tb-faqs

FAQs

COVID-19 FAQs as of October 16, 2020

Here is the latest information about COVID-19 and B&M activities and responses in the format of Frequently Asked Questions (FAQs). New questions and answers have been added below. You will also find some updated answers to previously submitted questions, shown in italics, in the Past FAQs section.

“Information on this page does not constitute medical advice or treatment recommendations. Please contact your health care provider if you have any concerns”.

You will also find some updated answers to previously submitted questions, shown in italics, in the Past FAQs section.

 

COVID Crisis Management with Dr. Levine

The data shows that initially in the last two months younger people were affected disproportionately. That doesn’t appear to be the case anymore. There are more cases in the 40-60 age group right now.

At the moment supply of the vaccine may seem to be constrained, but it will ramp up quickly. We don’t usually have a huge supply at this point in the year anyway. The demand is going to be higher this year, but the government has ordered many more vaccination kits than is typically the case. It just will take time for the shots to get to every pharmacy, medical office, etc.

I would strongly encourage you to follow the indoor gathering limits of 10, taking into account the type of space in which the meetings are held. . A group of 10 individuals meeting in a huge gym is very different from the same number of people congregating in a small meeting room. I would encourage you to eliminate in person meetings or at least minimize the number of people meeting to reduce the risk as much as possible.

This is an evolving area of knowledge. A number of people in various countries have gotten the virus a second time. It’s not common – these are pretty isolated incidences – but clearly not every infection confers long lasting immunity. It’s something that is worth keeping an eye on. How repeat infections apply to a future vaccine is also an open question.

While it is possible to contract the infection through surface contact it doesn’t seem to be a specifically important form of spread. Droplet spread and airborne transmission is more prevalent and risky. That’s not to say you should stop cleaning surfaces, but it doesn’t need to be the main focus. Masking and distancing are more effective in preventing the spread of the virus than avoiding potentially contaminated surfaces.

We are still not completely sure about the role airborne transmission plays with this virus. It’s clear that relatively large droplets emitted by breathing, speaking and sneezing are the main way this virus is transmitted. How important small droplets are for transmission via air currents is unclear, but they don’t appear to be unimportant. However, we do think that small droplets are not as infectious as large droplets.

In practical terms the more time you spend in an enclosed space, for example in an office, the risk of contracting COVID-19 by airborne spread increases. As we begin working more inside during the winter months, the issue of indoor airborne spread will likely increase in importance.

Yes, I recommend that they remain off work and get a test. You cannot assume that people who are sick have just come down with a “regular” cold. There is no way to distinguish a cold from COVID-19 symptoms without a test. Sick people showing symptoms have to remain off work aand possibly get another test after that period as well.

 

More FAQs

There are plenty of fun alternatives to trick-or-treating! Consider encouraging kids to dress up and participate in virtual activities and parties. You may want to organize a candy hunt with people living in your household. Or you may want to have a scary Halloween night and watch movies and trade frightening stories. There is no reason why Halloween cannot be enjoyable.

Even if your kids can go out, trick-or-treating this year will be tricky. Ensure that your kids go out with members of their household and remain within their neighbourhood; that they maintain physical distancing of at least two metres (six feet); and that they wear a face mask designed to prevent the spread of the virus. Also, ensure that they avoid high-touch surfaces and objects, such as door bells and handrails, and that they wash hands thoroughly or use hand sanitizer.

The standard would be that both conditions are met: either a negative test plus 48 hours of being symptom free, or an asymptomatic individual with a negative test and the 48 hours met while waiting for the test results.

Anything that can be done to lessen the chance of contracting seasonal flu is a good thing for everyone, not just the elderly or those with underlying health issues. Everyone should get vaccinated.

If they get COVID-19 they are more likely to have increased severity of symptoms but they are not more likely contract the disease. Those with compromised immune systems may have an increased chance of contracting the disease.

Although there is still much to learn about the virus, it increasingly appears that not only does COVID-19 affect the upper respiratory system and lungs but may also possibly affect blood vessels.

It depends on which classes and which schools. There is a very wide spectrum of resources in terms of particular school boards, particular schools, the demographic within a certain community, and the constraints that they each face.

Parents and teachers need to make wearing masks something that is fun for kids; it needs to be something that is part of their personality. Whatever methods that teachers and resource staff can use to create a positive culture around mask wearing is important.

It comes down to what’s the given environment. Schools that are more likely to have difficulties with ventilation that is outdated or have fewer resources in general to do distance learning may represent an unsafe situation.

This is another logistical challenge that is going to require attention. School buses are not designed to allow distancing within them by keeping seats empty.

Masks are critical. A school bus is an indoor environment that is not well ventilated, and for some kids it can be upwards of 45 minutes or longer. Additionally it’s important to make sure that hands are washed before getting on the bus and that hand sanitizer is provided on the bus at entry.

Actually, the answer is somewhat complicated. It depends on an assessment of the probability that the negative test is a “true negative” rather than a “false negative”. This assessment would be informed by a variety of factors, including:

  • the nature and severity of the person’s symptoms and the timeline of those symptoms
  • any epidemiological link between the person and a known case or cluster/outbreak of cases, including an analysis of the nature/duration of any contact
  • local prevalence of COVID-19 
  • risk behaviours (e.g. diligence in wearing PPE and practicing hand/face hygiene, diligence in avoiding contact with known cases, history of attendance in higher risk environments (such as crowded indoor spaces), etc, etc). 

So each situation really needs to be assessed on its own merits. In some cases, an employee could RTW immediately after a negative test is received (these could include situations where the symptoms are determined to be unlikely to be COVID-19 related (from a clinical perspective), and where the symptoms are resolved or significantly improved, and where there is not a known connection to a positive case). Other situations may require a full 10-14 days off work, even with a negative test and with resolution of symptoms, depending on the specifics of the situation. Unfortunately, this means that a “one size fits all” approach is probably not possible or advisable. 

There are no definite plans to change the recommendations for physical distancing in Canada at this time. A recent review of this issue in the Lancet found that transmission of viruses was lower with physical distancing of 1 m or more, compared with a distance of less than 1 m, and that protection was increased as distance was lengthened, with the review finding a reduction of risk by approximately 50% with each additional metre of distance (this should be viewed as being very approximate given the limitations of the research to date). It is clear that the further people remain apart, the lower the risk will be for direct droplet-borne spread (which accounts for the bulk of spread of COVID-19).  So policy recommendations from authorities in this regard would seem to be more about how much risk reduction they want to achieve using physical distancing, balanced against competing imperatives (e.g. available space, population density, etc.) and this may vary somewhat according to the particular context of the authority making the recommendation (e.g. rates of mask use, testing positivity rate, success in contact tracing, etc.) What is appropriate in one jurisdiction might not be appropriate in another. As with everything else to do with COVID-19, the answer is “complicated”!

The CDC continues to recommend a 14 day quarantine following close contact with a known case of COVID-19 (see https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/quarantine.html). This is in line with Canadian requirements, and with most other global jurisdictions. The recommendation for being off work for 10 days is for *cases* (i.e. 10 days after onset of symptoms, or after a positive test), *not for contacts of cases*. The rationale is that following contact with a known case of COVID-19, it can take up to 14 days for an individual to manifest symptoms, so the full 14 day period must be waited out to determine whether the contact leads to a new case (f the contact remains asymptomatic for the full 14 days, they would be released from quarantine). However, once a person develops symptoms and becomes a case (generally on the basis of a positive test), we know that the period where they are maximally contagious to others is from 48-72 hours prior to symptom development until 10 days after the onset of symptoms. So this leads to a difference in recommendations for quarantine/isolation between contacts of cases and cases themselves. Paradoxically, it can lead to asymptomatic contacts of known cases being off work for longer periods than the cases themselves! 

For COVID-19, a “close contact” is anyone who was within 6 feet of an infected person for at least 15 minutes. An infected person can spread COVID-19 starting 48 hours (or 2 days) before the person has any symptoms or tests positive for COVID-19.  (CDC)

Yes, you are considered a “close contact” even if you are wearing a mask while you were around someone with COVID-19. Masks are meant to protect other people from the wearer, not to protect you from becoming infected. (CDC)

Duration of the COVID-19 virus in the body is more complicated than what you might expect (as is everything else related to it!). There appears to be significant variability between individuals in terms of duration of symptoms and in terms of duration of viral shedding (these two parameters do not always correspond). In the case of asymptomatic individuals (i.e. discovered to have a positive test), viral shedding can persist for quite a few weeks in some cases, but the period of infectivity is thought to be mostly limited to the first 10 days of “illness”. Since we cannot determine the start date of the “illness”, we recommend starting the 10 day count from the date on which they were tested (not the date on which the positive result was obtained, which would generally be 1-2 days later). 

Answer provided by Dr. Noah Levine

Testing positive twice is most likely indicative of an infected individual who, despite having recovered symptomatically, continues to shed virus RNA (which is what the COVID-19 detects). The current evidence is that this asymptomatic shedding of virus RNA following recovery from symptomatic infection can persist for many weeks, but is most likely not a significant source of viral spread (there are many theories about why this might be the case). It is also conceivable that following recovery from symptomatic infection, the individual became re-infected (most likely with a different strain), resulting in a second course of illness. Without knowing more about the specific clinical details of the case in question, it is difficult to be more precise in my response. 

Answer provided by Dr. Noah Levine

This scenario is not at all surprising, for a few reasons. First of all, the test itself has a false negative rate of up to 30 per cent, meaning that the first test for this individual had up to a 30 per cent chance of being reported as negative even if the virus was actually present. Secondly, it can take several days for sufficient virus to be excreted in the upper respiratory tract to register a positive test, so if a person is tested very early after contact with an infected individual, the test can be negative even while an infection is “brewing”. Thirdly, it is also possible that the person was actually not infected at the time of the first test and then became infected during the five day interval between the tests (e.g. when out grocery shopping, or from some other contact or mode of transmission). So there are many reasons why one might observe the phenomenon of a negative test followed by a positive test. For this reason, we caution employers not to place too much stock on a negative test when making return to work decisions. 

Answer provided by Dr. Noah Levine

All B&M employees who work in health care settings are required to continually abide by the hospital or clients standards. At this time, CDC and OSHA have recommended using a combination of standard precautions, contact precautions, airborne precautions, and personal protective equipment (gowns, gloves, N95 masks, and eye protection) to protect healthcare workers with exposure to the virus.

Engineering controls such as physical barriers, airborne infection isolation rooms will likely be set up in health care settings. Ensure that you understand the layout and ask questions if you’re unsure.

If ever in doubt, contact your direct supervisor, or your Regional HSE for guidance.

All B&M employees who work in airport settings are required to continually abide by the airport or clients standards.

Alert your health care provider immediately if you think you have been infected with COVID-19; including exposure to someone with the virus and have signs/symptoms of infection.

If you believe you have been exposed on the job, alert your direct supervisor and Regional HSE.

Your healthcare provider can determine if your signs and symptoms are explained by other causes, or if there is reason to suspect you may have COVID-19. If laboratory testing is appropriate, your healthcare provider will work with health officials in your province/state to collect any clinical specimens for diagnosis.

There is no current vaccine or specific treatment available. Hospitals can provide supportive care for infected people.

It is not yet known whether the weather and temperature will impact the spread of COVID-19. Some other viruses, like the common cold and flu, spread more during the cold winter months, but that does not mean it is impossible to become sick with these viruses during other months. At this time, it is not known whether the spread of COVID-19 will decrease when weather becomes warmer.

Absolutely not. No one race or ethnicity is more or less susceptible to COVID-19 than another.

Early information, out of China, where COVID-19 first started, shows that some people are at higher risk of getting sick. These include:

  • Older adults
  • People with serious chronic medical conditions such as:
    • Heart disease
    • Diabetes
    • Lung disease

If you are within these higher risk groups, the following are some precautions suggested by the CDC:

  • Contact your health care provider to ask about obtaining extra necessary medications to have on hand incase you need to stay home for a prolonged period of time
  • If you cannot get extra medications, consider mail-order medications
  • Have enough household items and groceries so that you will be prepared to stay at home for a period of time.
It can take 2 to 14 days for a person to develop symptoms after initial exposure to the virus. The average is about 5 days.

The WHO reports that 80% of patients have a mild to moderate disease from infection. The milder cases are because the body’s immune response is able to contain the virus in the upper respiratory tract. These are typically healthy people with no pre-existing conditions.

In 13.8% of severe cases, and 6.1% of critical cases, the virus made its way to the lower respiratory tract through the windpipe. As the virus moves towards the lungs, it will continue to replicate and can cause problems such as bronchitis and pneumonia.

When pneumonia occurs, a thin layer of alveolar cells is damaged by the virus. The body then reacts by sending immune cells to the lung to fight it off. This results in the linings becoming thicker than normal. As they thicken more and more, they choke off alveoli (air pockets), which is what you need to get oxygen to your blood.

While there is no concrete answer, it’s anticipated that a vaccine will take approximately 12-18 months.

Vaccines are given to people who are healthy as a preventative measure. Preventative vaccines don’t treat or cure sickness, but rather they gear up your immune system to fight the potential disease.

The purpose of the vaccines would be to help your immune system by recognizing the difference between your healthy cells, and the harmful cells.

Flattening the curve refers to using protective practices to slow the rate of COVID-19 infection so hospitals have room, supplies, and doctors for all the patients who need care.

Do not travel by air anywhere and seriously reconsider car travel outside of your home region for any reason.

Stopping the transmission of COVID-19 means we all must adopt extreme measures to limit our social interaction with others both at work, in public and at home.  This is what social distancing is. 

If we only practice it at work and not home, we are seriously undermining our collective efforts to slow the spread of the virus. 

Please follow these social distancing recommendations for work and home:

  1. Keep your distance – stay 6 feet apart from others whenever possible.
  2. Avoid all physical contact, even when greeting – no handshakes, hugs, kisses, knuckle bumps or high fives.
  3. Take care of your family but limit socializing with anyone outside the home or office– no lunches, parties, playdates, sleepovers or visiting friends.
  4. Reduce the frequency of going out in public, even to stores and restaurants,
  5. Limit interactions with older people, even parents and relatives, as they are the most vulnerable
  6. Stay home if you are sick, isolate from everyone, including family, whenever possible. And seek medical attention

These changes to your daily lives and preferred routines represent burdensome and annoying sacrifices.  But recent experiences of countries worldwide have demonstrated that taking these actions early can have a dramatic impact on the magnitude of the outbreak.

We are encouraging everyone to be vigilant about monitoring their health for symptoms of COVID-19 and also identifying and reporting sources of potential exposure to the virus (contact with people who are infected, recent international travel). 

In the vernacular of public health isolation and quarantine mean different but related practices.  With respect to a health emergency such as COVID-19, isolation is simply the practice of keeping ill people separate from those who are well while quarantine is the practice of restricting the movement of people who were exposed to a contagious disease to see if they become sick.

So for B&M, we are using the term isolate” to describe our internal and personal efforts to keep ill people away from those who are well. 

Isolate basically means you stay at home if you have COVID-19.  Isolation is required for those who have been confirmed to have COVID-19. Isolation is a health care term that means keeping people who are infected with a contagious illness away from those who are not infected. Isolation can take place at home, or at a health care facility.

Self-isolate (or self-quarantine) means you stay at home because you suspect you may be ill because you have COVID-like symptoms and/or you suspect you came in contact with a person who has a suspected or confirmed case at home, in public or while travelling.

If you are ill with COVID-19 symptoms, contact your supervisor or HSE rep, and stay at home.  Isolate yourself from family and others to the best of your ability.  Follow the instructions of your local/regional health unit regarding next steps.  Seek medical attention if your condition worsens, particularly as it relates to breathing difficulties.

 

This means you have been explicitly instructed to separate yourself from others, with the purpose of preventing the spread of the virus, including those within your home. If you are ill, you should be separated from others in your household to the greatest extent possible.

Until cleared by your health care professional, self-isolation means:

  • Do not use public transportation, including taxis or ride share programs (like Uber)
  • Do not go to work, school or other public areas
  • Limit the number of visitors in your home
  • Stay in a separate room away from other people in your home as much as possible; use a separate bathroom, if possible
  • Make sure that any shared rooms have good air flow (open windows)
  • Cover your coughs and your sneezes; wash your hands after (even if you sneeze into a tissue, or your elbow)
  • Wash your hands after emptying waste baskets
  • Use soap and water to wash your hands
  • Dry your hands with a paper towel, or towel that no one else uses
  • Use alcohol based hand sanitizer
  • Wear a mask if you are within 2 meters of people, or need to leave your house to see your health care provider
  • Clean all high-touch/traffic” areas such as counters, toilets, sink tap handles, tabletops, doorknobs, TV remotes, phones, and bedside tables daily, using regular household cleaners
  • Wear disposable gloves when cleaning surfaces
  • Do not return to work, school or public activity until you have been cleared by your health care practitioner.

We greatly appreciate people’s concerns about this issue and rest assured we are responding with sensible and fair solutions that align with our company values.  Unfortunately, there is not an easy answer to this question because the answer is different according to what you do, where you do it, and where you live. 

B&M must work in concert and be compliant with local government labour regulations and collective agreements so our internal rules governing leave compensation will vary according to geography and relevant collective agreements.   As of March 16, we are providing corporately-developed pay and leave guidelines to all B&M Regions, specific to the COVID-19 pandemic, so all offices can quickly set and implement local policy.

Governments are also actively deploying strategies to provide greater access to pandemic financial relief for employers and employees to incent responsible self-isolation practices and to extend support to ill citizens.

Those who are infected with COVID-19 may have little to no symptoms. You may not know you have symptoms of COVID-19 because they are similar to a cold or flu. Symptoms may take up to 14 days to appear after exposure to COVID-19. This is the longest known infectious period for this disease.

Symptoms include:  fever (greater than 38 degC or 100.4 degF), dry cough, and difficulty breathing. 

 

Some patients have reported gastrointestinal symptoms such as nausea and diarrhea, however it’s relatively uncommon.

Symptoms become more severe once the infection has made its way to the lower respiratory tract

COVID-19 is spread mainly from person to person through close contact. For example, in a household, workplace or public space. Respiratory droplets that are spread when you cough or sneeze, or close contact such as touching or shaking hands then touching your mouth, nose or eyes before washing your hands.

In general, large gatherings with transient interactions including walking by a person who may be infected with COVID-19 or briefly being in the same room with that person are considered a low risk.

 

It is thought to spread mainly from person-to-person. Between two people who are in close contact with each other; through respiratory droplets produced when an infected person coughs.

People are thought to be most contagious when they are the most symptomatic. However, some spread might be possible before people show symptoms.

It can also be spread by touching a surface or object that has the virus on it, and then touching their own mouth, nose or possibly their eyes. This is not thought to be the main way that the virus spreads.

There is currently no vaccine for COVID-19 so we recommend that the best everyday ways to protect yourself and others from the spread of germs is to:

  1. Wash your hands regularly and thoroughly with soap and water or alcohol-based hand sanitizer. The World Health Organization (WHO) provide an excellent tutorial on the most effective hand washing technique https://www.youtube.com/watch?v=3PmVJQUCm4E
  2. Stop touching your eyes, nose and mouth with unwashed hands
  3. Keep your germs to yourself – Sneeze and cough into your sleeve or a disposal tissue. Stay at home if you are sick.
  4. Maintain a safe distance from sick people – at least 3 feet whenever possible
  5. Monitor your health for the signs and symptoms of the COVID-19 virus particularly fever, the onset of a dry cough, or difficulty breathing.

Beyond staying abreast of B&M updates, we encourage you to continue to stay informed by visiting the World Health Organization (WHO), PHAC and CDC websites:

  1. https://www.who.int/emergencies/diseases/novel-coronavirus-2019
  2. https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection.html
  3. https://www.cdc.gov/coronavirus/2019-nCoV/index.html

Municipal health authorities are also an excellent source of general COVID-19 information, local updates, and specific instructions to citizens. For example, Toronto Public Health or City of Kansas City.

Like the flu, coronaviruses are spread principally through direct contact.  Although less likely, they can be spread indirectly when respiratory droplets from an infected person contaminate nearby surfaces and objects.  To proceed with caution, we recommend good workplace hygiene – regularly disinfecting shared facilities like washrooms and kitchens, work surfaces (including door handles, coffee pots, and appliances), phones, keyboards and laptops with anti-bacterial wipes or disinfectants –particularly in high traffic areas or when workstations are shared by multiple people.

There is no known risk of COVID-19 entering Canada or the US on parcels or packages coming from affected regions. Currently there is no evidence to support the transmission of COVID-19 associated with imported goods.

If you become sick when you are travelling or after you return, avoid contact with others, inform your supervisor and a member of HSE, and in most Provinces and States, contact your local public health unit to advise of your symptoms, where you have been travelling, and if you’ve made contact with a sick person. If feeling ill during a flight home or upon arrival, inform the flight attendant or a Border Security Officer.

If you are a healthy individual, the use of a mask is not necessary. However, if you are experiencing symptoms of an illness that spreads through the air, wearing a mask can help prevent the spread of the infection to others. Certain work environments within Black & McDonald may also require the use of a mask, typically defined by hazard assessment. Wearing a mask when you are not ill and are not at high risk for developing symptoms may give a false sense of security. Masks can easily become contaminated and need to be changed frequently and fitted properly for them to provide adequate protection.

 

Patients with confirmed or possible COVID-19 should wear a facemask when being evaluated medically. The general public, who are otherwise healthy, do not need to use facemasks. The CDC recommend following everyday preventative actions such as hand-washing, covering your cough and staying at home when you are sick.

While a recent study suggests that the virus that causes COVID-19 may have the potential to infect some types of animals, similar to what is known for SARS-CoV, there is currently no evidence that pets or other domestic animals can be infected with COVID-19 virus or can be a source of infection to people. This however, is still under investigation as there are many unknowns to COVID-19.

The Black & McDonald COVID-19 Crisis Management Committee along with Regional resources will continue to review and assess the overall risk levels to our employees, customers, clients and subcontractors.

If you have any questions or require support, please reach out to your Health & Safety Representative or Corporate HSE.