As essential businesses continue to operate, it’s crucial to consider how to handle a confirmed COVID-19 case in the workplace. Despite safety precautions to avoid the spread, one of your employees may get sick – do you know what to do? The COVID-19 pandemic has drastically altered how we work and operate. Take a proactive approach to safely keep your business operational in the event of a confirmed COVID-19 case by developing sound disinfection policies and procedures.

1. How to Prepare for and Respond to a
Confirmed COVID-19 Case at Your
Lab or Manufacturing Facility
Ian Lanza, Director of Technical Services
Triumvirate Environmental, Inc.

2. 2
During This Webinar
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✓ Communicate via the questions tab in your webinar panel.
✓ Unanswered questions will be responded to personally after the
webinar.
✓ Webinar recording and slides will be emailed to you this week.

3. Meet Your
Presenter
Ian Lanza
Director of Technical Services
Triumvirate Environmental, Inc.
3

4. Agenda
4
COVID-19 Public Health Crisis
Relevant COVID-19 Facts
Decontamination Strategies
Response to a Confirmed Case of COVID-19
Q&A

5. Triumvirate’s Perspective
• Highly technical environmental services provider
• Perform IH and facility disinfection and decontamination services for
biotech, pharmaceutical manufacturing, hospitals, and other biological
laboratory research organizations
▪ Work in BSL 1, 2, and 3 labs
▪ Biological decontaminations
▪ Biological safety cabinet decontamination and certification
▪ Wastewater treatment facilities
• Hazardous waste and regulated medical waste packaging,
transportation, and treatment
• EHS consulting for biological research, gene therapy manufacturing,
and healthcare
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6. Brief Timeline
6
31 Dec. 2019
China reported a cluster of cases
of pneumonia in Wuhan, Hubei
Province. A novel coronavirus
was eventually identified.
15 Jan.
The first U.S. case is confirmed, in
a man who traveled from Wuhan.
30 Jan.
The WHO declares a global
health emergency.
29 Feb.
Washington state reports the first
COVID-19 death in the U.S.
12 Mar.
The NBA suspends its season.
15 Mar.
33 states and the District of
Columbia closed public schools,
according to Education Week.
This included the New York City
school system, the largest in the
country.
26 Mar.
The U.S. leads the world in
confirmed COVID-19 cases.

7. COVID-19
Public Health
Crisis
• 2 million confirmed cases in the world
• 609,685 confirmed cases in the U.S.
• Anticipated peak in the U.S. from early
April through May
• The virus could kill up to 240,000
Americans
• Each state and even city will have a
different peak
• Unclear how the pandemic will end
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8. Stay at Home
Orders
• The President’s Coronavirus Guidelines
for America: 30 Days to Slow the
Spread
• Cyber and Infrastructure Security
Agency: Guidance on the Essential
Critical Infrastructure Workforce
• State, county, and city ordinances to
stay at home
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9. Essential Services: Considerations for
Business
• Follow guidance from CDC, federal, and local government to limit the
spread of the virus.
• Workers should be encouraged to work remotely when possible and
focus on core business activities.
• Separate staff by off-setting shift hours or days and/or social
distancing. These steps can preserve the workforce and allow
operations to continue.
• All organizations should implement their business continuity and
pandemic plans or put plans in place if they do not exist.
https://www.cisa.gov/publication/guidance-essential-critical-
infrastructure-workforce
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10. Federal Guidance for Essential
Workforce
• Most U.S. workers remain at a low risk of exposure
• Several industries are at higher risk
▪ Healthcare (including pre-hospital and medical transport workers, healthcare
providers, clinical laboratory personnel, and support staff)
▪ Deathcare (including coroners, medical examiners, and funeral directors)
▪ Airline operations
▪ Waste management
▪ Travel to areas where the virus is spreading
• Even though most U.S. workers remain at a low risk of exposure, it is
prudent to take steps to protect essential workers.
• All organizations should implement their business continuity and
pandemic plans or put plans in place if they do not exist.
10

11. Resources for Businesses and
Pandemic Plans
11

12. Agenda
12
COVID-19 Public Health Crisis
Relevant COVID-19 Facts
Decontamination Strategies
Response to a Confirmed Case of COVID-19
Q&A

13. 13
Human coronaviruses were first identified in the mid-1960s.
There are seven coronaviruses that can infect people:
• Common human coronaviruses
▪ 229E (alpha coronavirus)
▪ NL63 (alpha coronavirus)
▪ OC43 (beta coronavirus)
▪ HKU1 (beta coronavirus)
• Coronaviruses that infect animals can evolve and make
people sick and become a new human coronavirus. Three
recent examples are:
▪ MERS-CoV (Middle East Respiratory Syndrome)
▪ SARS-CoV (Severe Acute Respiratory Syndrome)
▪ SARS-CoV-2 (the novel coronavirus that causes COVID-19)
Human Coronavirus Types

14. Transmission “Facts”
• The onset and duration of viral shedding and the period of
infectiousness for COVID-19 are not yet known.
• There are reports of asymptomatic infections (detection of virus
with no development of symptoms) and pre-symptomatic
infections (detection of virus prior to development of symptoms)
with SARS-CoV-2, but their role in transmission is not yet
known.
• Incubation period is believed to be 2-14 days.
• Virus detected in respiratory body fluids, blood, and stool.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/faq.html
14

15. • Primarily transmitted through respiratory droplets and contact routes
▪ Mucous and conjunctivitis -> direct contact (1 meter)
▪ Fomites in the immediate environment around the person -> indirect contact with
objects contaminated with the virus
https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-
causing-covid-19-implications-for-ipc-precaution-recommendations
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Modes of Transmission Causing
COVID-19: Respiratory Droplets

16. Modes of Transmission Causing
COVID-19: Aerosols
• <5 µm particles called droplet nuclei
• May persist for up to 3 hours
• May travel more than 1 meter
▪ https://www.who.int/news-room/commentaries/detail/modes-of-transmission-
of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations
• Data suggests some aerosols could travel 4 meters
▪ https://wwwnc.cdc.gov/eid/article/26/7/20-0885_article
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17. Presence of SARS-CoV-2 on Surfaces
• 2 hours to 9 days (Journal of Hospital Infection of similar
coronaviruses)
• 72 hours
• 7 days – CDC guidance for disinfecting facilities
• 17 days – CDC study of the Diamond Princess Cruise ship. CDC
acknowledged this data can not be used to determine if transmission
occurred from surfaces and that more research on fomite
transmission was warranted.
17

18. Agenda
18
COVID-19 Public Health Crisis
Relevant COVID-19 Facts
Decontamination Strategies
Response to a Confirmed Case of COVID-19
Q&A

19. Keeping Your Workforce Safe
with Cleaning, Disinfection,
and Decontamination Efforts
Cleaning
Disinfection
Decontamination
Routine and Proactive Cleaning and Disinfection
19

20. Cleaning vs. Disinfecting
Cleaning
• Refers to the removal of dirt and impurities, including germs,
from surfaces.
• Cleaning alone does not kill germs.
• Cleaning decreases the amount of germs, and therefore
decreases the risk of spreading infection.
• Solvents and detergents (soap and water) to remove grit and
dirt.
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21. Cleaning vs. Disinfecting
Disinfecting
• Disinfection requires prior cleaning to maximize effectiveness.
• Kills germs remaining on a surface after cleaning further
reduces any risk of spreading infection.
• Does not necessarily clean dirty surfaces or remove germs.
• See EPA List N: Disinfectants for Use Against SARS-CoV-2
▪ Search for first two sets of the EPA Registration Number
▪ This list changes daily
21

22. Decontamination
• “Decontamination renders an area, device, item, or material safe to
handle.” BMBL Appendix B
• May include cleaning, disinfection, or sterilization or any combination, with
the emphasis on eliminating risk of infection transmission.
• Decontamination efforts are more prudent in the event of known
contamination or a known COVID-19 case.
• Triumvirate’s SOPs and approach are considered decontamination. We
employ cleaning and disinfecting methods with real-time and post-
decontamination analysis to assure complete decontamination.
• Janitorial services are general with more broad cleaning and disinfection,
and less emphasis on identifying contamination and ensuring the methods
are appropriate for the specific situation.
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23. Routine Cleaning and Disinfection
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Routine cleaning of high-touch
surfaces such as tables, doorknobs,
light switches, countertops, handles,
desks, phones, keyboards, toilets,
faucets, and sinks.
Routine disinfection may be
appropriate for common areas
with potential higher viral load
(restrooms, kitchens).
Keep work areas uncluttered
and as clean as possible. This
will make any disinfection
activities much easier.

24. Agenda
24
COVID-19 Public Health Crisis
Relevant COVID-19 Facts
Decontamination Strategies
Response to a Confirmed Case of COVID-19
Q&A

25. Confirmed
Case of
COVID-19
in the
Workplace
25
Create Create an Action Plan
Complete Complete a Risk Assessment
Compile Compile Facts

26. Collect Case Facts
• Person under investigation or confirmed COVID-19
▪ Symptoms of individual
• Timeline of infection and work activities
▪ When was the individual last present in the facility
▪ Where in the facility did the individual go
• Which areas were routinely cleaned and disinfected
• Identify co-workers or others who may be at high risk of
transmission
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27. Risk Assessment – Risk of Infection to
Your Workforce
27
• Infection from contamination
• Chance of live virus at your
site
• Time of potential
contamination
• Define the locations
potentially contaminated

28. Risk Assessment – Comfort of Your
Workforce
• How is your workforce
responding to the case?
• Is personal well-being as a
result of a confirmed case
impacting productivity or
morale?
• Is the case distracting your
workforce?
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29. Create a Work Plan
29
Initial Response
Develop the Decontamination Scope of Work
Communicate
Complete the Decontamination Scope

30. Initial Response
30
Seal off the workspaces
associated with the sick
person
Increase air flow to the
areas (fan ventilation, open
windows)
CDC recommends waiting
24 hours prior to disinfection
activities

31. Develop Decontamination Scope of
Work
31
WHERE: Define the
area to be
decontaminated
WHAT: Clean,
disinfect, and
decontaminate
HOW: Disinfectants
and type of surface
WHO: Identify qualified
professionals to
complete the scope of
work

32. WHERE: Define Work Area
• Review the locations at the facility in which the employee
worked
• Review work activities and time in each space
• Review PPE and routine cleaning activities
• Identify high-touch areas around the facility
32
Floor plans are a great resource for establishing primary and secondary areas of
contamination and help guide the decontamination efforts.

33. WHAT: Clean, Disinfect, Discard
Decontaminate
• Review current state of area (clean, dirty, routinely cleaned or
disinfected)
• Identify hazards not associated with COVID-19
• Identify sensitive equipment, products, materials requiring
special handling/attention
• Identify appropriate decontamination methods (clean and/or
disinfect)
• Discuss paper products, food, personal items (coffee cups),
knickknacks, supplies, and other objects potentially in scope
33

34. HOW: Surface Types
• Hard Surfaces – Clean, then disinfect.
• Paper Products – Discard as biowaste, or disinfect.
• Food – Discard as biowaste. Clean dishes and utensils (consider
coffee cups and water bottles).
• Porous Surfaces – Discard as biowaste, clean, launder, or disinfect.
• Electronics – Follow manufacturer instructions or wipe surface with
70% IPA or other approved disinfectant.
• Linens, Clothing, and Other Laundry Items
▪ Do not shake dirty laundry.
▪ Launder with service or use hottest water temperature and, if possible,
chlorine-containing detergent. Dry thoroughly.
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35. Workspaces
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36. HOW: Disinfecting Agents
• If cleaning, use agents that will
clean (soaps).
• Use an EPA-approved
disinfectant, per manufacturer’s
use instructions.
• Review details of disinfectant
plan, including different methods
and strategies for different types
of surfaces and objects.
36

37. WHO: Qualified and Appropriate
• COVID-19 decontamination response must have the following
safety and compliance training:
▪ Hazard Communication (29 CFR 1910.1200)
▪ Bloodborne Pathogens (29 CFR 1910.1030)
▪ Proper disposal of regulated waste, and PPE (29 CFR 1910.132)
• Hazard Recognition: Special consideration for lab areas or
areas with hazardous materials
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38. Communicate
• Review decontamination plan with relevant site stakeholders.
▪ Owners of the space
▪ Employees in an impacted space
▪ Security
▪ Leadership
• Review methods with appropriate stakeholders. Consider how
the method will impact types of surface.
▪ Desks
▪ Bench areas
▪ Materials and equipment
38

39. Complete Scope
• Estimated time of activities
• Complete decontamination
• Manage waste appropriately
• Identify when the space will be released
back to employees
• Provide decontamination confirmation and/
or report
39

40. Quality Assurance
Tiered verification
approach to confirm
that your facility
decontamination is
effective
Risk Assessment
Scope of Work
and SOPs
Visual
Inspections
Surface
Sampling
40

41. Surface Sampling
• Verification sampling methods and on-site monitoring
instruments to rapidly verify decontamination efforts in real time.
▪ Industry accepted methods for determining “clean”
▪ Real-time analysis
• Laboratory confirmation of COVID-19
▪ Longer lead times
▪ Not readily available
41

42. What to Do If There Is a PUI and Not a
Confirmed COVID-19 Case
• Evaluate the details of the case and make a judgment based on
those facts.
• Make decisions that are in the best interest of your business.
• Make decisions that will enable your business to continue to
provide essential services during our response to the pandemic.
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43. What We Are Seeing
• Every response is unique depending on the risk assessment
(risk of transmission and psychological risk to workforce).
• Confirmed cases are always resulting in official COVID-19
decontamination – generally 1 to 2 days to return to operations.
• PUIs are all evaluated on a case-by-case basis.
• Increased routine cleaning and disinfection activities.
• Proactive decontamination of labs and workspaces.
▪ Routine
▪ Prior to workforce returning or prior to large increases in workforce.
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44. Triumvirate Is Here to Help
• COVID-19 Decontamination Services –
We will work with you on the risk
assessment and share our evaluation of
the case as well.
• Pre-planning calls to talk through a
confirmed COVID-19 case at your site.
• More in-depth COVID-19 risk
assessments and policy support for your
facility.
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45. Triumvirate’s COVID-19 Services
• COVID-19 Risk Assessments and Risk Management
• COVID-19 Facility Decontamination
• Temperature Screening Assistance
• Mobile Testing Design and Support
• Infection Control Support
• Respirator Fit Testing
• Just Ask!
• www.triumvirate.com/coronavirus
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46. Questions?

47. THANK YOU!
CONTACT US!
1-888-834-9697
www.triumvirate.com