Corona Virus

INTRODUCTION
In December 2019, an unprecedent outbreak of pneumonia of unknown etiology emerged in Wuhan City, Hubei province of China. A novel coronavirus was identified as the agent responsible for the outbreak. On 30 th January 2020, the World Health Organization (WHO) declared the Chinese outbreak to be a Public Health Emergency of International Concern, posing a high risk to countries with vulnerable health systems. On February 11, 2020, WHO termed the virus that causes the coronavirus disease of 2019 as COVID-19. On March 11 th , 2020, as a result of the 13-fold increase number of cases outside of China and the triplication of the number of affected countries, WHO characterized COVID-19 as a pandemic.
A pandemic is a global outbreak of disease. Pandemics happen when a new virus emerges to infect people and can spread between people sustainably. Because there is little to no pre- existing immunity against the new virus, it spreads worldwide. 2 For this to happen, the virus must be able to infect people and, the spread of person to person must be efficient and sustained.
On March 19, 2020, WHO alerted all countries to prepare to respond to different health scenarios recognizing that a one fits all approach for COVID-19 was not feasible. WHO recommendations reinforced the need for countries to assess their risk and implement necessary measures at the appropriate scale to reduce both the COVID-19 transmission and the economic, public, and social impacts. WHO recommended that all countries preparedness and response plans for COVID-19 should aim to:

• Slow and stop transmission, prevent outbreaks, and delay spread.
• Provide optimized care for all patients, especially the seriously ill.
• Minimize the impact of the epidemic on health systems, social services, and economic activity.

On April 16, 2020, the United States President released guidelines for states, cities, and countries to start easing Coronavirus restrictions. The guidelines, presented in phases, define the individuals and the employers’ responsibilities, requiring the development and implementation of appropriate policies in accordance with Federal, State and local regulations and guidance, and informed industry best practices regarding: social distancing, protection equipment, temperature checks, sanitation of common and high-traffic areas, disinfection and business travel.

Puerto Rico:

On March 12, 2020, the Governor of Puerto Rico declared an emergency state related to the imminent impact of Coronavirus in the Island. 5 Since March 12 th , the Governor of Puerto Rico has issued several Executive Orders limiting the economic activity to slow and stop transmission, prevent outbreaks, and delay the spread. On March 23, 2020, a Health Advisory Board, namely the “Health Task Force”, was activated by Executive Order 2020-026 with the responsibility of performing studies, investigations, and development of strategic plans to manage the emergency and the coordinated response to the pandemic. On the same date, an Economic Advisory Board, namely the “Economic Task Force”, was formally activated by the Governor of Puerto Rico utilizing the governance provided by the PR-Business Emergency Operations Center (PR-BEOC) in accordance to the requirements of the Joint Operational Catastrophic Incident Plan (JOCIP). The Economic Task Force integrated all of the PR-BEOC Leaders that represent the Critical Infrastructure Sectors as defined by the Department of Homeland Security (DHS), economists, and industry leaders representing several associations. The role of the “Economic Task Force” is to provide recommendations to minimize COVID-19 impact on the economic activity of Puerto Rico.

As recommended by the WHO guidelines, all government plans should aim to minimize the impact on health systems, social services, and economic activity. To that intent, the “Economic Task Force” has developed an economic re-activation model that considers critical economic indicators and health system capacity criteria. The model is intended to provide guidance for the orderly re-activation of the economic sectors without affecting the spread nor the health system capacity. Recognizing that all sectors are different and that a one fits all model is not sustainable, the “Economic Task Force” approved the development and distribution of guidelines that serve as a template for individual business re-activation plans in preparation for opening or for resuming physical or virtual operations when, by Executive Order of the Governor of Puerto Rico, a particular economic sector re-activation is granted.

OBJECTIVES

During a pandemic, employers play an essential role in protecting employee health and limiting negative impacts on the economy and society. This document provides guidance for businesses to re-activate their operations and maintain their essential services and operations during and after the period of the COVID-19 emergency declaration in Puerto Rico, while minimizing the impact of the pandemic to the health system capacity, and the contagion of the employees.

ABOUT COVID-19

Coronaviruses are a large family of viruses that may cause illness in humans or animals. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome 7 (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes coronavirus disease COVID-19. 8 Coronaviruses are single strand enveloped RNA virus belonging to the family of Coronaviridae of zoonotic origin. COVID-19 is the clinical syndrome associated with SARS-CoV-2 infection, which is characterized by a respiratory syndrome with a variable degree of severity, ranging from a mild upper respiratory illness to severe interstitial pneumonia and Acute Respiratory Distress Syndrome (ARDS). Coronaviruses are named for the crown-like spikes on their surface. There are four genera of the coronaviruses, known as alpha, beta, gamma, and delta. 10 The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV.

SYMPTOMS

According to the Centers for Disease Control and Prevention CDC, generalized symptoms may appear 2-14 days after exposure (based on the incubation period of MERS and SARS.

• Fever
• Cough
• Shortness of breath or difficulty breathing
• Chills
• Repeated shaking with chills
• Muscle pain
• Headache
• Sore throat
• New loss of taste or smell

The list of symptoms is not all-inclusive; therefore, CDC recommends consulting a medical provider for any symptoms of concern.

HOW COVID-19 SPREADS

According to CDC guidelines and the PR Department of Health available information as of the date of the approval of this guideline, COVID-19 is thought to be spread mainly from person to person.

Between people who are in close contact with one another (within about 6 feet). Through respiratory droplets produced when an infected person coughs, sneezes, or talks that can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. By people who are not showing symptoms. It may be possible that a person can get COVID-19 by touching a surface or object that has SARS-CoV-2 on it and then touching their mouth, nose, or possibly their eyes, but this is not thought to be the primary way the virus spreads.