Physical Distancing

Minimum standards are recorded in this spreadsheet. The current minimum standards for Physical Distancing are: 

• Compartmentalize operation into Bubbles 

• There should be at least 3 bubbles per program

• Each bubble should span over 2 physical rooms / spaces / divisions 

• With controls in place on base, avoid close contact and maintain 6 feet physical distance when possible.

• Due to the lack of controls and increased vulnerability in the community, avoid close contact and maintain a minimum of 6 feet physical distance.

• According to the shielding levels, communal space may be used by multiple people when physical distancing is followed.

• Avoid sharing personal items and limit their exposure to others.

Open-air communal spaces are preferred to help avoid close contact and increase ventilation. For all enclosed rooms, it is recommended that staff analyze the space and assign a maximum number of people allowed in at a time to ensure appropriate physical distancing practices are followed. This number should be posted in a visible spot at every entrance. 

Each base should have one designated entry and exit point to ensure a controlled check-in and health screening process. It is also recommended that each bubble have a defined exit to be used for the daily health reminders, e.g. check temperature, wear a mask, etc. When possible, clearly assign and mark separate entry and exit points for buildings and rooms with multiple doors. To help limit contact in enclosed spaces, markers should also be placed in hallways and on staircases to direct foot traffic on opposite sides.  

Bubbles are where an individual sleeps and eats, with access to dedicated washroom facilities. This is an example of a collective control, providing an environment where those who wish to limit the number of close contacts / viral load  they build, can. 

By applying bubbles from the outset, we provide an environment and we can leverage in case we need to increase controls due to situational changes, such as outbreaks and further waves of the virus. 

This application is reliant on a way to record that people have built close-contacts, so that we know who has been in contact with who. If we have no clear division between people on a Program, then we would need to quarantine all, as we should not send any potential carrier out to the community. 

All Hands and Hearts have some limitations in the separation we can create within our population. The separation offers a relatively low level of protection against spread within each bubble. But, combined with other health surveillance, implementing effective bubbles within our operations will slow the spread of a single infection across the entire Program. Much of this strategy is to reduce the likelihood that we would need to place an entire program in quarantine, pausing all output. 

• An individual arrives infected (and asymptomatic)

• A individual may be contacted by a tracing company and told to isolate for 14 days. 

• An individual is infected by another AHAH member within their same bubble. 

• An individual is infected by another AHAH member. 

• An individual is infected by an external source. 

• A staff member breaks the seal of one or more bubbles. 

Each bubble should contain the following: 

• Sleeping quarters for x people (the unit of separation)  

• Dedicated toilet(s)

• Dedicated shower(s) / washing facilities 

• Safe food preparation or delivery methods.

• Individually allocated cutlery / plates / cups / etc…

• Availability of hot water for washing and clean drinking water for drinking

• Ample PPE stocks (specifically RPE)

• Ample stocks of cleaning materials, inline with CDC guidance 

• A computer or tablet to facilitate connection and coordination 

• Internet connectivity

• Space for relaxation, ideally including open air spaces. 

The exact unit of separation AHAH employs will vary from location and be dependent on availability of resources and the affordability. 

A further factor in the unit of separation is the quantity of staff and volunteers who will live on the program.

A set of clear checklists and signage will be created and displayed in any accommodation to promote the CDC recommended standards of hygiene and sanitation. 

A “bubble maestro” will be allocated to each bubble, they will act as an interface between the house and the Staff.

Bubble assignments should be allocated based on the worksites, ensuring there is always an appropriate number of volunteers on each team. This will be at the discretion of each program. It is recommended that each program team work with VaAR to plan out the bubbles in advance. This may help when booking the volunteers travel to base as we can try to mirror the bubbles during any pre-quarantine or group travel that may be required. 

Space out bedding 6ft apart with head-to-toe positioning when possible and appropriate. If distancing bedding 6ft apart is not feasible, place barriers between bedding in addition to head-to-toe positioning. Each program should install these physical barriers prior to the volunteers arriving as it will be communicated to them in their pre-departure information. For example, barriers such as curtains can be draped and secured over each bunk bed or a stand-alone barrier of fabric or plastic can be placed between single beds to provide an extra level of protection and privacy. 

All individuals on base should avoid sharing personal items and limit their exposure to others. They are instructed to keep belongings in personal bags or storage containers in their assigned living space to eliminate cross contamination and ensure space is able to be thoroughly cleaned. Living quarters within your bubble will be cleaned at least once per day according to the bubble rota.

Signage linked here.

Staff offer an obvious threat to the integrity of each bubble. If the previous ways of working are not adapted, we will sabotage our approach. 

Interaction between staff

• Should be kept to the minimum. 

• Wherever possible, video technologies should be leveraged in preference to meeting in person, including group meetings.

• Subject to the same minimum standards as anyone else on the base. 

• If face-to-face contact is required, use open air, or well ventilated space. 

Staff interaction with volunteers

• Should be kept to the minimum. 

• Wherever possible video technologies should be leveraged in preference to meeting in person, including group meetings.

• If face-to-face contact is required, use open air, or well ventilated space. 

Where do the staff sleep? 

This is a decision the Ops team will need to make. The answer may differ program-to-program. 

Options include: 

• Distributed between the volunteers to act as guardians at each house? 

• In the original base setup, assuming adequate physical distance can be maintained. 

• Compartmentalized for the sake of continuity? (PD & PCs, OM & PMs)

Off program staff visits 

Special measures must be implemented for off-program staff visits in order to reduce the risk of spread across multiple programs. Off-program accommodation with day visits to programs are encouraged instead of overnight visits to minimize contamination of living quarters. 

Off-program staff should follow the organization’s policy and contact the Program Director at least 2 weeks before arrival to ensure adequate time to prepare. Off-program staff must have a reason to visit program.

• All off-program staff will be required to arrive with a recent molecular-biological COVID-19 test (PCR test), indicating they test negative.

• Off-program staff should avoid joining a program if they have been in a country other than their own within the last two weeks

  • • If they are arriving from another program and must stay on base, the staff member should stay in an off-program accommodation until they complete a COVID-19 test with results indicating they test negative.

    • When arriving to base, it is recommended that the staff member travel separately from other staff and volunteers if coming from another program

• If staff are staying in off-program accommodation, they  must complete a health screening questionnaire and temperature check upon entry to base. Inside the base, off-program staff must wear a mask at all times and comply with all increased hygiene and physical distancing guidelines. 

• If off-program staff members must stay overnight, separate temporary living quarters will be assigned when possible to minimize interaction with staff and volunteers on base. If it is not possible to designate a separate temporary sleeping area, a physical barrier must be placed between the off program staff member and other on-program staff with a minimum of 6 feet separation between beds.

  • • They will use the showers and restrooms of the on-program staff with additional cleaning and sanitizing of these facilities. If necessary, the hired cleaners will be contracted for additional hours to complete this. 

Recommended onboarding procedure for non-residential volunteers.

Non-Residential Volunteer Health Questionnaire

The working environment for the staff team should be reviewed. We should look at the traditional approach of using an office and not assume it is the default place where people should work from. 

• Ensure physical distancing can be followed

• Increased ventilation through use of open windows and doors (when safe) or air purifiers 

• Avoid using other's devices and equipment

  • • Provide sanitation wipes near shared equipment for each user to disinfect after use (printer)

• Encourage staff to disinfect their working area after use

• Staff on duty should disinfect office at the end of the day 

Signage linked here.

Closed at times of increased risk. 

According to shielding level.

• In line with local regulations;

• Should be minimized (use of online order and delivery/pick up, where available);

• Maintain distance (6ft / 2meters);

• Wear PPE (N95 mask if in area where physical distancing cannot be maintained);

• Process for entering base:

  • • Sanitize hands before entering and keep mask on

    • Take your temperature and complete a self-health check

    • Go directly to your assigned hand washing station and wash hands for at least 20 seconds

• Favour private vehicles over public transport. 

• Ideally, transport mirrors the “bubbles” within the program;

• Wear face masks when in vehicle;

• Vehicles should not be crowded, especially for journeys of over 15 minutes;

• Windows open for good ventilation when possible; 

• Disinfect vehicle every time it returns to base (unless picking up/dropping off).

Drivers 

Recent research shows that Healthcare workers, who are exposed to SARS-COV-2 repeatedly can build a higher level of viral load. Therefore, it is suggested that multiple exposures can have a cumulative effect. Drivers have potential to be exposed to viral load from multiple people who may each be shedding small quantities of virus, which accumulate to give the driver an infectious dose.