By: Department of Disabilities, Aging and Independent Living
Instructions: This guidance is compiled from information provided primary by the Vermont Department of Health and the Center for Disease Control and Prevention. Links to these and other sources are provided at the end of this document. This guidance is intended to provide people who receive services, support workers, home providers and other caregivers information on the symptoms, prevention and precautionary measures regarding the spread of COVID-19 when providing support to an individual in a home setting (own apartment, shared living home, staffed living or group living arrangement). The intent is for the person’s service coordinator, shared living provider, home manager or other agency staff person to implement infection control measures that create and maintain a home setting that is as safe as possible for all those living in the home.
We recognize that all homes have different structural features and that there may be certain constraints due to the physical ability of the people living in the home. It is the intent that this guidance will be taken into consideration and implemented to the greatest extent possible.
Information and resources will be added to this document as needed. This tool is not a regulatory requirement and the content does not reflect DAIL policy.
See the Resource section at the end of the document for more detailed guidance.
A. Standard Infection Control Procedures
During this time of Governor Scott’s “Stay Home, Stay Safe” Order, the individual being supported and the people the individual lives with, should limit who they come into contact with, including, but not limited to, agency staff, contracted workers, family, friends and other visitors. Given the risks to both individuals and caregivers, visitors in the home should be limited to those who have an essential need to be there. Any time someone comes into the home exposes everyone to all people the visitor has been in contact with.
1. Anyone potentially in contact with the person or household members needs to be screened using the following advised screening questions and processes from the Vermont Department of Health prior to entering the home or having contact.
a. Have you traveled outside of Vermont to any of the affected countries or regions?
b. Have you been in contact with a person who has tested positive for COVID-19?
c. Have you had any of the following symptoms in the last few days?
o Respiratory symptoms such as cough?
o Fever?
o Difficulty breathing?
2. Going out into the community should be limited to when it is absolutely necessary.
Considering having groceries or prescriptions delivered. Check your local stores – many are offering delivery or curbside pickup.
3. Going outside to walk and get exercise is encouraged while keeping a physical distance of
6 feet between people.
4. Try to keep a physical distance of 6 feet between people when in the home and when outdoors. While this may not always be possible, avoid any unnecessary touching and other close contact between all household members.
B. Hand Hygiene
The following guidance is recommended for all people who live in or enter the home.
1. Wash hands immediately upon entering the home – every time.
2. Wash hands immediately prior to leaving the home – every time.
3. Have soap, water and clean towels or paper towels and a wastebasket available by all sinks.
4. Wash hands often with soap and water, specifically:
a. After going to the bathroom. b. Before eating.
c. After sneezing, coughing or blowing one’s nose.
d. After contact with blood, stool or body fluids (such as saliva, sputum, nasal mucus, vomit, urine).
e. After contact with visibly contaminated surfaces. f. After physical contact with people in the home.
g. After removing personal protective equipment (e.g., gloves, gown, facemask). h. After performing a personal care procedure.
5. Follow proper hand washing practices:
a. Turn on the faucet, wet hands and apply soap.
b. Scrub hands (including fingers, thumbs, wrists) for at least 20 seconds.
c. Rinse hands and use clean towel or paper towel to dry hands completely and turn off faucet.
6. Assist the individual being supported to do hand washing and use alcohol-based hand sanitizer, when needed.
7. Have alcohol-based hand sanitizer (at least 60% alcohol) readily accessible and placed in appropriate locations, including
a. Entrances to bedrooms/personal spaces.
b. Bedside as needed depending on the level of supports the individual needs. c. Other convenient locations.
8. Alcohol-based hand sanitizer recipe (based on recipe from the World Health Organization)
– 1 cup (250 mL) isopropyl alcohol (91%)
– 1 teaspoon (5 mL) glycerol (or other moisturizer such as aloe vera gel, warm honey or olive oil)
– 2 Tablespoons (33 mL) water
Add the ingredients in the order listed above to a clean container, mixing with a spoon. If using honey, stir until the honey is completely dissolved. Keep this mixture out of the
reach of children. The final concentration of isopropyl alcohol in this mixture is 75%, so keep it away from flames.
C. Sanitary Practices to Follow
1. Get plenty of rest, eat healthy and stay well hydrated.
2. Keep good air flow in shared spaces in the home.
3. Avoid touching your eyes, nose and mouth with unwashed hands. If you touch your eyes, nose or month, wash your hands right away.
4. Avoid contact with people who are ill.
5. Avoid sharing personal items, such as food, drink, dishes, drinking glasses, cups, eating utensils, towels, bedding and personal hygiene products.
6. Clean all surfaces at least daily that are touched often, such as counters, tabletops, doorknobs, light switches, bathroom fixtures, toilets, bedside tables, phones, keyboards by using a regular household cleaning spray or wipe.
7. Reduce the sharing of bedrooms and bathrooms, whenever possible.
8. Cover mouth and nose with a tissue when you cough or sneeze, then throw the tissue in the trash and wash hands.
9. Change from outdoor clothes to indoor clothes, including shoes, when entering the home. Change from indoor clothes to outdoor clothes, including shoes, when leaving. This includes paid workers.
10. Consider discontinuing use of nebulizers, air purifiers or aerosol devices as they may spread germs through the house. Open windows to get fresh air into the home, weather permitting.
11. Maintain an adequate supply of all prescription medications, ideally a 90-day supply.
12. Maintain an adequate supply of relevant over-the-counter medications.
NOTE: Some research indicates using non-steroidal anti-inflammatory medications (such as Advil, Motrin, Aleve, Ibuprofen) can lead to decreased immunity and increase risk of contracting COVID-19. Contact your health care provider if you are taking one of these.
13.Handle and store linens and clothing appropriately using the following practices:
a. Ensure mattresses, pillows, bedding and linens are maintained in good condition and are clean.
b. Wear gloves and keep movement of dirty linens and clothes minimal to contain possible contamination.
c. Immediately remove and wash linens and clothes that have blood, stool or body fluids on them.
d. Wash hands when done.
e. Return clean linens and clothes in a way that maintains cleanliness.
D. Transmission-Based Precautions
1. Monitor temperatures of people in the home a few times a day and monitor for symptoms of COVID-19.
2. COVID-19 symptoms may appear 2-14 days after exposure. Monitor people for the following symptoms:
a. Emergency Warning Signs:
o Trouble breathing
o Persistent pain or pressure in the chest
o New confusion or inability to arouse
o Bluish lips or face
b. COVID-19 Symptoms:
o Fever
o Cough
o Shortness of Breath
o Loss of smell or taste (possible first symptom)
3. If a person in the home has COVID-19 symptoms, contact the person’s health care provider immediately. Do not go to a Hospital Emergency Room or Urgent Care unless directed by the health care provider. Call 911 if there is a medical emergency.
4. Contact the person’s service coordinator or other identified service agency staff person if the individual being supported or other people in the home have COVID-19 symptoms or have been tested positive for COVID-19.
If a person in the home has symptoms or has been tested positive for COVID-19, practice the following guidance:
5. Isolate the person and follow the standard recommendation of 6 feet of physical distancing. Other members of the household and support workers should stay in another room or be separated from the person as much as possible.
6. The person should not handle pets or other animals while sick.
7. Any person who has symptoms or tested positive should wear a clean, disposable facemask to prevent the spread of infection. It is not recommended that people wear facemasks if they are well.
8. Appropriately use personal protective equipment (PPE), such as facemasks, gloves and gowns, when available.
a. Wear a facemask when within three feet of a person; ideally a fit-tested N95
respirator, and prior to entering a person’s bedroom or personal space.
b. Wear gloves and gowns if in close or physical contact with the person and/or when
entering a person’s bedroom or personal space.
c. Throw out disposable facemasks and gloves after using them. Do not reuse. Wash hands after removing gloves and other PPE.
d. Follow best practice guidance on the disposable of PPE and personal care supplies
and equipment. Place all used disposable gloves, facemasks and other contaminated items in a lined container before disposing of them with other household waste. Wash hands or use alcohol-based hand sanitizer with immediately after handling these items. Wash with soap and water if hands are visibly dirty.
E. Stay Connected While Being Physically Distant
During this time of uncertainty, many people are feeling understandably angry, worried, and scared. Staying away from friends and family can make the feeling of isolation worse. People are encouraged to keep connections with family, friends, and your community in new ways. Use technology to communicate, enjoy the outdoors, take time to learn a new skill, follow up on long-overdue projects, or volunteer to support those who may be in need. It is important to get outside for fresh air and exercise. Spend time outdoors as a family or consider individual outdoor activities like biking or hiking, as it’s easier to keep a good distance from each other.
Resources
PLEASE NOTE: Guidance concerning COVID-19 is changing rapidly; please regularly check the Center for Disease Control and Prevention (CDC) website for updated and addition information.
Vermont Department of Health Website
COVID-19 – What You Need to Know Now: For Health Care Professionals
VDH COVID-19 info page
What to Do if You are Diagnosed with COVID-19 https://www.healthvermont.gov/sites/default/files/documents/pdf/COVID-19_What-to-do-if- you-are-diagnosed-with-COVID-19_final.pdf
Center for Disease Control and Prevention Website
Caring for Someone at Home:
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/care-for someone.html
Infection Control: Transmission-Based Precautions:
https://www.cdc.gov/infectioncontrol/basics/transmission-based-precautions.html
Interim Infection Prevention and Control: Recommendations for Patients with Suspected or Confirmed COVID-19 in Healthcare Settings:
https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html
Healthcare Supply of Personal Protective Equipment
https://www.cdc.gov/coronavirus/2019-ncov/hcp/healthcare-supply-ppe-index.html
When and How to Wash Your Hands
https://www.cdc.gov/handwashing/when-how-handwashing.html
Cleaning and Disinfecting Your Home: Everyday Steps and Extra Steps when Someone is Sick
https://www.cdc.gov/coronavirus/2019-ncov/prepare/disinfecting-your-home.html
People Who are at Higher Risk for Severe Illness https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-at-higher- risk.html
Interim Guidance for Implementing Home Care of People Not Requiring Hospitalization for COVID-19
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-home-care.html
What to Do if You are in Close Contact with Someone Who has COVID-19 https://www.healthvermont.gov/sites/default/files/documents/pdf/COVID-19_What-to-do-if- you-are-a-close-contact-of-someone-with-COVID-19_final.pdf
What to Do if You are Sick – Steps to Help Prevent the Spread of COVID-19 if You are Sick
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html
Caring for Yourself at Home: 10 Things You can Do to Manage Your Health at Home
https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/caring-for-yourself-at-home.html
Department of Disabilities, Aging and Independent Living Website
DAIL Novel Coronavirus Information
https://dail.vermont.gov/novel-coronavirus-information
Additional Resources
COVID-19 Food Safety Tips – with Dr. Jeffrey VanWingen
Green Mountain Guide for Emergency Planning: My Personal Safety in an Emergency Kit https://dail.vermont.gov/sites/dail/files/documents/GrnMtnGuideforEmergPlan_forprint%20c opy.pdf
Tips for Working with Support Staff During COVID-19 (Plain Language) https://selfadvocacyinfo.org/wp-content/uploads/2020/03/Plain-Language-Tips-For- Working-With-Support-Staff-During-COVID-19-March-30-2020.pdf