As we continue to learn together we also have a great opportunity to move forward together as we address the key issues in our industry. A few weeks ago, the conversations were very different amidst rumors of a rising tide of issues related to a potential outbreak of COVID-19. Our industry was eagerly heading into conference season until one-by-one these events were shutting down, first as a precautionary measure and then more rapidly as the spread of the novel coronavirus expanded. Many restorers are facing tough decisions with regards to calls for service for COVID-19 with limited information.
Thankfully key voices in the industry have been rising to the occasion and doing their best to share sound information amongst peers. Some examples include:
- The Restoration Industry Association (RIA) held their first Town Hall Industry Briefing via webinar on March 5, 2020.
- Restoration & Remediation (R&R) Magazine has compiled ongoing coronavirus coverage in an attempt to keep restoration professionals informed.
- The Global Biorisk Advisory Council, a division of ISSA, has released three Tip Sheets (see references below).
- RIA, IICRC and NADCA released a joint statement requesting Federal, State and Local Officials to consider our industries as essential businesses.
On March 19, 2020, in a joint effort, the RIA and the Institute of Inspection Cleaning and Restoration Certification (IICRC) released a Preliminary Report for Restoration Contractors Assisting Clients with COVID-19 Concerns.
Collaboration within the industry continues
This level of collaboration between the RIA and IICRC has been a refreshing example to the restoration industry of what we can accomplish when we work together. During the 2019 International Restoration Convention + Industry Expo, the two associations signed a strategic partnership agreement enabling each organization to focus on their core mission while contributing to the good of the industry.
In the Preliminary Report, the authors are quick to point out, “This report is intended solely for informational purposes to supplement the training and other research performed by the restorer and is not to be construed as advice.” The document, which is currently 10 pages long and will take about 30 minutes to read, runs the reader through:
- Basic information about coronavirus
- Infection control principles
- Potential services
- Pre-work preparations
- Crew safety
- Cleaning of touchpoints
- Applying disinfectants
- Post-work project evaluation
- Project documentation
- Acknowledgements
Infection Control Principles for COVID-19
As most are aware, current knowledge leads us to believe that the spread of SARS-CoV-2 is primarily through direct exposure to aerosolized droplets as well as potential exposure to objects and surfaces with residual viral particles. Cleaning efforts are being recognized as playing a role in slowing the spread of the virus. The Preliminary Report notes, “Restoration contractors must emphasize to their clients that actions taken to reduce exposure from secondary transmission from surfaces with reservoirs of viral material must be matched with procedures to prevent recontamination.”
While this is not a foreign concept to most contractors providing clean up services for related contaminants, it is an important distinction when addressing this specific virus which lacks verified protocols for response and verification. Reducing exposure to employees as well as the potential for cross contamination are key factors within the infection control plan. Infectious control environments must be treated differently than any of the remediation projects that are more familiar to most restorers.
Scope Clarity is Essential for Coronavirus Response
Few would dispute that cleaning of touchpoints and specialized treatment, which would include the application of disinfectants, serves an essential service in the process of slowing the spread of this virus. The authors of this report note that the Centers for Disease Control and Prevention (CDC) guidelines must serve as a baseline for this work. Restorers who work in healthcare environments should be familiar with the Infection Control Risk Assessment (ICRA) guidelines which provide important guidance for infection control measures.
The Global Risk Advisory Council (GBAC), a division of ISSA, has released three Tip Sheets
- #1 Personal Protective Equipment (PPE) - 1/30/2020
- #2 Risk Assessment - 2/7/2020
- #3 Disinfectants - 2/18/2020
Being Prepared to Assist Clients with SARS-CoV-2 Clean Up
Employees must be properly trained to provide this service. Contractors should pay special attention to gather all the data available and document how this information was presented to employees prior to engaging in any services. Do you have the proper training, equipment, adequate insurance and prior experience with other biological contaminants in order to provide a quality service to your clients? In addition to considerations regarding PPE, environmental controls and verification of services rendered, the report notes, “Equipment must be scrupulously cleaned between each project.” This should not be something new to restoration contractors who respond to sewage (category 3 water), crime scene, mold or a host of other contaminants, but these precautionary measures are all the more essential with regards to COVID-19.
GBAC outlines a six steps protocol which includes:
- Incident Site Risk Assessment - Quality Control
- Pre-Disinfect
- Load Reduction
- Forensic Cleaning
- Final Disinfection
- Post Site Assessment - Quality Control.
What, Why and How are we Creating Value?
RIA and IICRC note that, “The combination of touchpoint cleaning and application of disinfectant to other surfaces is a proven strategy to break the chain of infection.” In the second RIA Industry Briefing on COVID-19, Norris Gerhart, of Gerhart & Associates and RIA ERS Chair, outlined some key considerations for those responding to novel coronavirus clean up, which include:
- Understanding the products that you are using
- Proper training for donning and doffing PPE to prevent cross contamination
- Detailed documentation
- Outlining verification methods
A functional recommendation from the Preliminary Report included developing a facility specific checklist of critical touchpoints. Working with the client to define the critical areas and then providing this checklist as a quality control measure for ensuring the onsite workers these areas. Proper cleaning will include removal of soils and existing surface contaminants prior to applying specific products while adhering to manufacturers application methods as well as the adequate dwell time for the cleaner/sanitizer.
Moving Forward as an Industry of Professionals
In our Three Questions with a Pro interview with insurance claims professional, David Princeton, he encouraged contractors to understand both the express promises of their scope of work as well as the implicit promises. This consideration of how a contractor presents their services coincides with the recommendations shared by The Restoration Lawyer, Edward H. Cross (which will be posted soon!), warning that the standard work authorization and/or contract which includes language such as, “Returning the structure to pre-loss conditions,” could be especially problematic in COVID-19 response.
RIA President-Elect, Mark Springer noted that this is intended to be a “living document” and updates will be made as new information is acquired. COVID-19 is exposing holes in our systems throughout the country and restorers responding to calls for service should be working to ensure that through their efforts they aren’t making matters worse for their employees, clients or communities. Documentation is key in any loss. In the case of coronavirus response, documentation of all processes will be essential. Stay tuned and help spread facts and verified information as we put the pieces of this puzzle together.