5 Stages of Pandemic Preparedness
It is not a question of if there will be another pandemic — but when. Consider how quickly the COVID-19 variants developed and spread. And who can forget outbreaks such as SARS and the H1N1 swine flu? Remember how many people insisted, “We learned our lesson and will be better prepared next time?” Then COVID-19 hit, and few, if any, facilities were prepared.
Now is the time for in-house custodial departments and building service contractor (BSC) teams to develop a fluid and flexible program for cleaning and disinfecting. The action plan should include processes and protocols that adjust product selection and usage, procedures, frequencies, and verification as the threat levels, type of pathogen(s), and transmission paths change.
The Missing Middle
Most cleaning operations have standard operating procedures (SOPs), as well as pandemic plan operations (PPOs). Yet facilities — especially large, complex operations — need to have programs that live somewhere between the two.
Using SOPs as a pathogen threat level rises or the method of transmission changes is not enough to ensure a safe and healthy facility. Conversely, relying on a PPO when the health threat is higher than usual, but is nowhere near pandemic levels, is similarly unwise.
Over and underuse of cleaning and disinfecting resources can also be harmful to the cleaning staff and building occupants. Both are an ineffective and inefficient use of resources, including products, equipment and labor. Performing the same procedures more frequently is also not the answer. Strategic, targeted hygiene is needed as threat levels rise and fall.
Most facilities need at least two levels between SOPs and PPOs and possibly even a third. Below are the five levels of cleaning protocols most custodial operations — whether in-house or a BSC — should be prepared to put in place quickly and efficiently as necessary:
• SOPs — No direct pandemic threat exists, so the SOP should be followed.
• Level 2 — Pandemic pathogens pose a threat in the country but not in the state/province.
• Level 3 — Pandemic pathogens pose a threat in the state/province but not in the immediate region.
• Level 4 — Pandemic pathogens pose a threat in the region but not in the facility.
• PPO — Threats posed by pandemic pathogens exist in the facility.
Custodial teams must be prepared to adjust the cleaning and disinfecting products, procedures, frequencies, training/retraining, and verification for each level.
As the threat level increases, custodial teams must be prepared to:
• Use cleaners and disinfectants with higher efficacy and disinfectants with kill claims for the specific pathogen(s) of concern.
• Increase the overall frequency of cleaning and disinfecting, especially floors and high-volume touch points, especially right before and after high-traffic use.
• Avoid reusing cloths and alternate surfaces of a folded cloth.
• Clean in one direction with no overlapping or rubbing in circles.
• Be vigilant about not using the same cloths and mops for different tasks or areas to avoid cross-contamination.
• Use specialized equipment when necessary to combat the targeted pathogens, such as electrostatic sprayers.
• Consider the use of residual or continuous acting disinfectant technologies to augment — not replace — cleaning and disinfecting efforts.
• Create a system for building occupants and visitors to differentiate clean and disinfected from potentially contaminated surfaces and areas.
• Verify cleaning and disinfecting using methods such as florescent gel, ATP meter testing or imaging technology.
• Track cleaning and disinfecting results.
• Create data-driven reports of results.
• Communicate results to stakeholders on a regular basis.
As the threat level rises, it is important to continually increase efforts in the areas above. That said, adjusting them downwards as the threat level recedes is equally essential. This scaling back helps prevent:
• Disinfectant overuse that can harm people, assets and the environment.
• Creating pathogen resistance that can lead to the need for increasingly potent formulations.
• Unnecessary product and labor costs.
• Employee burnout and low morale from being in a continuously high-alert environment.
• Building occupant anxiety.
Beyond Cleaning and Disinfecting
In addition to cleaning and disinfecting, the items below should be adjusted based on the pandemic threat level, method(s) of transmission and a facility’s resources.
Physical restraints. This includes measures such as limiting access, screening, the use of masks and barriers, and physical distancing.
Sub-surfaces. Exposed surfaces are usually cleaned and disinfected more often during higher pandemic threat levels. However, less visible areas, such as drains and urinal pipes can harbor pathogens and should be cleaned regularly.
Personal protective equipment (PPE). Frontline workers must be carefully trained — and retrained — regarding when and what PPE is required based on the threat level. The training must include the proper way to fit, don and remove the PPE. Doing either improperly can harm users and spread infectious pathogens.
Touchless equipment. If the budget allows, before the next pandemic is an ideal time to replace older hand-operated equipment with touchless options. This includes everything from doors and toilets to hand soap and towel dispensers. To help keep workers safer (and to help them clean more effectively — usually with greater productivity) invest in a touchless spray, scrub, and dry vac system.
Handwashing. As the No. 1 infection-prevention method, washing hands frequently and properly for 20 seconds is always important — it is essential when pandemic threat levels start to rise. Ensure soap, sanitizer and towel dispensers are filled. Hand dryers should also be in good working order and emit enough air to dry hands thoroughly. Post signs throughout the facility regarding the importance of handwashing, especially in restrooms and food service areas. Locate hand sanitizing stations throughout the facility where access to running water for handwashing is limited.
Face masks and hand dryers. If the pathogens’ method of transmission is or could be by air, be sure to provide proper face masks — surgical or N95/KN95 depending upon the threat level — and disable any air hand dryers.
Room layout. In addition to ensuring six-foot social distancing when pandemic threat levels are rising, discourage the use of common areas by removing items used by multiple people. This includes comfy chairs and couches, computers, coffee makers and water coolers.
Breakroom supplies. These should be single-serve and individually wrapped.
Communication. When infection levels are high, stakeholders are more likely to be on edge, worried about their safety and the safety of other building occupants. This is when it is vital to track and report the procedures being followed, as well as data showing the facility is being cleaned and disinfected frequently and correctly. Doubt breeds concern, while information and data breed confidence that the situation is being handled efficiently and effectively.
Follow recommendations of the authorities. The recommendations and guidelines of reputable federal and local authorities and governments should be followed, particularly during high-threat levels. Information during high-alert times changes rapidly. There should be a point person(s) responsible for staying on top of the most current guidelines and a system for disseminating this information to the entire custodial team and other stakeholders.
Breathing Easy at Any Level
As many in the industry have learned from COVID-19, dangerous viruses and other pathogens can be spread by contaminated air. Indoor air quality (IAQ), ventilation, and filtration systems are always critical and should be checked regularly. However, when infection rates are higher, cleaning and testing the facility’s IAQ should be done more frequently. Components to check include:
• HVAC effectiveness and efficiency
• Fresh air circulation methods
• Air filtration with filters rated MERV 13+ up to HEPA
• Air humidity, with 40-60 percent the ideal range
• Real-time sensors and reporting for key performance indicators, such as particulate matter, CO2, volatile organic compounds, humidity, etc.
• External and internal ducts
• Air purification system(s)
Third-party certification by a reputable entity can help validate the overall cleaning operations. Certification can also help communicate to building occupants and visitors that proper cleaning and disinfecting procedures and protocols are being followed. The point, however, is not just to seek certification, but to implement all the requirements and continue to look for ways to improve operations.
Another consideration is to use a cleaning and disinfecting expert to help conduct an integrated and comprehensive assessment of the site and the cleaning operations. Experts can also help develop and implement a long-term, sustainable improvement plan to deliver the highest levels of clean, safe, healthy at the lowest overall cost.
While everyone wishes otherwise, the reality is another pandemic is lurking in the not-so-distant future. Custodial teams prepared to face the threat level-by-level will be recognized for their forethought, and for keeping their facilities safe and their occupants healthy.
Mike Sawchuk of Sawchuk Consulting assists in-house facility service providers, BSCs, manufacturers, and distributors in the professional cleaning industry in improving their outcomes with insightful, pragmatic solutions. He can be reached at www.sawchukconsulting.com.