You can protect workers by supporting them in maintaining both personal preventive behaviors (socially distancing, wearing cloth masks, washing hands) and environmental interventions. Evaluate your workplace to identify scenarios where workers cannot maintain social distancing of at least 6 feet from each other and/or riders. Use appropriate combinations of controls following the hierarchy of controls to address these situations to limit the spread of the virus that causes COVID-19. A committee of both workers and management may be most effective at identifying all possible scenarios.
While protecting workers, it is important to note that control recommendations or interventions to reduce exposure to SARS-CoV-2 (the virus that causes COVID-19) must be compatible with any safety programs and personal protective equipment (PPE) normally required for the job task. Approaches to consider may include the following:
Create a COVID-19 Workplace Health and Safety Plan
Review the CDC Interim Guidance for Businesses and Employers and the Resuming Business Toolkit for guidelines and recommendations that all employers can use to protect their employees.
Continue to follow state and local regulations for paratransit operators in addition to the recommendations here.
Identify an on-site workplace coordinator who will be responsible for COVID-19 assessment and control.
When developing plans, include all employees in the workplace, for example: operations staff, utility employees, relief employees, janitorial staff, maintenance, and supervisory staff.
Notify all workers that any COVID-19 concerns should be directed to the identified coordinator.
Implement flexible sick leave and supportive policies and practices.
Develop policies that encourage sick employees to stay at home without fear of reprisals, and ensure employees are aware of these policies.
If contractors are employed in the workplace, develop plans to communicate with the contracting company regarding modifications to work processes.
Consider conducting daily in-person or virtual health checks (e.g., symptom and/or temperature screening) of employees on their scheduled workdays.
Screening options could include having employees self-screen before arriving at work or taking employees’ temperatures and assessing potential symptoms prior to beginning work (see CDC Interim Guidance for Businesses and Employers).
Make sure employees can maintain at least 6 feet of distance while waiting for screening, if done on-site.
Make employee health screenings as private as possible and maintain the confidentiality of each individual’s medical status and history.
Take action if an employee is suspected or confirmed to have COVID-19
Immediately separate employees who report with or develop symptoms at work from other employees and arrange for private transport home. These employees should self-isolate and contact their health care provider immediately.
Close off any areas that were used for prolonged periods of time by the sick person, if it is practical to do so.
Perform enhanced cleaning and disinfection after anyone suspected or confirmed to have COVID-19 has been in the workplace. Cleaning staff should clean and disinfect offices, bathrooms, common areas, and shared equipment used by the sick person, focusing especially on frequently touched surfaces or objects. If other workers do not have access to these areas or items, wait 24 hours (or as long as possible) before cleaning and disinfecting.
Employees who test positive for COVID-19 should immediately notify their employer of their results.
Sick employees should follow CDC recommended steps to self-isolate or seek care. Employees should not return to work until the criteria to discontinue home isolation are met, in consultation with healthcare providers.
A test-based strategy is not recommended to validate an employee’s illness, or to qualify an employee for sick leave or return to work.
Develop hazard controls using the hierarchy of controls to prevent infection among workers. You may be able to include a combination of controls noted below.
Engineering Controls (Isolate people from the hazards)
Alter the workspace using engineering controls to prevent exposure to the virus that causes COVID-19.
Where possible, establish physical barriers between coworkers and between workers and passengers.
Use strip curtains, plastic barriers, or similar materials to create impermeable dividers or partitions.
Close or limit access to common areas where employees are likely to congregate or gather and interact, such as break rooms and entrance or exit areas.
Consider making foot-traffic single direction in narrow or confined areas, such as aisles and stairwells, to encourage single-file movement at a 6-foot distance.
Use visual cues such as floor decals, colored tape, and signs to remind workers to maintain a distance of at least 6 feet from others, including in the paratransit vehicle (if possible) and in break areas.
Consider using visual cues for passengers as well, such as at the paratransit entry doors.
Place hand sanitizer with at least 60% alcohol in multiple locations throughout the paratransit vehicle for workers and passengers.
Use touch-free stations where possible.
Clean and disinfect vehicle surfaces and tools between passengers.
Use devices that do not require employees to handle customer credit and debit cards, and institute a cashless policy. If this is not possible, ensure that cash and cards are handled with care by employees, and that employees either wash their hands with soap and water or use hand sanitizer with at least 60% alcohol between customers.
Provide workers with adequate time and access to soap and clean water for handwashing and a way to dry their hands.
Remind employees to wash their hands often with soap and water for at least 20 seconds. If soap and water are not available, they should use hand sanitizer with at least 60% alcohol.
Provide hand sanitizer, tissues, and touch-free lined trash receptacles in the vehicle for both passengers and employees to use.
Maintain social distancing in the vehicle, if possible.
Use larger vehicles, such as cutaway buses or vans, when feasible to allow greater distance between vehicle occupants.
Limit passenger loads whenever possible, unless passengers are immediate family or personal aides.
Develop a protocol when physical contact with any passenger is necessary, and instruct operators to avoid touching passengers’ hands and avoid close face-to-face interactions, if feasible.
Confirm that vehicles’ fresh air vents and blowers are working properly and train operators on proper use to provide fresh air flowing in a clean-to-less-clean airflowpdf iconexternal icon through the paratransit vehicle.
Limit in-person assessments to determine whether riders are eligible for paratransit services.
Encourage customers to use grocery and pharmacy delivery service where available without cost, reducing the need for passenger rides to obtain groceries and medications.
Have schedulers request that passengers bring and wear a cloth mask if appropriate while entering and exiting the vehicle and during transport. Wearing cloth masks may be difficult for individuals with physical, sensory, cognitive, or behavioral impairments and is not recommended for children under 2 years or anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove the cloth mask without assistance.
During routine scheduling, have schedulers ask whether passengers
Are confirmed positive for COVID-19
Have been in close contact in the past two weeks with someone with confirmed COVID-19
Have signs or symptoms consistent with COVID-19
Alert drivers to passengers who respond “yes” to any of these questions and take the following steps:
Use a dedicated vehicle for suspected or positive COVID-19 passengers that is large, has rear entry, contains a physical barrier between driver and passenger spaces, is equipped with rear exhaust ventilation, and has wipeable seat covers.
If the driver must use a vehicle without an isolated driver compartment and ventilation, open the outside air vents in the driver area and, if equipped, turn on the rear exhaust ventilation fans to the highest setting. This will create a negative pressure airflow from the driver to the passenger area.
Train operators on the safe transport of these passengers, including the proper use of PPE. See Infection Control Guidance for Healthcare Professional about Coronavirus for more information.
After the trip, direct the operators to clean and disinfect the vehicle and wash their hands.
Communicate regularly with local public health officials to obtain information on outbreak locations, with a focus on common pickup locations, such as assisted living facilities. Identify alternative transport options for passengers from these facilities. Where transport is necessary, instruct operators to avoid entering these facilities, if feasible.
Remind employees that people may be able to spread COVID-19 even if they do not show symptoms. Consider all close interactions (within 6 feet) with employees, passengers, and others as a potential source of exposure.
Post signs and reminders at entrances, in the transit vehicle, and in other workplace areas where paratransit workers and passengers are likely to see them. The signs and reminders should provide instruction on social distancing, hand hygiene, respiratory hygiene, wearing cloth face coverings or masks, and etiquette for coughing and sneezing. Signs should be accessible for people with disabilities and easy to understand. Include signs for non-English speakers as needed.
Ensure communication and training are accessible for people with disabilities, easy to understand, in preferred language(s) spoken or read by the employees, and provide accurate and timely information.
Use images (infographics) to account for language differences.
Reinforce training with signs (preferably infographics) placed in strategic locations. CDC has free, simple posters available to download and print, some of which are translated into different languages.
Require paratransit employees to wear cloth masks as appropriate.
Cloth masks are intended to protect other people—not the wearer. They are not considered to be PPE.
Emphasize that care must be taken when putting on and taking off cloth masks to ensure that the worker or the cloth mask does not become contaminated.
Cloth masks should be routinely laundered.
Cloth masks should not be worn if their use creates a new risk (for example, interferes with driving or vision or contributes to heat-related illness) that exceeds their COVID-19-related benefits of slowing the spread of the virus. Cloth masks also should not be worn by anyone who has trouble breathing or is unable to remove the mask without assistance. CDC provides information on adaptations and alternatives that should be considered when cloth face coverings or masks might not be feasible (such as for people who are deaf or hard of hearing, have intellectual or developmental disabilities, or have sensory sensitivities).
Consider requiring visitors to the workplace (service personnel, customers) to also wear cloth masks.
Personal Protective Equipment (PPE)
PPE is the last step in the hierarchy of controls because it is more difficult to use effectively than other measures. To be protective and not introduce an additional hazard, the use of PPE requires characterization of the environment, knowledge of the hazard, training, and consistent correct use. This is why special emphasis is given to administrative and engineering controls when addressing occupational hazards, including when applying guidance to slow the spread of the virus that causes COVID-19.