Make4Covid Combined Standard Operating Procedures

V2.2, updated April 16, 2020

Authors

Dr. Jeffrey S. Kieft - Virologist, Professor and Vice Chair, Biochemistry and Molecular Genetics, University of Colorado, Anschutz Medical Campus

Dr. Olivia S. Rissland - Molecular Biologist, Assistant Professor, Biochemistry and Molecular Genetics, University of Colorado, Anschutz Medical Campus

Contents

1. Background
2. SOP for makers
3. SOP for drivers
4. SOP for drop off points
5. SOP for obtaining consumables from distribution points
6. SOP for quality control/warehouse handling
7. SOP for volunteering after having been sick
8. Revision History

Background

A. Modes of infection:

COVID-19 is a viral infection caused by the SARS-CoV-2 virus (Zhu, 2020). It can be passed on to others through two possible or suspected modes that are of concern for this operation:

1. Through aerosolized respiratory droplets (Benesch, 2020). While coughing and sneezing were thought to be the only way to produce these droplets, recent reports suggest normal conversation can also produce aerosolized droplets with viral particles, although the amount is likely less than that produced from coughing, etc. Inhalation of droplets can lead to infection.
2. Preliminary studies show that the virus can remain infectious on surfaces for at least 72 hours after deposition, dependent on the surface material and the environmental conditions (van Doremalen, 2020; Kampf, 2020; NAS Report, 2020). For example, the virus remains infectious on plastic much longer than it does on cardboard, under similar environmental conditions. Transmission of the virus from contaminated surfaces has not been documented but contact with infectious surfaces and then transfer to mucous membranes is a suspected mode of infection (CDC guidance).

B. Other factors:

• Although there are few detailed controlled studies of SARS-CoV-2, data from studies of the very similar viruses that caused previous outbreaks of SARS and MERS provide guiding principles.
• The virus can be made non-infectious by a number of chemical, radiological, or thermal treatments (Kampf, 2020; Rabenau, 2020; Chin, 2020). These include:
  • 70% alcohol solutions [ethanol, isopropanol]
  • 2-5% bleach solutions
  • Common household disinfectants
• Dr. Joshua Rabinowitz (professor of chemistry and genomics at Princeton) has proposed that the severity of infection may be linked to the viral dose received, although controlled studies have not yet been published.
• Individuals that are infected, but asymptomatic can spread viral particles (CDC guidance).

C. Philosophy:

• The rate at which the pandemic is expanding is such that research cannot keep pace (Benesch, 2020), therefore these Standard Operating Procedures (SOPs) are designed with an abundance of caution. Specifically, these SOPs assume that the virus may be transmissible through both modes outlined above. Thus, we assume that community-made parts and their packaging could have infectious virus on their surfaces.
• The following procedures are in place to limit the risk of contamination during printing and packaging and to protect all those handling the material during quality control and transport. Because there is no practical way to test for the presence of the virus during production and transport, or to completely decontaminate the materials ‘in the field’ these SOPs are designed to minimize risk by providing procedures for safe handling and disinfection.
• We assume that the receiving hospitals will be disinfecting the materials upon arrival, but these SOPs are designed to minimize the risk that virus will be present on the materials.

D. Principles for all SOPs:

• Given the decentralized nature of this effort, it is critical for all to be conscientious of their own personal responsibility to protect others. The material being made handled WILL be used by medical personnel on the front line of this effort, it is paramount that all pledge to do everything possible to avoid putting them at risk.
• Those who are feeling unwell or are in households with people not feeling well, should not produce or handle any parts or packaging.
  • Most common symptoms: fever; dry cough; high respiratory rate; shortness of breath; high resting heart rate for at least two consecutive days; loss of smell/taste
  • Common symptoms: headache; aches and pains; sore throat; fatigue
  • Less common symptoms: diarrhea (although more common in children); runny nose
  • Sneezing is very rarely seen in COVID-19 infections
• Current CDC guidelines for ending self-isolation for those that have had symptoms but have not been tested are: 72 hours after the end of all symptoms AND 7 days after symptoms started (CDC interim guidance). Out of the abundance of caution, we specify that volunteers wait 5 days after the end of symptoms before continuing work (see the SOP for clearance).
• Producers are being directed to use sanitary procedures, and to not produce if they are symptomatic or could be infectious. However, because producers may be infected but asymptomatic, we must assume that the exterior of packaged material (e.g. bags, boxes) could have infectious virus.
• We will use chemical means to inactivate viruses “in the field” to the highest extent possible using data from most recent studies.
• Minimize contact between boxes and personnel.
• Maintain social distancing. Drivers should pick up and drop off at outside, non-public locations, and should not enter buildings.
• During transportation, the goal is to keep the driver and the material “separate.” Equipment and materials for carrying and disinfecting the boxes always stays in one part of the car or truck, separate from the driver.

E. Scientific Advisors:

• Dr. Jeffrey S. Kieft, Virologist, Professor and Vice Chair, Biochemistry and Molecular Genetics, University of Colorado, Anschutz Medical Campus
• Dr. Olivia S. Rissland, Molecular Biologist, Assistant Professor, Biochemistry and Molecular Genetics, University of Colorado, Anschutz Medical Campus

F. References:

1. Chin, A.W.H et al. (2020) Stability of SARS-CoV-2 in different environmental conditions. medRxiv preprint. DOI:10.1101/2020.03.12-5%.20036673
2. Kampf, G. et al. (2020) Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents. Journal of Hospital Infection 104: 246-22-5%1. DOI: 10.1016/j.jhin.2020.01.022
3. Rabenau, H.F. et al. (2002-5%) Stability and inactivation of SARS coronavirus. Medical Microbiology and Immunology 194: 1-6
4. van Doremalen, N. et al. (2020) Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine, Mar. 20. DOI: 10.102-5%6/NEJMc2004973
5. Benesch B. & Redifer S. (2020) DSIAC & HDIAC Technical Inquiry Response Report. COVID-19 White House Task Force Viral Mitigation and Decontamination. Defense Systems Information Analysis Center; Homeland Defense & Security Information Analysis Center. March 2020.
6. CDC Interim guidance: Discontinuation of Home Isolation for Persons with COVID-19 https://www.cdc.gov/coronavirus/2019-ncov/hcp/disposition-in-home-patients.html.
7. Zhu N., Zhang D., Wang W., et al. (2020) A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine. 2020 Jan. 24. DOI: 10.102-5%6/NEJMoa2001017
8. CDC guidance: How COVID-19 spreads https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html
9. Relman, D.A. (2020) Rapid Expert Consultation on SARS-CoV-2 Survival in Relation to Temperature and Humidity and Potential for Seasonality for the COVID-19 Pandemic. Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats. The National Academies of Science

SOP for makers

Reminders:

When printing or handling any parts for COVID-19 relief efforts, please work alone. This minimizes risk of transmission of the disease. Remember the goal here is not to protect YOU, but to protect the parts you are making.

Monitor yourself for any symptoms. Most common symptoms: Fever, dry cough, high respiratory rate or shortness of breath, high resting heart rate, lack of smell; Common symptoms: headache, aches and pains, sore throat, fatigue; Uncommon symptoms: diarrhea (more common in children), runny nose. If you or anyone in your household is feeling unwell, do not print any parts.

It is possible for infectious virus to remain viable on some materials for days. The following procedures are in place to limit the risk of contamination during printing and packaging. This is an effort that requires many people, all must be conscientious of the responsibility this carries.

Before you start, gather up:

• Disinfectants (choose one of these - all are effective at inactivating the virus)
  • Household cleaner (such as Lysol - approved by the EPA)
  • 70% alcohol (isopropanol or ethanol; “rubbing alcohol” is good, as is “grain alcohol” of 140 proof or more; handy to have a spray bottle with this)
  • 2-5% bleach (mix ⅓ cup in one gallon of water; handy to have a spray bottle with this)
  • Handy to have some disinfecting wipes around (Clorox or similar).
• Soap & water (for washing your hands, gloves, etc)
• Gloves
  • Latex, nitrile, or thicker kitchen “dishwashing” gloves are all good. All can be be reused if you spray them with your disinfecting solution or wash thoroughly with soap and hot water between uses
  • If you have cloth gardening-style work gloves these are OK as long as you disinfect by washing with detergent between uses
• Facemask (homemade cloth is encouraged; fancy N95s are not useful in this case because they protect YOU, not the material)
• Clear Plastic bags (1 gallon Ziplock is good; to put finished material in)
• **Sharpies/permanent marker **(for labeling bags)
• Duct tape (optional - to seal up plastic bags)
• Cardboard Boxes or paper bags (to package the final products for pickup)

NOTE: If you do not have disinfecting solution, gloves, or any sort of mask, this is a “HARD STOP.” Do not start to print. If you have any questions about these procedures, please refer to the FAQs.

Get ready to print:

Take a moment to self-assess. Do you have any of the symptoms listed above? Is anyone in your household ill? If you have a thermometer, take your temperature to be sure. If you have any doubts, do not print. It is better to be cautious, recover, then print when you are sure.

Set up all your materials in a controlled environment (i.e. for a single person to access for the duration of use). It is important to minimize movement and control access to printers while running.

• Wash your hands for 20 seconds. Yes, even we are telling you to do this!
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. The goal is to remove or inactivate virus that might be there.
• Wipe all work surfaces, machine areas, staging areas and tools with your disinfecting solution or wipes.
• Prep build trays as you normally would for printing. If you are printing with the bed at more than 70 degrees C, this will inactivate any virus on that surface.
• Preheat the machine.

Start printing:

• Please check the Make4Covid site frequently for approved designs and changes. We are using feedback from makers, hospitals, safety experts, to constantly improve the designs.
• Minimize contact with printers from anyone, including yourself.
• If the print seems to be going wrong or you are having problems, contact the helpers at Make4Covid, who are constantly gathering information and are eager to advise.

At the end of printing:

• Allow parts to cool as usual
• Wash hands for 20 seconds
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
• Examine your prints, using the rubric that is available online. https://docs.google.com/document/d/1EIoRQNk4CRQ9VlQT0zodL8NWwtJ4a9XVdoqNsvXAsc8/edit
• If the prints do not meet these standards, decide if you can improve them with some light post-processing. If not, discard and seek assistance in improving your product. Note that many parts are being submitted that have serious defects and are unusable.
• Place the finished items into a clear plastic bag. Ziplocks are ideal, because they allow the parts to be examined and sorted.
• Once parts are in a bag, set aside in a clean location.
• Each bag will need: 5, 10, or 20 headbands and NO stiffeners (update 4/6/2020)

Once a bag is complete (5, 10, or 20 headbands):

• Wash hands for 20 seconds.
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
• Seal the bag or fold and tape the opening closed. Write your name, the date of sealing, quantity, version of product, and material type on the bag or tape. This is important because if problems with your prints are found later, we can contact you so you can correct it.

Packing the material for collection:

• Wash hands for 20 seconds.
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
• Using your disinfectant, spray or wipe down the inside of the cardboard box (does not need to be soaked).
• Disinfect both sides of each Ziplock bag the same way, then put in the box.
• When the box is full, close and seal. Write on the top of the box: Your name, the number of units, type of materials used, date of sealing. Please write this clearly and large so items can be identified and tracked!

Arranging for transfer of finished product:

• When you are ready to send your printed material on its way, go to the Make4COVID site page and click the green button at the top left (“Make!”).
• In the “Finished?” pull-down tab, fill out the forms with all the relevant information.
• The Make4COVID transport team will get back to you with more information. Smaller producers may be asked to bring their boxes to a drop off point, or arrangements might be made for them to be picked up.

If you are told your materials will be picked up:

• Wash hands for 20 seconds.
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
• Using your disinfectant, spray or wipe down the OUTSIDE of the cardboard box (does not need to be soaked).
• Carry each box outside.
• Remove gloves, wash hands for at least 20 seconds with soap and water.

If you are asked to bring your materials to a drop-off point:

• Gather up your gloves, a mask, and your disinfection supplies you used when printing.
• Wash hands for 20 seconds.
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
• Put disinfection supplies in the truck or back of your car.
• Carry the box out to your car, preferably put in the truck or back
• Remove gloves, leave with the box and supplies
• Drive to the drop off location. Exit car, don gloves stored in cargo area.
• Using your disinfectant, spray or wipe down the OUTSIDE of the cardboard box (does not need to be soaked).
• Carry the box to the drop off point.
• Return to your car, remove gloves, and treat hands with hand sanitizer (if available).
• After returning home, wash hands for at least 20 seconds with soap and water.

SOP for drop-off points

Reminders:

When printing or handling any parts for COVID-19 relief efforts, please work alone. This minimizes risk of​ transmission of the disease.

Monitor yourself for any symptoms. Most common symptoms: Fever, dry cough, high respiratory rate or shortness of breath high resting heart rate, lack of smell; Common symptoms: headache, aches and pains, sore throat, fatigue; Uncommon symptoms: diarrhea (more common in children), runny nose. If you or anyone in your household is feeling unwell, stay home.

It is possible for infectious virus to remain viable on some materials for days. The following procedures are in place to limit viral loads during printing and packaging. This is an effort that requires many people, and all must be conscientious of the responsibility this carries.

General guidelines for drop-off points:

• Social distancing practices must be followed at all times to include maintaining a six foot distance and limiting conversations.
• Only people actively dropping off or picking up materials should be in the vicinity
• Boxes or other materials should be handled only when necessary.
• Gloves must be worn at all times.

When you are ready to bring your materials to a drop-off point:

• Gather up your gloves, a mask, and your disinfection supplies you used when printing.
• Wash hands for 20 seconds.
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
• Put disinfection supplies in the truck or back of your car.
• Carry the box out to your car, preferably put in the truck or back
• Remove gloves, leave with the box and supplies
• Drive to the drop off location. Exit your car, don gloves stored in the cargo area.
• Using your disinfectant, spray or wipe down the OUTSIDE of the cardboard box (does not need to be soaked).
• Carry the box to the drop off point.
• Return to car, remove gloves, and treat hands with hand sanitizer (if available).
• After returning home, wash hands for at least 20 seconds with soap and water.

If you are also obtaining materials from a drop-off point:

• After dropping off the box of materials, return to your car and re-treat your gloved hands with the disinfecting materials you have in your car.
• Walk over to the distribution point, get the materials and carry back to your car.
• While wearing the gloves treat them with the disinfecting solution.
• Remove gloves, leave in the cargo area of your car. Get back in your car and treat hands with hand sanitizer (if available).
• After returning home, wash hands for at least 20 seconds with soap and water.

SOP for obtaining consumables from distribution points

Reminders:

When printing or handling any parts for COVID-19 relief efforts, please work alone. This minimizes risk of transmission of the disease.

Monitor yourself for any symptoms. Most common symptoms: Fever, dry cough, high respiratory rate or shortness of breath high resting heart rate, lack of smell; Common symptoms: headache, aches and pains, sore throat, fatigue; Uncommon symptoms: diarrhea (more common in children), runny nose.If you or anyone in your household is feeling unwell, stay home.

It is possible for infectious virus to remain viable on some materials for days. The following procedures are in place to limit viral loads during all handling. This is an effort that requires many people, and all must be conscientious of the responsibility this carries.

General guidelines for drop-off points:

• Social distancing practices must be followed at all times to include maintaining a six foot distance and limiting conversations.
• Only people actively dropping off or picking up materials should be in the vicinity
• Boxes or other materials should be handled only when necessary.
• Gloves must be worn at all times.

To obtain materials from a drop-off point:

• Gather up your gloves, a mask, and your disinfection supplies you used when printing.
• Wash hands for 20 seconds.
• Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
• Put disinfection supplies in the truck or back of your car.
• Drive to the drop off location. Exit your car, don gloves stored in your car’s cargo area. While wearing the gloves treat them with the disinfecting solution.
• Walk over to the distribution point, get the materials and carry back to your car.
• While wearing the gloves treat them with the disinfecting solution.
• Remove gloves, leave in the cargo area of your car. Get back in your car and treat hands with hand sanitizer (if available).
• After returning home, wash hands for at least 20 seconds with soap and water.

SOP for drivers

Reminders:

Monitor yourself for any symptoms. Most common symptoms: Fever, dry cough, high respiratory rate or shortness of breath high resting heart rate, lack of smell; Common symptoms: headache, aches and pains, sore throat, fatigue; Uncommon symptoms: diarrhea (more common in children), runny nose. If you or anyone in your household is feeling unwell, stay home.

It is possible for infectious virus to remain viable on some materials for days. The following procedures are in place to limit viral loads during all handling. This is an effort that requires many people, and all must be conscientious of the responsibility this carries.

Driver preparation:

1. In the truck bed or cargo area

• Disinfectant:
  • Household cleaner (such as Lysol - approved by the EPA)
  • 70% alcohol (isopropanol or ethanol; “rubbing alcohol” is good, as is “grain alcohol” of 140 proof or more; handy to have a spray bottle with this)
  • 2-5% bleach (mix ⅓ cup in one gallon of water; handy to have a spray bottle with this)
  • Handy to have some disinfecting wipes around (Clorox or similar).
• Gloves:
  • Latex, nitrile, or thicker kitchen “dishwashing” gloves are all good. All can be be reused if you spray them with your disinfecting solution or wash thoroughly with soap and hot water between uses
  • If you have cloth gardening-style work gloves these are OK as long as you disinfect by washing with detergent between uses)

2. In the cab/driving area

• Bottle of hand sanitizer (if available).
• Household disinfectant and paper towels (or disinfectant wipes).
• Face mask (homemade cloth is fine; recommend washing every day)

Planning the pickup and delivery:

1. Pick up

• Coordinate for materials to be picked up either from drop-off point or from producer.
• Ensure the producer knows all pickups are non-contact and social distancing must be maintained.

2. Drop off

• Coordinate where materials will be placed outside
• Ensure receiver knows all pickups are non-contact and social distancing must be maintained** **

At pickup:

1. Put on your face mask. Exit cab, don gloves stored in cargo area. Rub or spray some of the disinfectant on your gloved hands. The the goal is to remove or inactivate any virus that might be there
2. Validate the pickup location – for unmanned locations, locate the sign
3. If manned, have the producer move the products to a safe location at least 6 feet from your location
4. Check to see that the containers are marked with the date, name of the producer and the version – if not please ask the producer to provide that information on the package
5. Using the disinfecting solution, spray or wipe the parts of the box or bag that will be touched. They should be visibly damp but do not need to be soaked.
6. Carry the container and place in the cargo area, touching the sprayed parts with gloved hands.
7. Rub or spray some of the disinfectant on your gloved hands. Remove gloves, leave in the cargo area.
8. Return to the cab, treat hands with hand sanitizer. Wipe down the steering wheel, shifter, etc. with disinfectant.

During transport:

1. In the absence of precipitation and if possible, leave the truck bed uncovered during transport (if possible), to allow natural UV exposure to potential virus.

During drop off or delivery:

1. Put on your face mask. Exit cab, don gloves stored in cargo area. Rub or spray some of the disinfectant on your gloved hands. The the goal is to remove or inactivate any virus that might be there
2. Using the disinfecting solution, spray or wipe the parts of the box or bag that will be touched. They should be visibly damp but do not need to be soaked.
3. Carry the container and place in the cargo area, touching the sprayed parts with gloved hands.
4. Rub or spray some of the disinfectant on your gloved hands. Remove gloves, leave in cargo area.
5. Return to cab, treat hands with hand sanitizer. Wipe down steering wheel, shifter, etc. with disinfectant.

SOP for Warehouse/Quality Control

Reminder:

Monitor yourself for any symptoms. Most common symptoms: Fever, dry cough, high respiratory rate or shortness of breath high resting heart rate, lack of smell; Common symptoms: headache, aches and pains, sore throat, fatigue; Uncommon symptoms: diarrhea (more common in children), runny nose. If you or anyone in your household is feeling unwell, stay home.

It is possible for infectious virus to remain viable on some materials for days. The following procedures are in place to limit viral loads during printing, packaging, and handling. This is an effort that requires many people, and all must be conscientious of the responsibility this carries.

Setting up storage and staging areas:

1. Storage and staging areas should only be accessible to warehouse volunteers
2. The area will be designated as a “no touch” area, meaning that staff on site are directed not to touch material.
3. At the start of the day, the staging area work surfaces will be sanitized with household disinfectant, 2-5% bleach, or 70% alcohol solutions.

Accepting a delivery:

1. The driver will call the warehouse staff upon arrival
2. Wash your hands for 20 seconds with soap and water.
3. Wash hands for 20 seconds.
4. Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. The goal is to remove or inactivate any virus that might be there.
5. Go outside to meet the driver. Have the driver open the cargo area. Unload the delivery and carry directly to storage or staging.
6. If not immediately examining material, wash or treat gloved hands as above. Remove gloves, wash your hands for 20 seconds with soap and water.
7. Ask the driver if there were any discrepancies with the pick up locations; not well identified or other problem to be corrected. Note any discrepancies.
8. Outside of receiving hours, instruct drivers to leave the delivery in a designated location using their SOP.

Examination of components within bags:

1. Wash your hands for 20 seconds with soap and water.
2. Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. The goal is to remove or inactivate any virus that might be there.
3. Open boxes one at time. Document the packages noting the quantity, producer and version.
4. All components should be visually inspected without unsealing the plastic packaging, if possible.
5. Components deemed unusable must be set aside.
6. Gather all the components that pass inspection. Spray or wipe with disinfecting solution, and place into the active inventory location update the inventory database or spreadsheet
7. Place any components that failed into a separate area. Document the items and provide feedback on the inventory database or spreadsheet
8. When finished inspecting, rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. The goal is to remove or inactivate any virus that might be there.
9. Remove gloves. Wash your hands for 20 seconds with soap and water.

Examination of components that must be removed from the bags:

Plastic sealed bags should only be opened when absolutely necessary

1. Wash your hands for 20 seconds with soap and water.
2. Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. The goal is to remove or inactivate any virus that might be there.
3. Carefully open the bag and remove the item to be examined.
4. Spray the item on both sides with disinfecting solution.
5. Test the suitability with as little handling as possible, then return to the bag and return the bag to box. Prioritize minimizing contact with material when repackaging.
6. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water.
7. Remove gloves, then wash hands with soap and water for 20 seconds.

When there is reason to believe that proper safety procedures were not followed:

1. Set items aside in a storage location, ensuring that they are marked with the date. Designate as “IN 14 DAY QUARANTINE”
2. Items will be left for 14 days before re-entering circulation and being packaged for end users.

When items are designated for deliver to NON HEALTHCARE PERSONNEL:

1. Set items aside in a storage location, ensuring that they are marked with the date. Designate as “IN 5 DAY HOLD”
2. After 5 days items will be packaged for end users.

Prepare validated product sets for delivery to end user:

1. Wash your hands for 20 seconds with soap and water.
2. Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. The goal is to remove or inactivate any virus that might be there.
3. Place 100 faceshields, 100 bands and enough elastic (based on availability) into a box (quantities may change based on the client)
4. Label the box with the quantity and version of the headband
5. Affix the liability form to the box
6. Tape up the box
7. Move the box to the outgoing area of the warehouse
8. Using the disinfecting solution, spray or wipe the exterior of the box.
9. Update the inventory database with the number of boxes.
10. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water.
11. Remove gloves, then wash hands with soap and water for 20 seconds.

SOP for Volunteers Who Have Been Sick

Goals:

(1) Minimize spreading of virus from potentially infectious individuals, and (2) provide a timeline for returning to work if a volunteer has been sick.

Guiding principles:

• Given the current lack of testing, volunteers must monitor their own symptoms to find individuals at high-risk of having COVID-19 infections and to determine when volunteering can start again.
• Producers are directed to not produce if they or any household member are symptomatic or could be infectious.
• To minimize the potential of spreading infectious virus, producers will wait 5 days from the end of symptoms for their household before starting volunteering again.
• However, because producers may be infected but asymptomatic, we will continue to assume that the exterior of packaged material (e.g. boxes) could have infectious virus.
• Use chemical means to inactivate viruses “in the field” to the highest extent possible using data from most recent studies.

COVID-19 symptoms:

• Most common symptoms: Fever, dry cough, high respiratory rate or shortness of breath, high resting heart rate, lack of smell;
• Common symptoms: headache, aches and pains, sore throat, fatigue;
• Uncommon symptoms: diarrhea (more common in children), runny nose;
• Not associated with COVID-19: sneezing.

You are ready for work if you meet BOTH of these criteria:

1. It has been at least 5 days since recovery of symptoms for all individuals in the household: no more fever (without the use of fever-reducing medications) AND improvement in respiratory symptoms
2. At least 7 days have passed since symptoms first appeared for all individuals in the household.

Revision History

April 16, 2020 - V.2.2

• Added the license term: CC BY-SA 4.0 license
• Background
  • Added a citation to a new study by Relman, D.A. (2020) to support the finding that the virus can remain infectious on surfaces for at least 72 hours.
• SOP for Makers
  • Added details on the required supplies before starting a job, including Disinfectants, Soap & Water, Gloves, Clear Plastic bags, Sharpies/permanent marker, Duct tape, and Cardboard boxes or paper bags.
  • Added a note to emphasize that not having disinfecting solution, gloves, or masks is a HARD STOP
  • Provided detailed instructions on how to disinfect throughout the procedure:
    • Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
    • Using your disinfectant, spray or wipe down the OUTSIDE of the cardboard box (does not need to be soaked).
• SOP for Drop-off Points
  • Provided detailed instructions on how to disinfect throughout the procedure:
    • Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
    • Using your disinfectant, spray or wipe down the OUTSIDE of the cardboard box (does not need to be soaked).
• SOP for obtaining consumables from distribution points
  • Provided detailed instructions on how to disinfect throughout the procedure:
    • Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
    • Using your disinfectant, spray or wipe down the OUTSIDE of the cardboard box (does not need to be soaked).
• SOP for Warehouse/Quality Control
  • Added detailed instructions on how to disinfect throughout the procedure:
    • Put on gloves and a facemask. Rub or spray some of the disinfectant on your gloved hands. Or, you can wash your gloved hands using soap and hot water. Again, the goal is to remove or inactivate any virus that might be there.
    • Using your disinfectant, spray or wipe down the OUTSIDE of the cardboard box (does not need to be soaked).
  • Added detailed instructions on how to deal with situations when
    • There is a reason to believe the proper safety procedures were not followed
    • Items are designed for deliver to non healthcare personnel