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COVID-19 Contingency Plan

Introduction.

This COVID-19 contingency plan outlines the main purpose and guidance to PHSC plc subsidiary directors of mitigation actions to minimise the risk to staff, customers and business productivity following the recent outbreak of COVID-19.

It follows the latest guidance from the Government on Social Distancing and seeks to maintain a balance between maintaining the health, safety and welfare of our stakeholders and business continuity, as follows:

The Prime Minister  set out a number of social distancing measures to reduce the risk of infection from the spread of coronavirus. For those who remain well, are under 70 or do not have an underlying health condition, they are advised to limit their social contact where possible, including using less public transport, working at home and considering not going to pubs, restaurants, theatres and bars.

This government guidance has been updated several times, and workplaces are now able to start resuming their trade, provided sufficient social distancing and other safety measures are in place.  The intention was never to  close business although some organisations had no other option. And now there is an equally big challenge in getting staff back to work. Indeed, some business have found that there is no need for staff to return to the workplace, but others do need to return.  This will mean taking sensible measures that maintains business continuity whilst protecting health of our staff, customers and other stakeholders. We will continue to monitor our COVID-19 Contingentcy Plan, using a risk-based approach in response to updated information from Public Health England, and continuing to provide

P rofessional H elp at S ensible C ost

This plan will be revised and updated as and when there is significant new guidance from Public Health England / Health Protection Scotland.

  • To minimise the risk of PHSC plc personnel contracting COVID-19
  • To minimise risk of infecting PHSC plc clients
  • To minimise the impact upon PHSC plc subsidiaries from the potential effects of business disruption due to staff sickness/ isolation or other inability to service clients
  • To maintain its duty of care to employees, contractors, customers and others who may be affected by our operations.
  • To reassure customers and other key stakeholders of PHSC’s proactive and reactive strategy for managing risks presented by Covid-19. Ad-hoc discussions en-route whilst auditing with individuals.

Subsidiary directors are to identify any staff or associates working for the subsidiary who may be more vulnerable due to underlying health issues that could be exacerbated if COVID-19 was contracted. Such information will be processed in line with our Data Protection protocols.

Any staff who come within the category of vulnerable to be assessed for suitability for travelling on public transport / working with clients where there are high numbers of staff etc so as to minimise contact with persons or environment who may be infected. If no such assignments are available, then consideration should be given to providing alternative desk-based work, either at the office or at home.

Work schedules to be closely monitored and close liaison with clients to occur daily. Where a client wishes to postpone or is closed down by PHE or Health Protection Scotland our cancellation terms and conditions should be considered. Directors have discretion over the circumstances of each case. It may be that other non-site work might be completed instead.

Work that can be completed remotely should be agreed, eg via telephone, webinars and arranging for photographs/documents to be sent to our consultants where feasible.

In the short term, agreement with clients should be made in advance to minimise time spent on site, and reasonable distance between individuals, particularly where training is being delivered. We will also identify their own COVID-19 Contingency Plan, and work within its parameters.

Directors are to brief/remind consultants (bearing in mind the Chartered Safety Practitioner status of our management systems and health and safety consultants) on leading by example at all times, including when at client sites or when in transit.

Briefings / guidance must be given to staff on:

  • Hand hygiene protocols
  • To obtain (if possible) hand sanitizer and carry with them
  • Wearing of face masks / coverings whilst commuting, in lifts and other enclosed spaces
  • To cough or sneeze into a tissue and dispose immediately, or to cough/sneeze into their elbow if a tissue is not immediately available.
  • Always to keep 2 metres distance wherever possible from their clients, or a minimum of 1 metre if the area is crowded.
  • To avoid touching face, nose and mouth. If someone coughs/ sneezes immediately in the proximity of a staff member to ask to be excused to wash hands and sanitise.
  • Not to shake hands with clients and to explain politely the reason why, in the current circumstances.
  • To update directors if they feel they are experiencing symptoms associated with a cold, flu or virus (high temperature, headache, aching muscles, respiratory problems).

When visiting clients, do not come into close contact with them. Do not shake hands and explain the reasons why. Maintain a polite and safe distance from clients wherever possible

Maintain a safe distance from people you are in contact with (ideally 2 metres).

Seek to arrange transit to client sites in the short-term via your own vehicle rather than public transport, to avoid close contact with large numbers of the public.

Encourage staff when not at work to avoid large crowds. Encourage spare time activities to include such pleasures as walks in the country-side or by the sea. Being in nature is not only healthy mentally and physically, but the COVID-19 virus dies naturally in the countryside so risk of infection is very low.

Avoid wherever possible using door handles / rails in public places. If possible, cover your hands with a tissue or a sleeve when opening /closing doors or holding handrails on stairs. If this cannot be avoided, wash your hands at the earliest convenience afterwards, or use sanitiser.

Reassure clients of our measures in all correspondence.

For staff who have report writing days, encourage them to do so at home unless they need to be in the office, and consider the appropriateness of administration staff to work from home if this is viable.

Undertake a daily check of your team to ensure they continue to follow these guidelines, and to check on their physical and emotional health. This can be a worrying time for some employees, especially if they or their family come within the vulnerable group of people.

Check work schedules to identify at the earliest stage to monitor those clients who may be more likely to close down (eg healthcare centres, schools, leisure centres).

Monitor the effectiveness of the controls in this strategy and review these against your own local COVID-19 Contingency Plan.

If a staff member reports symptoms, ask them to self-isolate and contact NHS on 111 for further advice. This website also provides useful information: https://111.nhs.uk/covid-19

If they are still feeling well, seek to provide them with work that can be completed from home (even if this is updating training programmes, writing a blog or other ancillary task that was not planned but could provide benefit to the company. Isolation must occur for at least two 2 weeks, although this may change in accordance with PHE guidance. If testing occurs and the result is negative for COVID-19 then self-isolation can be reduced to a few days until the person’s symptoms reduce sufficiently/disappear. Guidance from a health professional will be sought on the suitability of someone to return to work.

Liaise with other subsidiary directors to provide a suitable replacement member of staff so as not to inconvenience the client. There is sufficient additional resource within the group to support a short-term and medium level of disruption due to staff sickness.

If no suitable replacement is available then liaison with the client will be necessary to postpone. In such circumstances directors should consider maintaining business relationships and the inconvenience this may cause and if/what other compensating work can be provided if this is necessary. Usually the client will be happy to reschedule and work plans must cater for the need of flexibility under the current circumstance.

Training Services

Those members of staff who interact with training delegates may have to adhere to additional controls, given that they meet and work with personnel outside the business. We will sleek to identify our clients’ own COVID-19 Contingency Plan and follow its requirements.

As with containment, government advice shall form the basis of actions to be taken.

We may seek to provide training in larger premises where increased distance between delegates can be achieved.

Communications with delegates will be of high importance – firstly to reassure that arrangements are in place to protect their health and also to ask them to provide necessary information to the company if necessary. Communications with delegates may include (depending on the nature of the situation):

  • Asking delegates to confirm their recent travel movements
  • Asking delegates to confirm that they have not been in contact with persons infected or persons who may have been exposed to the disease (the definition of contact will depend upon the nature of the disease)
  • Asking delegates to follow some key instructions on arrival at our training venue, which may include following guidance on personal hygiene, use of PPE etc – the exact arrangements will depend upon the nature of the disease
  • Reassuring delegates of arrangements made should they have reservations to attend

Download PDF: PHSC plc   COVID-19  Contingency Plan 

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PRESENTING: How to create a coronavirus contingency plan for your office to ensure your employees feel safe and supported

The novel coronavirus pandemic has affected the way people operate. With almost all US states declaring states of emergency , a national emergency , and more than 4,700 confirmed cases of COVID-19 and 92 deaths in the United States , social distancing and remote work has become a new norm. And there are more precautions to take to mitigate the virus' spread.

Leadership can implement certain strategies, like remote work and heightened office cleanliness, to ensure worker safety in the time of COVID-19. One such way is an emergency contingency plan: a comprehensive set of procedures businesses put in place in case they experience an event that could impact operations or employee well-being.

A contingency plan geared toward this pandemic could include revisiting sick leave policies and enforcing travel restrictions. Here's a guide to making a plan that will work for your team, according to people with experience devising them.

Subscribe here to read our feature: Here's the exact coronavirus contingency plan every leader should create to keep their teams from panicking and build trust in a time of crisis

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Watch: How to stay safe at work during the COVID-19 pandemic

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COVID-19 Pandemic Planning Scenarios

Summary of recent changes.

  • The Infection Fatality Ratio (IFR) parameter has been updated to reflect recently published estimates. This parameter is now presented as the number of deaths per 1,000,000 infections for ease of interpretation.
  • The healthcare utilization statistics in Table 2 have been updated to include a 0–17-years-old age group.
  • This will be the final update to the COVID-19 Pandemic Planning Scenarios, as there is now a substantial body of published literature that modelers can draw on to inform parameter estimates and assumptions for their models for the general population and for sub-populations of interest. In addition, CDC has several sources that will continue to update COVID-19-related data over time, including COVID Data Tracker , COVID-19 Case Surveillance Public Use Data , and COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) .

The Five Scenarios

  • The Parameter Values:  Definitions
  • Box 1 Description of the Five COVID-19 Pandemic Planning Scenarios

CDC and the Office of the Assistant Secretary for Preparedness and Response ( ASPR) have developed five COVID-19 Pandemic Planning Scenarios that are designed to advance public health preparedness and planning and help inform decisions by public health officials who use mathematical modeling and by mathematical modelers throughout the federal government. Models developed using the data provided in the Planning Scenario tables can help evaluate the potential effects of different community mitigation strategies (e.g., social distancing). The Planning Scenarios may also be useful to hospital administrators in assessing resource needs and can be used in conjunction with the COVID-19 Surge Tool .

Each Planning Scenario is based on a set of numerical values for the biological and epidemiological characteristics of COVID-19 illness, which is caused by the SARS-CoV-2 virus. These values—called parameter values —can be used in models to estimate the possible effects of COVID-19 in U.S. states and localities. This document was first posted on May 20, 2020, with the understanding that the parameter values in each Scenario would be updated and augmented over time as we learn more about the epidemiology of COVID-19. This will be the final update of the COVID-19 Pandemic Planning Scenarios, as there is now a substantial body of published literature that modelers can draw on to inform parameter estimates and assumptions for their models. In addition, CDC has several sources that will continue to update COVID-19-related data over time, including:

  • COVID Data Tracker is the repository for CDC’s COVID-19 data. COVID Data Tracker combines data from across the response and provides summary statistics by category (e.g., cases and deaths, testing, and vaccinations). These data are updated daily.
  • COVID-19 Case Surveillance Public Use Data are deidentified line-level data from COVID-19 cases reported to CDC. This includes data on demographics and clinical information (e.g., symptom-onset date and hospital status) and is updated monthly. In addition, a restricted-use version of these data, which includes county and state information, is available to users who complete a registration process, sign a data use agreement, and obtain approval from CDC.
  • COVID-NET is a population-based surveillance system that collects data on laboratory-confirmed COVID-19-associated hospitalizations through a network of more than 250 acute care hospitals in 14 states. COVID-NET provides information on age-specific clinical outcomes as well as age- and location-specific COVID-19 hospitalization rates and are updated weekly.

In this final update, the age-specific estimates of Infection Fatality Ratios (IFRs) have been updated to reflect recently published estimates of IFRs from a systematic review and meta-analysis. 1 These updated estimates have a wider uncertainty range to better reflect the potential variation in IFR geographically and over time. These values are intended to capture the national-level burden of COVID-19 deaths; however, national-level estimates may not reflect region-specific IFRs. Therefore, caution should be used when applying suggested IFR values to specific states, counties, and cities. This update also includes parameter values for healthcare utilization in individuals aged 0–17-years-old.

New data on COVID-19 are available daily, yet information about the biological aspects of SARS-CoV-2 and epidemiological characteristics of COVID-19 remain limited, and uncertainty remains around nearly all parameter values. For example, current estimates of IFRs do not account for time-varying changes in hospital capacity (e.g., bed capacity, ventilator capacity, or workforce capacity) or for differences in case ascertainment in congregate and community settings or in rates of underlying health conditions that may contribute to a higher frequency of severe illness in those settings. A nursing home, for example, may have a high incidence of infection (because of close contacts among many individuals) and severe disease (because of a high rate of underlying conditions) that does not reflect the frequency or severity of disease in the broader population of older adults. In addition, the practices for testing nursing home residents for SARS-CoV-2 upon identification of a positive resident may be different than testing practices for contacts of confirmed cases in the community. Observed parameter values may also change over time. For example, the percentage of transmission occurring before symptom onset will be influenced by how quickly and effectively both symptomatic people and the contacts of known individuals with COVID-19 (cases) are quarantined. In addition, observed parameter values may be influenced by the recent emergence of novel SARS-CoV-2 variants.

The parameters in the Planning Scenarios:

  • Are estimates intended to support public health preparedness and planning;
  • Are not predictions of the expected effects of COVID-19;
  • Do not reflect the impact of any behavioral changes, social distancing, or other interventions; and
  • Do not reflect the impact of the emergence of novel SARS-CoV-2 variants.

The five COVID-19 Pandemic Planning Scenarios (Box 1) represent a range of possible parameters for COVID-19 in the United States. All parameter values are based on current COVID-19 surveillance data and scientific knowledge.

  • Scenarios 1 through 4 are based on parameter values that represent the lower and upper bounds of disease severity and viral transmissibility. The parameter values used in these Pandemic Planning Scenarios are likely to change as we obtain additional data about the upper and lower bounds of disease severity and the transmissibility of SARS-CoV-2, the virus that causes COVID-19.
  • Scenario 5 represents a current best estimate about viral transmission and disease severity in the United States, with the same caveat: the parameter values will change as more data become available.

Parameter values that vary among the Pandemic Planning Scenarios are listed in Table 1, while parameter values common to all five scenarios are listed in Table 2. Definitions of the parameters are provided below, and the source for each parameter value is indicated in the Tables.

The Parameter Values: Definitions

Parameter values that vary across the five COVID-19 Pandemic Planning Scenarios ( Table 1 ) include measures of viral transmissibility, disease severity, and pre-symptomatic and asymptomatic disease transmission. Age-stratified estimates are provided, where sufficient data are available.

Viral Transmissibility

  • Basic reproduction number (R 0 ): The average number of people that one person with SARS-CoV-2 is likely to infect in a population without any immunity (from previous infection) or any interventions. R 0 is an estimate of the average transmissibility in a completely naïve population. R 0 estimates vary across populations and are a function of the duration of contagiousness, the likelihood of infection per contact between a susceptible person and an infectious person, and the contact rate. 2 , 3 A separate but related parameter is the effective or time-varying reproduction number (R e or R t ), which estimates the average transmission in a population with mitigation measures and immunity.

Disease Severity

  • Infection Fatality Ratio (IFR): The number of individuals who die of the disease among all infected individuals (symptomatic and asymptomatic). This parameter is not necessarily equivalent to the number of reported deaths per reported case because many cases and deaths are never confirmed to be COVID-19 and there is a lag in time between when people are infected and when they die. This parameter also reflects the existing standard of care, which might vary by location or hospital and could be affected by the introduction of new therapeutics. The IFR values presented in Table 1 are intended to capture the national-level burden of COVID-19 deaths; however, these values may not reflect IFR in specific states, counties, or cities in the United States.

Presymptomatic and Asymptomatic Contribution to Disease Transmission

A presymptomatic case of COVID-19 is an individual infected with SARS-CoV-2 who has not yet exhibited symptoms at the time of testing but who later exhibits symptoms during the course of the infection. An asymptomatic case is an individual infected with SARS-CoV-2 who does not exhibit symptoms at any time during the course of infection. Parameter values that measure the presymptomatic and asymptomatic contribution to disease transmission include:

  • Percentage of infections that are asymptomatic: The percentage of persons who are infected with SARS-CoV-2 but never show symptoms of the disease. Asymptomatic cases are challenging to identify because individuals do not know they are infected unless they are tested over the course of their infection, which is typically done systematically only as a part of a scientific study.
  • Infectiousness of asymptomatic individuals relative to symptomatic individuals: The contribution to transmission of SARS-CoV-2 from asymptomatic individuals compared to the contribution to transmission of SARS-CoV-2 from symptomatic individuals. For example, a parameter value of 50% means that an asymptomatic individual is half as infectious as a symptomatic individual, whereas a parameter value of 100% means that an asymptomatic individual is just as likely to transmit infection as a symptomatic individual.
  • Percentage of transmission occurring before symptom onset: Among symptomatic cases, the percentage of new cases of COVID-19 due to transmission from a person with COVID-19 who infects others before exhibiting symptoms (presymptomatic).

Parameter values that do not vary across the five Pandemic Planning Scenarios (Table 2) are:

  • Level of pre-existing immunity to COVID-19 in the community: The percentage of the U.S. population with existing immunity to COVID-19 before the start of the pandemic, which began in late 2019.
  • Ratio of estimated infections to reported case counts: The estimated number of infections divided by the number of reported cases. The level of case detection likely varies by the age distribution of cases, location, and over time.
  • Time from exposure to symptom onset: The number of days from the time a person has contact with an infected person that results in COVID-19 infection and the first appearance of symptoms.
  • Time from symptom onset in an individual and symptom onset of a second person infected by that individual: The number of days from the time a person becomes symptomatic and when the person who they infect becomes symptomatic.

Additional parameter values common to the five COVID-19 Pandemic Planning Scenarios are these 10 measures of healthcare usage:

  • Median number of days from symptom onset to SARS-CoV-2 test among SARS-CoV-2–positive patients
  • Median number of days from symptom onset to hospitalization
  • Median number of days of hospitalization among those not admitted to the intensive care unit (ICU)
  • Median number of days of hospitalization among those admitted to the ICU
  • Percentage of patients admitted to the ICU among those hospitalized
  • Percentage of patients on mechanical ventilation among those hospitalized (includes both non-ICU and ICU admissions)
  • Percentage of patients who die among those hospitalized (includes both non-ICU and ICU admissions)
  • Median number of days on mechanical ventilation
  • Median number of days from symptom onset to death (for patients who die)
  • Median number of days from death to reporting of that death

These healthcare-related parameters (Table 2) assist in the assessment of resource needs as the pandemic progresses.

For each Pandemic Planning Scenario:

  • Parameter value for viral transmissibility is the Basic Reproduction Number (R 0 )
  • Parameter value for disease severity is the Infection Fatality Ratio (IFR)
  • Percentage of transmission occurring before the symptom onset (from presymptomatic individuals)
  • Percentage of infections that are asymptomatic
  • Infectiousness of asymptomatic individuals relative to symptomatic individuals

For Pandemic Scenarios 1-4:

  • These Scenarios are based on parameter values that represent the lower and upper bounds of disease severity and viral transmissibility. The parameter values used in these Scenarios are likely to change as we obtain additional data about the upper and lower bounds of disease severity and viral transmissibility of COVID-19.

For Pandemic Scenario 5:

  • This Scenario represents a current best estimate about viral transmission and disease severity in the United States, with the same caveat: The parameter values will change as more data become available.

Scenario 1:

  • Lower-bound values for virus transmissibility and disease severity
  • Lower percentage of transmission before the onset of symptoms
  • Lower percentage of infections that never have symptoms and lower contribution of those cases to transmission

  Scenario 2:

  • Higher percentage of transmission before the onset of symptoms
  • Higher percentage of infections that never have symptoms and higher contribution of those cases to transmission

  Scenario 3:

  • Upper-bound values for virus transmissibility and disease severity

Scenario 4:

  Scenario 5:

  • Parameter values for disease severity, viral transmissibility, and presymptomatic and asymptomatic disease transmission that represent the best estimate, based on the latest surveillance data and scientific knowledge.

Table 1. Parameter Values that vary among the five COVID-19 Pandemic Planning Scenarios. The scenarios are intended to advance public health preparedness and planning.  They are not predictions or estimates of the expected impact of COVID-19.

* The best estimate representative of the point estimates of R0 from the following sources:

  • Chinazzi M, Davis JT, Ajelli M, et al . The effect of travel restrictions on the spread of the 2019 novel coronavirus (COVID-19) outbreak. Science . 2020;368(6489):395–400; Imai N, Cori A, Dorigatti I, et al . (2020). Report 3: Transmissibility of 2019-nCoV. Online report
  • Li Q, Guan X, Wu P, et al . Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med . 2020;382(13):1199–1207.
  • Munayco CV, Tariq A, Rothenberg R, et al . Early transmission dynamics of COVID-19 in a southern hemisphere setting: Lima-Peru: February 29th-March 30th, 2020. Infect Dis Model . 2020;5:338–345.
  • Salje H, Tran Kiem C, Lefrancq N, et al . Estimating the burden of SARS-CoV-2 in France Science 2020;81(5):816-846.

The range of estimates for Scenarios 1–4 represent the upper and lower bound of the widest confidence interval estimates reported in: Li Q, Guan X, Wu P, et al . Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med . 2020;382(13):1199–1207.

Substantial uncertainty remains around the R0 estimate. Notably, Sanche S, Lin YT, Xu C, et al . High contagiousness and rapid spread of severe acute respiratory syndrome coronavirus 2 . Emerg Infect Dis . 2020;26(7):1470–1477. This study estimated a median R0 value of 5.7 in Wuhan, China. In an analysis of eight European countries and the United States, the same group estimated R0 of between 4.0 and 7.1 in the preprint manuscript: Ke R, Sanche S, Romero-Severson E, Hengartner N. (2020). Fast spread of COVID-19 in Europe and the United States suggests the necessity of early, strong, and comprehensive interventions. medRxiv .

† These estimates are based on age-specific estimates of infection fatality ratios from Levin AT, Hanage WP, Owusu-Boaitey N, et al . Assessing the age specificity of infection fatality rates for COVID-19: Systematic review, meta-analysis, and public policy implications.  Euro J Epidemiol . 2020;35(12):1123–1135.

Using a meta regression of data from England, France, Ireland, Italy, Netherlands, Portugal, Spain, Geneva (Switzerland), Belgium, Sweden, Ontario (Canada), and 12 U.S. locations (Atlanta, Georgia; Connecticut; Indiana; Louisiana; Miami;, Minneapolis, Minnesota; Missouri; New York; Philadelphia, Pennsylvania; Salt Lake City, Utah; San Francisco, California; and Seattle, Washington), Levin et al . produced estimates of IFR and associated 95% confidence intervals for 0.5–year age bands from 1 to 96 years old. To obtain the estimated values for each scenario, the IFR estimates by age were averaged to broader age groups, using weights based on the age distribution of cases from COVID-19 Case Surveillance Data reported by February 14, 2021 (public use version of data: https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data/vbim-akqf ).

§ The percent of cases that are asymptomatic (i.e., never experience symptoms) remains uncertain. Longitudinal testing of individuals is required to accurately detect the absence of symptoms for the full period of infectiousness. Current peer-reviewed and preprint studies vary widely in follow-up times for re-testing, or do not include re-testing of cases. Additionally, studies vary in the definition of a symptomatic case, which makes it difficult to make direct comparisons between estimates. Furthermore, the percent of cases that are asymptomatic may vary by age, and the age groups reported in the studies can vary.

Given these limitations, the range of estimates for Scenarios 1–4 is wide. The lower-bound estimate approximates the lower 95% confidence interval bound estimated from: Byambasuren O, Cardona M, Bell K, Clark J, McLaws ML, Glasziou P. Estimating the extent of asymptomatic COVID-19 and its potential for community transmission: Systematic review and meta-analysis. Official Journal of the Association of Medical Microbiology and Infectious Disease Canada 2020;5(4):223–234. The upper-bound estimate approximates the upper 95% confidence interval bound estimated from: Poletti P, Tirani M, Cereda D, et al . (2020). Probability of symptoms and critical disease after SARS-CoV-2 infection.  arXiv preprint arXiv:2006.08471 . The best estimate aligns with estimates from:

  • Oran DP, Topol EJ. Prevalence of asymptomatic SARS-CoV-2 infection: A narrative review. Ann Intern Med . 2020;173(5):362–367.
  • Oran DP, Topol EJ. The proportion of SARS-CoV-2 infections that are asymptomatic: A systematic review. [published online ahead of print, 2021 January 22] Ann Intern Med .
  • Buitrago-Garcia D, Egli-Gany D, Counotte MJ, et al . Occurrence and transmission potential of asymptomatic and presymptomatic SARS-CoV-2 infections: A living systematic review and meta-analysis.  PLoS medicine , 2020;17(9):e1003346.
  • Ravindra K, Malik VS, Padhi BK, Goel S, and Gupta M. (2020) Consideration for the asymptomatic transmission of COVID-19: Systematic review and meta-analysis.  medRxiv .
  • Beale S, Hayward A, Shallcross L, Aldridge RW, and Fragaszy E. (2020) A rapid review of the asymptomatic proportion of PCR-confirmed SARS-CoV-2 infections in community settings.  medRxiv .

^ The current best estimate is based on multiple assumptions. The relative infectiousness of asymptomatic cases to symptomatic cases remains highly uncertain, as asymptomatic cases are difficult to identify and transmission is difficult to observe and quantify. The estimates for relative infectiousness are assumptions based on studies of viral shedding dynamics. The upper bound of this estimate reflects studies that have shown similar durations and amounts of viral shedding between symptomatic and asymptomatic cases:

  • Lee S, Kim T, Lee E, et al . Clinical course and molecular viral shedding among asymptomatic and symptomatic patients with SARS-CoV-2 infection in a community treatment center in the Republic of Korea.  JAMA Intern Med. 2020;180(11):1–6.
  • Zou L, Ruan F, Huang M, et al . SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med . 2020;382(12):1177–1179.
  • Zhou R, Li F, Chen F, et al . Viral dynamics in asymptomatic patients with COVID-19. Int J Infect Dis . 2020;96:288–290.

The lower bound of this estimate reflects data indicating that viral loads are higher in severe cases relative to mild cases (Liu Y, Yan LM, Wan L, et al . Viral dynamics in mild and severe cases of COVID-19. Lancet Infect Dis . 2020;20(6):656–657) and data showing that viral loads and shedding durations are higher among symptomatic cases relative to asymptomatic cases (Noh JY, Yoon JG, Seong H, et al . Asymptomatic infection and atypical manifestations of COVID-19: Comparison of viral shedding duration. J Infect . 2020;81(5):816–846.

** The lower bound of this parameter is approximated from the lower 95% confidence interval bound from: He X, Lau EH, Wu P, et al . Temporal dynamics in viral shedding and transmissibility of COVID-19.  Nature Med.  2020;26(5):672–675. The upper bound of this parameter is approximated from the higher estimates of individual studies included in: Casey M, Griffin J, McAloon CG, et al . (2020). Estimating presymptomatic transmission of COVID-19: A secondary analysis using published data.  medRxiv. The best estimate is the geometric mean of the point estimates from these two studies and aligns with estimates from:

  • Moghadas SM, Fitzpatrick MC, Sah P, et al . The implications of silent transmission for the control of COVID-19 outbreaks.  Proc Natl Acad Sci USA . 2020;117(30):17513–17515.
  • Johansson MA, Quandelacy TM, Kada S, et al . 2021. SARS-CoV-2 transmission from people without COVID-19 symptoms.  JAMA Network Open  2021;4(1):e2035057-e2035057.

Table 2.   Parameter Values Common to the Five COVID-19 Pandemic Planning Scenarios . The parameter values are likely to change as we obtain additional data about disease severity and viral transmissibility of COVID-19.

Parameter values are based on data received by CDC between December 31, 2020, and February 14, 2021, including COVID-19 Case Surveillance Data (public use version of data: https://data.cdc.gov/Case-Surveillance/COVID-19-Case-Surveillance-Public-Use-Data/vbim-akqf ); data from the Hospitalization Surveillance Network ( COVID-NET ) (through December 31, 2020); and data from Human and Health Services Protect ( HHS Protect ) (through February 14, 2020).

* McAloon C, Collins Á, Hunt K, et al . Incubation period of COVID-19: A rapid systematic review and meta-analysis of observational research.  BMJ Open . 2020;10(8):e039652; Ma S, Zhang J, Zeng M, et al . Epidemiological parameters of COVID-19: Case series study. J Med Internet Res. 2020;22(10):e19994.

† He X, Lau EH, Wu P, et al . Temporal dynamics in viral shedding and transmissibility of COVID-19. Nat Med. 2020;26(5):672–675; Saurabh S, Verma MK, Gautam V, et al . Transmission dynamics of the COVID-19 epidemic at the district level in India: Prospective observational study.  JMIR Public Health Surveill . 2020;6(4):e22678.

§ The point estimate is the geometric mean of the location-specific point estimates of the ratio of estimated infections to reported cases, from Havers FP, Reed C, Lim T, et al . Seroprevalence of antibodies to SARS-CoV-2 in 10 sites in the United States, March 23-May 12, 2020.  JAMA Intern Med . 2020 Jul 12. doi: 10.1001/jamainternmed.2020.4130. The lower and upper bounds for this parameter estimate are the lowest and highest point estimates of the ratio of estimated infections to reported cases, respectively.

^ Estimates only include symptom onset dates during March 1, 2020 – January 31, 2021, to ensure cases have had sufficient time to obtain SARS-CoV-2 tests. Estimates represent time to obtain SARS-CoV-2 tests among cases who tested positive for SARS-CoV-2. Estimates are based on line-level case surveillance data reported to CDC.

** Estimates only include symptom onset dates during March 1, 2020 – January 31, 2021, to ensure cases have had sufficient time to observe the outcome (hospital discharge or death).

†† Based on data reported to COVID-NET  by December 31, 2020. https://gis.cdc.gov/grasp/COVIDNet/COVID19_5.html

§§ Cumulative length of stay for persons admitted to the ICU, inclusive of both ICU and non-ICU days.

^^ Estimates only include death dates between March 1, 2020 – January 31, 2021, to ensure sufficient time for reporting.

  • Levin AT, Hanage WP, Owusu-Boaitey N, et al. Assessing the age specificity of infection fatality rates for COVID-19: Systematic review, meta-analysis, and public policy implications.  Euro J Epidemiol . 2020;35(12):1123–1138.
  • Dietz K. The estimation of the basic reproduction number for infectious diseases .  Stat Methods Med Res . 1993;2:23–41.
  • Delamater PL, Street EJ, Leslie TF, et al . Complexity of the basic reproduction number (R0).  Emerg Infect Dis . 2019;25(1):1
  • COVID-19 Pandemic Planning Scenarios – May 20, 2020 [283 KB, 7 pages]
  • COVID-19 Pandemic Planning Scenarios – July 10, 2020 [1 MB, 9 pages]
  • COVID-19 Pandemic Planning Scenarios – September 10, 2020 [326 KB, 9 Pages]

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Covid-19 coronavirus: 10 key points for effective contingency planning

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1. Coordinate your response

Consider setting up a dedicated team, reporting to senior management, to take responsibility for assessing and managing the potential impact of Covid-19 (and the steps put in place by relevant Governments and authorities to deal with it). Ensure that the team:

  • Has representatives from support functions including HR, IT, purchasing, procurement, security and legal and is split across different regions and time zones (where relevant).
  • Develops or implements a business continuity plan, taking into account relevant legal and regulatory obligations and the issues we set out below. 
  • Prioritises effectively and manages potentially conflicting imperatives.
  • Establishes and maintains clear internal and external protocols for regular and emergency communication with employees and other key stakeholders.
  • Monitors and responds to developments and takes advice, with appropriate senior management and/or legal oversight. 

2. Manage the impact on the workforce

Employers will need to comply with health and safety duties and broader duties of care and good faith owed to workers. Steps to consider, subject to local law requirements, include taking action to:

  • Monitor local Governmental and World Health Organisation advice and notify/remind staff of recommendations not to travel to particular areas and of measures to help prevent the spread of Covid-19.
  • Introduce policies prohibiting or limiting business travel, particularly to high-risk areas, and consider alternative communication solutions (eg video-conferencing).
  • Introduce policies on the self-isolation of staff (whether mandated by law, imposed by you or requested by individual staff members).
  • Establish procedures requiring staff to report if they feel unwell or are absent, and to report possible infection or exposure to the virus (including following private travel to high-risk areas) or concerns involving others they have been in contact with at work.
  • Provide staff with the right equipment for disinfecting hands and (if official advice recommends) protective masks, and with any additional health and safety training or support that they might need.
  • Implement flexible or home-working arrangements and accommodate requests where feasible for particular roles – considerations might include whether the technology and equipment used to cater for a surge in remote working are reliable and whether further measures are necessary to maintain customer confidentiality.
  • Plan resourcing strategies such as the re-allocation of staff, the splitting of teams, the rotation of in-office/home-working arrangements or the cross-training of staff who perform business-critical functions, to minimise the risks of disruption if large numbers of staff, or key staff, are absent.
  • Have back-up arrangements in case employees responsible for health and safety are unable to perform their roles.
  • Make special arrangements for vulnerable employees. 
  • Consider carefully any proposal to repatriate staff from high-risk areas, particularly the impact on local staff in terms of workload and from a segregation and potential discrimination perspective.

Wider legal issues that you might also need to consider include whether: 

  • Local management has the authority that it needs to take appropriate action.
  • Employment terms or legislation permit or require periods of self-isolation (whether mandatory or self-imposed) to qualify as paid sick leave or as unpaid leave.
  • You have a right to require staff to work from home.
  • You are able to conduct voluntary or mandatory screening.
  • Voluntary absences or work from home arrangements require remuneration, or, if quarantine is imposed by Government, whether Social Security allowances are payable.
  • Workers can be required to use annual leave for relevant absences.
  • You will allow requests for staff absence where a family member has the virus or is self-isolating (or if schools are closed or childcare arrangements impacted) and, if so, on what basis.
  • You have a duty to inform/consult with health and safety representatives or works councils/trade unions in relation to the measures being taken.
  • You are compliant with discrimination and privacy legislation in relation to staff who may contract the virus and ensure proper protection for those from high-risk areas against bullying, discrimination or harassment.
  • You are eligible to apply for subsidies or financial support from national authorities if there is a business shutdown due to the virus, or a reduction in capacity due to sickness.

3. Manage contractual risks 

Evaluate the potential implications for your customer and supply chain contracts. Review how Covid-19 will affect your ability to perform your contractual obligations (either directly or due to issues in your supply chain). Assess what rights you might have if your counterparty is unable to perform. Consider:

  • Event of Default – will a failure to fulfil obligations result in an Event of Default?
  • Force Majeure and frustration – will the effects of Covid-19, or any response to it, be caught by a Force Majeure provision or frustrate your contract? This may require you to consider whether Covid-19 has made it impossible or unlawful for either party to fulfil its contractual obligations.
  • Change in law/illegality – will any relevant Government response trigger change in law provisions or render performance illegal?
  • Material Adverse Change – will the effects of Covid-19, or any response to it, fall within a MAC clause?
  • Suspension of performance/termination – are either of these possible and/or likely and, if so, what are the consequences, both under the terms of the contract – for example, liquidated damages – and as a matter of law?
  • Notification obligations – are there notification obligations in relation to possible delays/suspension/termination/frustration?
  • Mitigation – are there express provisions requiring parties to mitigate their losses in relation to possible Force Majeure or other events, such as obligations to use “reasonable endeavours” and devise commercial workarounds? Even if there are no express contractual provisions a failure to mitigate may still affect the amount of damages that can be recovered.
  • Payments – can they be effected remotely?
  • Guarantees/indemnities/performance bonds/liquidated damages – is there a risk of these being called on if obligations are not performed? 
  • Consequences of getting it wrong – if you act (or fail to act) based on an incorrect assessment of your rights, will you be in breach?
  • Related contracts – will a failure to perform one contract have implications for other contracts? 
  • Non-contractual overlay – are there non-contractual obligations in a relevant jurisdiction that should inform your approach?
  • Insolvency risks – do you need to deal with supply chain insolvencies? Is it possible (or necessary) to look to alternative suppliers or to agree to a commercial re-negotiation
  • Renegotiation of terms – have you considered no waiver, no oral modification, entire agreement and related provisions, and ensured that any alternative arrangements are properly documented?

4. Manage financial arrangements

  • Representations/Repeating Representations – is the company able to make the specified representations at the required times?
  • Undertakings – can the company still comply with its undertakings? Does it benefit from any thresholds, grace periods or other reliefs?
  • Information covenants – will financial statements be delayed? Are relevant parties (such as external auditors) able to access premises/information as needed? Will delivery of documents (such as financial reporting, operational certificates or waiver requests) be delayed due to employee absences? Is it necessary to disclose the impact on operations or any default?
  • Financial ratios – are these adversely affected by historic or forecast loss of operational revenue or changes in asset valuations?
  • Event of Default – is the company in a default situation and at risk of acceleration or of credit support being called or security being enforced?
  • Material Adverse Effect provisions – will these be triggered? 
  • Cross-default risk – is the company at risk of default under any agreement due to its position under other agreements and financings?
  • Insolvency – is the company at risk due to impact on revenues?
  • Debt service – has the company put in place staffing and IT arrangements to ensure that it is still able operationally to effect repayments of principal and interest when due?
  • Disruption event provisions – is there a risk of material disruption to market or individual payment systems which is beyond the control of the parties? 
  • Credit support – are financial support arrangements at risk of being called due to defaults or inability to access financing?
  • Lender obligations – have lenders put arrangements in place to ensure disbursement is unaffected and waiver/amendment requests can be considered in required timeframe?
  • Lender failings – are lenders at risk of being “yanked” or of their views on waiver requests not being counted due to an inability to respond?
  • Access to financing – will lenders be able to process applications for new forms of financing, refinancing or credit support (such as letters of credit) when needed? Will companies be able to meet conditions precedent? Are alternative measures available?
  • Negotiating new financing – will financial and operational forecasts and due diligence need to be updated? Will logistical arrangements need to be adjusted for transaction closing steps?

5. Consider insolvency risks

  • Finding alternative suppliers.
  • Tightening credit terms and including retention of title clauses until payment has been made.
  • Renewed efforts to collect any payment arrears.
  • Your termination rights and whether local law would permit you to exercise them in the event of insolvency.
  • The impact of other companies in your group going into insolvency, in particular, your access to vital assets (IP, IT, employees etc) and whether it is still appropriate to exercise group treasury/cash sweep mechanisms.
  • The impact of global stock market underperformance on pension scheme deficits and whether any obligations arise to consult with interested parties as a result.
  • Your ability to meet your payment obligations as they fall due and any steps you may need to take to manage your cash flow, such as pushing out your creditors. If your financial situation worsens, you may need to consider whether management is obliged to make an insolvency filing. Ensure that directors/management consider their duties and carefully document decisions. 

6. Maintain appropriate data and documents

Ensure compliance with relevant data protection legislation. In the EU, data concerning health is subject to enhanced protection under the GDPR as special category data.

Document decisions and steps taken in response to the outbreak, for example where this may be necessary to comply (or evidence compliance) with contractual or legal/regulatory obligations or helpful in the event of possible future disputes (whether arising under contracts or otherwise). For example, some express obligations to mitigate may require you to demonstrate efforts made. Consider also whether and if so how documents might be protected from disclosure in any dispute (whether on the grounds of legal privilege or otherwise).

7. Consider potential insurance claims

Consider whether the consequences of any business interruption can be claimed under existing insurance policies, and discuss with brokers any need for cover on specific new exposures. In particular:

  • Review existing cover, especially business interruption insurance and “credit insurance”, if any. For instance, existing cover may provide for “loss of use” of premises due to contamination or payment protection in the event that a debtor becomes insolvent and unable to pay. There may also be specific requirements in relation to unoccupied premises. Check terms for notice periods and other formal requirements.
  • Make notifications where applicable and comply strictly with obligations in relation to how and when to notify.
  • Discuss with brokers whether bespoke cover may be advisable, including where there are large employee absences contemplated or where large groups of employees may need to be repatriated.
  • Consider whether insurer consent will be required for any steps you anticipate taking to respond to events and whether mitigation activities may fall under any available heads of cover.

8. Manage wider operational risk

Consider wider operational impacts, for example in relation to:

  • Managing the wider logistics (and costs) of halting “business as usual" activities – this may be significant in some sectors, for example where factory shutdowns are required.
  • Inability to hold or attend physical meetings and events (for example shareholder general meetings) – to what extent can these be held remotely? Will the technology be sufficiently reliable?
  • Minimum staffing levels required to maintain operations.
  • IT disruption (for example where this is outsourced) and ability to continue financial and operational activities dependent on IT systems, whether on site or remotely.
  • Attendance at site visits, tests and inspections.
  • Attendance at time-critical events, in particular where there may be adverse consequences from a failure to attend, such as court or tribunal hearings or public exams.
  • Inability to obtain signatures, for instance in relation to documents requiring physical signing.
  • Obligations to report on risks arising from (or the impact of) Covid-19, including in financial reports, or under market abuse laws.
  • Providing timely information required by regulatory or legal authorities, for example where relevant staff or access may be unavailable.
  • How to respond to stakeholder queries or press enquiries and whether you need to appoint a spokesperson and internal PR controls to manage this.

9. Consider impact on potential M&A transactions

Businesses looking at entering into M&A transactions with targets that may have trading links with affected areas or sectors may wish to consider delaying or taking steps to protect themselves, for example via bespoke due diligence, conditions, termination rights, pre-completion undertakings, warranties or indemnities. Please see our February 2020 bulletin on this issue, here, for further details .

10. Stay up to date on your rights and obligations

Ensure that the team leading the response keeps up to date with the evolving situation:

  • Comply with current legal obligations and guidance: many aspects of your response will be informed by your legal and regulatory obligations in each relevant jurisdiction and by guidance already given by relevant authorities. It is important that your response team has a good understanding of those obligations and ensures compliance with them.
  • Identify and respond appropriately to changes to relevant legal obligations or guidance: your room for manoeuvre may well be constrained not just by the current legislative regime in relevant jurisdictions but also by any new emergency legislation or regulatory and industry guidance. Any legislation may well allow for draconian measures to be introduced in a very tight timeframe. Guidance from Governments, regulators, multilateral organisations (for example the World Health Organisation) and industry groups or representative organisations in relevant jurisdictions may also be updated frequently and will need to be monitored. Regulators are already making clear their expectations, for example in the UK, the recent FCA/Bank of England/HM Treasury statement that they expect all firms to have contingency plans in place to deal with major events.
  • Liaise with Government and industry bodies where necessary on the extent and impact of any controls that may be imposed.

Allen & Overy is advising clients on a range of coronavirus-related issues. For more information on the potential impact of coronavirus on your business or transaction, please speak to your usual A&O contact.

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COVID-19 (Coronavirus) Business Continuity Plan

A 7-step guide to creating a business continuity plan for dealing with COVID-19.

Updated on June 25th, 2023

The SMB Guide is reader-supported. When you buy through links on our site, we may earn an affiliate commission. Learn more

A business continuity plan (BCP) is a strategic plan a business would follow to prevent and recover from major disruptions to business. Typically, businesses establish a continuity plan for natural disasters, such as floods, arson, and terrorism.

The COVID-19 (Coronavirus) outbreak presented businesses with many unforeseen challenges due to its fast spread, global reach, and resulting lockdowns. This guide was created to help businesses modify and improve their business continuity plans during this time to be better prepared for the effects of the pandemic.

COVID-19 Business Continuity Plan Template

Use our general business continuity plan in Word format to help stay on task.

How to Prepare for COVID-19:

1. prioritize your employees' safety..

The well-being and health of your employees should be your top priority. Start by addressing the needs of employees who display COVID-19 symptoms. To keep your entire team safe, send any employees with flu-like symptoms home. In this scenario, ensure you maintain transparent communication with all your employees, as this will go a long way in reassuring them.

Look into remote working solutions. To do this, you'll need to determine if you have the tools, technology, and capacity to support a small or large remote team. In addition, you might need to consider introducing or expanding flexible work arrangements. Depending on your type of business and industry, businesses may also need to reorganize teams and reallocate resources.

One of the adjustments businesses have to make is to implement infection protection measures. You need to create a strategy that enables employees to continue to work without endangering them. You can do this by establishing employee well-being programs and policies that support a safe working environment.

2. Identify the risks and impact of COVID-19.

As a business, it's vital that you stay updated on the latest news and regulations put into place by government officials. This also provides you with more information to help identify the risks and overall impact COVID-19 will have on your business.

The following are possible impacts that businesses should consider:

Employees may be unable to travel to work due to travel restrictions put into place . For employees that make use of public transport, the risk of infection is much higher due to close contact with other individuals. Additionally, since schools are officially closed, many parents may be unable to attend work due to childcare issues.

Employees may be prohibited from attending work . In the case of national shutdowns, employees will be unable to enter workspaces.

A visible slowdown in sales. During a national shutdown, customers will be unable to purchase services and products, which will lead to a rapid decrease in sales.

Additional costs for hiring temporary employees . Depending on the type of business or industry you're based in, you may need to continue work during a national shutdown. This will generally require essential employees only and if essential employees are diagnosed with COVID-19, you will need to consider hiring temporary employees.

Diminished workforce performance. If your employees are forced to work remotely but do not have access to the same quality of resources and technology, you could see a decrease in productivity.

Additional cost of establishing a remote workforce. As mentioned above, you may need to put resources in place to help employees maintain the same level of functionality. However, this will cost your business as employees might require special equipment, communication devices, and software.

Your business might be forced to close down. If your business does not provide essential services and cannot afford a remote workforce, you will have to close down during lockdowns. This could result in unpaid time off, especially for businesses like restaurants, salons, and bars.

3. Establish open and transparent communication.

Employees will look towards their community leaders, government officials, and employers for guidance during these uncertain times. Therefore, it's important that you encourage open dialogue with your employees and be as transparent as possible.

Leave as little to interpretation as possible . Employees will expect clear and straightforward steps that they can follow. When setting up your continuity plan, consider the diverse perspectives of your employees and which communication platforms will best suit their needs. This will help you determine how detailed your plan should be.

Establish a communications plan that provides employees, senior management, customers, suppliers, and government regulators with regular updates . Make sure your updates stem from verifiable news sources, such as the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO).

4. Reshape your business plans for continuity purposes.

As the impact of COVID-19 continues to reshape the way businesses operate, it's critical that you review existing business plans, including your current business continuity plan and business disaster recovery plan.

To help address the COVID-19 challenges, businesses should:

Monitor direct cost escalations . This should also include the COVID-19 impact on overall product margins, which may require businesses to renegotiate terms and conditions where necessary. Businesses may be vulnerable to financial stress and long-term implications if they are slow to react.

Consider alternative supply chain options. If your business needs to source products or materials but the supplier is based in areas significantly affected by COVID-19, consider looking for alternative options. Remember to maintain active communication with all suppliers.

Identify how the COVID-19 pandemic impacts budgets and business plans. Start by conducting assessments with multiple scenarios to understand the potential impact on your business's overall performance. After detailing how long the impact is expected to last, and how it affects suppliers and budget predictions, revise your business's plans.

Look into alternative funding. Many businesses will face the issue of short-term capital demands. Based on your findings from the business plans assessment, you might need to look at near-term capital raising, short-term liquidity, debt refinancing, or additional credit support from banks, partners, or investors.

5. Prioritize key business functions and processes.

Start by identifying the key products and services your business provides, as well as the customers they're delivered to. This will help determine which high-risk areas are vulnerable, outline dependencies, and estimate the potential financial losses your business may face. Then, prioritize which business functions require additional attention.

6. Make use of support policies and funding.

Across the U.S., local governments and organizations have implemented several financial, social insurance, and tax-related policies to help support small businesses during this time. It is important to note that government support may differ based on your location and industry.

Monitor nationwide government and business opportunities that could support your business during this period. For example, the Small Business Administration (SBA) is providing low-interest working capital loans to small businesses and non-profit organizations.

7. Review and revise your business strategy.

Once the COVID-19 pandemic is controlled, you should consider reshaping your entire business strategy. This should include an assessment of all plans, including marketing, communications, and BCP. Your current revision will be done quickly and somewhat under duress as the situation continues to change dramatically.

If your assessment reveals any deficiencies, you will need to identify:

  • Root causes.
  • Timeliness of action.
  • Lack of infrastructure.
  • Labor shortages.
  • External environment issues.

Once this is complete, consider putting new internal guidelines, plans, and policies in place based on the lessons learned. This will help you better respond to future crises and pandemics.

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Mar 4, 2022

What is included in a COVID-19 business continuity plan?

  • Policies that address various types of natural disasters.
  • Processes that must be followed during this time.
  • Guidelines that detail the business processes, assets, human resources, business partners, and more.
  • An outline of the risks the business faces and how it will impact operations.
  • Safeguards and processes to help mitigate the risks.

How do I prepare my business for COVID-19?

  • Prioritize your employees' safety .
  • Identify the risks and impact of COVID-19 .
  • Establish open and transparent communication .
  • Reshape your business plans for continuity purposes .
  • Prioritize key business functions and processes .
  • Make use of support policies and funding .
  • Review and revise your business strategy .

Where can I find a COVID-19 business continuity plan template?

Download our COVID-19 business continuity plan template for free.

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Contingency Plan for the Intensive Care Services for the COVID-19 pandemic ☆ ☆☆

Plan de contingencia para los servicios de medicina intensiva frente a la pandemia covid-19, p. rascado sedes.

a Servicio de Medicina Intensiva, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, A Coruña, Spain

M.Á. Ballesteros Sanz

b Servicio de Medicina Intensiva, Hospital Universitario Marqués de Valdecilla, Santander, Spain

M.A. Bodí Saera

c Servicio de Medicina Intensiva, Hospital Universitario de Tarragona Joan XXIII, Tarragona, Spain

L.F. Carrasco RodríguezRey

d Servicio de Medicina Intensiva, Hospital Universitario 12 de Octubre, Madrid, Spain

Á. Castellanos Ortega

e Área de Medicina Intensiva, Profesor asociado de Medicina Universidad de Valencia, Hospital Universitario y Politécnico La Fe, Valencia, Spain

M. Catalán González

C. de haro lópez.

f Área de Críticos, Corporación Sanitaria i Universitaria Parc Tauli, CIBER Enfermedades Respiratorias, Sabadell, Spain

E. Díaz Santos

A. escriba barcena.

g Servicio de Medicina Intensiva, Hospital Universitario Fuenlabrada, Madrid, Spain

M.J. Frade Mera

J.c. igeño cano.

h Servicio de Medicina Intensiva y Urgencias, Hospital San Juan de Dios de Córdoba, Spain

M.C. Martín Delgado

i Servicio de Medicina Intensiva, Hospital de Torrejón, Torrejón de Ardoz, Madrid, Spain

G. Martínez Estalella

j Directora Enfermera, Hospital Clínic de Barcelona, Spain

N. Raimondi

k División de Terapia Intensiva, Hospital Juan A. Fernández, Buenos Aires, Argentina

O. Roca i Gas

l Servicio de Medicina Intensiva, Hospital Universitario Vall d’Hebron, Barcelona, Spain

A. Rodríguez Oviedo

E. romero san pío.

m Hospital Universitario Central de Asturias, Oviedo, Spain

J. Trenado Álvarez

n Jefe de Servicio de Medicina Intensiva, Hospital Universitario Mutua Tarrasa, Barcelona, Spain

o Universidsad de Barcelona, Barcelona, Spain

In January 2020, the Chinese authorities identified a new virus of the Coronaviridae family as the cause of several cases of pneumonia of unknown aetiology. The outbreak was initially confined to Wuhan City, but then spread outside Chinese borders. On 31 January 2020, the first case was declared in Spain. On 11 March 2020, The World Health Organisation (WHO) declared the coronavirus outbreak a pandemic. On 16 March 2020, there were 139 countries affected. In this situation, the Scientific Societies SEMICYUC and SEEIUC, have decided to draw up this Contingency Plan to guide the response of the intensive care services. The objectives of this plan are to estimate the magnitude of the problem and identify the necessary human and material resources. This is to provide the Spanish Intensive Medicine Services with a tool to programme optimal response strategies.

En enero de 2020 China identificó un nuevo virus de la familia de los Coronaviridae como causante de varios casos de neumonía de origen desconocido. Inicialmente confinado a la ciudad de Wuhan, se extendió posteriormente fuera de las fronteras chinas. En España, el primer caso se declaró el 31 de enero de 2020. El 11 de marzo, la Organización Mundial de la Salud declaró el brote de coronavirus como pandemia. El 16 de marzo había 139 países afectados. Ante esta situación, las Sociedades Científicas SEMICYUC y SEEIUC han decidido la elaboración de este plan de contingencia para dar respuesta a las necesidades que conllevará esta nueva enfermedad. Se pretende estimar la magnitud del problema e identificar las necesidades asistenciales, de recursos humanos y materiales, de manera que los servicios de medicina intensiva del país tengan una herramienta que les permita una planificación óptima y realista con que responder a la pandemia.

On January 7, 2020, the Chinese authorities identified a new virus in the Coronaviridae family as the cause of an outbreak of pneumonia in the city of Wuhan in Hubei Province. The virus has subsequently been named SARS-CoV-2 and the disease, COVID-19. 1

According to data from the European Centre for Disease Prevention and Control (ECDC), from 31 December 2019 to 16 March 2020 the disease had spread to 139 countries, and there were 16,741 reported cases, including 6507 deaths. 2

In Spain, according to data from the Ministry of Health, on 16 March at 13:00 there were 9191 positive cases, of which 432 were admitted to intensive care units (ICU). 3

In this situation, the scientific societies SEMICYUC, representative of specialists in Intensive Care Medicine, and SEEIUC, representative of critical care nurses, are considering the need to develop a contingency plan to respond to the needs that this new disease will entail, with the following objectives:

  • 1. To provide health authorities, managers and clinicians with a technical document that addresses all aspects related to identifying the care needs of critically ill patients in the face of the new SARS-Cov-2 pandemic, for the comprehensive and realistic planning of intensive care services at national, regional and hospital level.
  • 2. To ensure optimum care for severely ill COVID-19 patients and other critical patients with other diseases.
  • • To protect health and non-health workers in all ICUs.
  • • To prevent hospitals serving as amplifiers of the disease.
  • • To protect non- COVID-19 patients from infection, in order to maintain the capacity to provide essential non-COVID-19 medical care.
  • 4. To optimise the human resources of intensive care services.
  • 5. The rational, ethical and organised allocation of limited healthcare resource to ensure the greatest good for the greatest number of people.

COVID-19 pandemic forecast

The proposal for planning possible scenarios is based on FluSurge 2.0 software. It was developed by the CDC and provides a freely downloadable spreadsheet to estimate the demand for services, in both a moderate and severe pandemic situation. 4 The tool allows changes of the population at risk, the available hospital resources and assumptions on the epidemiological course of the pandemic, and then provides a rough estimate of needs in that context. Thus, it estimates the number of hospitalisations and deaths, the number of people hospitalised, the number of patients requiring care in ICU, how many of these people will require mechanical ventilation and the degree of saturation of the services available to care for them.

It is important to highlight that FluSurge 2.0 has been specifically designed to assess the possible effect of a pandemic caused by the influenza virus and has been validated only for that purpose. Its application to the COVID-19 pandemic should be approached with caution.

The calculation of possible scenarios requires several initial assumptions about the characteristics of the pandemic. The estimates used are based on the published series on the Chinese outbreak, 5 , 6 the experience in Italy 7 and experience with the influenza virus H1N1. 8

A mean hospital stay of 11 days, a mean ICU stay of 14 days, a rate of 11% of hospitalised patients requiring ICU admission and 6.5% requiring mechanical ventilation were considered.

Considering an attack rate (proportion of persons within a population who become infected with a certain disease) of 35% and a duration of the pandemic of 12 weeks (data that are adjusted to the progression of the most affected Autonomous Communities), the following are expected:

  • • 278,435 hospital admissions in 12 weeks.
  • • Peak demand in week 7.
  • • The need for more than 9000 ICU beds at times of greatest demand.
  • • The need for more than 5000 ventilators in the weeks of greatest demand.

The proposed scenario has been designed to plan for needs in the event that containment measures are not sufficient. The following are recommended:

  • • Plan according to the actual situation at any given time.
  • • Re-evaluate progression in response to containment measures.

Phases of response to the pandemic

It is recommended that the response be adapted in line with progression of the pandemic. 9 , 10

Phase 0. Preparedness

  • • Normal care activity.
  • • Elaboration of protocols and contingency plan.
  • • Bed availability study.
  • • Equipment forecast.
  • • Staff training.

Phase 1. Start of the pandemic

  • • Cancellation of elective surgery.
  • • Fitting of additional spaces such as ICU beds.
  • • Completing staff teams. Freeing-up of extra- ICU activity.
  • • Sectorised work teams.

Phase 2. Saturation of the ICU

  • • Suspension of all elective activity.
  • • Organise shifts.
  • • Sectorise COVID-19 patients.
  • • Strict admission criteria.

Phase 3. Collapse of the ICU and the hospital

  • • Prioritise the care of patients most likely to recover.
  • • Nurse: patient ratio based on availability.
  • • Prioritise the overall benefit to the individual.

Need for human and technical resources

Coronavirus committees.

The coronavirus committees are working groups at national, regional and local levels (specific to the hospital) that prepare the necessary resources and the action plan for all possible scenarios.

The committees have the following objectives:

  • • To define and agree the contingency plan with the administration.
  • • To guarantee the acquisition of material.
  • • Complete the necessary protocols.
  • • Plan spaces.
  • • Define procedures for transfer.
  • • Organise the work teams.

The role of the intensive care specialist on the committees is essential to:

  • • Prepare pathways and areas for critical patient care.
  • • Define hospital and out-of-hospital transfer pathways.
  • • Report on the situation and the needs of the ICU.

Technical resources

The following recommendations have been established:

  • • Critical COVID-19 patients must be cared for in an ICU by specialists in intensive care medicine.
  • • Each ICU bay or station must be equipped with a ventilator for advanced invasive ventilation.
  • • There must be a transport ventilator for every 10 patients.
  • • All of these aspects must be considered when creating extraordinary ICU bays in other areas of the hospital.
  • • Cohorting and isolation in cohorts is recommended.
  • • Cohorting should take precedence over the concept of closed-door rooms.
  • • If an ICU has both open and closed bays, it is recommended that closed bays are used initially.
  • • If necessary, extend the physical space of the ICU.

Human resources

A plan for change in care must be made in each centre to include burden sharing, care responsibilities and working hours.

The following staffing of intensive care doctors is recommended 11 :

Ordinary working hours:

  • - One intensive care specialist for every 3 patients.
  • - In the event of saturation, other non-intensive care physicians (including resident physicians) can be included, coordinated by an intensive care specialist.

On-call duty:

  • - Two intensive care specialists or 1 intensive care specialist plus 1 4th/5th-year resident for every 12 beds.
  • - In the event of saturation, other non-intensive doctors (including resident doctors) coordinated by an intensive care specialist.

The following nursing staffing is recommended 12 :

  • • One nurse per shift for every 2 critical patients.
  • • Back-up of 1 nurse for every 4–6 beds for support in moments of maximum workload (prone, intubation, transfers, etc.).
  • • One Assistant Nursing Care Technician (TCAE) for every 4 beds.
  • • Back-up per shift every 8–12 beds for organisation and cleaning of material, support and replacement.

Staff training 9

SEMICYUC will edit the training material: computer graphics, posters, etc.

Each hospital must organise training sessions with at least the following content:

  • - Epidemiology of COVID-19.
  • - Impact on activity.
  • - Transmission.
  • - Diagnosis of COVID-19.
  • - Personal protection measures: personal protective equipment (PPE), procedures and isolation.

Internal communication. Information transfer

We recommend 13 :

  • • Establishing an information transfer period.
  • • Avoiding close contact during information transfer.
  • • Special care in handing off the therapeutic plan and anticipating changes.
  • • Undertaking structured hand-offs, e.g. through SBAR (Status, Background, Assessment and Recommendations).
  • • Appropriate completion of clinical history.

Communication and information to patients and relatives

  • • In ICUs where there are cases of COVID-19, it is recommended that the relatives of all patients admitted to the ICU should be informed on a daily basis, as well as when there are no cases, without providing any additional information that could infringe on the privacy of the patient and his/her family.
  • • It is recommended that all family members of patients admitted to an ICU where there are COVID-19 cases receive the usual daily information provided by the team outside the unit.
  • • COVID-19 patients will be kept in isolation and accompaniment/visits completely restricted. Only in situations reviewed on an individual basis by the care team due to compelling need (e.g. near death) or other clinical, ethical and/or humanitarian considerations, will limited, controlled,short, supervised visits be permitted on an exceptional basis, after training the family member how to put on and take off PPE by helping and supervising them.
  • • Families are advised to keep the accompaniment of patients, whether or not they have COVID-19, to a minimum.

Visits to patients without COVID-19 in units where COVID-19 patients have been admitted will be adapted to the architectural characteristics of the unit.

Optimised use of resources

Coronaviruses are mainly transmitted by respiratory droplets of more than 5 μm and by direct contact with secretions from infected patients. They may also be transmitted by aerosols in therapeutic procedures that produce them. Therefore, we recommend 14 , 15 , 16 , 17 :

  • • Precautions for the treatment of all probable or confirmed patients under investigation should include standard, contact and droplet transmission precautions.
  • • Strict hand hygiene should be observed.
  • • All professionals should be trained in the use of PPE.
  • • Ideally, patients should be isolated in a separate room, if possible, with negative pressure.
  • • Priority should be given to cohorting in a specific area.
  • • Waste generated is considered class III waste.
  • • PPE should be removed inside the bay, with the exception of respiratory and eye protection.
  • • Clothing and dishes do not require special treatment-

Personal protective equipment

Equipment must include 14 :

  • • Gloves and protective clothing.
  • • Respiratory protection.
  • • Eye and face protection.

We recommend the following in terms of respiratory protection14, 16:

Confirmed cases under investigation should wear surgical masks if possible.

Use 2 high efficiency antimicrobial filters (inspiratory and expiratory branches) in the case of invasive mechanical ventilation. 18

Use closed suction systems.

For non-invasive ventilation, the use of anti-viral filters and preferably double-tube equipment is recommended.

Avoid manual ventilation with a bag mask. If this is done, a high efficiency antimicrobial filter should be used.

Avoid active humidification, aerosol therapy and circuit breakers. 18

To enter the room or a 2 m perimeter, if procedures that generate aerosols are not going to be performed, it is recommended that the following are used 15 :

  • - Gown (can be disposable paper).
  • - Mask (surgical or FFP2 if available and ensuring sufficient stock at all times).
  • - Anti-splash eye protection.

If an aerosol-generating procedure is to be performed, the following are recommended16, 18:

  • - FFP2 or preferably FFP3 mask, if available.
  • - Tight fitting full frame eye protection or full-face shield.
  • - Long-sleeved waterproof gown.

The current recommendation is to use the mask only once. Although there is no clear evidence on this, in the event of a shortage, the masks can be reused by the same practitioner for a maximum period of 8 h of continuous or intermittent activity. There can be extended use of the mask if it is not stained or wet. 19

Optimising the use of PPE

Rational use of PPE is necessary and exposure times must be minimised. To this end, the following recommendations should be followed:

Promote registration, control and monitoring measures that do not require entering the room.

  • • Plan tasks and remain in the room for the shortest time possible.
  • • Group tasks that require entering the bay.
  • • Adjust perfusions to make changes during one programmed entry to the bay.
  • • Deliver care, examinations, etc., with the minimum number of people.
  • • Do not suction by protocol.
  • • Take samples together to prevent unnecessary entries.
  • - Prepare the sample for sending inside the bay.
  • - Clean the external part of the tube with a surface disinfectant or wipe impregnated with disinfectant.
  • - Samples will be transported in person avoiding transport systems such as pneumatic tubes.

The professionals responsible for the patient should supervise any action on the patient by non-service personnel.

Indications for admission to ICU due to SARS-CoV-2 pneumonia

General criteria for admission to ICU

We recommend using objective criteria for ICU admission based on the recommendations of the American Thoracic Society (ATS), the Infectious Diseases Society of America (IDSA) 20 and recent evidence from analysis of the SARS-CoV-2 (COVID-19) epidemic in China 21 ( Table 1 ). ICU admission will be considered when there is 1 major criterion or 3 or more minor criteria.

Major and minor criteria for admission to the intensive care unit (ICU).

Optimisation in the event of saturation

  • • In a situation of saturation or being overrun, it is necessary to prioritise the care of the cases that are potentially more likely to recover.
  • • ICU triage protocols for pandemics should only be activated when ICU resources over a wide geographic area are or will be overwhelmed despite all reasonable efforts to expand resources or obtain additional resources.
  • • Guidelines for adjusting therapeutic effort are essential.

Inclusion/exclusion criteria 22 , 23 , 24 , 25

  • • A triage instrument that objectively classifies patients is proposed.
  • • The only measure proposed so far, although not validated, is based on the use of SOFA. 22
  • • After the first assessment, patients should be reassessed on days 2 and 5, when they could be reclassified.

The following are exclusion criteria for admission:

  • • Poor prognosis despite ICU admission.
  • • Need for resources that cannot be provided.
  • • Not meeting severity criteria
  • • The specific recommendations for admission exclusion criteria in the event of a mass disaster can be applied. 25

Expansion plan

The expansion plan includes the transformation and fitting out of additional spaces for the care of the critical patient in the event that ICU beds have been overwhelmed and enlarging the team of staff who are experts in critical care.

Expansion of intensive care services

Possible sites for critical patients must have 22 , 26 , 27 :

  • • Medical gases.
  • • Respirators for invasive and non-invasive mechanical ventilation.
  • • Possibility of high-flow oxygen therapy.
  • • Possibility of advanced monitoring.
  • • Possibility of continuous extrarenal purification techniques.
  • • Points for hand hygiene.
  • • The availability of central monitoring (telemetry) would be desirable.

As a guideline, the spaces that can be used to extend ICU beds are 28 :

  • • Intermediate care units attended by intensive care specialists: nurse:patient ratios need to be adjusted to those of a conventional ICU.
  • • Resuscitation units and post-anaesthetic recovery units. Elective surgery must be suspended. Patients must be cared for by specialists in intensive medicine.
  • • Critical or intermediate care areas of the emergency services.
  • • Make space available near the ICU with new equipment.
  • • Transform conventional hospitalisation areas, day hospitals or major outpatient surgery areas.
  • • In the event of overcrowding, transfer to another centre with available space should be considered.

We recommend that, if 100% saturation of intensive care services is anticipated, centralisation of resources should be considered. To that end:

  • • Develop an inter-hospital transfer procedure.
  • • A critical patient coordinator should be designated in each Autonomous Community to comprehensively manage all the critical beds in each Community.

Expansion of staff

We recommend 29 , 30 :

Conducting a census of all medical personnel who specialise in intensive care medicine, to also include:

  • - Physicians with on-call contracts.
  • - Intensive care specialists dedicated to other tasks in the hospital.
  • - Unemployed doctors.
  • - Recent retirees.
  • • Conduct a census of other staff physicians or residents who may have the capacity to care for less serious patients, coordinated by the intensive care department.
  • • Extending substitution contracts.
  • • Carry out a plan for medical staffing and burden sharing in all hospitals.
  • • Conduct a census of nursing staff with knowledge and experience in critical patient care.
  • • Develop a plan to relocate experienced nurses to critical areas
  • • Consider the peak care load in forecasts.
  • • If medical or nursing staff who are not undertaking their usual work are included in critical care activities, they should first receive training.
  • • Training should include 2 key areas: intensive care medicine or nursing and infection control.

Inter-hospital transfer

  • • Necessary personnel: attending physician, attending nurse and emergency health technician.
  • • Appropriate PPE for the staff in the care cabin is recommended for situations where there is aerosol risk.

Consider the following during transfer:

  • • The driver must be isolated from the patient's compartment.
  • • Family members must not travel in the transport vehicle.
  • • Limit the number of care providers in the care cabin.

Intra-hospital transfer

  • • A protocol for the transfer pathway must be established: itinerary, elevator, number of participants, PPE.
  • • Steps for transfer:
  • 1. Inform the receiving department of the start of the transfer.
  • 2. Prepare the material.
  • 3. Place PPE.
  • 4. Inform the receiving department of the start of the transfer.
  • 5. Block the lift for transfer and disinfection.
  • 6. Security personnel with a surgical mask will precede the team to clear the area.
  • 7. Disinfection of trafficked areas.

Conflicts of interest

☆ Please cite this article as: Rascado Sedes P, Ballesteros Sanz MÁ, Bodí Saera MA, Carrasco RodríguezRey LF, Castellanos Ortega Á, Catalán González M, et al. Plan de contingencia para los servicios de medicina intensiva frente a la pandemia COVID-19. Enferm Intensiva. 2020;31:82–89.

☆☆ This article is published simultaneously in Medicina Intensiva ( https://doi.org/10.1016/j.medin.2020.03.006 ) and in Enfermería Intensiva ( https://doi.org/10.1016/j.enfi.2020.03.001 ), with the consent of the authors and editors.

Contributor Information

Ricard ferrer roca.

aa Presidente, Spain

Álvaro Castellanos Ortega

bb Vicepresidente, Spain

Josep Trenado Álvarez

cc Secretario, Spain

Virginia Fraile Gutiérrez Tesorero

dd Vicesecretaria, Spain

Alberto Hernández Tejedor

Manuel herrera gutiérrez.

ee Presidente del Comité Científico, Spain

Paula Ramírez Galleymore

ff Vicepresidenta del Comité Científico, Spain

M. Ángeles Ballesteros Sanz

gg Vocal Representante de los Grupos de Trabajo, Spain

Pedro Rascado Sedes

hh Vocal Representante de las Sociedades Autonómicas, Spain

Leire López de la Oliva Calvo

ii Vocal Representante de los Médicos en Formación, Spain

María Cruz Martín Delgado

ab Presidenta Anterior, Spain

Marta Raurell Torredá

bc Presidenta, Spain

Miriam del Barrio Linares

cd Vicepresidenta, Spain

Marta Romero García

de Secretaria, Spain

María Teresa Ruiz García

ef Tesorera, Spain

María Pilar Delgado Hito

fg Directora de la Revista, Spain

Juan José Rodríguez Mondéjar

gh Vocal de los Grupos de trabajo, Spain

Carmen Moreno Arroyo

hi Vocal de la Industria, Spain

Alicia San José Arribas

ij Vocal de Relaciones internacionales, Spain

María Jesús Frade Mera

jk Vocal de Investigación, Spain

Appendix A SEMICYUC Board of Directors

President, Ricard Ferrer Roca; Vice president, Álvaro Castellanos Ortega; Secretary, Josep Trenado Álvarez; Vice-secretary, Virginia Fraile Gutiérrez; Treasurer, Alberto Hernández Tejedor; President of the Scientific Committee, Manuel Herrera Gutiérrez; Vice-President of the Scientific Committee, Paula Ramírez Galleymore; Member for Working Groups, M. Ángeles Ballesteros Sanz; Member for the Autonomous Societies, Pedro Rascado Sedes; Member for Doctors in Training, Leire López de la Oliva Calvo; Former President, María Cruz Martín Delgado.

Appendix B SEEIUC Board of Directors

President, Marta Raurell Torredá; Vice-president, Miriam del Barrio Linares; Secretary, Marta Romero García; Treasurer, María Teresa Ruiz García; Journal Editor, María Pilar Delgado Hito; Member for Working Groups, Juan José Rodríguez Mondéjar; Member for Industry, Carmen Moreno Arroyo; Member for International Relations, Alicia San José Arribas; Member for Research, María Jesús Frade Mera.

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Covid-19 contingency plan 2020

Since the outbreak of the COVID-19, usually called Coronavirus, now threatening our nation, the Ministry of Education and Training (MOET), through the establishment of a Technical Working Group, has come to develop this plan. lt is aligned to the National Contingency Plan which will safeguard the ed ucational continuity for all children in Vanuatu during this emergency period. The document is intended to be utilized by the MOET to strengthen the quality of the national and provincial education response to the COVID-19 outbreak. By doing so, schools across the country will be better supported for children to return to learning as soon as possible in safe and protective environments.

Stanford University

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Stanford contingency plans evolve as COVID-19 cases surge nationwide

Mandates imposed by the county and state based on the evolving COVID-19 pandemic may prompt changes in the university’s fall academic and undergraduate housing plans. Final decisions about fall plans are targeted for mid-August.

Contingency plans for undergraduate housing and study on campus are being created by Stanford administrators to account for any expansion in restrictions mandated by the nationwide surge in COVID-19 cases.

contingency plan for covid 19 sample

Sarah Church, vice provost for undergraduate education, and Susie Brubaker-Cole, vice provost for student affairs, report on Stanford’s ongoing contingency plans for undergraduate housing and study on campus. (Image credit: Stacy H. Geiken & L.A. Cicero)

The university’s need to remain flexible in planning for the fall was communicated to undergraduate students and their families by Sarah Church, vice provost for undergraduate education, and Susie Brubaker-Cole, vice provost for student affairs, in the Wednesday Re-Approaching Stanford newsletter.

“State and county orders may prohibit our on-site activities if case numbers locally do not improve,” they wrote. “For these reasons, we may need to change plans, and we will reach a decision in mid to late August.”

Church will also be communicating directly with Stanford faculty and instructors with more details about the fall contingency planning process. Similarly, staff communications are being prepared by University Human Resources.

Government restrictions

Specifically, Church and Brubaker-Cole tell undergraduate students and their families that a worsening of the pandemic may cause the governments with jurisdiction over the Stanford campus to impose restrictions, including shelter-in-place orders, that would affect the in-person classes and living circumstances currently planned for fall. Plans for graduate students to move into on- and off-campus housing, however, are – at this point – expected to move forward.

The state has already mandated remote learning in elementary, middle and high schools in counties – including Santa Clara County – with indications of increases in COVID-19 cases. Such counties are placed on a state “watch list.” On Wednesday, higher education officials throughout California were awaiting more specific directions from California Gov. Gavin Newsom for colleges and universities.

As they await further government guidance, Stanford administrators are working with medical experts on such issues as predicting how many cases might be expected on campus in light of COVID-19 case increases nationally.

If the university needs to cancel or alter on-site fall quarter classes and undergraduate housing, Brubaker-Cole and Church said the university will reconfigure plans previously announced for first-year students and sophomores with the objective that they will not have to wait until summer to reside on campus.

Some practices, regardless of the circumstances in the fall, will have to change. For instance, families and guests will not be able to enter residential or dining facilities during move-in and will be asked to leave immediately after dropping off their undergraduate student.

Other safeguards are also being considered as the pandemic evolves. Face coverings, testing, contact tracing and quarantine/isolation, for instance, will become a part of student life for graduate and undergraduate students alike. Students will be asked to sign a campus compact – similar to those being created at peer institutions – that outlines the university’s expectations and accountability processes.

COVID-19 testing

Brubaker-Cole and Church said that all undergraduates will be tested twice during their first week on campus. Students also will be asked to minimize contact with each other during that first week. Students who test positive will be isolated in housing that limits exposure to other community members. The university plans to continue to test students periodically throughout their 10-week stay on campus, and before they return to their homes. Similarly, testing and isolation plans are in the works for graduate students, whose arrival schedules differ from undergraduates.

For contact tracing, Vaden Health Service will perform exposure notification and care management for students, in accordance with county standards. Those who come in close contact with a student who tests positive or who may have been exposed to COVID-19 will be asked to quarantine and undergo testing.

The university’s objective will be to prevent the spread of disease and ensure students feel safe and supported.

Back-up plans

Undergraduate students and their families are being encouraged to create back-up plans for fall housing, to purchase refundable tickets for travel and to bring to campus no more than two suitcases and a backpack – in other words, what a student can reasonably carry.

At this point, Residential & Dining Enterprises (R&DE) Student Housing Assignments will begin reaching out to undergraduate students with information about the housing assignment process for fall quarter, based on previously announced plans. Under those plans, the university will accommodate first-year students and sophomores during fall and summer quarter and juniors and seniors during winter and spring.

The university is forgoing the Draw, the system that has typically been used to assist undergraduates in applying for housing, in favor of a new Autumn Housing Allocation process that emphasizes ensuring friend groups can live in the same residence.

Due to COVID-19 restrictions, it may not be possible for students to visit other residence halls. Additionally, students may only be able to eat in one designated dining hall based on their housing assignment. Some undergraduate students will be housed in one of the new Escondido Village Graduate Residences that are anticipated to open this fall.

Student life

Student Affairs has established a Student Organizations Working Group to help students remain engaged when they’re not on campus, set up organizations for success while complying with evolving COVID-19 expectations and develop best practices. Students’ ability to gather as organizations while on campus will depend on California’s phased re-opening process and related Santa Clara County public health orders. At this point, it is highly unlikely that campus events and parties will be allowed, and even smaller gatherings could be limited.

The application process for students with special circumstances requesting to live on campus for additional quarters launched July 6 . The application and review processes have ended, and students have been notified of the status of their application. The university was able to accommodate 73 percent of the 1,204 students applying.

The R&DE Stanford Dining management team and staff have been implementing new procedures to provide a safe dining hall environment for students and for the staff working there. R&DE Stanford Dining developed the CleanDining program, which builds upon the already high standards of food safety and sanitation followed in the dining halls.

At mealtime, for instance, students will have their temperature checked and will wash their hands as they enter. Students must wear face coverings and maintain a six-foot physical separation. Meals will be pre-packed and provided for take-out service only, including those for students with special dietary needs.

In addition, R&DE Stanford Dining has put new procedures in place to keep the dining staff and the food served safe. Staff must wear face coverings and gloves and wash their hands frequently. Dining halls will continue to receive enhanced cleaning and disinfecting using a hospital-grade electrostatic fogger, which disinfects all objects and surfaces.

R&DE’s custodial and maintenance teams have also modified operations to protect students and workers. All R&DE staff are required to complete both university and department COVID-19 safety training. Staff wear face coverings and possibly gloves and other forms of personal protective equipment, depending on the work being done. Common spaces, such as hallways and bathrooms, and high-touch areas, like doorknobs and elevator buttons, receive enhanced cleaning and disinfecting twice daily, seven days a week.

Stress and uncertainty

Church and Brubaker-Cole acknowledge in their letter to students and families the stress and uncertainty COVID-19 planning has caused.

“We know many of you are struggling with the health and economic impacts of this pandemic,” they wrote. “We remain committed to providing information as quickly as we are able to help ensure students and families have what they need to make decisions.”

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    The College of Health Professions (COHP) Contingency Plan is developed based on traditional infection prevention and industrial hygiene practices set forth by The Occupational Safety and Health Administration (OSHA) and the Center for Disease Control and Prevention (CDC). The College will follow federal, state, local, and the UTHSC guidelines.

  14. PDF Guidance for health system contingency planning during widespread

    the management of COVID-19 cases; non-essential services need to be reviewed regularly against other pressing demands that may be more urgent. Referring to pandemic influenza plans may be useful, but COVID-19 is different, particularly in the distribution of cases across age groups and the uncertainties surrounding treatment options. Therefore,

  15. Safe and Healthy School Operations, Contingency Plans, and

    CREATING CONTINGENCY PLANS IN THE EVENT THAT IN-PERSON INSTRUCTION MUST CEASE. Given how infectious COVID-19 is and that any effective vaccines or treatments are likely to be unavailable before schools would reopen in the fall, every school that reopens for in-person learning must have in place a contingency plan detailing under what ...

  16. Pandemic Crisis: Simulation Contingency Plans

    Creating a detailed formal contingency plan for emergencies is essential for nursing programs. Additionally, the pandemic highlighted the importance of continuing faculty development and education in online, virtual, and simulation pedagogy.

  17. Contingency Plan for the Intensive Care Services for the COVID-19

    The objectives of this plan are to estimate the magnitude of the problem and identify the necessary human and material resources. This is to provide the Spanish Intensive Medicine Services with a tool to programme optimal response strategies. Keywords: Coronavirus, COVID-19, SARS-CoV-2, Pandemic. On January 7, 2020, the Chinese authorities ...

  18. Research Project Management Contingency Planning

    Methods for Disinfecting COVID-19 from Surfaces. ... It is a best practice to share contingency plans with the entire research team, a departmental representative, your College/School's Associate Dean for Research, as well as the Office of Research & Innovation.

  19. PDF School Contingency Plan Manual for COVID 19 Resurgences

    School Contingency Plan Manual for COVID 19 Resurgences Purpose of the Manual This manual shall serve as a guide in activating the contingency plan to minimize the impact of a COVID-19 resurgence to the school community.

  20. Covid-19 contingency plan 2020

    Since the outbreak of the COVID-19, usually called Coronavirus, now threatening our nation, the Ministry of Education and Training (MOET), through the establishment of a Technical Working Group, has come to develop this plan. lt is aligned to the National Contingency Plan which will safeguard the ed ucational continuity for all children in Vanua...

  21. WHO guidance for contingency planning

    WHO guidance for contingency planning. View/ Open. WHO-WHE-CPI-2018.13-eng.pdf (‎305.3Kb)‎ ...

  22. PDF Nati Contingency Plan for Novel Coronavirus (COVID-19)

    National Contingency Plan for Novel Coronavirus (COVID-19) 3 | P a g e ACKNOWLEDGEMENTS Development of this National Contingency Plan for Novel Corona Virus (COVID-19) is a key towards achieving country operational readiness. This plan has been prepared to guide what needs to be done in preparedness and response to the outbreak.

  23. Stanford contingency plans evolve as COVID-19 cases surge nationwide

    Contingency plans for undergraduate housing and study on campus are being created by Stanford administrators to account for any expansion in restrictions mandated by the nationwide surge in COVID-19 cases.