COVID-19: A Guide for Direct Care Workers

Note: A similar version of this content was first published on March 20, 2020 as the 30-minute class COVID-19: A Guide for Direct Care Workers. The current version of the content, updated on March 30, 2022, is a 60-minute self-study class that contains expanded guidance about facemaks, PPE, and household cleaning and disinfecting.

CareAcademy's FREE COVID-19 Certification Class prepares direct care workers to perform critical frontline work during today's challenging times. With this self-study class, gain relevant, reliable information about the virus and learn how to care for yourself and your care recipients amidst the COVID-19 pandemic. At the end of the class, claim your certificate and let your agency and care recipients know that you're COVID-19 Certified through CareAcademy.

Note to CareAcademy Customers: Assign the class, Overview of  COVID-19, to your caregivers via your CareAcademy dashboard to take advantage of automated reporting.

Learning Objectives

• Describe COVID-19, its symptoms, the people most at risk of serious illness from it, and how it is transmitted.
• Identify reliable sources of information about COVID-19.
• Apply strategies for reducing the spread of the COVID-19 virus.
• Describe tactics for providing care to someone who has COVID-19.
• Explain why cleaning and disinfection is important during the COVID-19 pandemic.
• Suggest strategies for self-care for direct care workers during the COVID-19 global pandemic.

Contents

• Understanding COVID-19
  • Staying Up to Date
  • What Is COVID-19 (Novel Coronavirus)?
  • How COVID-19 Spreads
  • Ways to Reduce the Spread of COVID-19
• Caring for Someone with Known or Suspected COVID-19
  • Precautions When Caring for Someone with the Virus
  • Tips for Caring for a Care Recipient with COVID-19
    • Keep the Care Recipient Isolated and Limit Contact
    • Cleaning and Disinfecting
  • Protect Health Care Professionals and Others in the Community
• Protecting Yourself and Your Loved Ones
  • Caring for Yourself
  • Caring for Loved Ones

Understanding COVID-19

Cases of COVID-19 (coronavirus disease 2019) continue around the globe, and particularly in the United States. As a caregiver, you are on the front lines, so it is vital that you stay informed. 

This class offers a brief overview of what is known about COVID-19, how it spreads, strategies for preventing the spread, and how to care for someone who has, or may have, the virus.

Try to Keep Calm

We are still learning more about the COVID-19 virus, including the mortality (death) rate. It’s important to stay calm and think clearly, as there is a lot of inaccurate information available regarding the virus.

Why Is COVID-19 Important?

On March 11, 2020, the World Health Organization (WHO) declared COVID-19 a global pandemic. A global pandemic is a new disease that has spread around the world. This means fully stopping the spread of the virus is not the goal (because it is already everywhere)—instead, we must focus on reducing how fast it spreads and how sick it makes people.¹

Staying Up to Date

The COVID-19 situation continues to evolve. To stay informed with the latest information, consult the websites for the:

• Centers for Disease Control and Prevention (CDC)
• World Health Organization (WHO)

Your state and local health departments will have the latest information relevant to where you live. Use the resources below to locate the state and local health department websites:

• State health departments
• Local health departments

You are expected to follow your agency’s policies and procedures and comply with all state and federal laws and regulations at all times.

We are continuing to learn about COVID-19. New information is continuously developing, including guidance for direct care workers. Contact your agency, supervisor, or care team for specific guidance about how the COVID-19 pandemic impacts your responsibilities.

What Is COVID-19 (Novel Coronavirus)?

COVID-19

A new virus was detected in late 2019 in Wuhan, China. On February 11, 2020, WHO announced an official name for the disease that is causing the current coronavirus outbreak. The name of the disease is coronavirus disease 2019 (COVID-19).² This novel (new) coronavirus causes a respiratory (lung) infection. It has not previously been seen in humans.

Coronaviruses are not new. In fact, the common cold is a type of coronavirus. Some other coronaviruses, like SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome), can cause serious illnesses.³

Symptoms of COVID-19

Symptoms of COVID-19 may appear 2 - 14 days after exposure to the virus.

A wide range of symptoms has been reported. Some individuals have no symptoms at all and others may have mild symptoms. Symptoms may begin gradually but become very serious. If a person becomes very sick, they can develop pneumonia. People with these symptoms or combinations of symptoms may have COVID-19:

• Fever
• Cough
• Shortness of breath or difficulty breathing
• Chills
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea
• Skin rashes⁴

These are not the only possible symptoms. If a client has any other symptoms that seem serious, contact your supervisor.

Emergency Warning Signs

If you, a loved one, or a client has any of these emergency warning symptoms of  COVID-19, call 911 immediately:

• Trouble breathing
• Persistent (continuing) pain or pressure in the chest
• New confusion
• Inability to wake or stay awake
• Blush lips or face⁵

Vulnerable Populations

We are learning more about COVID-19 every day. What we do know is that older adults are most at risk of getting the sickest and dying from COVID-19; the older a person is, the higher their risk of death.

Adults are at increased risk of severe illness or death if they are severely obese (body mass index [BMI] of 40 or higher), or have a chronic comorbid (existing and unrelated) illness such as heart disease or diabetes.⁶

Studies in the United States have shown that racial and ethnic minorities (African American, Native American, and Latinx communities) have had higher death rates than White populations in nearly every state.7 This may be because these groups are more likely to have reduced access to vaccinations and health care, and a higher percentage of chronic medical conditions.⁸

Those at highest risk for COVID-19 are also most likely to get more sick more quickly. If you have a client in a high-risk group, be extra vigilant (alert) for any changes in their medical status. If you observe any changes in your client’s status, notify your supervisor immediately. 

If the client has any emergency symptoms, call 911.

Treatment for COVID-19

Vaccines

The best prevention of the spread of Covid-19 is vaccination. Vaccines are now widely available in the U.S. to anyone aged 5 and over. Health care personnel may be required by employers to be vaccinated. Check with your employer to see what rules apply to you.

There are no treatments available for mild cases of COVID-19. In more severe cases, treatments are determined by health care providers. People who think they might have the virus should call their health care provider for advice on what to do next.⁹

COVID-19 Mortality (Death) Rate

We don’t know yet how deadly COVID-19 is. Some estimates indicate that it is 10 times more deadly than influenza.¹⁰ The chance of dying is much higher as individuals get older, and if they have comorbid conditions. 

Related to COVID-19’s mortality rate, is the number of patients who need to be admitted to hospitals and need ventilation to help support their breathing. Unvaccinated individuals are at greatest risk for hospitalization and death. Individuals aged 65 and over who are vaccinated may still be at greater risk than younger people, but their risk of hospitalization is considerably higher if they are unvaccinated. Also, hospitalization rates for African American, Native American, and Latinx persons are 2-3 times higher than for Whites.¹¹

Long Term Effects

Many people who have had COVID-19 continue to have symptoms months after the beginning of the disease, even after tests can no longer detect the virus in their body. In the United States, this is known as "long Covid."

The most common lingering symptoms are:

• Fatigue
• Shortness of breath or difficulty breathing
• Cough
• Joint pain
• Chest pain
• Memory, concentration or sleep problems
• Muscle pain or headache
• Fast or pounding heartbeat
• Loss of smell or taste
• Depression or anxiety
• Fever
• Dizziness when you stand
• Worsened symptoms after physical or mental activities

How COVID-19 Spreads

Community Spread

COVID-19 is spread through respiratory secretions (droplets from coughs and sneezes).

Since COVID-19 was first detected, nearly every country in the world has had cases. “Community spread” means people have been infected with the virus in a geographic area, including some people who are not sure how or where they became infected.¹³ Each health department determines community spread differently based on local conditions.

How Contagious is COVID-19?

COVID-19 is more contagious than seasonal flu. If one person has the flu, they are likely to pass it on to at least one other person. If one person has COVID-19, they are likely to pass it on to at least two to three other people. So COVID-19 is more than twice as contagious as seasonal flu. By comparison, if one person has measles (a highly contagious disease), they are likely to pass it on to at least 18 others. 

The most challenging aspect of COVID-19 is that it may be caught from people who have no symptoms¹⁴ Studies indicate that infected people may be most infectious two days before they develop symptoms, and early in their illness. People who develop severe disease can be infectious for longer.¹⁵

Variants of COVID-19

 Viruses tend to mutate (change) over time, and new variants (forms) occur. Several variants of the virus that causes COVID-19 have appeared in the United States since the beginning of the pandemic. These variants seem to spread more easily and quickly than other variants, leading to more cases of COVID-19. As of now, the approved vaccines seem to be effective against these variants. The CDC and other health public health officials continue to track changes in the virus.¹⁶

Ways to Reduce the Spread of COVID-19: Social Distancing

When people don’t take enough care to prevent the spread of the virus, health care systems are overwhelmed and have more patients at one time than can be taken care of reasonably and safely.

By slowing the spread of the virus, we increase the chance that everyone who needs care can get the care they need, and fewer people die or become very ill.

Even though many people may become infected, we are better able to take care of them if everyone who can get vaccinated, avoids unnecessary contact, practices good hygiene, and wears face masks in public places. 

Close Contact

Close contact with a person with known or suspected COVID-19 means any of the following:

• Being within approximately 6 feet (2 meters) for a total of 15 minutes or more
• Direct physical contact (e.g., hugging or kissing)
• Sharing dishware or utensils 
• Having contact with respiratory secretions (e.g., coughs or sneezes)

Close contact can occur while caring for, living with, visiting, or sharing a public space or room with a person with an active case of COVID-19.¹⁷

Social Distancing

Social distancing (also known as “physical distancing”) means deliberately (carefully) increasing the physical space between people to avoid spreading illness. This means avoiding places where people meet or gather; avoiding public transportation, if possible; and avoiding close contact with others.¹⁸ 

Since COVID-19 may be caught from people who have no symptoms, social distancing is especially important for reducing the spread of COVID-19.¹⁹ 

The expectation is that by practicing social distancing, we can reduce the daily number of cases of COVID-19. That is why the authorities limited the number of people who can gather, closed schools and houses of worship, and canceled public events, unnecessary travel, and visits to nursing homes.

Please contact your agency for guidance on limiting physical contact with care recipients during the current COVID-19 pandemic.

Quarantine and Isolation

In addition to social distancing, public health experts recommend other tactics to limit the spread of infectious diseases. These tools are quarantine and isolation.

Quarantine separates and restricts the movement of well people who were exposed to a contagious disease to see if they become sick. 

Self-quarantine is recommended for people who have been in close contact with someone who has COVID-19. 

Self-quarantine involves:

• Using good hygiene and washing hands frequently
• Not sharing things like towels and utensils
• Staying at home
• Not having visitors
• Staying at least 6 feet away from other people in the household
• Wearing a mask around others

The CDC now suggests that people without symptoms can end quarantine after 5 days, and continue to wear a mask around others for an additional 5 days.

At the end of the self-quarantine period, a person should continue to monitor their symptoms until 10 days after exposure. If they have any symptoms they should self-isolate and contact their health care provider.²⁰

Isolation is used to separate ill persons who have a communicable disease from those who are healthy.²¹ For people who are confirmed to have COVID-19, isolation is appropriate. Isolation is a health care term that means keeping people who are infected with a contagious illness away from those who are not infected. Isolation can take place at home or at a hospital or care facility.²²

Travel Recommendations and Restrictions

Travel increases the chance of getting and spreading COVID-19. Cases have been reported in all states, and around the world. To prevent the virus from spreading, authorities have implemented restrictions on travel. 

The CDC maintains a list of general travel restrictions and recommendations to help reduce the spread of COVID-19. Visit the CDC’s website for up-to-date information. The Resources page at the end of this class contains a link to the appropriate page.²³

Testing for COVID-19

Testing for COVID-19 helps to identify those who are infected so that they can avoid infecting others. Those who should be tested include:

• People who have symptoms of COVID-19.
• People who have had close contact (within 6 feet of an infected person for a total of 15 minutes or more) with someone with confirmed COVID-19, ideally 5 days after contact.
• People who require screening for work, school, or other public settings.
• People who have been asked or referred to get testing by their healthcare provider, local or state health department.

Remember, you can still spread the virus even if you have no symptoms, so if you get tested, you should self-quarantine/isolate until you get the test results.

Every home in the U.S. is eligible to order four free at-⁠home COVID-⁠19 tests. Americans with health insurance can also get up to eight at-home coronavirus tests for free thanks to a government requirement. Insurers are also required to cover testing at testing sites and medical offices. Medicare recipients may or may not be eligible for reimbursement for home test kits.²⁴

If you test positive, remain isolated and follow the advice of your health care provider. If you test negative, this means you don’t currently have the virus.

However, if you have any symptoms, contact your health care provider to determine if you need to be re-tested.²⁵

Ways to Reduce the Spread of COVID-19: Good Hygiene

Good Hygiene

Everyday preventive actions will help reduce the spread of COVID-19.

Hand Hygiene

Practice appropriate hand hygiene on a regular basis. This means washing hands frequently, with soap and water, for at least 20 seconds. When soap and running water are unavailable, use a hand sanitizer with at least 60% alcohol. Always wash hands before and after providing personal care.

View the video to learn the appropriate technique for washing your hands.

Additional Hygiene Practices

These measures will also help prevent the spread of COVID-19:

• Avoid touching your eyes, nose, and mouth.
• Cover your cough or sneeze with a tissue (then throw the tissue in the trash) or use the inside of your elbow. Wash your hands immediately after you cough or sneeze.
• Avoid touching “high-touch” surfaces in public places. Use a tissue or your sleeve to cover your hand or finger if you must touch something.
• Avoid handshaking with people.
• Wash your hands after touching surfaces in public places.

Wear Facemasks in Public

Masks prevent people who may have the virus and do not know it from transmitting it to others, and also protect the wearer from catching the virus.²⁶

The effectiveness of the mask depends on both how it is made and how it is worn. Masks are most effective if they fit securely. If you knot the facemask where the loops attach to the ear, it helps the mask fit more closely to your face.

The CDC recommends masks with two or more breathable layers. The CDC recommends masks with two or more breathable layers. The CDC website offers additional guidance on the use of masks.²⁷

Cleaning and Disinfecting

The COVID-19 virus can stay in the air for multiple hours and on surfaces for days.²⁸ However, there is no evidence that anyone has gotten COVID-19 from touching a contaminated surface.²⁹

The CDC recommends daily cleaning of frequently touched surfaces and objects. This includes tables, doorknobs, light switches, countertops, handles, desks, cell phones, keyboards, toilets, faucets, and sinks.

You do not need to use disinfectants unless someone who is positive for COVID-19 has been in the home in the last 24 hours.

Caring for a Client with Known or Suspected COVID-19

You should always follow your agency’s policies when providing care. Your agency should be keeping up to date with the latest information from federal, state, and local public health authorities. If you have any questions about how to care for someone who has COVID-19, you should contact your supervisor.

As a direct care worker in a non-healthcare setting, you may have close contact with a person undergoing testing for the virus or who has tested positive for COVID-19. As the number of people with the virus increases, individuals who do not require hospitalization need to be cared for in the home.

Precautions When Caring for Someone with the Virus

All health care professionals, including direct care workers, are at a higher risk of getting COVID-19 because of the older and sicker population they care for. It is important to take preventive measures to avoid contracting the virus while you care for someone who has COVID-19.

Monitor Your Own Health

Call your health care provider right away if you develop symptoms suggestive of COVID-19 (such as fever or cough). Call your supervisor and do NOT go to work.³⁰

You may be instructed to get tested. Follow the instructions provided by your employer, health care provider, or public health department for when and where to get tested.

Practice Infection Control

The most important thing you can do when caring for someone with COVID-19 is to practice good general infection control measures:

• Wash your hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer that contains at least 60% alcohol, covering all surfaces of your hands and rubbing them together until they feel dry. 
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Clean and disinfect surfaces frequently. 

Use of Personal Protective Equipment (PPE)

When providing care for someone with suspected or known COVID-19, it is particularly important to wear appropriate PPE, including any recommended eye protection, masks, gowns, and gloves. The CDC and state and local health officials continue to update recommendations as more is learned about the virus.

Masks

Follow your agency’s policies at all times for the use of masks and other PPE. Here are some best practices for the use of masks:

• Wear a facemask at all times when caring for someone with known or suspected COVID-19.  Ideally, put the mask on before entering the client’s home, and ideally, remove the mask after leaving the client’s home and dispose of it in the outdoor trash bin.
• Wear a disposable facemask when you touch or have contact with the care recipient's blood, stool, or body fluids, such as saliva, sputum, nasal mucus, vomit, and urine. 
• Use an N95 respirator when performing aerosol-generating procedures with care recipients who have or may have COVID-19. An aerosol-generating procedure is one that sends particles into the air, such as the use of a nebulizer or a CPAP machine.
• Remove a mask that is damaged or soiled, or if breathing through the mask becomes difficult. Discard it safely, and replace it with a new one.
• Dispose of used masks in a lined container.

Eye Protection

Some states now recommend the use of eye protection (such as face shields or goggles) by healthcare personnel, in addition to face masks. Standard eyeglasses are not PPE and do not provide sufficient eye protection.³¹

Gloves

Always wear single-use, disposable gloves when:

• Touching blood, stool or bodily fluids (such as saliva, sputum, nasal mucus, vomit, urine.)
• You or the client has broken areas of skin 
• Assisting with personal care, such as bathing, oral care, and toileting
• Handling soiled clothing or linens
• Cleaning and disinfecting surfaces

Immediately clean your hands with soap and water or alcohol-based hand sanitizer after removing gloves. 

Throw out disposable gloves after using them. Do not reuse them. Place used disposable gloves in a lined container before disposing of them with other household waste.³²

Encourage the Care Recipient to Practice Infection Control

Make sure the care recipient washes their hands often with soap and water for at least 20 seconds. Handwashing is especially important after they blow their nose, cough, sneeze, or go to the bathroom, and before they or prepare food.

If soap and water are not readily available, they can use an alcohol-based hand sanitizer with at least 60% alcohol. Make sure they cover all surfaces of their hands and rub them together until they are dry.

Remind the care recipient to avoid touching their eyes, nose, and mouth with unwashed hands.

Care recipients should cover their mouth and nose with a tissue when they cough or sneeze and immediately wash their hands afterward. Make sure they throw used tissues in a lined trash can.³³

Have the Care Recipient Wear a Mask 

Whenever a care recipient with known or suspected COVID-19 is around others, including you and other direct care workers, they should wear a well-fitting facemask. This includes when they are in the same room or vehicle with you, when around pets, and at a health care provider’s office.

Monitor the Client’s Health

If your client with known or suspected with COVID-19 has any of these symptoms, call 911 immediately: 

• Trouble breathing
• Persistent (continuing) pain or pressure in the chest
• New confusion 
• Inability to wake or stay awake
• Bluish lips or face³⁴

Tips for Caring for a Care Recipient with COVID-19

View the video to learn some strategies for caring for a client with the virus.

Keep the Care Recipient Isolated and Limit Contact

If you are caring for someone with known or suspected COVID-19 who can be cared for at home, they should stay in home isolation as recommended by their health care provider, unless they need medical assistance. If they need to see a health care provider, be sure to call first before arriving in person. 

If there are other people living in the home, the care recipient should stay in a separate room and away from others as much as possible. The care recipient should also use a separate bathroom, if one is available. If a separate bathroom is not available, after each use by the care recipient, you should clean and disinfect the bathroom wearing a mask and gloves.

Make sure that shared spaces in the home have good airflow, such as by an air conditioner or an opened window, weather permitting.

Prohibit visitors who do not have an essential need to be in the home.

The care recipient should remain in home isolation until they are no longer at risk of transmitting the virus to others. This decision should be made by their health care provider, possibly in consultation with state and local health departments.

Assist with Basic Needs 

You should help the care recipient with basic needs in the home and provide support for getting groceries, prescriptions, and other personal needs.³⁵

Avoid Sharing Household Items 

No one in the home should share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with the care recipient. After the care recipient uses these items, you should wash them thoroughly with soap and water.³⁶ Electronics (like cell phones and tablets) should not be shared.

Take Precautions When Providing Food

Provide food (or feed) the care recipient in their room, if there are other people in the household. Handle dishes, glasses, and utensils with gloves, and wash them with hot water or in a dishwasher. Wash your hands after touching any items used by the care recipient.

Perform Only Essential Cleaning

If the care recipient is isolated in a bedroom, try to limit your contact with them by reducing the amount of cleaning you do to only soiled items and surfaces on an as-needed basis. Always use appropriate PPE when entering the client’s room, and handling soiled materials and disinfectants.

Avoid bringing supplies in and out of a care recipient's room. Keep a supply of cleaning materials in their bedroom and bathroom, including tissues, paper towels, cleaners, and an EPA-registered disinfectant. If they feel up to it, the care recipient can clean their own space.

Clean soft surfaces, such as carpets, rugs, and drapes, with soap and water or with cleaners made for use on these surfaces. When vacuuming an area occupied by a sick person, wear a mask when vacuuming.³⁷

Cleaning and Disinfecting

Protect yourself and others in the home by disinfecting frequently touched surfaces and objects regularly. This includes tables, doorknobs, light switches, countertops, handles, desks, cell phones, keyboards, toilets, faucets, and sinks. Also, clean and disinfect any surfaces that may have blood, stool, or body fluids on them.³⁸

If a surface is dirty, clean it first with detergent or soap and water. Then disinfect it.

Wear disposable gloves when cleaning and disinfecting surfaces. Discard gloves after each cleaning. Wash your hands immediately after gloves are removed.

Provide a lined trash can for the client. Use gloves when removing garbage bags, handling, and disposing of trash. Wash hands after handling or disposing of trash.

Disinfectants for COVID-19

Use a household bleach solution, an alcohol solution with at least 70% alcohol, hydrogen peroxide, or an Environmental Protection Agency (EPA)-registered household disinfectant to eliminate COVID-19 from surfaces. 

Always follow the manufacturer’s instructions for products, including how much product to use, how to apply it, and the “contact time.” Contact time (also known as “dwell time,” “wet time,” or “kill time”) is the amount of time a product needs to remain in contact with a surface to be sure it kills all the germs.

Bleach

Bleach is a strong and effective disinfectant against the virus that causes COVID-19, and is recommended for use on hard surfaces. To make a bleach solution, mix:

5 tablespoons (1/3 cup) bleach per 1 gallon of water or 4 teaspoons bleach per 1 quart of water

Alcohol

A solution of 70% alcohol, such as rubbing alcohol, is an effective disinfectant against the coronavirus on hard surfaces. Alcohol should be left on surfaces for 30 seconds. Alcohol is generally safe for all surfaces but can discolor some plastics.³⁹

Hydrogen Peroxide

If bleach or alcohol is unavailable, hydrogen peroxide may be effective on coronavirus. Use it undiluted in a spray bottle and spray it on the surface to be cleaned. Let it sit on the surface for at least 1 minute. Hydrogen peroxide can be used on metal surfaces but it can discolor fabrics.⁴⁰

Disinfecting Wipes

Use disinfecting wipes recommended by the EPA on electronic items that are touched often, such as phones and computers. Pay close attention to the directions for using disinfecting wipes. It may be necessary to use more than one wipe to keep the surface wet for the stated length of contact time. Make sure that the electronics can withstand the use of liquids for cleaning and disinfecting.

EPA-Recommended Disinfectants

The EPA’s website has a list of disinfectants that are effective against the COVID-19 virus.

When using an EPA-registered disinfectant (or any disinfectant), follow the label directions for safe, effective use. Make sure to follow the contact time.

If you can’t find a product on the EPA list, look at the product's label to confirm it has an EPA registration number and that human coronavirus is listed as a target pathogen.⁴¹

Avoid Unauthorized Products

The following items should NOT be used as disinfectants because they do NOT kill the virus that causes COVID-19:

• Vinegar
• Vodka
• Tea tree oil
• Lemon juice
• Baking soda

Manage Waste

Provide a lined trash can for the client. Use gloves when removing garbage bags, handling, and disposing of trash. Wash hands after handling or disposing of trash.

Wash Laundry Thoroughly

Take precautions to prevent infections when doing laundry for a care recipient:

• Avoid shaking dirty laundry to reduce the chance of spreading the virus through the air.
• Place a disposable bag liner in the clothes hamper.
• If clothes or bedding have blood, stool, or bodily fluids on them, they should be removed and washed immediately.
• Wear disposable gloves while handling items soiled with blood, stool, and other bodily fluids and keep soiled items away from your body. After removing your gloves, wash your hands or use an alcohol-based hand sanitizer.
• Read and follow directions on labels of laundry or clothing items and detergent. Use a normal laundry detergent according to washing machine instructions.
• Dry laundry completely, on as hot a temperature as possible. Take care to read clothing labels. Some materials shrink at warmer temperatures.
• Wash hands after putting items in the washing machine and after putting items in the dryer.
• Disinfect surfaces in the laundry area, (such as the knobs and the latch on the washing machine or dryer) after using the machines. Clean and disinfect clothes hampers and laundry baskets like other hard surfaces. Wash hands afterward.⁴²

If the care recipient has known or suspected COVID-19:

• Laundry from a person with COVID-19 can be washed with items of a person who does not have the virus.

Avoid shaking dirty laundry to reduce the chance of spreading the virus through the air.

Protect Health Care Professionals and Others in the Community

• Emergency Personnel: If the care recipient has a medical emergency and you need to call 911, notify the dispatcher that the care recipient has, or is being evaluated for, COVID-19. If possible, put a facemask on the care recipient before emergency medical services arrive.⁴³
• Health Care Providers, Office Staff, and Other Patients: When visiting a health care provider, the care recipient should put on a facemask before entering the building to protect the other people in the office or waiting room from getting infected or exposed to COVID-19.⁴⁴
• Nursing Home Staff and Residents: Many facilities, such as nursing homes and assisted living facilities, have had significant outbreaks of COVID-19. They limit visits from families and others to prevent the spread of the virus. If you are permitted to enter the building, you will likely be screened at the entrance. For example, your temperature may be taken and you may be asked about any recent respiratory or gastrointestinal symptoms.
  You will be expected to wear a facemask at all times, perform frequent hand hygiene, and be restricted to only the patient’s room or other area designated by the facility.⁴⁵

• Pets and Other Animals: It is recommended that people with known or suspected COVID-19 limit contact with animals. While it is rare, there have been a few examples of pets, including cats and dogs, infected with the virus that causes COVID-19, mostly after close contact with people with the disease. If pets are infected, they may have no symptoms or only mild symptoms. Most of the pets that have gotten sick have only had mild illnesses and have fully recovered.
  
  When possible, a caregiver or another member of the household should care for any animals while the care recipient is sick. If the care recipient must care for the pet while they are sick, they should wear a facemask, and wash their hands before and after they interact with pets.⁴⁶

Protecting Yourself and Your Loved Ones

Caring for Yourself

You cannot take care of your care recipients or your loved ones if you do not take care of yourself. Ways to protect yourself and others are discussed below.

Monitor Your Health

Call your health care provider right away if you develop symptoms suggestive of COVID-19 . Call your supervisor and do NOT go to work. If you have tested positive for COVID-19 or suspect you have been infected, check with your agency. It is possible that you will not be able to return to work until at least 5 days have passed since your first symptoms first and at least 24 hours have passed since your last fever without the use of fever-reducing medications, and any symptoms (e.g., cough, shortness of breath) have improved.⁴⁷

If you have had close contact (within 6 feet) for more than 15 minutes with a person with known or suspected COVID-19, or if you have had contact with the secretions of a person with COVID-19, check with your agency. It is possible they will recommend you self-quarantine for 5 days.

Practice Preventative Hygiene

Practice good hygiene, regular cleaning and disinfecting, and the other preventative measures discussed earlier. Taking these preventative actions both when you are at work and at home will help reduce your chance of catching and spreading COVID-19.

Wear Facemasks in Public

Wear masks in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies).

Practice Social Distancing

Take appropriate precautions when you are at work, at home, and as you move around your community to help prevent catching and spreading the virus. Remember, the actions you take in your personal encounters can also impact your client. When going out in public, remain at least 6 feet away from others. The CDC also recommends:

• Know the Guidance: Always follow the guidance from local public health authorities where you live.
• Travel Safely: If you must use public transit, try to keep at least 6 feet from others. If using a rideshare or taxi, avoid pooled rides, and sit in the back so you can remain at least 6 feet away from the driver, and try to keep windows open.⁴⁸
• Limit Errands: Try to visit stores in person only when you absolutely need to, and stay at least 6 feet away from others. If you can, use drive-thru, curbside pick-up, or delivery services to limit face-to-face contact with others.
• Socialize Safely: Use video chat or social media to remain connected with friends or family members. If meeting others, keep the group small, try to meet outside, and stay at least 6 feet from others who are not from your household. 
• Avoid Events and Gatherings: It is safest to avoid crowded places and gatherings if you cannot stay at least 6 feet away from others. If you must be in a crowded space, try to keep 6 feet of space between yourself and others at all times, and wear a mask.
• Stay Active: Exercise where you can maintain at least 6 feet of distance between yourself and others.⁴⁹

Get Vaccinated

Vaccines are the best way that we have to slow the spread of COVID-19 and return to business-as-usual. The CDC states that vaccines are essential for health care workers.⁵⁰ Your agency should have information about when and where you will have an opportunity to get the vaccine.

If you have questions about getting COVID-19 vaccine, you should talk to your health care provider for advice. If you choose to be vaccinated, inform your vaccination provider about all your allergies and health conditions.

Share the Facts

Make sure that you keep informed of the latest updates on the virus by consulting reliable sources on a regular basis. Help debunk myths and rumors by sharing factual information from sources like the CDC.

Protect Your Mental Health

The developments of the COVID-19 pandemic may be stressful for people and communities. Everyone reacts differently to stressful situations. 

Here are some steps you can take help cope with stress and support yourself mentally and physically:

• Avoid excessive exposure to media coverage. Take breaks from watching, reading, or listening to news stories.
• Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.
• Have a good support network. Share your concerns and how you are feeling with a friend or family member.
• Express yourself. Reduce stress by keeping a daily diary or a gratitude journal.
• Seek support. Contact the National Disaster Distress Helpline for 24/7 emotional support and crisis counseling. Calls (1-800-985-5990) and texts (text TalkWithUs to 66746) are answered by trained counselors who will listen to your concerns, explore available supports, and offer referrals to community resources.⁵¹

Caring for Your Loved Ones

The best way to protect your loved ones from COVID-19 is to encourage them to get vaccinated, if it is safe for them to do so. Check with your state department of health for information on who is eligible, and where vaccines are being distributed.

Practice social distancing and good hygiene to protect your loved ones. Isolate yourself from those at higher risk (such as those who are older or have chronic illnesses) and wear a mask if isolation is not possible.

Have a backup direct care worker in case you become sick with COVID-19. A backup direct care worker will ensure that your loved ones continue to receive care so you can focus on caring for yourself.

Check with your state and local department of health for resources, such as child care assistance, for essential personnel, like yourself and other health care professionals.

Final Test and COVID-19 Certificate

It's Time to See What You've Learned

Now that you've gone through the material in this self-study class, it's time to move on to the Final Test.

Take the Final Test & Claim Your Certificate

¹WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. (n.d.). Retrieved March 18, 2020, from https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

²WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. (n.d.). Retrieved March 18, 2020, from https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020

³Naming the coronavirus disease (COVID-19) and the virus that causes it. (n.d.). Retrieved March 18, 2020, from https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

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⁸ Tai, D. B., Shah, A., Doubeni, C. A., Sia, I. G., & Wieland, M. L. (2020, June 20). The Disproportionate Impact of COVID-19 on Racial and Ethnic Minorities in the United States. Retrieved December 7, 2020, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7337626/

⁹Facts about COVID-19 Vaccines. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits/facts.html.

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²⁹Anthes, E. (2021, April 8). Has the Era of Overzealous Cleaning Finally Come to an End? The New York Times. https://www.nytimes.com/2021/04/08/health/coronavirus-hygiene-cleaning-surfaces.html.

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