RETURNING TO THE OFFICE SAFELY
Like most businesses in Kenya, Nairobi Garage has been impacted by the current global pandemic. Businesses are in turmoil right now, and the lack of a timeline for things to return to normal, or what normal will become, is unclear. However, despite the challenges we are all facing, Nairobi Garage has chosen to remain open. You can read more about the factors behind that decision on this post.
As businesses and teams look at normalising their operations and plan for the future, we wanted to provide useful information regarding the spread of COVID-19 and specifically to highlight the measures we’re taking to make returning to work and the office as safe and smooth as possible.
How COVID-19 Actually Spreads in an Office Context
In order to understand how to keep you and your employees safe, it is important to begin with a review of how COVID-19 appears to actually spread in real-world office contexts. As you know, we are not public health officials. What is conveyed here is our best understanding based on the scientific studies we have reviewed. We expect to learn more daily over the coming months, and what we learn will impact our response.
The best view we have found of the threat from COVID in offices today comes from an excellent CDC-published study about an outbreak in a Korean office building in early March. It is really worth a read. They obtained cell-phone data for every single person who had spent more than 5 minutes in or near the building, tested everyone, and got a crystal clear picture of how this plays out. The key findings were that: (a) the virus did not meaningfully appear to spread throughout the building through the HVAC systems, (b) there appears to have been little spread in common areas of the building (elevators and lobbies and such), (c) nearly everyone who contracted it sat immediately next to each other in the same room for a prolonged period of time. In short, in the real world this virus appears to spread nearly entirely through one path: directly from person-to-person, over short distances (e.g. a few feet), when there is prolonged contact. The virus appears to be able to travel a few more feet when there is air blowing strongly past one person toward another (e.g. due to a fan), such as in this case in a Guangzhou restaurant.
Notably, the studies we have reviewed suggest that touching contaminated surfaces is, in practice, relatively speaking, a lesser threat. The New York Times recently underscored this view. While we are told to use gel and wash hands regularly to avoid transmission through touch (e.g. elevator buttons, door knobs), and we should, overall there is good news. This study in the American Journal of Microbiology notes “there are no documented cases thus far of a COVID-19 infection originating from a fomite [touch]”. This comprehensive article from the American Bankers Association looking directly at this issue notes “it is possible to be infected with SARS-CoV-2 through indirect transmission, but it appears to be exceedingly rare”. This isn’t to say the virus doesn’t last on surfaces. It does appear to. And absence of evidence is not evidence of absence. But as of this writing, available studies don’t seem to suggest that in practice COVID-19 is transmitted frequently via touch.
The CDC generally seems to concur. In their April 13th guidance, they write:
“Current data suggest person-to-person transmission most commonly happens during close exposure to a person infected with the virus that causes COVID-19, primarily via respiratory droplets produced when the infected person speaks, coughs, or sneezes. Droplets can land in the mouths, noses, or eyes of people who are nearby or possibly be inhaled into the lungs of those within close proximity.”
With regard to touch-based infection, they write: “transmission also might occur through contact with contaminated surfaces followed by self-delivery to the eyes, nose, or mouth.” Elsewhere, they have used the words that it “does not easily” transmit through touch.
With regard to airborne transmission, the CDC says: “airborne transmission from person-to-person over long distances is unlikely”. This WHO study observes “in an analysis of 75,465 COVID-19 cases in China, airborne transmission was not reported.” For this reason, while we are taking actions to make our HVAC systems safer, this is also not our principal focus. As with touch, some amount of virus indeed spreads in an airborne manner. This just doesn’t appear to be a significant way that people actually contract COVID-19.
If new studies change these views, so will our response, and we will update this document.
With regard to person-to-person spread of the virus, the need for “prolonged contact” to communicate this virus is an important, relatively recent observation. There is growing evidence, echoed in the South Korea study, that infections principally occur based on prolonged exposure to an infected individual, as opposed to casually passing by them. The CDC has gotten on board with this, and now only recommends quarantine if you have come in contact with a COVID-19 infected individual, and that contact was “prolonged”. The CDC seems to define “prolonged” as a period of 15 minutes plus now, and, for instance, Partners in Health, which manages contact tracing in Massachusetts, uses a 15 minute guideline. The South Korea study notes:
“Despite considerable interaction between workers on different floors of building X in the elevators and lobby, spread of COVID-19 was limited almost exclusively to the 11th floor, which indicates that the duration of interaction (or contact) was likely the main facilitator for further spreading of SARS-CoV-2.”
Nairobi Garage will take steps to mitigate spread through all possible modes of transmission, including casual contact. We will pay particular attention to the mode that current information suggests represents the largest risk: close person-to-person contact for 15 minutes or longer.
How We Can Prevent the Spread of COVID-19 in an Office Context
The world’s growing appreciation that the disease spreads principally via prolonged, direct person-to-person contact, through breathing in droplets, calls on us to prevent the spread of those droplets. The most effective ways to do this appear to be through use of face coverings, safe spacing, and reducing the number of virus carriers in our proximity. That said, experts believe you need to be exposed to the virus for a prolonged period of time, e.g. 15 minutes, for it to be infectious. This means it is OK to slip your mask off briefly to take a sip of coffee, etc.
Face coverings: The CDC strongly encourages the use of face coverings in public. Some jurisdictions, such as Massachusetts and Rhode Island, now require face coverings, including in offices. This meta-analysis of 21 studies on mask use and this very detailed write-up of the whys suggest that face coverings really do work to keep us safe. Here are some highlights drawn from these articles (emphasis ours):
- From a study on the Wuhan COVID-19 outbreak published in the British Journal of Hospital Infection, “Among the 493 medical staff, none of the 278 staff (56 doctors and 222 nurses) in the N95 group became infected, but 10 of 213 staff (77 doctors and 136 nurses) from the no-mask group were confirmed as infected”.
- From an NIH study on a previous coronavirus outbreak looking at passengers on a flight from New York to China where the virus spread, of the 9 people they tracked down who got sick on the flight and 32 who didn’t, they found none of the mask-wearers got sick, while 35% of non-mask wearers did.
What these studies show is how masks can help keep you safe. Many believe the bigger function of masks is to keep others around you safe, for instance if you are an asymptomatic COVID-19 carrier. This recent study in Nature Medicine found that surgical masks (the inexpensive type many people wear on the street now) blocked the spread of seasonal coronavirus (e.g. cold) droplets leaving the wearer’s mouth 100% of the time, and this study showed surgical masks blocked 89% of large droplets carrying another disease. A possible laboratory for this approach has been Japan. As of this writing, Japan reports about 600 COVID-19 deaths vs. over 75,000 in the US, despite Japan having fully half the population of the US. High public mask use in Japan may be a factor. (This said, there are wide discrepancies between the spread in different countries, and there may be other factors at play.)
More research may alter our views of this, but given what we know now, it seems that any responsible safety plan for an office must include a clear focus on the use of face coverings.
Safe spacing: The concept of safe spacing takes advantage of the fact that large droplets appear to fall typically within ~3 feet (0.9 meter) of the person emitting them. If we remain 6 feet (1.8 meters) apart, we stay out of the line of fire of the bulk of these droplets.
Beyond this, we have identified a number other ways we believe we can make offices safer and comfortable when returning to work. Our full list of safety measures is detailed below.