By Dr Amar-Singh HSS
So you’ve got your mask and you’ve got your hand sanitisers. And you have prepared by learning about safe physical distancing, hand washing, dealing with contaminated surfaces and to keep away from crowds. But there’s much more to prepare for before returning to the office.
The lockdown (MCO) has done a very good job of decreasing the current wave of the pandemic, but it has pushed (deferred) the pandemic to a later date.
We need to work to prevent the second and subsequent waves of Covid-19, some of which may be even bigger than the first one. We are just starting out in this Covid-19 pandemic that is estimated to last one to two years or longer.
The Ministry of Health (MOH) staff have done a good job in helping to reduce the current hot spots, but we must realise that low-grade community spread of Covid-19 is still on-going; much of it asymptomatic.
We know the lockdown (MCO) strategy has been effective but is not sustainable in the long-run as it hurts the poor, businesses and causes collateral damage to other illnesses. To relax our lockdown, it has to be done in stages and with all Malaysians acting responsibly, maintaining vigilance and strict discipline.
We need to behave and act as though everyone around us is Covid-19 positive. We need to behave and act as though we have an asymptomatic infection of Covid-19 and can infect others. We need to protect all older persons as if they are our parents and all those vulnerable to Covid-19 as our sisters and brothers.
As you plan to return to the office, here is a checklist of some of the things you need to consider and prepare for:
- How are you going to manage public transport?
If you are using public transport to commute to and back from work, recognise that buses, trains and LRTs are higher risk for transmission, especially those with closed windows and air-conditioning.
Best to wear a mask and avoid touching your face, try and keep some distance from other passengers if possible, limit touching surface, sanitise your hands before getting on-board and once disembarking, and if possible open windows to increase airflow. Car-pooling is an option but you need to keep to the same group all the time.
- Has your office prepared a clear standard operating policy (SOP) or checklist to minimise the risk of staff getting the virus or spreading it?
Every office will need a SOP/checklist and will need to train all staff (virtually), including the cleaners and security guards, to ensure everyone is on the ‘same page’. Three SOPs I have written with colleagues, that may give ideas, can be found here: Child Care Centres, GPs, Supermarkets.
- How is the office building going to limit the number of people who enter and leave when coming to work and going home?
We need to prevent a mass entry and exodus of people. One way is to stagger entry and leaving times as well as consider having multiple exits and entrances. Consider foot-operated door openers or motion-sensor automatic office doors.
- Has your office thought about staggered working hours or work from home?
As we begin to open more offices it is important to offer, in the beginning, the possibility of staggered and reduced working hours. Some staff can come for the first half of the day (8am-12noon) and the others come in the second half of the day (1-5 pm).
Another option is for staff to take turns to come and work on alternate days. A clear work-from-home policy might be applicable for some staff, provided there are clear guidelines that do not allow the boss to disturb staff with emails/messages after working hours. All these initiatives will reduce crowding in the office.
- How is the office building going to handle lifts?
Lifts are a closed environment and, if packed, a high risk for transmission. Use the stairs if possible, otherwise have a limit to the number that can travel in the lift at any one time, with masks on and all facing different directions in the lift. We will need ‘standing spots’ (circles) marked out in all lifts. There will be a need to have 1-meter queue lines or circles outside the lift.
- What are you going to do about the office air-conditioning?
This is one of the most difficult areas to modify with the current structure of many of our offices. The US Centers for Disease Control (CDC) recommends “increase ventilation by opening windows or adjusting air conditioning”.
Consider installing high-quality air filters in offices to prevent re-circulated air from spreading the virus.
- How can we modify the open office environment?
An open office environment has a higher risk for the virus spreading. A recent Covid-19 outbreak at a call centre in South Korea on the 11th-floor resulted in 94 (43.5%) out of 216 employees being infected. It underscored the risk in a crowed office environment as well as the risk of an open-office setting.
Consider reducing the number of employees working at any one time (see staggered suggestions above) as well as putting up partitions between work stations. Seating arrangements should be such that staff are at least 1 to 2 meters distance apart.
Use floor marks around all work stations to indicate personal space that is not to be encroached on. Avoid co-working spaces or desk sharing. Consider looking at templates or office design online to help plan and reorganise your office environment. Consider looking at this new design concept called the “Six Feet Office”.
- How will you modify the office meeting?
Office meetings are high-risk events, especially if the meeting or discussion room is full. Plan to meet virtually, even when you are in the same building/office. Use conference and video call extensively and limit face-to-face meetings to a very small number of people that are spaced out in a room.
- How to avoid contamination of common used items?
It will be important to discourage the sharing of office supplies and equipment. Think how contact with the photocopy machines and printers can be minimised.
- How are you going to deal with the pantry, prayer areas and common staff areas?
These are recognised as very high-risk areas and should be avoided. Staff should be encouraged to bring packed food and eat at their own work station.
Be concerned about the frequently, commonly used office coffee maker; perhaps avoid its use for now. Prayer times may need to be staggered and prayer items like mats must not be shared.
- Have you a plan for mask safety and changing masks?
We are wearing masks primarily to protect others from our saliva droplets – I protect you and you protect me. We cannot be certain who is infected as many are asymptomatic. Different masks have different capability. Ideally N-95 and 3-ply surgical mask should be reserved for health care professionals.
When using cloth masks, remember that you will require at least two. Half way through a work day, at the meal break time, remove the used mask correctly and put it into a plastic bag. Wash your hands with soap and water (or alcohol-based hand sanitiser) and have your meal. Then clean hands again and wear the second clean mask. Remember to ensure the cleaning staff and security have adequate masks provided by the management.
- What is the plan to limit staff socialising?
Encourage staff not to socialise at the office, even in small groups, especially at arrival, lunch or when leaving. Instead, advise staff to confine communication to work-related needs.
- What is the policy for the toilets?
Toilets are high-risk surface contact areas and often poorly ventilated. There should be clear guidelines displayed on the toilet door (both sides) on steps to take to minimise contamination. Foot-operated soap dispensers and door openers would be ideal. As are elbow-operated or contactless tap-heads to enable easier hand washing.
Advise staff to close the toilet seat cover after using and before flushing, to reduce waste aerosol transmission. Door handles need to be disinfected by the person using the toilet when entering and leaving.
- What is the new cleaning routine for the office?
Clean and disinfect all frequently touched and common user surfaces in the office like door knobs, elevator buttons, toilet sink heads, escalator rails, handrails, light switches, countertops, etc. Floors should be cleaned at least daily
For routine cleaning and disinfection of surfaces and objects, wear disposable gloves and use household bleach diluted with water (1:100 ratio, e.g. 10ml bleach to 1 litre water) or alcohol solutions with at least 60-70% alcohol.
For effective disinfecting solution against coronavirus, refer to this cleaning and disinfecting guideline from CDC USA and this Interim List of Household Products and Active Ingredients for Disinfection of the Covid-19 Virus from the National Environment Agency, Singapore (also adopted by our MOH). Explore the possibility of using UV lighting to disinfect offices at night (used in some hospitals) but without compromising safety.
- How will we use gloves optimally?
Disposable gloves should only be worn during cleaning activities and then discarded. Staff, security and cleaners should be discouraged from wearing gloves all the time as this gives a false sense of security. With gloves on, you may touch many surfaces, becoming a risk to others and self.
- What is the policy if someone is unwell?
Staff who are unwell should be encouraged to stay at home and inform their respective supervisor/supermarket administrator. They should be given paid leave. Staff who have just returned from overseas should be offered mandatory, paid 14-day leave of absence to quarantine themselves. Also have a plan what to do if a staff member becomes sick while at work.
- How do we deal with travelling, site visits, conferences, etc?
For the next few months it would be wise to defer all conferences and travel, even within the country. Air travel may pose a high risk for infection. Site visits and inter-office meetings should be conducted virtually.
- Do you have a plan to minimise virus transmission to your family?
When you reach home avoid interacting with other household members or touching surfaces. Soak your clothes worn to the work place in soap and water and have a shower immediately. This will reduce the risk to your loved ones.
We will get through this difficult period by all of us working together, changing our behaviour and taking personal responsibility to protect others. All business and organisations should plan how to adapt their office to ensure safe physical distancing.
We need a strong, regular routine that pays attention to details and becomes second nature to all of us. This will help overcome our fear and get us back to some aspects of our previous work and life.
Bionotes of expert
Datuk Dr Amar-Singh HSS is a senior Consultant Paediatrician. He is an individual member of the Malaysian Health Coalition. He has served at the Hospital Raja Permaisuri Bainun, Ipoh for more than 35 years prior to retiring as Head of the Paediatric Department and Head of the Clinical Research Centre Perak in 2018. During his tenure, he was responsible for Paediatric & Research services in the state of Perak. Dr Amar also sits as the Advisor of the National Early Childhood Intervention Council. He is a Senior Fellow of the Galen Centre for Health and Social Policy and a recipient of the Outstanding Asian Paediatrician Award 2012 as well as 2016 SENIA Advocacy Award. As a senior paediatrician, he has a long standing interest in health and development issues pertaining to children with disability and facing abuse, as well as disadvantaged & marginalised communities (particularly in the Orang Asli/Indigenous People). He often writes on the development of the health sector and has a series of editorials on these and other health issues in several Malaysian media outlets.
* This is the personal opinion of the writer or publication and does not necessarily represent the views of Science Media Centre Malaysia
**All previous posts about COVID-19 here: https://sciencemediacentremalaysia.com/tag/covid-19/
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