Outpatient Drug and Alcohol Rehab Centers During COVID-19

We know that drug and alcohol rehab centers are an essential business as the alcoholism and drug addiction doesn’t stop because a pandemic occurred. In order to continue to keep your services going and keep everyone safe, you must follow the recommended guidelines to keep everyone safe from the virus while providing the essential care they need.

So what can you do to prevent the spread of the virus? Use the following tips.

Know the Signs and Symptoms of COVID-19

First, know that not everyone shows symptoms but carries COVID-19. Those that do show symptoms may show some or all of the following:

• Fever of 100.4 degrees or higher
• Difficulty breathing
• Cough
• Shaking and chills
• Sore muscles
• Headaches
• Confusion
• Loss of taste or smell
• Sore throat

Even showing one of the above symptoms is enough to isolate a client to protect everyone. You don’t need to wait for an official diagnosis. Any symptoms should be presumed to be the virus. 

Anyone that experiences extreme symptoms, such as chest pain, confusion, blue lips, or the inability to breathe should contact 911 immediately.

Know Who’s at Risk

Everyone is at risk as no one is immune to COVID-19; it’s a new virus. However, there are people in certain groups that are of higher risk, they include:

• Adults ages 65 years and older
• Anyone with a compromised immune system
• Anyone with pre-existing conditions including heart disease, diabetes, and lung disease

How COVID-19 Spreads

COVID-19 is highly contagious from person-to-person as well as object to person. Most commonly, it’s spread from the droplets of a cough or sneeze, but it can also be spread by touching another person, close contact with another person, and contact with an infected surface. 

How can you prevent the spread of COVID-19 through your clinic? Implement the following tips.

Hang Signs

Hang signs in plain sight of everyone for the following:

• Promote proper and frequent handwashing
• Highlight the importance of hand sanitizer when handwashing isn’t immediately available
• Talk about the importance of letting someone know of any symptoms you present including coughing, sneezing, difficulty breathing, or a fever

If at all possible, prevent anyone with symptoms from entering the clinic. Hang signage on the doors and windows alerting everyone to be aware of their symptoms and to avoid entering if they have a fever, sore throat, cough, or any other flu-like symptoms. 

Have Adequate Hand Washing and Hand Sanitizing Stations

Handwashing and sanitizing is the best way to prevent the spread of the virus. Make it easy for your clients and employees to properly clean their hands by offering:

• Plenty of handwashing stations that are easy to access in all areas
• Provide hand sanitizer in areas where handwashing isn’t immediately possible (make sure the sanitizer has at least 60% alcohol)
• Highlight the importance of washing hands before eating, after going to the bathroom, and after contact with anyone (infected or not infected)
• Provide adequate tissues to ensure anyone coughing or sneezing can cover their mouth. If Kleenex isn’t available, promote coughing or sneezing into an elbow
• Avoid sharing of any tools, utensils, or cups

Make Social Distancing Possible

In an environment where closeness is encouraged, this can be a difficult concept, but it’s vital. Eliminate all handshaking, hugs, or other close contact. You may need to rearrange common areas or even individual rooms to ensure that everyone can keep a 6-foot distance at a minimum. 

Any common areas, such as waiting rooms should have no more than 10 chairs and the chairs should be placed at least 6 feet apart. The waiting rooms should be used as minimally as possible in order to avoid the risk of spreading the illness. 

In addition, all mealtimes should be staggered so that no more than 10 people are in one room at a time. If it is at all possible, serve meals individually. If weather permits, have clients eat outdoors to minimize the risk of exposure. If eating outdoors isn’t an option, keep all windows and doors open to bring the fresh air through as well as to avoid contact with doorknobs whenever possible. 

Don’t allow visitors in the clinic at any time. For the time being, only clients and employees should be present. 

Any transportation of clients should only be of essential need – such as essential doctor’s appointments. Even doctor’s appointments should be limited, when applicable. If clients can conduct the appointment virtually, encourage it rather than risking further exposure.

Eliminate all group activities and find alternatives instead. A few solutions include individual activities or virtual group activities to eliminate the risk of exposure. Either postpone the activities or eliminate them altogether to avoid the risk of exposure. 

Set Up Proper Screening

The screening of clients and employees is essential every day:

• Before admitting any new clients, take their temperature and assess their respiratory health. If there is a fever of 100.4 or higher or respiratory issues, don’t take them in and ask them to isolate for 14 days before coming back. 
• Reassess clients at least once daily including taking their temperature, but more frequently if possible. Arm clients with the necessary information to report their own symptoms should they begin to feel ill and encourage them to report their symptoms immediately.
• If anyone presents with symptoms of COVID-19, you should assume they have it and isolate them immediately. Isolation should last for at least 10 days from the first day of symptoms plus another 3 days once the symptoms end.

Isolation Rules

If a client presents symptoms, use the following guidelines:

• Provide the client with a surgical mask to cover his coughs and sneezes to prevent spreading the illness
• Limit the number of staff members that come into contact with the infected person. Have a procedure set up so that everyone knows how to react quickly and with ease.
• Limit the exposure the infected client has with any other clients by placing him or her in an isolated room where no one else will go and/or have contact.
• If possible, have the client transported to his/her home to remain in isolation for at least 14 days. If that’s not possible, have a dedicated area for isolation.

If you do have to send clients home, utilize an online program to ensure their safety and wellbeing, continuing with their treatment as best as possible while continuing to isolate and reduce the spread of COVID-19.

The same rules apply to employees. Any employees that present with symptoms should self-isolate themselves at home for at least 10 days, plus the 3 days of recovery. Employees should be encouraged to contact their healthcare provider if their symptoms worsen.

Dealing With Exposure

Unfortunately, in the case of COVID-19, we have to be mindful of not only people with symptoms but also people with exposure to those with symptoms. 

Anyone that has had any of the following should be quarantined for 14 days:

• Contact with anyone with symptoms (closer than 6 feet for more than 10 minutes)
• Contact with a cough or sneeze from an affected person
• Shared utensils, food or drink with an affected person
• Caring for an infected person without a mask or gloves 
• Contact with an infected person but up to 48 hours before the infected person showed symptoms

These guidelines are in place for those with current symptoms as well as those that show new symptoms, but had contact with anyone 48 hours before the symptoms occurred. 

For any employee that has had contact with an infected person, but is not showing symptoms may work only in times of extreme shortage. If this is the case, the exposed employee must wear a mask at all times for at least 14 days. Exposed employees should also self-monitor by taking their temperature twice a day to ensure they aren’t symptomatic. If they become symptomatic, they must isolate themselves immediately. 

Transportation

If you must transport affected clients (or employees) home or to another facility, use the following precautions:

• Transport the affected person alone (don’t transport multiple affected people together)
• If you have to transport more than one person at a time, ensure there is 6 feet between each person
• All infected persons (clients or employees) should wear a surgical mask
• Roll all windows down to allow fresh air in
• Cover all vehicle seats with plastic coverings that can be disinfected after each use
• Provide adequate hand sanitizer
• Provide adequate tissues
• All drivers should wear PPE when transporting infected clients or employees including mask, gloves, and protective eyewear

Coming Back to Work

Employees may only be allowed back to work once they are in isolation if the following occur:

• It’s been at least 10 days since the first symptom
• It’s been at least 3 days since the symptoms have stopped (this includes any fever over 100.4 and respiratory issues)
• All employees must stay in isolation for at least 10 days even if their symptoms only lasted for a day or two

Wearing Proper Protection

Employees at outpatient drug or alcohol rehab centers aren’t required to wear PPE; however, each employee should take precautions by wearing proper face coverings, such as a scarf or fabric face mask. Any symptomatic individuals (clients or employees) should be provided with a surgical mask while on-site and while proper transpiration to self-isolation is arranged.

Any employees that must conduct clinic duties on clients should be provided with proper PPE and all employees no matter their duties should practice proper handwashing after handling symptomatic clients, touching surfaces, or handling protection equipment.

Always ensure there are adequate handwashing stations available for employees, especially in areas where they may be in contact with exposed individuals. When handwashing stations aren’t available, make sure enough hand sanitizer is available. 

Sanitization Practices

Cleaning and sanitization practices must be ramped up during the COVID-19 pandemic. Continually disinfecting common areas is crucial to stop the spread of the virus. This includes countertops, doorknobs, faucets, sinks, handles, and phones.

Disinfecting means using approved cleaning agents that kill the virus. This is more than cleaning as cleaning only wipes away dirt and some germs, but not COVID-19 germs. If EPA-registered disinfecting agents aren’t available, mix 1 tablespoon of bleach with 1 quart of water. 

Any cleaning staff should use caution when cleaning items from an affected individual. Avoid shaking any fabric items, clothing, sheets, or even dishes and silverware. Keep the items at a safe distance, immediately wash and disinfect them and properly wash your hands.

Outpatient drug and alcohol centers must remain open to help those affected by drug addiction and alcoholism, but with the utmost precautions to protect everyone involved in the situation. Have dedicated staff members watch for symptomatic clients or employees; watch for proper handwashing and sanitizing; and report any issues that put anyone at risk for the spread of COVID-19.