How to Return to Work Safely

Most people have little control over when or whether they can — or have to — go back to work, as health officials, politicians, and companies make decisions about restarting the economy. But there are several steps many workers can take, particularly office workers, to reduce the risk of infection for themselves and co-workers when they do go back. These measures dovetail with preventive steps bosses and business owners can take in order to avoid fresh outbreaks and keep their workers safe.

Beyond ensuring adequate testing and contact tracing for Covid-19, the most important measure to help prevent the spread of the disease in the workplace involves bringing only critical workers back initially — the minimum needed to get a given business rolling, says Joseph Allen, DSc, assistant professor of exposure-assessment science at Harvard T.H. Chan School of Public Health.

Beyond that, the solutions are many, and they should all be employed. “There’s no silver bullet here,” says Allen, a forensic investigator of sick buildings, in which employees fall ill due to mold, bacteria, or other pathogens that often prove difficult to find, and co-author of the new book Healthy Buildings.

How Covid-19 spreads

Understanding the range of protective measures requires an understanding of the ways SARS-CoV-2, the coronavirus that causes Covid-19, is now thought to spread:

• By direct contact with an infected person
• When infected respiratory droplets from a cough, a sneeze, talking, laughing, singing, or breathing fall to surfaces that are then touched by another person
• When smaller infected droplets, called aerosols, stay suspended in the air for several minutes and are inhaled or ingested by others
• Through human poop (yes, you heard right)

“The question of which mode dominates is largely irrelevant,” Allen argues. It doesn’t matter if a given infectious pathway is responsible for 2% or 50% of cases, and we may never find out (these percentages are not known for the flu, he points out). What matters is taking precautions to limit each form of spread.

“We should be throwing everything we have at this virus, which includes controls for all modes of transmission,” Allen told reporters in a conference call in April.

His suggestions reflect best practices to prepare workplaces for Covid-19 adopted by the federal Occupational Safety and Health Administration (OSHA).

Allen lays out three pillars for a safer workplace:

Improve sanitization

Sanitizing commonly touched surfaces at work — door handles, elevator buttons, desks, phones, coffee machines — is obviously vital. While it’s conceivable employees could help with this, the task is not small, and employers must do the bulk of the dirty work themselves or hire professionals. It involves a two-step process of cleaning with soap and water and then sanitizing with a disinfectant such as a diluted solution of bleach or isopropyl alcohol (the CDC has instructions here).

If there’s an exhaust fan, leave it running when you leave the bathroom. Don’t go into the bathroom right after someone else. And, of course, wash your hands properly and often.

There are additional risks you may be less aware of lurking in the bathroom, which you can help lessen.

Flushing a toilet generates aerosols that can float around for up to 30 minutes, research finds. If that toilet contains the feces of an infected person, well, you get the idea. The remedies are simple: If the toilet has a lid, close it before flushing, Allen suggests. If there’s an exhaust fan, leave it running when you leave the bathroom. Don’t go into the bathroom right after someone else. And, of course, wash your hands properly and often.

Companies with the means could use the current downtime to consider installing touch-free faucets and toilets and even touch-free bathroom doors, Allen suggests.

Improve ventilation and filtration

The World Health Organization and the U.S. Centers for Disease Control and Prevention have been slow to emphasize that the coronavirus may be spreading through the air, beyond the six feet typically advised for physical separation, Allen and other experts have argued. “There are many of us in my field that are convinced that the science says airborne transmission is happening.”

To visualize why this matters, think of someone with bad breath, Allen suggests. “When you’re really close to them or right in front of them, you know it. But further away, they’re still emitting but it’s not going to be as potent.” It’s similar with the coronavirus. Larger respiratory droplets will fall nearby. Aerosols will waft and disperse.

Scientists don’t know how many coronavirus particles it takes to make someone sick, but experience with other viral diseases suggests the dose matters. Therefore, Allen says, it’s important to dilute the concentration in a given space. That can be done simply by opening windows. Several studies have shown that increasing ventilation by opening windows reduces the spread of disease in general.

Employers should install high-grade filters (with a rating of MERV 13 or better) in their heating, ventilation, and air conditioning (HVAC) systems, Allen says. “It doesn’t really cost all that much to upgrade your filter to a higher grade,” he points out. It’s not entirely clear how effective this can be, however.

“Filtration in building heating, ventilation, and air conditioning (HVAC) systems can be a part of an overall risk mitigation approach but is not generally regarded as a solution by itself,” states the National Air Filtration Association, a nonprofit that represents the industry. “There is no direct scientific evidence of benefit, but some reduced exposure can reasonably be inferred based on the ability of some filters to remove particles that contain a SARS-CoV-2 virus.”

Portable air purifiers, though not cheap, can also reduce risk, Allen says. High-quality air purifiers, including those with HEPA filters, can indeed remove germs from the environment, and experts think this is true for the coronavirus, according to Consumer Reports.

Reduce density and don’t mask the realities

Today’s open office plans, with desks crowded next to each other and cubicle walls removed, present unique challenges amid a viral pandemic. But the challenges can be overcome, Allen says.

First, as more and more workers return, businesses should consider creating separate shifts, or alternate work days, so fewer people are in the office at a given time. Conference rooms should be closed.

There are ways to improve physical distancing that employees can implement, too. If your desk faces another, try moving them to create an offset angle so respiratory droplets and aerosols are directed into walls or open aisles instead of directly at each other.

Some businesses are considering the installation of plexiglass barriers between office workstations, and even a possible return to the once outdated cubicle.

Somewhat surprisingly, the least effective measure, in the grand scheme of protecting most workers outside of health care professionals and first responders, is wearing a mask or other personal protective equipment (PPE), Allen and other experts say.

Do it, they advise, but just know that it comes after all the priorities above in terms of effectiveness. “There’s a role for PPE, for sure,” he says. But he’s concerned employers will consider PPE the best or only defense. “You don’t give someone a mask and say ‘Well, our responsibilities are done.’”

Whether employees are encouraged or required to wear face masks will come down to state and local health department guidelines or individual company decisions. There’s no “law of the land” on this. “If public health professionals recommend widespread use of PPE, such as masks, it will require clarity as to what is needed and who is responsible for providing such equipment, especially if shortages persist,” Suzanne Clark, president of the U.S. Chamber of Commerce, said in a letter to members last month. If face masks are to be relied on, people need to know how to wear them properly.

Allen advises masks especially in areas where employees gather, and particularly in elevators.

New York City’s Health Department, which knows a thing or two about elevators, suggests the buttons be sanitized regularly, and everyone should maintain the six-foot separation rule, in line and inside the elevator. Yes, that means a potentially long wait or, as the city suggests, taking the stairs.

OSHA also advises companies to provide hand sanitizer and additional tissue boxes and trash receptacles, to actively promote proper hygiene, and to encourage sick employees to stay home. The agency provides more in-depth advice based on exposure risks that differ by job type, such as controlling the number of customers in a retail store or providing gloves and eye protection to employees in high-risk jobs.

Allen stresses that none of these measures will make sense if we don’t first have wide-scale testing to know when people are infected or if they might be immune, and widespread contact tracing to notify people who might have contracted the disease. And, he says, nothing will eliminate all the risk as decisions are made to get the economy rolling again.

“There’s no such thing as zero risk,” he says. “The goal here is to minimize risk.”