Risk-informed decision-making guidelines for workplaces and businesses during the COVID-19 pandemic

Objective: Provide a framework for risk-informed decision making about public health actions for workplaces/businesses during the COVID-19 pandemic.

Audience(s): Employers and business owners can use this document to consider risks associated with their workplace/business, the implementation of risk mitigation strategies, and in consultation with local public health authorities (PHA) regarding decisions to close workplaces. PHA can use this tool to support decision-making about workplaces/businesses in their jurisdictions.

Workplaces and businesses can contribute to the transmission of respiratory pathogens, such as the virus that causes COVID-19. It is important for these settings to implement appropriate public health measures to prevent and reduce the spread of COVID-19 amongst employees, contractors, and clients.

Workplaces/businesses can implement key measures to limit the spread of the virus in their settings. Workplaces/businesses are heterogeneous; therefore, the Public Health Agency of Canada recommends employers, business owners, and PHA conducting a risk assessment when determining the specific public health actions related to a workplace/business during the COVID-19 pandemic. This involves considering the epidemiology of the disease, assessing characteristics of the workplace/business settings and its employees/clients, and assessing the weight (importance) of associated risks. Decisions to respond to COVID-19 within the workplaces/businesses can be considered on a continuum from minimal changes needed (e.g., promoting public health messages), to enhancing communication for employees, contractors and clients, to implementing risk mitigation strategies, to closing the workplace.

Epidemiology of COVID-19

Epidemiologic evidence suggests this virus transmits readily by respiratory droplets and contact. This suggests that transmission in a workplace/business setting is likely either directly via close contact or indirectly via contaminated surfaces and/or objects (fomites).  This risk could be greater if employees/clients share workstations (e.g., communal computers, electronic devices).

It is possible that cases transmit the virus in the early phase of their illness, when their symptoms are non-specific or mild.

Epidemiologic evidence suggests that COVID-19 manifests as a non-severe disease in most cases (~80 %), with a smaller proportion of cases developing severe pneumonia, and some dying. People at higher risk of complications and severe disease include the elderly, and people with underlying chronic or immunocompromising medical conditions.

The estimated incubation period is 5-6 days on average, ranging from 1 to 14 days. People who have been exposed in the community or while traveling could become ill and contagious at the workplace/business setting.

Risk assessment framework

The risk assessment tool for workplaces and businesses in the Canadian context is based on advice contained in the World Health Organization’s guidance Footnote 1, Footnote 2 and in the Centers for Disease Control and Prevention (CDC) guidance Footnote 3, and on public health assumptions that reflect the currently available scientific evidence and expert opinion.  It is subject to change as new information on transmissibility and epidemiology becomes available. For information regarding COVID-19, including other community-based public health guidance, visit the Canada.ca and WHO web sites.

Risk mitigation (including personal protective equipment)

Risk of infection with the virus that causes COVID-19 can be mitigated using multiple strategies in combination. The first strategy is to avoid situations and people that pose a risk, by having people stay home when ill and maintaining a 2 metre distance from others. When it’s not possible to avoid contact with others, hand hygiene and respiratory etiquette are very important to reduce spread. Personal protective equipment (PPE), such as face masks and gloves, can be used in certain situations to protect people from infectious diseases. PPE is used on the advice of an organization’s occupational health and safety office and is based on a risk assessment that considers both the risk associated with a specific task/activity as well as the characteristics of the source of the infection (e.g. a sick person or a contaminated environment). The use of respirators (e.g. N-95 respirators) are not recommended, except in healthcare settings when particular high risk procedures are being performed or in other industries when respirators are routinely used.  Workers who are exposed to people who are ill with respiratory symptoms, such as coughing and sneezing, may use face masks and eye protection if the nature of their work warrants it. Gloves are only recommended when workers will be in direct contact with an ill person, or a contaminated object or environment. PPE must be used correctly to prevent contamination when taking it on and off; hand washing remains critical even when using PPE. Training on the use of PPE should be provided.

Practicing frequent and thorough hand hygiene (washing hands for 20 seconds with soap and water, or using alcohol-based hand sanitizer), as well as not touching one’s face, are the best ways to prevent infection. Those who are ill should stay home from work, and should always practice respiratory etiquette, by coughing into their arm or a tissue.

Population at Risk: Employees/Contractors/Clients
Population at Risk: Employees/Contractors/Clients
Characteristics Risk consideration Public health rationale Weight Risk mitigation strategies
Demographics of your workforce and clientele Are employers/business owners aware that employees/clients are from demographic groups at greater risk of severe disease, such as older adults or people with underlying medical conditions? Older adults, people with immune compromising conditions and chronic diseases appear to be at greater risk of severe disease, so consideration should be given to protecting them from possible exposure to COVID-19 cases. However, the health status of employees/clients may not be disclosed to their employers. Workplaces/businesses cannot assume they know the health status of their employees. High importance
  • Communication about risk to staff/clients should be emphasized;
  • Encourage the use of individual measures such as frequent hand hygiene, social distancing, respiratory etiquette and staying home when ill;
  • Provide options to the medically at risk to reduce social contacts at work, such as teleworking arrangements, if possible.
Are your clients at greater risk of spreading the disease (e.g., young children)? Young children may be at greater risk of amplifying disease transmission because they are generally less compliant with effective hand hygiene and respiratory etiquette practices and tend to socialize with others in a way that is likely to increase transmission. Preventing transmission from these populations indirectly protects the larger population and may reduce demand on the health care system. Medium importance
  • Consideration should be given to modifying service delivery (e.g., reducing number of clients using services at the same time, providing services outdoors) and promoting use of individual measures such as frequent hand hygiene, social distancing, respiratory etiquette.
  • Consider need for increased frequency of cleaning especially of high touch services.
- Are your employees at greater risk of being infected due to recent international travel or attendance at an identified risk setting (e.g., conference where cases were known to be present)?

Returning international travelers and people who potentially had contact with a case (e.g., at a conference or within their household) are being asked to self-isolate at home for 14 days.

If they are essential service workers (such as health care providers, critical infrastructure workers) they may need to return to work within the 14 day period in order to provide health care services or avoid essential service interruption.

High importance
  • Plan for absenteeism or alternative working arrangements (i.e., teleworking);
  • For returning travellers, who are asymptomatic, and deemed essential workers (i.e., health care providers, and critical infrastructure workers), considerations should be given to more stringent self-monitoring and other measures to reduce exposure and transmission to others. In consultation with PHA, employers should conduct a risk assessment considering local epidemiology, response goal, critical infrastructure resources and potential positive and negative impacts of recommendations.
Local demographics and epidemiology Is the local community experiencing an increased rate of COVID-19 infection? The risk of exposure to staff/clients may be higher in the workplace if there is ongoing local community transmission. High importance
  • Consider involving the local PHA in decision-making about workplace/business closure.
Is the local population at increased risk of severe disease if COVID-19 circulated? Businesses that interact with communities with a high number of elderly residents, higher rates of chronic disease or challenges accessing health care services may want to reduce their activities to limit exposures within the community. Medium importance
Environment: Workplace/Setting
Type of service

What kind of service does your workplace/business provide (e.g., customer service, food service, manufacturing, hoteling, rideshare, etc.)?

The risk of being exposed and/or acquiring the infection is greater if employees/clients interact more closely (i.e., close contact) with one another or with numerous clients (e.g. personal care services).

The duration of the exposure also has an impact on the risk of transmission. The longer the exposure, the higher the risk for transmission.

Given that COVID-19 can survive on surfaces and objects for hours to days, work and/or services that are transactional in nature may represent a higher risk of exposure (e.g., exchange of money or items).

High importance
  • Adjust workplace policies and procedures to reduce social contact, such as teleworking arrangements, flexible hours, staggering start times, use of email and teleconferencing;
  • Consider going cashless, and encourage hand hygiene after exchange of money or items;
  • Reinforce safe food handling practices.
Will employees/clients be participating in activities that promote transmission? Activities that could contribute to spread include, but are not limited to singing, cheering, close physical contact (less than 2m), and touching common objects (e.g., hand rails, utensils). High importance
  • Reinforce social distancing measures (e.g. avoid greetings like handshakes, maintain 2m distances between people if possible);
  • Avoid sharing communal office equipment/supplies (e.g., tablets, electronic devices);
  • Avoid potlucks, buffets, where serving utensils, plates, trays and other objects may be handled by multiple people.
  • Employees should perform hand hygiene between client interactions.
Does your workplace/business provide essential services? Essential workers are considered critical to preserving life, health and basic societal functioning. This includes, but is not limited to, first responders, health care workers, critical infrastructure workers, hydro and natural gas, and workers who are essential to supply society by critical goods such as food and medicines. High importance
  • Consider the societal impacts of altering, reducing or stopping services;
  • Review and revise, as needed, your business continuity plans to prioritize key functions in the event of high workplace absenteeism.
Setting/Location In what setting is your workplace/business located (i.e., a community-setting, large public space, office)? A workplace/business located in a public space with high traffic is at an increased risk of being exposed/infected with COVID-19 due to the number of people coming in and out of the setting (i.e., high number of potential introductions of the virus). High importance
  • Workplaces/businesses that operate in public spaces and/or urban centres can consider modifying service delivery/hours or closing to reduce spread;
  • Encourage employees/clients to take public transit at non-peak times or to use a personal vehicle if possible to limit contact with others.
  • Employers/businesses with more than one location are encouraged to adopt a tailored approach on workplace measures based on local context.
Is the majority of the work/service carried out indoors, outdoors or both? Work/services offered outdoors (i.e. higher ventilation) are likely to be lower risk than those held indoors (e.g., construction work vs. administrative work in an office). Medium importance
Is your workplace/business in a geographically remote area or in close proximity to a densely populated area? A workplace/business located in a more densely populated area (e.g., metropolitan), may have higher exposure/infection risks. Proximity of a workplace/business to a densely population area could result in a more rapid dissemination of disease. Medium importance
How do clients/customers/contractors primarily access your workplace/business (e.g., public transit, personal car)? Workplaces/businesses accessible primarily via public transit may be at an increased risk of transmission due contact of potentially contaminated surfaces/objects and proximity with other individuals (especially at peak times) for a long period of time. Medium importance
Planning Does your workplace/business have a pandemic preparedness plan? Workplaces/businesses with robust pandemic are more likely to be able to adapt their operations/activities based on recommended public health advice. High importance
  • Review and revise, as needed, your business continuity plans to prioritize key functions in the even of high workplace absenteeism;
  • Update emergency contact information of employees/contractors.
Does your workplace/business have a robust business continuity plan addressing issues like critical operations, prioritization of work/services, surge capacity planning, cross-training of employees. Workplaces/businesses with robust business continuity plans are more likely to be able to adapt their operations/activities based on recommended public health advice. High importance
How will staff absenteeism impact your operations?

Many employees/clients could be ill or be a caregiver to an ill person (e.g., elderly parent, child), therefore would be unable to attend work for a number of days or weeks. Are employees cross-trained to assume other functions within your workplace/business?

Determine how you will operate if absenteeism spikes from increases in sick employees, those who stay home to care for sick family members, and those who must stay home to watch their children if dismissed from school.

High importance

  • Prepare to institute flexible workplace and leave policies for employees who are sick, in self-isolation, or caring for family members.
Do you have a risk communication plan to share information with your employees, contractors and clients?

Workplaces and businesses with an existing risk communication plan are more likely to be able to ease employees'/clients' fear, anxiety, rumors, and misinformation. This will contribute to a more productive workforce in uncertain times.

Good communications channels are key to reinforce public health measures in the workplaces such as hand hygiene, respiratory etiquette, and staying home when ill in order to limit transmission. It may also help with compliance with public health advice.

Medium importance
  • Develop a risk communication plan to ensure effective and efficient communication with employees, contractors and clients.
Does your workplace/business employ a small or large number of employees? The larger the number of employees/clients, the greater the likelihood of one of them being a case or a contact of COVID-19. Large numbers of people may also create greater likelihood of crowding (e.g., boardroom, gym class). However, larger workforces may be better able to manage absenteeism. Medium importance
  • Consider staggering work hours to reduce crowding and close contact;
  • Consider retaining employees with critical functions only to reduce crowding and close contact.
Policies and practices Can your workplace/business support flexible workplace policies (i.e., teleworking arrangements, staggered hours). Workplaces and business with flexible workplace policies will help reduce transmission amongst staff by reducing close contact between employees and/or clients. High importance
  • Consider relaxing sick leave policies that support employees in self-isolating when ill, exposed to cases, or returning from international travel, such as suspending the need for medical notes to return to work.
Mental health Does your workplace/business offer mental health support to your employees? Employees/clients may experience increased stress associated with COVID-19, that can bring up historical traumas, trauma of past emergency events, or exacerbate ongoing personal or community stressors. Mental health support may contribute to a more present and productive workforce. Low importance
  • Tailor plans for minimizing stress based on the employee/client situation;
  • Provide mental health support services.
Infrastructure Can your workplace/business infrastructure be easily altered/modified to implement public health and infection prevention and control measures (e.g., additional hand cleaning stations, spatial separation of 2-metre between workstations)?

Respiratory droplets tend to fall within 2 metres of their source, so maintaining a 2-metre distance from others is a precaution to prevent spread.

If the employer/owner is unable to modify the workplace/venue to maintain spatial separation between employees and/or clients (ideally 2 meters), the risk of transmission is greater (e.g., spacing out tables in restaurants, leaving a couple of empty seats between moviegoers).

Hand hygiene should be performed more frequently. Alcohol-based hand rub (60% alcohol or greater) or hand washing sinks with soap and disposable towels should be made readily available.

Medium importance
  • Provide access to handwashing facilities and place hand sanitizing dispensers in prominent locations throughout the workplace/business, if possible;
  • Provide additional respiratory etiquette supplies such as tissues, lined waste container, and hand hygiene products/supplies;
  • Consider increasing the spatial separation between desks and workstations as well as individuals (e.g., employees, customers) from each other, ideally a 2 metre separation or use a physical barrier (e.g., cubicle, Plexiglas window), if possible;
  • Enhance your environmental cleaning procedures and protocols with a special attention to high-touch surfaces and object.
Are there restricted points of entrance and exit that force people to be in close proximity and/or pass through high-touch areas (e.g. turnstiles, fingerprint entry, doors and elevators)? Crowding and lines at bottlenecks can put employees/clients at increased risk of exposure to respiratory droplets. High-touch surfaces can also be contaminated and increase the risk of transmission. Use approved hard surface disinfectants. Medium importance
Environmental cleaning Does your workplace and business have existing environmental cleaning procedures and protocols? Can they be enhanced to align with public health advice? Routine cleaning of frequently used surfaces and objects help to prevent the transmission of COVID-19 in order to mitigate the risk of people becoming infected through self-inoculation after touching contaminated surfaces. The virus that causes COVID-19 has the potential to survive in the environment for up to several days.Cleaning, particularly of frequently touched surfaces, can kill the virus, making it no longer possible to infect people. High importance
  • Enhance your environmental cleaning procedures and protocols with a special attention to high-touch surfaces and object (e.g., phones, elevator buttons, computers, desks, lunch tables, kitchens, washrooms, cash registers, seating areas, surface counters, customer service counters, bars, restaurant tables/menus).
Will high-touch surfaces be cleaned and disinfected frequently?

The virus that causes COVID-19 may live on surfaces for a few hours or up to a few days. High-touch surfaces can be contaminated and increase the risk of transmission. Use approved hard surface disinfectants.

The frequency (i.e., one contact versus multiple contacts) and duration (i.e., transient contact versus prolonged contact) of exposure to high-touch surfaces and objects could potentially increase the risk of contamination.

Medium importance

Occupational Health and Safety - Including use of Personal Protective Equipment (PPE)

This guidance does not pertain to a high risk setting such as a health care setting.

Do your employees have access to Occupational Health and Safety services on site? How will symptomatic individuals in the workplace/business setting be handled? How will contacts be handled? Although screening may not identify all individuals infected with COVID-19 in the workplace/business, occupational health and safety professionals may be able to quickly and safely identify and isolate symptomatic individuals in the workplace. Medium importance
  • Plan for rapid isolation of a symptomatic employee;
  • Identify an area where employees/clients can be isolated if they become ill at the workplace;
  • Ensure that health care professionals onsite are using appropriate PPE and IPC measures, as per usual procedure.
Has the Occupational Health and Safety office assessed risk associated with employee interactions with the public? Employees whose duties require them to interact face to face with the public may be at increased risk due to their proximity to people whose health status is not known. High importance
  • Employees who interact in person with the public (within 2 m), or with objects handled by the public, or with spaces occupied by the public, should perform hand hygiene often and between every interaction with members of the public.
  • Tools and technologies to minimize contact with the public should be used, such as having customers scan and pack their own purchases when possible.
  • Barriers to protect employees who must interact within 2 metres of the public can be considered, such as clear plexiglass screens.
  • Workers who are exposed to people who are ill with respiratory symptoms, such as coughing and sneezing, may use face masks and eye protection if the nature of their work warrants it. Gloves are only recommended when workers will be in direct contact with an ill person, or a contaminated object or environment. PPE must be used correctly; training on their use should be provided
  • There is no evidence on the usefulness of face masks worn by healthy/asymptomatic persons as a mitigation measure, therefore it is not recommended. Employees should be reminded not to touch their faces.
  • Misuse of gloves and other personal protective equipment increases risk of infection due to improper handling of potentially contaminated gloves and equipment. If they must be worn because the staff may come in contact with contaminated material they must be applied correctly (link to instructions in Case and Contact management guidance: Public health management of cases and contacts associated with novel coronavirus disease 2019 (COVID-19).
Has the occupational health and safety office assessed the risk of employees interacting directly with spaces occupied by the general public? Employees whose duties require them to have direct contact with spaces occupied by the general public may be at increased risk due to contact with objects that could be contaminated. High importance
  • Mitigation as above
Traveling Does your workplace/business conduct frequent domestic/international travel?

Returning business travelers from international destinations are currently being advised to self-isolate for symptoms for 14 days following their arrival in Canada. This leads to greater absenteeism if the worker cannot work from home etc.

The evolving nature of the outbreak makes planning travel unpredictable, and international travel comes with the risk of increased exposure, being quarantined abroad, or becoming a contact of a case during plane travel.

High importance
  • Actively monitor travel advisories and provide information about the risk of travel;
  • Cancel all non-essential travel outside of Canada;
  • Assess the need for business travel based on the risks and benefits, and consider alternative approaches such as virtually attending meetings; Plan for absenteeism or alternative working arrangements (i.e., teleworking) if international travellers are unable to return to the workplace as per PHA advice.

Footnotes

Footnote 1

WHO. Getting your workplace ready for COVID-19. Feb 27 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19.pdf

Return to footnote 1 referrer

Footnote 2

WHO. Non-pharmaceutical public health measures for mitigating the risk and impact of epidemic and pandemic influenza. March 6 2020. Available at: https://www.who.int/influenza/publications/public_health_measures/publication/en/

Return to footnote 2 referrer

Footnote 3

US CDC. Interim Guidance for Businesses and Employers to Plan and Respond to Coronavirus Disease 2019 (COVID-19). February 2020. Available at: https://www.who.int/docs/default-source/coronaviruse/getting-workplace-ready-for-covid-19.pdf

Return to footnote 3 referrer

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