COVID-19

As everyone knows, we are in the midst of a worldwide pandemic with COVID. COVID is present in all 50 states. It is scary times that we are living in.

COVID-19 is a respiratory disease that is caused by SARS-CoV-2, a new coronavirus discovered in 2019. At this time, the virus is spread mainly from person to person through respiratory droplets when an infected person talks, coughs, or sneezes. Some people can have the virus and have no symptoms. Symptoms can range from mild to severe, and adults 65 years and older and people of any age with underlying chronic medical conditions are at higher risk for severe illness.

World-wide, as of 4/1/2021, there have been 131 million cases of COVID-19, with 74.5 million people that have recovered and 2.85 million deaths These are staggering numbers. The current world population is 7.8 billion people, and roughly over 10 percent of the world population has been infected with COVID. We need to protect ourselves, our clients, and our families. This means even with receiving the COVID vaccine, you need to remain proactive and protect yourself and others. 

• Some people who are infected may not have symptoms, which is why everyone should wear masks, social distance, and wash their hands frequently. 
• COVID is spread by droplets. These droplets are formed by people when they talk, cough or sneeze, and they can be inhaled by someone passing by. Droplets can also land on surfaces and be picked up by an individual when they touch that surface and then touch their face, eyes, nose, or mouth. So the first way to protect and care for everyone is to wear a mask. This will stop droplets from entering the air around you. You do not need to wear a mask in your own home when you are with your family but it does mean you wear one when leaving the home and enter public air space. Even if you’ve had the COVID vaccine, this doesn’t mean that you can go without a mask. It is now mandatory to wear a mask in public both in New Hampshire and Vermont. This has been ordered by the governors of both states. It is a strict TLC policy that you wear your mask at all times while working.
• Not all masks are created equal. A good way to check the effectiveness of a mask is to light a candle and don your mask. Now try to blow the candle out. If you can blow the candle out your mask is not an effective one. It is allowing droplets in and out. Cloth masks are good as you can wash and reuse them so you should have more than one and wear them for one day only and then wash it.
• The spread of COVID is more likely when people are in close contact with one another (within about 6 feet). COVID-19 seems to be spreading easily and sustainably in the community (“community spread”) in any affected geographic area. So, to stop the spread we are asking for you to maintain a six-foot distance from the next person. If you are doing personal care with a client you can not maintain that six-foot distance so we are requiring that you wear a face shield, as well as a face mask during personal care. This will help to protect both of you. We are now asking the client to wear a mask while we are in the home as well as having the caregiver wear one.
• Another aspect of social distancing is not attending gatherings where more than 10 people will be present like family events, parties, weddings, funerals. This can also include church, school, sports events, and meetings.  It may feel like a hardship to avoid these types of events but it could be lifesaving to someone. When at all possible avoid crowds. Take advantage of early morning shopping times when the stores are not as busy. Follow the arrows on the floors so that the flow of shopping is orderly. Avoid eating in restaurants, get take out.
• If you test positive for COVID, you will need to follow the guidelines given by both the Vermont Dept of Health, and the New Hampshire Dept of Health.  The guidelines differ in each state.  

• If you test negative for the COVID-19 test, you still should take steps to monitor for symptoms and take the standard precautions. 
• Symptoms may appear 2-14 days after someone is exposed to the virus and can include fever, chills, muscle and body aches, vomiting, diarrhea, cough, shortness of breath, difficulty catching your breath, and any new loss of taste and smell. 
• If you exhibit any symptoms, (such as fever, cough, shortness of breath) please stay home, to prevent you from potentially exposing others. 
• If you develop severe symptoms, ( new confusion, abnormal breathing, chest pain, inability to wake or stay awake, or pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone, and loss of taste/smell, contact your MD

Prevention Tips

• Do not rush this step.
• For at least 20 seconds, wash your hands with soap and water.  If soap and water aren’t available, using hand sanitizer that contains at least 60% alcohol.  With using the hand sanitizer, allow the sanitizer to dry on its own. Don’t wipe your hands. You can count to 20 or you can sing Happy Birthday, Twinkle Twinkle Little Star, or Frere Jacques through twice. The most important part of protecting yourself and your clients is good hand hygiene. You need to wash your hands thoroughly and often (wash the tops, bottoms, and between your fingers). 
• We are recommending that all field staff get tested for COVID every 2 weeks. If you are asymptomatic and getting routine testing you do not need to miss work but if you are being tested because of symptoms or possible exposure you will need to stay out of work until a negative test is gotten. Please contact Lauren with your test results.

Office Staff Protocol and Daily Safety Precautions:

If you are not feeling well, PLEASE do not come to work. We encourage you to follow the usual health precautions and daily morning temperature checks.

• Each morning when you enter the TLC office, please check your temperature when entering the building (forehead thermometer is on the wall to the right when you enter the office).  
• Wash your hands often throughout the day and use the sanitizer available throughout the office.
• When using common areas such as a bathroom or kitchen, please disinfect and or wipe down the surfaces before and after using them. 
• No more than two people in each office space.  All staff must continue to follow social distancing (6 feet apart) while in the office. 
• When meeting other staff members in the office, the social distancing protocol must be followed, as well as you need to have your mask on when you’re not in your own office. 
• Avoiding interaction with those who are sick. 
• Refrain from touching your face and practice proper coughing/sneezing etiquette.
• Avoid crowded events and non-essential travel.
• Cleaning/disinfecting frequently touched surfaces is a very important job during this crisis. It should be done at a minimum daily, but 3 times daily is ideal.  You can make your own bleach solution by placing 3 teaspoons of bleach in a quart of water. This solution is good for 24 hours only. You can use this solution to clean/disinfect frequently touched surfaces. These surfaces include but not limited to doorknobs, light switches, TV remotes, computer mice, keyboards, phones, faucets, toilet handles, car steering wheels, and tables.
• We are asking both clients and staff to monitor their temperatures on a daily basis and to report if it is above 99.4. Everyone needs to be on the watch for any of the s/s of COVID, which are new or worsening cough, fever, chills, shortness of breath. Extreme fatigue may be present along with a loss of the sense of smell and taste.  Ask and report if you or the client have had any contact with someone who has visited from another state or country or who have been to another country.

What to do if you have symptoms

• If you have any symptoms of COVID please call TLC and report it immediately. You should speak to one of the nurse case managers or Mohamed and receive further direction from them. If you are being tested for COVID you will not be allowed to work until we have received a negative test result. Please be in contact with Lauren regarding test results. 

What to do if your client has COVID or COVID symptoms

• If we have a client who has been diagnosed with COVID you may be asked to care for them. If you are willing to provide care then you will be issued the proper precaution attire. This will include N 95 mask, gown, booties, face shield, and gloves. You should practice donning and doffing your PPE so it becomes second nature to you.
• There are numerous videos on YouTube that you can watch on how to don/doff your PPE.

Office Visitor Protocol

• The front door will remain locked and not open to the public for the foreseeable future.   
• Any visitors (including TLC non-office employees, orienteers, etc.), should be calling the office when possible before arriving. 
• Any visitors that physically come into the office will need to complete the “Client and Employee Questionnaire”. This will be emailed to any anticipated visitors (orientees) and additional copies will be left at the front desk. 
• Once a visitor arrives, their temperature will need to be checked and a face mask put on. All visitors MUST  wear masks. Masks and gloves will be available at the Front Desk.  

Key Things to Know. Per the CDC:

• COVID-19 vaccines are safe and have been proven to be effective. Side effects from the vaccine are normal. 
• Those who have been fully vaccinated can start to resume some of the things as prior to COVID. Please be vigilant and continue to practice handwashing, social distancing and wearing a mask.
• Your body will develop full protection (immunity) 2 weeks after your last vaccine. 
• These vaccines cannot give you COVID-19. 

What We are Still Learning

• We are still learning how well vaccines prevent you from spreading the virus that causes COVID-19 to others, even if you do not have symptoms.
• It is not known how many people have to be vaccinated against COVID-19 before most people can be considered protected. Which is also known as herd immunity. 
• It is unknown if the vaccine is effective against the new variants of the virus that causes COVID-19.
• We are still learning how effective the vaccines are against new variants of the virus that causes COVID-19.

There are three vaccines available out there to protect our caregivers and our clients. The manufacturers are Moderna, Pfizer, and Johnson and Johnson. Which vaccine you receive depends on which one is available at the site. If you receive the Moderna you will need to have a second injection in 4 weeks. With Pfizer, you will receive a second shot in 3 weeks and the Johnson and Johnson vaccine is a one dose only.

.There are potential side effects from each vaccine. Most people experience only mild symptoms but that does vary per person. Injection site soreness or redness, fever, headache are the most common and are usually of short duration.

We are advising our caregivers to register and receive the vaccine. You can register online for your vaccine. To register for a vaccine appointment, visit healthvermont.gov/MyVaccine (preferred) or call 855-722-7878

IN NH please go to the following website. www.vaccines.nh.gov.

Remember to report to TLC any symptoms you may have or any potential exposure. We do not want to make each other or our clients ill.

Important takeaways for you:

1. Monitor your temperature and clients temperature before each shift
2. Report any symptoms or possible exposure
3. Wear a mask while in the client’s home or when in public
4. Wear a face shield and a mask when doing personal care or in instances where you cannot maintain safe social distancing
5. Avoid groups of more than 10 people
6. Disinfect all high touch area/objects
7. Good hand hygiene for at least 20 seconds with soap and water or hand sanitizer