RBA Consulting: Workplace Outbreak Preparedness and Response

Workplace outbreak preparedness and response scenario

1. Basic concepts

• Coronaviruses are a large family of viruses. They can cause illnesses ranging from common colds to severe disease, including SARS, identified in 2002, and MERS, identified in 2012.
• COVID-19 symptoms can include fever, cough and breathing difficulties. Some cases progress to severe illness; older people and people with certain underlying conditions are at higher risk. Symptoms and severity vary, so assessment should follow current medical guidance.
• Infectious diseases are caused by pathogens and may spread directly or indirectly. Transmission routes differ by disease and may involve respiratory particles, food or water, blood, bodily fluids, contaminated surfaces or vectors.

An infectious disease has a causative agent and may spread in a community. Its course varies by pathogen and individual; not every case follows all of the stages below.

A general teaching framework describes the following stages:

1. Incubation: the interval between infection and the first symptoms.
2. Onset: initial clinical symptoms become apparent.
3. Acute illness: symptoms may be most evident; clinical assessment and appropriate tests help guide diagnosis and care. Complications may occur.
4. Decline: symptoms begin to improve, although complications or other infections may still require medical assessment.
5. Recovery: strength and normal function return at a pace that varies among individuals. The distinction between decline and recovery is not always clear.

• An outbreak is an occurrence of cases above what is normally expected for a particular population, place and period. A fixed two-week duration or one disease-specific numeric threshold is not a universal definition.

2. Prevention

General prevention measures should be chosen for the disease and its transmission routes:

• Vaccination: use available vaccines according to current health-authority recommendations and individual eligibility. Vaccines help reduce the risk of disease or severe outcomes; protection and effects on transmission differ by vaccine and pathogen.
• Personal hygiene: clean hands at appropriate times, including before eating and after using the toilet; maintain oral and skin hygiene. Respiratory protection is relevant in appropriate risk settings, while mosquito protection is relevant to vector-borne disease.
• Food and water safety: cook food adequately, use safe drinking water, store prepared food appropriately, protect it from pests, and separate raw and cooked food equipment to help reduce foodborne infections.
• Environmental hygiene: provide safe water, manage human and animal waste, collect refuse, and remove mosquito-breeding sites. Vector-control measures should follow local public-health guidance.
• Prevention of sexually transmitted and bloodborne infections: use appropriate barrier protection, testing and healthcare advice, and do not share injecting equipment. Prevention should be based on exposure risk and evidence, without stigmatising groups of people.

Measures relevant to COVID-19 include:

• Vaccination: COVID-19 vaccines are available. Follow current health-authority recommendations and advice appropriate to the worker’s health status.
• Avoid close contact with people who are unwell where possible, avoid touching the eyes, nose and mouth with unclean hands, and wash hands thoroughly with soap and water.
• Improve ventilation and the appropriate supply of outdoor air; maintain ventilation and air-conditioning systems. Setting an air conditioner to 25°C or above does not by itself prevent COVID-19 transmission.
• Use a well-fitting mask covering the nose, mouth and chin in relevant risk situations, particularly crowded or poorly ventilated settings, following current guidance.
• If unwell, stay home where possible and avoid exposing other people; seek appropriate medical advice when needed.
• Cover coughs and sneezes and clean frequently touched surfaces as appropriate. Combine measures according to risk and current guidance.

References: WHO public advice on COVID-19 and ventilation and air conditioning .

3. Organising the workplace response

• Establish a prevention and response committee; arrange reporting, first aid and access to appropriate medical assessment and treatment.
• Implement isolation, cleaning and disinfection as directed by competent health authorities and qualified personnel.

Example epidemic prevention and response organisation chart

Historical workplace outbreak response workflow

Emergency contact register — complete and verify before use