plastics, or metal objects.

It is also useful:

• Separate crockery, cutlery and towels for people in red or orange. If we live together.
• If possible, people in red or orange, do not go outside to buy.
• Containers purchased from supermarkets, it is advisable to clean them with cloth and diluted bleach when you get home, “in the dirty area”.
• When cooking, avoid “cross contamination” between cooked and uncooked food.
• The 4 key steps in food safety are: cleaning, separating, cooking and cooling.
• Avoid drinking directly from cans or glass bottles.
• Do not eat (gum) in front of vulnerable people. It can increase the emission of particles. And needless to say, avoid sneezing. If it is going to happen, sneeze covering us with a handkerchief or putting the mouth in the flexion of the elbow.
• Disinfect surfaces such as cell phones, plastic cards, keys or coins.
• Do not share mobile or electronic tablets. Disinfect them before that, if necessary share them.

About rings and bracelets: some experts have been affirming that it is advisable not to wear them, since handwashing can be deficient in the areas of the fingers where they are, leaving remains without rinsing or areas where soap does not arrive. It is very important to wash the regions between the fingers well.

Disinfection.

• We know that household hygiene and cleaning with bleach and detergent is necessary, as usual. In this case, it is advisable to double the cleaning frequency.
• The biocidal disinfectant recommended for surfaces is bleach, since its effectiveness is very great. Bleach from supermarket have a concentration of 0.07%.
• You can prepare a container with bleach / detergent and water, with the ratio of one liter of water and a little cup of coffee plenty of bleach.
• It is also necessary to disinfect metal objects such as keys or coins, containers, plasticized, which you think have also been manipulated before by other people. With bleach diluted only with water. Alcohol can also be used 70-96º
• ATTENTION: do not mix bleach with vinegar, ammonia or salfuman. Neither the previous products among them, due to its high toxic power.

·Home ventilation.

The purpose of ventilation of closed spaces is to maintain good indoor air quality.

Overcrowding and the lack of “fresh air” are risk factors in the spread of the coronavirus.

Refrain from using mechanical ventilation in confined spaces (air conditioning) if you are not sure that good maintenance and recent disinfection have been carried out.

According to research, the coronavirus spreads better in a cold and dry environment than in a wet one.

c) Away from home: caution and civism.

· Community surface: any surface outside the home where we have the certainty that more than one person has touched. The virus can remain there for a while.

· We have the obligation to disinfect all our community surfaces (Patios, landings of the building, etc. …) As we have seen our millitary forces and municipal disinfection teams do. It also depends on us.

· We have to remain in our homes according to the orders of the public authorities. “Stay at home”.

-Distance between people at least 2 meters.

· Go to the supermarket with gloves (request them at the establishment) and a mask (as far as possible) and keep the safety distance from other customers.

· Inside an automobile.

• If your vehicle is for shared use with several drivers, previously clean the contact surface with 96ºC alcohol. Clean the seat belts.
• The use of a vehicle by two people must be adjusted to the requirements of the current alarm state. The members must be placed diagonally and with a mask.
• Avoid eating inside the vehicle. Do not drink directly from purchased cans or bottles. It is advisable to bring 96ºC alcohol or hydro alcohol gel for hand hygiene.
• If there are two people inside the vehicle or we must transport a person who is allegedly contaminated. Efforts must be made to increase ventilation and air renewal inside the vehicle. The filters of the air conditioners are NOT designed to retain or filter viruses, its use must be AVOIDED (do not put the air conditioning of the car). It is better to open all or part of the windows (depending on weather conditions).

· At work (non-sanitary).

• If teleworking is not possible and we have to work with several people, it is interesting to hold a meeting between the workers (safety distance) and the person in charge of the job, as well as follow the specific guidelines for each job, issued in the current situation, by the Ministry of Health (Spain).
• Design a structured work plan supported by labor institutions if it is possible.
• Perform work shifts to avoid a crowded work space.
• Clean the work area and objects or devices in contact with skin and mucosa.
• Do not share mobile phones or touch tablets (as far as possible) or clean them with 96ºC alcohol in advance, for one minute. Use the hands-free call.
• Use our own tools or disinfect it before sharing it. Wear gloves for contact.
• Avoid close contact. Maintain the safety distance of 1.5 to 2 meters. It is the least accomplished!
• Wear a mask for rhinitis, tearing or sneezing. Mask and gloves if the workplace is made up of several people or devices such as telephones, computer keyboards, etc. are going to be touched.
• If the job requires direct contact with people or customers. Use amask, gloves and protective barriers (methacrylate) with access and ease to the exchange of information and a transaction.

The Ministry of Health (Spain) has published guidelines called “buenas prácticas en los centros de trabajo”.

https://www.mscbs.gob.es/gabinetePrensa/notaPrensa/pdf/GUIA110420172227802.pdf

Summary and synthesis of the recommendations for reincorporation into workplaces and its relationship with potential exposure to COVID-19 (F.J. Zorrila Tuset. Higher technician in labor risk).

Staff access to the workplace

• For all those positions where teleworking can be carried out, this option will be used instead of traveling to the workplace. All those meetings that involve the movement of different workers between centers will be held, except for force majeure, by videoconference.
• It must be organized by the company so that the proper separation of 2 meters is guaranteed between any two people who access it. This entry and exit should be made considering the capacity of the center and the speed of entry of the staff, if necessary staggered shifts will be established.
• If agglomerations are foreseen, a person in charge of the organization and control of accesses and exits will be appointed, as well as the exterior signage of the appropriate locations in which those who are waiting to access the work center should be located to maintain a distance between them 2 meter security.
• The day registration system should not require physical contact with the equipment used.
• In the event that worker has to travel in a means of collective transport, the worker must be informed of the need to maintain the social safety distance recommended by the health authority with the rest of the users and, in the event that said safety cannot be guaranteed. measure, the worker must be equipped with adequate and effective means of individual protection (mask and gloves).
• The tourist-type work vehicles will only be occupied by the driver. If it is essential for two people to circulate in a vehicle, this will be done by traveling in the vehicle with the passenger in the rear seat opposite the diagonally facing driver and both occupants using disposable nitrile gloves and FFP2 masks. Every time the displacement is completed and prior to being used by another worker, the worker who completes his displacement will be responsible for disinfecting the contact points such as interior and exterior door handles, luggage compartment, handles and buttons, steering wheels, handbrake, gear shifting, seat belts etc.

Hygienic measures for all workers.

• Hand hygiene and a safety distance (2m) are the main measures for infection prevention and control.
• Cover your nose and mouth with a tissue when you cough and sneeze, and dispose of it in a trash can with a lid and pedal. If scarves are not available, use the inside of the elbow to avoid contaminating your hands. Avoid touching your eyes, nose, or mouth.
• The use of mask and gloves has been previously discussed.
• Avoid drinking or eating without previously washing your hands.
• Contaminated work clothes should be stored separately from street clothes, using separate lockers or bagging work clothes. For clothes, a full cycle wash is recommended at a temperature between 60 and 90º.

General measures for companies

• Inform all staff about COVID-19, its transmission routes and the individual preventive measures to be taken, emphasizing hygienic measures. So that the staff is familiar with the procedures of action in the event that a worker presents symptoms.
• The facilities will be ventilated frequently.
• If it is a matter of cleaning the facilities, with special attention to the surfaces that may be capable of favoring transmission.
• Hydroalcoholic solution dispensers for hand disinfection will be placed in areas that are in need.
• The resumption of activity should be guided by the principle of minimizing risk. Therefore, the return to normality of activities that carry a risk of crowding should take place last. In any case, you should avoid carrying out activities that involve crowds of people.
• Meetings involving a high concentration of workers in confined spaces will be limited to the maximum.
• Internal training courses that involve the movement of workers between provinces will be postponed, assisting different workers from different work centers.