Health department issues checklist for churches to prevent spread of COVID-19

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This guidance - issued by the N.C. Department of Health and Human Services - provides the steps places of worship should take, and some additional guidance and preventative measures to prevent the spread of COVID-19.

Social Distancing and Minimizing Exposure

Social distancing is a key tool to decrease the spread of COVID-19. Social distancing (“physical distancing”) means keeping space between yourself and other people outside of your home. Stay at least 6 feet (about 2 arms’ length) from other people; do not gather in groups; stay out of crowded places and avoid mass gatherings. Phase 2 includes several requirements and recommendations to support social distancing in spaces where the public may gather.

It is recommended that places of worship:

❑ Space seating arrangements so there are 6 feet between groups who live in the same household. Consider limiting seating to alternate rows.

❑ Ensure members of a choir or music ensemble maintain a distance of 6 feet from each other.

❑ Post signage reminding people about social distancing. Know Your W's sign templates are available in English and Spanish on the NC DHHS COVID-19 response site.

❑ In indoor and outdoor areas where people gather, provide floor markings at six-foot intervals to encourage social distancing.

❑ Clearly mark designated entry and exit points; if a house of worship or building has only one entry/exit point, try to stagger entry and exit times if possible.

❑ Provide an option for virtual services.

❑ Continue remote working for staff as much as possible. This includes clergy holding virtual visits
by phone or online when possible. Stagger shifts where remote working is not possible.

❑ Provide education for staff on how to properly wear, remove, and wash face coverings.

❑ Consider whether gatherings such as religious classes, youth events, support groups, or other
programming may be held virtually to ensure social distancing.

❑ Limit the use of frequently-touched objects such as worship aids, prayer books, hymnals, attendance registers, or other shared or passed items. Encourage congregants to bring their own prayers, bulletins, songs and texts through electronic means if possible.

❑ Consider a stationary collection box, or mail or electronic methods of collecting financial
contributions instead of shared or passed collection trays or baskets.

❑ Encourage avoidance of physical contact among attendees as permissible within the community’s faith tradition.

❑ If food is offered at any event, have pre-packaged boxes or bags for each attendee, instead of a buffet or family-style meal. Avoid serving food from common dishes.

Cloth Face Coverings

It is strongly recommended that all staff and congregants wear a cloth face covering when they may be near (less than 6 feet from) other people. An FAQ about face coverings is available in English and Spanish.

❑ It is encouraged that places of worship provide cloth face coverings for staff and congregants. If provided, they must be single use or properly laundered using hot water and a high heat dryer between uses.

❑ Please share guidance to employees on use, wearing, and removal of cloth face coverings, such as CDC’s guidance on wearing and removing cloth face masks, CDC’s use of cloth face coverings, and CDC’s cloth face coverings FAQ’s.

Cleaning and Hygiene

Washing hands with soap for 20 seconds or using hand sanitizer reduces the spread of transmission.

It is recommended that places of worship:

❑ Perform ongoing and routine environmental cleaning and disinfection of high-touch areas (e.g., doors, doorknobs, rails) with an EPA approved disinfectant for SARS-CoV-2 (the virus that causes COVID-19), and increase disinfection during peak times or high density times.

❑ Systematically and frequently check and refill hand sanitizers and assure soap and hand drying materials are available at sinks.

❑ Prominently provide alcohol-based hand sanitizer (at least 60% alcohol) at entrances and exits and near high-touch areas.

❑ Promote frequent use of hand washing and hand sanitizer for staff and attendees. Require handwashing of staff immediately upon reporting to work, after contact with individuals, after performing cleaning and disinfecting activities, and frequently throughout the day.

❑ To the extent possible, do not use items that are not easily cleaned, sanitized, or disinfected.

❑ All shared religious objects should be properly disinfected between uses as possible. Provide adequate contact time for disinfectant as required by the manufacturer before shared
equipment is used by another person.

❑ Provide tissues for proper cough and sneeze hygiene.

❑ Increase circulation of outdoor air as much as possible by opening windows and doors, using fans, or other methods. Do not open windows and doors if they pose a safety risk. 

Monitoring for Symptoms

Conducting regular screening for symptoms can help reduce exposure. Staff should be encouraged to self-monitor for symptoms such as fever, cough, or shortness of breath.

If they develop symptoms, they should notify their supervisor and return home. More information on how to monitor for symptoms is available from the CDC.

It is recommended that places of worship:

❑ Have a plan in place for immediately removing employees from work if symptoms develop.

❑ Employees who have symptoms when they arrive at work or become sick during the day should immediately be separated from other employees, customers, and visitors and sent home.

❑ Conduct daily symptom screening of employees at entrance to workplace with immediately sending symptomatic workers home
to isolate.

❑ Post signage at the main entrance requesting that people who have been symptomatic with fever and/or cough not enter, such as Know Your Ws/Stop if You Have Symptoms flyers.

❑ Establish and enforce sick leave policies to prevent the spread of disease, including:

  • Enforcing employees to stay home if sick.
  • Encouraging liberal use of sick leave policy.
  • Expanding paid leave policies to allow employees to stay home when sick.

❑ Per CDC guidelines, if an employee has been diagnosed with COVID-19 or is presumed positive by a medical professional due to symptoms, the employee should be excluded from work until:

  • No fever for at least 72 hours since recovery (without the use of fever-reducing medicine) AND
  • Other symptoms have improved (e.g., coughing, shortness of breath) AND
  • At least 10 days have passed since first symptoms

❑ Per CDC guidelines, if an employee has been diagnosed with COVID-19 but does not have symptoms, they should remain out of work until 10 days have passed since the date of their first positive COVID-19 diagnostic test, assuming they have not subsequently developed symptoms since their positive test.

❑ Require symptomatic employees to wear masks until leaving the facility. Cleaning and disinfecting procedure should be implemented by designated personnel following CDC guidelines once sick employee leaves.

❑ Provide employees with information on help lines to access information or other support in reference to COVID-19, e.g. 211 and Hope4NC Helpline (1-855-587-3463).

Protecting Vulnerable Populations

Information on who is at higher risk for severe disease is available from the CDC and NCDHHS.

It is recommended that places of worship:

❑ Encourage the use of virtual services or designate exclusive times to access services for seniors and other at-risk groups as defined by the CDC.

❑ Enable employees to self-identify as high risk for severe disease and reassign work to telework, minimize face-to-face contact, or otherwise maintain a distance of six feet from others.

❑ Offer provisions for persons at higher risk such as how to minimize interaction with patrons, social distancing and spacing reminders, recommending wearing a cloth face covering.

Combatting Misinformation

Help ensure that the information your employees is getting is coming directly from reliable resources. Use resources from a trusted source like the CDC or NCDHHS to promote behaviors that prevent the spread of COVID-19.

It is recommended that places of worship:

❑ Make information available to workers about COVID-19 prevention and mitigation strategies, using methods like videos, webinars, or printed materials like FAQs. Some reliable sources include NC DHHS COVID-19, Know Your Ws: Wear, Wait, Wash, NC DHHS COVID-19 Latest Updates, NC DHHS COVID-19 Materials & Resources

❑ Put up signs and posters, such as those found Know Your Ws: Wear, Wait, Wash and those found Social Media Toolkit for COVID-19.

❑ If appropriate, have messaging such as a short video emphasizing the importance of maintaining physical distancing and hand hygiene.

Water and Ventilation Systems

Reduced use of water and ventilation systems can pose their own health hazards. There is increased risk for Legionella and other waterborne pathogens from stagnant or standing water.

Before reopening, it is recommended that places of worship:

❑ Follow the CDC’s Guidance for Reopening Buildings After Prolonged Shutdown or Reduced Operation to minimize the risk of diseases associated with water.

❑ Ensure ventilation systems operate properly and increase circulation of outdoor air as much as possible by opening windows and doors, using fans, or other methods. Do not open windows and doors if they pose a safety or health risk to people using the facility.

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