THE ATTENDING PHYSICIAN CONGRESS OF THE UNITED STATES H·166, U.S. CAPITOL WASHINGTON, DC 20515-9086 BRIAN P. MoNAHAN, MD, MACP PROFESSOR OF MEDICINE AND PATHOLOGY May 1, 2020 Attending Physician Pandemic Social Distancing and Daily Health Screening Implementation Guidelines for Congressional Offices and Work Centers The following guidelines provide for Pandemic Social Distancing and Daily Health Screening implementation in Congressional workplaces. These guidelines are based on current Centers for Disease Control and Prevention best practices to minimize risk of coronavirus transmission in the workplace through use of social distancing measures and daily screening of employee health prior to reporting for duty. 1. Minimize the Number of Staff in the Work Center. Each Office (Member office, Committee group, Support office) should continue to commit to the presence of the minimum in-office staff required to accomplish daily tasks. It is critical that an emphasis be placed on establishing the minimum necessarv personnel to be physically present in a work center with the balance of other personnel assigned to a telework or remote work capacity Each Office should maintain reliance on phone conversations/video type interactions over in-person meetings whenever possible. 2. Screen Visitors. Visitors should use hand sanitizer upon entry and prior to departure, and utilize a face covering for the duration of their visit. Use of a face cover is voluntary but highly recommended. (The visitor may choose to avoid the face cover provided they can maintain the 6 foot and other social distancing guidelines). 2.1. Those individuals who chose not to wear a face cover must follow the social distancing guidelines regarding 6-foot separation, no physical contact with staff, appropriate use of hand cleansing and cough etiquette. Refusal to follow the social distancing guidelines should cause the visit to be immediately concluded. 2.2. Any person that appears ill (shaking chills, flushed appearance, vomiting, frequent coughing, nasal drainage, etc.) should reschedule their appointment for a future time when they are in good health. 2.3. Offices should post clearly visible signage regarding these requirements within their office such as a reception countertop area or near an office entry door. In other public areas, signage will be provided by the Architect of the Capitol 2.4. Recommendations for use offace covers as an infection source control to reduce viral shedding applies equally to office staff and visitors. For all users, use of a face cover is voluntary in those instances were 6-foot separations and other social distancing requirements are maintained. 2.5. The US Capitol Police will not take enforcement actions regarding face coverings. If a visitor is not adhering to a specific office policy, and the office manager is requesting that individual be removed from the office, the US Capitol Police will assist with this request. 3. Maintain Meaningful Social Distancing Standards. Version 1.0 2 3.1. Determine Maximum Occupancy of Each Work Center or Other Space. Each Office should determine the maximum number of individuals that can safely occupy a work center or other space and conduct their work where possible without exceeding social distancing standards (six-foot separation). This number will be the maximum allowable number of individuals in the office at any given time. Maximum occupancy shall also be calculated for each reception room, hearing room or conference room.(note a 6-foot separation equates to 9 square feet per person occupancy load). lfthe workplace function can be accomplished with less than the maximum number, the fewest number of workers should be present. 3.1.1. There are specific areas in the Capitol where fixed seating and structures are present( for example the Dais of the Senate Chamber and House of Representatives Chamber) where 6 foot separations are not possible due to the structure and seating of essential personnel whose functions cannot be performed at another chamber position. In that instance, use of a face cover by all seated Dais participants would be considered a possible option for social distancing separation. Non-seated participants in the Chamber should maintain 6-foot separation from those seated Dais positions. The preferred option is to verify that the individual cannot be relocated from the Dais to another location in the Chamber where their duty can be performed. 3.1.2 . Limit Occupancy. Visitors and attendees that exceed the maximum occupancy for the space should wait outside the space. Any waiting area should also be subject to crowd control to limit aggregation of people and avoid crowding closer than 6-foot separation. Any area that is prepared for a video simulcast of proceedings should also incorporate social distancing guidelines. The alternate viewing or waiting areas should have suitable floor markings to facilitate the 6-foot separation guidelines with supervision of guideline adherence provided by the host of the primary event. 3.1.2.1. Occupancy guidelines may make allowances for those brief circumstances where close quarters will not allow for full social distancing (for example access to equipment or uniform storage areas during a personnel shift change). Use of a face cover by individuals in this brief circumstance is highly encouraged. Offices with limited space for employees to participate in shift breaks or meals may need to explore use of alternative spaces or staggered times to promote adherence to social distancing guidelines during these times. 3.1.2.2. 3.2. Use Telework or a Staggered Schedules. Staff of the Office in excess of the maximum occupancy of the work center should be in a telework status. Staff may be rotated between a telework and in-office status or individual staff arrival and departure work hours may be staggered as determined by the Office. 3.3. Avoid Gatherings. Each Office should evaluate activities within their work centers that cause individuals to aggregate together and avoid or limit such activities. Daily meetings, staff recognition events, etc. should be modified to occur via teleconference or meet distancing requirements. Areas typically used for informal staff gatherings, such as coffee or kitchen locations, break rooms, etc. should be modified or monitored to prevent crowds. Social gathering events should be avoided during this time. Limit face to face interactions to less than 15 minutes, if possible. Version 1.0 3 3.4. Avoid Crowding at Dining Facilities. Each Office should consider regulating business practices related to mealtimes and other breaks. These should be staggered throughout the day rather than at socially conventional times, such as 12 PM to 1 PM. If able, staff should be encouraged to bring food from home or use 'grab and go' options to promote dining at their workstation. This will minimize assembly of individuals at locations such as dining facilities, etc. 3.4.1. Seating areas at dining facilities may need to be marked to guide diners to appropriate 6-foot separation locations or have furniture rearranged or removed. Use of table top barriers (such as partitions of a suitable height) may be considered subject to further pending analysis of cleaning requirements between users. 3.5. Avoid Communal Food and Beverage Stations. Each Offices should evaluate office food and beverage procedures in general. Communal coffee and water dispensers should be avoided. Communal meal platters, such as continental breakfast trays, should also be avoided. Selfservice, commonly shared utensils, plates, cups, etc. should be removed from this area. Examples of good practices to minimize use of shared bulk containers include: sealed, single serving packets of sweeteners, creamers, condiments, etc. Staff should be encouraged to utilize their own personal utensils, plates, cups, etc., or designate these items from office supplies such that they will not be shared by other individuals. 3.6. Modify Office Layouts and Flow Patterns. Each Office should alter the physical layout of work center spaces where possible in accordance with any Architect of the Capitol parameters to maximize 6-foot distancing between Members, staff, and visitors. Additionally, offices should re-assess office flow patterns to limit intra-office and visitor traffic as much as possible. Selective removal of furniture may be helpful to minimize circumstances where individuals are seated too close together. 3.6.1. Seating. Where possible apply "every other desk" occupancy and reduce lounge and common space capacity. (see exception paragraph 3.1.1) 3.6.2. Circulatory Paths. Create "one-way" primary circulation paths to avoid bottlenecks in hallways and passageways where possible. 3.6.3. Signage. Post sighage encouraging hand washing, hand sanitizing and wiping down of surfaces in high traffic, shared spaces (elevator lobby, community desk, pantry, nooks, meeting rooms, restrooms, phone booths, etc.). Public space signage will be placed by the Architect of the Capitol where indicated. Private office space area sign placement will be responsibility of the Office. 3.6.4. Plexiglass Shields (Sneeze Guards) and Communal Land lines. An example of a good office practice to reduce potential virus exposure involves placement of a "sneeze guard" or plexiglass barrier at the point of entry between visitors and forward-facing customer service staff. A floor marking indicating a six foot standoff mark from the forward-facing employee, or a pair of floor stanchions with cord suspended between them are other alternatives. This will reduce risk of virus transmission with activities such as speaking, sneezing, or coughing. Another example would be to remove community use land line phones. Version 1.0 4 3.6.5. There are several functional areas at the Capitol such as Police barricades and screening facilities where Plexiglas barriers are not practical and thus cannot be used. 3.6.6. Hand Contact Points. Wherever possible, hand contact points should be minimized. In circumstances where US Capitol Police and Fire Marshall considerations permit, doors may be propped open. Motion sensing lights in community spaces would be helpful to reduce reliance on common touch objects in the office. 3.6.7. Cleaning. Each Office should create an overall cleaning schedule that accounts for periodic pauses in office activity throughout the day for hand cleansing (waterless hand cleanser, or soap and water) and cleansing of contact surfaces with approved materials by work center individuals. Individual workstation configuration should accommodate simplified cleaning measures wherever possible. For example, desktops should be free of clutter (devices, memorabilia, photographs, etc.), disposable membranes or plastic wrap may be used on keyboards, phones, or other devices, etc. 3.6.8. Ventilation. Each Office should consult with the Architect of the Capitol and US Capitol Police regarding ventilation systems to determine if any air circulation mitigation is required. The Architect of the Capitol is following CDC and American Society of Heating, Refrigeration, and Air Conditioning Engineers recommendations for building ventilation systems. 3.7. Encourage Use of Face Coverings. Use of a face covering, is voluntary unless required by specific Agency policy, and should be promoted at all times. Use of a face covering while in the office has the additional advantage of serving as a source control to minimize virus in the workplace environment and contributes to the cleaning process efficiency. Use of face covers is a service to the community to decrease the risk of infection overall. Although not a preferred prerogative, individuals retain the option of not using a face cover if they can maintain the 6foot separation guidelines. 4. Health Monitoring of the Work Force. 4.1. Participation in a Health Monitoring Program. Participation in a health monitoring program is required for all Congressional employees unless impacted by a collective bargaining agreement or in those instances where employment is exclusively by telework or at an isolated/solitary occupancy duty station. Employees already participating in an employer health monitoring program (for example US Capitol Police) do not have additional health monitoring requirements or reporting obligations. 4.2. Work Center Monitor. Each Office should assign an individual as Work Center Monitor in each work center. This person will have the responsibility of coordinating results of the health screening inventory from all employees in their assigned work center on a daily basis. Since most offices have an Emergency Coordinator role already identified, that individual is an example that may be designated for that purpose. In large organizations another functional area (for example Human Resource section) may serve as the Work Center Monitor. 4.3. Employee Self-Monitoring Procedures. Version 1.0 5 4.3.1. Self-Monitoring of Temperatures. Each employee shall measure their temperature each morning at their home before reporting to the workplace. (Unless utilizing an OAP approved contactless temperature monitoring program, temperature testing in the workplace is to be discouraged. Office based temperature measurements are problematic due to contact precautions and virus exposure risk to the person assigned the temperature testing role and issues of possible re-use of equipment without complete cleansing between users. Use of a communal "office thermometer'' is discouraged.) 4.3.2. Health Self-Assessment. Unless already participating in an employee workplace health monitoring program (for example US Capitol Police), each employee will complete a selfassessment utilizing the Health Screening Inventory tool found at the Office of Attending Physician website. This inventory consists of a series of brief "yes or no" questions. The individual will take their temperature with their own home thermometer as part of this self-assessment. 4.3.2.1. If the employee responds "yes" to any question on the Health Screening Inventory, the employee will be required to avoid the workplace setting and directed to consult with their health care provider. The employee should not come to the workplace. 4.3.2.2. If the employee responds "no" to all questions on the Health Screening Inventory, the employee may plan on reporting to work as usual. 4.3.3. Reporting of Self-Monitoring Results. Employees should report via phone, text message or email the results of their Health Screening Inventory to their designated Work Center Monitor or their existing Human Resource Department program before arriving in the workplace (a "screening attestation"). 4.3.3.1. The screening attestation need only say, "I answered 'no' to all questions," or, "I answered 'yes' to at least one question." 4.3.3.2. If a screening attestation is not received pre-arrival, employees will not be allowed into the workspace. 4.3.3.3. The workplace will not retain copies of the Health Self-Assessment other than the individual's screening attestation that they completed the Health Self-Assessment and did not respond "yes" to any question. Employees are not required to turn in a written copy of the Health Screening Inventory. 4.3.3.4. Individual work centers will monitor and assess compliance for their work center employees. There is no centralized reporting obligation of the individual work center to others. 4.3.3.5. US Capitol Police have no enforcement roles in health monitoring program compliance. 4.4. Workplace Monitoring. Individual work centers will monitor for the appearance of respiratory symptoms such as frequent coughing or sneezing. Individual work centers will need to develop Version 1.0 6 their own guidance with regard to actions consistent with the general approach that individuals who are visibly ill with a respiratory illness (fever, cough, sneezing, vomiting, shortness of breath, other signs such as loss of the ability to taste or smell, etc.) should not be present in the workplace until they have recovered . Self-reporting of symptoms by individuals is encouraged. 4.5. Return to Work. During the period of this Pandemic, the Centers for Disease Control has requested whenever possible, Offices should not require a doctor's note to return to the workplace after resolution of their symptoms but will rely upon the individual's assurance that they have consulted with their primary care provider. (This request is based on the need to diminish appointment burdens on medical resources for verification of well ness that compete with individuals seeking access for initial evaluation of illness where availability of health resources is impacted by the pandemic). Each individual work center should review their policies on requiring doctor's notes to return the individual to duty. Version 1.0 May 1, 2020 Health Screening Inventory Regarding your personal health, please answer the following questions to the best of your ability: Are you currently experiencing, or have you experienced within the past 7 days any of the following symptoms? Fever (Temp greater than or equal to 100.4 F) [] Yes [] No [] Yes [] No Chills with shaking or teeth chattering Sore throat [] Yes [] No Frequent cough [] Yes [] No [] Yes [] No Shortness of breath at rest []Yes [] No Pain or Tightness in your chest []Yes [] No Flu-like symptoms []Yes [] No Muscle pain (non-exercise related) [] Yes [] No Loss of ability to taste or smell Are you well, but a member of your household is sick at home with bronchitis-like or cold symptoms? []Yes [] No Are you or a member of your household awaiting COVID-19 test results, or have you been told to self-isolate? []Yes [] No *If you answered yes to any of the above questions, DO NOT report to work. Stay home and consult your personal physician for further guidance. *Before arriving to work, notify your work center monitor via text or email of your result by indicating 11 1answered no to all questions," or, 11 1answered yes to at least one question." Version 1.0