Background:
In December 2019, a new respiratory disease called Coronavirus Disease 2019 (COVID-19) was first detected in China and now spread more globally. COVID-19 is caused by a virus (SARS-CoV-2) that is part of a large family of viruses called coronaviruses. Selected travelers and individuals with potential exposure to confirmed COVID-19 cases will be placed under movement restrictions for as long as 14-days. Because facility staff may not be aware which individuals under movement restrictions are asymptomatic or symptomatic, cleaning of areas occupied by an individual under movement restriction should only proceed after consultation with the local health department (LHD).

Cleaning of Areas Where Asymptomatic Individuals are Staying:
If an individual under movement restriction is determined not to have symptoms of COVID-19 such as fever, cough or trouble breathing (asymptomatic), the LHD should advise the facility to immediately proceed with routine cleaning of the area within a few hours of the LHD verifying the individual is asymptomatic. No special cleaning procedures or additional personal protective equipment beyond what would normally be used during routine cleaning is required.

If it is not feasible for the facility to coordinate the timing of cleaning with the LHD verifying the individual is asymptomatic, the individual should be provided with basic cleaning supplies until the LHD determines facility staff may enter the room for routine cleaning. The individual should also be provided EPA- and DEC*- registered common household disinfectant products labeled to be effective against rhinovirus and/or human coronavirus for use as needed.

If an asymptomatic individual is released at the end of the movement restriction period, routine cleaning should be completed by the facility staff. No special cleaning procedures are required.

If room access by facility staff for a prolonged time is required during the period of movement restriction, such as for maintenance, arrangements should be made for the individual to be transferred to a separate room under the guidance of the LHD to ensure the individual is asymptomatic before and during this transfer period.

Cleaning and Disinfection of Areas Where Symptomatic Individuals are Staying:
If an individual develops symptoms during the movement restriction period, cleaning and disinfection should be completed after they leave the area. Facilities should collaborate closely with the LHD to determine when an area may be entered by facility staff for cleaning and disinfection. If feasible, the area may be left with the door closed after the individual is transferred, and entry should be prohibited while the individual’s symptoms are being investigated and/or laboratory confirmation is pending. Determining if an individual has COVID-19 may take several days. In this situation, if the individual is determined not to have COVID-19, the LHD will instruct the facility that routine cleaning should be performed. If the individual was determined to have COVID-19, the LHD should instruct the facility to proceed with cleaning and disinfection per recommendations below.

Once a symptomatic individual, who is confirmed to have COVID-19, has left the isolation area for at least 4 hours, the LHD may instruct the facility to proceed with cleaning and disinfection of the areas where the patient was present while symptomatic. Cleaning removes germs, dirt and impurities from surfaces or objects, while disinfecting kills germs on surfaces or objects.

• Perform targeted cleaning and disinfection of frequently touched hard, non-porous surfaces, such as counters, appliance surfaces, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, remote controls, bedside tables, and any other surfaces that are visibly soiled.
o Step 1: Cleaning: Always clean surfaces prior to use of disinfectants. Dirt and other materials on surfaces can reduce the effectiveness of disinfectants. Clean surfaces using water and soap or detergent to reduce soil and remove germs. For combination products that can both clean and disinfect, always follow the instructions on the specific product label to ensure effective use.
o Step 2: Disinfection: If EPA- and DEC*-registered products specifically labeled for SARS-CoV-2 are not available, disinfect surfaces using a disinfectant labeled to be effective against rhinovirus and/or human coronavirus. EPA- and DEC*- registered disinfectants specifically labeled as effective against SARS-CoV-2 may become commercially available at a future time and once available, those products should be used for targeted disinfection of frequently touched surfaces.
▪ Label directions must be followed when using disinfectants to ensure the target viruses are effectively killed. This includes adequate contact times (i.e., the amount of time a disinfectant should remain on surfaces to be effective), which may vary between five and ten minutes after application. Disinfectants that come in a wipe form will also list effective contact times on their label.
▪ For disinfectants that come in concentrated forms, it is important to carefully follow instructions for making the diluted concentration needed to effectively kill the target virus. This information can be found on the product label.
o Staff are reminded to ensure procedures for safe and effective use of all products are followed. Safety instructions are listed on product labels and include the personal protective equipment (e.g., gloves) that should be used.

• Wash all bedding/linens. Wash and dry with the warmest temperatures recommended on the fabric label and follow detergent label and instructions for use.

• Facility staff do not need to wear respiratory protection while cleaning. Staff should wear disposable gloves while handling potentially soiled items/bedding and while cleaning and disinfecting surfaces. Place all used gloves and other disposable contaminated items in a bag that can be tied closed before disposing of them with other waste. Wash hands with soap and water for at least 20 seconds immediately after removing gloves or use an alcohol-based hand sanitizer if soap and water are not available. Soap and water should be used if hands are visibly soiled.

If an individual has laboratory confirmation of COVID-19 and returns to the isolation area until their complete recovery, they should be provided with basic cleaning supplies to perform routine cleaning of the area as needed while they are symptomatic. They should also be provided EPA- and DEC* registered common household disinfectant products labeled to be effective against rhinovirus and/or human coronavirus for use as needed. Once the individual recovers and is released from the area by the LHD, the LHD will instruct the facility to proceed with cleaning and disinfection of the areas per above guidance.

For questions or more Information please visit: https://www.health.ny.gov/diseases/communicable/coronavirus/ or contact your local health department.