Q&A from the COVID-19 Safety Matters Training Course webinar from 4&5 June 2020

The below questions were answered by South African Occupational Health Specialist, Dr Marina Clarke. Please note, at the time of the webinar, South Africa was still at Lockdown Level 3.

Disclaimer: The webinar is provided for general information purposes only and does not constitute legal, medical or professional advice. Read full disclaimer

Question 1: Once you recover from the COVID-19, are you able to get it again, and how soon?

It depends on whether you suffered a mild or serious bout of COVID-19. Some evidence suggests that there is a three-month period of immunity.
In cases where people have serious/critical bouts of COVID-19, evidence shows it may take 18-24 months to heal completely (but this has yet to be properly established).


Question 2: Is there any possibility of transmission through the ears or ear canal?

No: the virus enters the body through mucous membranes (eyes, nose, mouth).


Question 3: Once recovered from COVID-19, how long before I may return to work? Do I require a medical certificate to confirm my recovery?

Mostly 14 days: it depends on whether you have had a mild or serious/critical case. And yes, you will need a return to work certificate from a health practitioner (a medical doctor or registered nurse).


Question 4: How do you know if you have the virus with no symptoms?

About half of the people who have been infected caught the virus from people who were infected, but not showing any signs and symptoms (asymptomatic) for the first two to three days before they started to get ill

Without a test, there is no way of knowing if you are asymptomatic and infected. Therefore we all need to assume we are COVID-19 positive and institute and maintain the mitigating measures (social distancing, hand hygiene, wearing a three-layer cotton mask, and disinfecting surfaces as discussed) when in public.


Question 5: My wife has brittle asthma. What precautions should I take, or what advice could you give me?

You and your wife need to be consistently meticulous in applying the COVID-19 mitigation principles and disinfect when you return home. She must use her medication as prescribed, and at stay home if possible. Check with her medical practitioner, who may recommend that she have the flu vaccine.


Question 6: Is there any evidence yet that animals assist in spreading the virus?

No, as yet there is no evidence to support the notion that animals spread this coronavirus.


Question 7: Can any insect carry the virus and spread it?

No, it is not spread by insects.


Question 8: Can the BCG vaccination reduce the severity of COVID-19?

Researchers are currently studying to see if the BCG vaccination protects individuals against COVID-19.


Question 9: I have been seeing articles recently suggesting that nicotine/tobacco deters the effectiveness of this disease. Is there any evidence that supports this?

No, there is no evidence as yet to support this.


Question 10: If a person tests positive for COVID-19 at the office, what is the procedure for the rest of the staff who were that was at the office that day?

The staff who were in close contact with the person who has tested positive, will be put in quarantine to monitor for COVID-19 signs and symptoms and tested after seven days. If they are COVID-19 negative at that point, with no signs and symptoms, they may return to work.


Question 11: How high is the risk for toddlers between three to four years?

Experts are still learning about COVID-19. There are fewer COVID-19 cases reported in children, who mostly are infected by an adult carer or family member. COVID-19 seems to be milder in children than in adults or older people. However, there have been cases of children developing more serious symptoms, sometimes several weeks after being infected with the virus.


Question 12: Can you contract COVID-19 when you do alcohol testing with a straw at the mine?

Ensure a new straw (in the wrapper and opened by you) is used every time you take an alcohol test and don’t touch the instrument. The person who conducts the test needs to wear a mask and keep the maximum distance possible from you.


Question 13: Is there a correlation between COVID-19 and blood clotting?

Experts are still learning about COVID-19. It appears that there might be a correlation.


Question 14: Is anemia a high risk factor?

My advice is that the cause of the anemia is investigated as it lowers immunity. Consult your medical practitioner for the risk in your specific case.


Question 15: What is the temperature that rings alarm bells with regards to COVID-19?

A temperature from 37.5°C and above needs to be reported and investigated.


Question 16: Does your exposure to the virus affect your symptoms? For example, what is the risk to healthcare workers who are exposed to the virus daily with many positive cases vs. someone who was exposed to one person in a shopping center?

The closer (less than one meter) and longer you are exposed to the source of the SARS-CoV-2 virus, the greater the risk of infection. Without the required PPE (face mask) you are at very high risk to become infected in such circumstances.


Question 17: Is the virus mutating as it spreads?

All viruses mutate, and the SARS-CoV-2 virus is no exception.


Question 18: Is the face shield necessary, since the disease can be transmitted through eyes as well?

The face shield in addition to the face mask is required in ICU clinical settings. Evidence shows that using a face shield as well as a mask does protect you when someone who is infectious coughs within about a half a meter from you. Remember, you also wear a face mask to protect others, as you may be COVID-19 positive without knowing it.


Question 19: What should you do if your temperature is scanned in above 38°C at a store, or a customer, and you have been driving with the heater on during cold temperatures in the morning?

Wait in an open area for about 10 minutes and ask them to repeat the screening of your temperature. If you do not have a fever, the repeat measurement will be in the normal range.


Question 20: Will the isolation criteria only apply for the people who were there on the day, or (in the case of shifts) will it apply for the staff on the previous day shift as well? (I’m asking specifically about office staff who don’t share work stations, but do work in an open plan office.)

It may apply to all staff who have had contact with the infected person in the past seven days. The COVID-19 dedicated staff member will have to investigate each situation, to check the mitigation. For example use a two-meter radius from where the infected person was working.


Question 21: Can the virus be spread by air-conditioning systems?

There is no conclusive evidence on this issue, however it is thought that it might, especially when air is recirculated where someone is COVID-19 positive.


Question 22: If you have recovered from Covid-19, have your heart and lungs been damaged? Will you be at more risk, say, if you get influenza?

It all depends whether you had a mild or serious case of COVID-19. You still need to consider having a flu vaccine every year, as the flu virus mutates. Screening Form


Question 23: Most stores and malls, etc. have hot air blowing through their aircons in winter. Would this be highly unsafe with regard to healthy ventilation?

Yes, it might be. Keep your visit to stores and malls to the absolute minimum, and if you have to go, keep the visit as short as possible.


Question 24: Is washing utensils (i.e., plates, glasses, spoons, etc.) with hot water and soap sufficient if they are contaminated with COVID-19?

Yes, as the soap will dissolve the outer layer of the virus.


Question 25:What medication should one keep at home which may be useful?

Paracetamol (Panado) for the fever, and ask your pharmacist for a suitable cough syrup, throat lozenges and multivitamin.


Question 26: While everyone mentions coins, what about paper money? How long does the virus stay on that?

The virus remains viable for four days on paper money: wash your paper money in warm soapy water and dry it in a sunny spot.


Question 27: What medication can you take after you have tested positive?

Treat symptomatically. Use paracetamol (Panado) for the fever and ask your pharmacist for a suitable cough syrup, throat lozenges, Vicks rub and a multivitamin.


Question 28: Why does the virus stay on cardboard for 24 hours and paper for four to five days?

Cardboard is more absorbent and dries the virus out quicker.


Question 29: If there is no ventilation in a room, how long will the virus be airborne?

It is influenced by the air movement, but it can stay ambient in the air for 45 minutes and up to three hours in the situation you described.


Question 30: What about your credit card or business cards?

Clean them by washing with soapy water or with an alcohol based wipe as long as the card is not damaged by the alcohol


Question 31: One of the earlier slides mentioned that the virus stays on plastic for five days. However, in contrast, the latest slide mentions 72 hours (three days) for plastic bottles. Which is more accurate?

Studies show that the length of time differs for different surface materials, textures, temperatures and humidity: when in doubt, rather be conservative.


Question 32: Which face mask would be the safest?

The N95 face and surgical face masks, but these are reserved for medical staff. A three-layered woven cotton material mask is adequate for public areas in conjunction with the mitigating strategies, i.e., two-meter physical/social distancing.


Question 33: Is it not bad to wear a mask all day and breathing in your own carbon dioxide?

There is much disinformation regarding masks circulating on social media. See https://www.poynter.org/fact-checking/2020/it-is-not-true-that-masks-cause-hypoxia-this-hoax-is-now-viral-and-dangerous/

People have been wearing face masks for many years. Health staff wears surgical and N95 face masks the whole time they are on duty, which can be 12 hours and more, without adverse effects.

Question 34: Are dust masks effective?

There are various kinds of dust masks. Consult the manufacturer for confirmation that they will filter out particles the size of the virus. The World Health Organization proposes the general public wears a three-layered woven cotton face mask in public areas.


Question 35: Due to increased hygiene practices and constant hand washing, we are no longer exposed to any germs. Is this detrimental to our immune system as a whole?

There is some risk with extended use of increased hand washing. But it is not accurate to say we are no longer exposed to any germs. There are different kinds of germs, of which one type is viruses. We are exposed to germs in many ways besides from our hands. We need to trust the researchers as risks are assessed and balanced.


Question 36: Which masks are better the washable ones or disposable ones?

The surgical disposable mask is better than the washable three-layered cotton material mask. However, the surgical masks are in short supply and preference must be afforded to those in very high risk professions such as health care providers. These masks are needed in the workplace for 21 days after an infected person first experiences COVID-19 signs and symptoms. The World Health Organization recommends that the general public wears a washable, three-layered woven cotton face mask as adequate.


Question 37: Is it not easier to just disinfect your hand after a sneeze than to have to wash your clothes and walk around with it the whole day at work?

Using hands to cover your mouth does not prevent droplets from spreading, therefore when you sneeze and/or cough, use tissue paper, which you discard immediately afterwards.

It is only when you do not have tissue paper on you that you resort to using your elbow. Yes you must wash your arm up to the top of your elbow and your clothes when you get home.


Question 38: What is the best way to boost our children’s immune system? Any recommendations on this?

Good healthy nutrition, drink water rather than sugary drinks and ask your pharmacist for advice on a multivitamin supplement.


Question 39: With all the contradictory viewpoints from top scientists and research organizations around the world, do you think that we are doing an overkill with regards to precautionary measures?

The mortality rate from COVID-19 is significantly lower than influenza B, which has been around for decades and its mortality index is not limited to the elderly but all age groups?

This is a new, highly infective respiratory virus that we learn more about every day. This virus has affected almost every country in the world with devastation at all levels of life. Therefore it is a matter of risk analysis and caution, rather than too little too late.

The CDC estimates that since October 2019 to mid-March 2020 (six months) between 29,000 and 59,000 people in the United States died from flu. In the five months since COVID-19 has been reported in the United States, 113,500 people are known to have died from COVID-19, and the pandemic has not yet peaked in all of the states: this despite severe lockdowns and mitigation.

You say, “The mortality rate from COVID-19 is significantly lower than influenza B.” John Hopkins University says “Doctors and scientists are working to estimate the mortality rate of COVID-19, but at present, it is thought to be substantially higher than that of most strains of the flu.”


Question 40: With regards to being affected and having to isolate for days, and be home for the 14 days waiting period before returning to work, will those days of isolation and waiting period affect one's sick leave days. 

Yes, it may affect your sick leave days. Consult your human resources department at work.


Question 41: Is zinc a good supplement to take?

Yes, it is an immune booster. A pharmacist will guide you on the dosage and product. Rather ask the pharmacist to advise you about a suitable multivitamin you can take


Question 42: Do we have any more information regarding the natural remedy from Madagascar?

This natural remedy is being researched and the results are not yet known.


Question 43: Is there something one can drink to boost the immune system as, I hear people talking about so many remedies?

Ask your pharmacist to advise you about a suitable multivitamin for you.


Question 44: Would taking a Vitamin C and/or multivitamin supplement reduce your chances of contracting the virus or have no beneficial effect at all?

Taking a multivitamin will boost your immune system and helps to combat viruses. Seek the guidance of your pharmacist.


Question 45: If you use medicine to clear your airways, will this not spread the virus to your lungs quicker?

No, not to my knowledge.


Question 46: How does more than 75% alcohol sanitizer preserve the virus?

The information regarding the composition of sanitizers that I was given was not completely accurate and I apologize for the error in this regard. Studies show that getting the correct concentration is important: 70% - 80% alcohol seems to be optimal.


Question 47: Once recovered from Covid-19, are there any long term effects or damage from the virus to your body, if you were a healthy person?

It depends whether you had mild or serious COVID-19 disease. A very small percentage of infected people have long-term effects that are serious, but it is still too early to verify this.


Question 48: Must the water be a certain temperature when you wash your hands?

Warm water is in order: the soap destroys the outer layer of the SARS-CoV-2 virus, thus destroying the virus.


Question 49: Alcohol-based sanitizer affects people with eczema. What can be used besides normal hand wash products?

There are a few different types of agents that neutralize the coronavirus besides alcohol. I suggest people who have reaction to the alcohol seek guidance from their health professional or pharmacist.


Question 50: Is it wise for people who suffer from diabetes and/or high blood pressure to go and get the flu vaccination ?

Yes, it is advisable. Each person who suffers from the conditions you mention, should check with their health care provider for guidance.


Question 51: What do you wipe surfaces with? Can you use a cloth, but how much surface can you cover with this cloth?

Once the bleach solution has been on the surface you are disinfecting, the viability of the virus is destroyed after 30 seconds. It is recommended that you wipe surfaces you disinfect with a dedicated cloth that can be washed, or paper towel that can be discarded.


Question 52: When washing hands and using cotton towels can you reuse them or must they be cleaned immediately? The same applies to using cotton cloths on work surfaces – is this a good idea or is it better to use paper?

It is better to use paper towels. If you use cotton towels, you need to wash them daily, if they are soiled, or if they get wet.


Question 53: I have noticed many places don't have any regulations when using a lift. What would your advice be?

My advice would be to take the stairs if at all possible (lifts need one to touch buttons to be operated, lack ventilation and social distancing could be problematic). But remember not to touch the banisters. If you must use the lift, wear a mask, turn away from others in the lift, cover your finger with a tissue when touching the buttons, and sanitize your hands afterwards. Also don’t enter a lift that has many people in it. Rather wait for the next one.


Question 54: Must you wipe all the items you buy from the supermarket?

There is currently debate as to whether packaging can transmit coronavirus or not. My response is preferably disinfect all items entering your home either by washing those you can with warm soapy water, or isolating those you can’t. Paper packaging (like that for flour) can be put in the sun for 24 hours.


Question 55: When putting a used mask into a zip lock bag, will it help to spray an alcohol solution into the bag and seal it? Will this disinfect the mask for wearing latter?

I am unable to guarantee that. A colleague puts his face mask on a piece of paper towel with the inside facing down, on his car’s dashboard, and in the sun as much as possible. He sprays alcohol sanitizer on the outside of the mask to disinfect and reuses this mask for the rest of the day. He is alone in the car, thus not wearing a face mask whilst driving.


Question 56: How safe it is to sanitize car keys?

Test that the alcohol doesn’t damage the plastic and then, using a damp alcohol wipe, clean the key/remote. Don’t let liquid get into the battery compartment, etc.


Question 57: Going from one hospital to another, excluding hand sanitizing, masks wearing, changing to a new mask, what do you suggest?

Spray disinfecting solution on the soles of your shoes after each visit and leave it on for at least 30 seconds then dry it with paper toweling before you get into your car. Be careful to dry so that the disinfectant does not damage your car carpet.


Question 58: I have noticed that my temperature differs from place to place. Is it the thermometers used or does body temperature fluctuate?

A healthy person’s body temperature fluctuates by about 0.5⁰C during the day. But it may also be lack of reliability of different thermometers, how the thermometer is operated, how far the thermometer is held from your forehead, etc. It could also be due to you traveling with your car heater on, or by being in the sun.


Question 59: Does drinking alcohol increase or decrease your odds?

Using alcohol to excess is likely to blunt your focus on mitigating factors.


Question 60: If you order takeaways, can the virus attach itself to the food?

To date there is no evidence that it does. However, it is advised that you heat your takeaway food in a microwave before enjoying it.


Question 61: Does one need to have ALL symptoms together, or is one symptom enough to cause alarm?

Alarm, no, but the sudden onset of one symptom requires reporting.


Question 62: What are your thoughts on children going back to school? Is preschool, especially, safe?

It is advised that crèche-aged children, if at all possible, should stay at home, as they are unable to practice social distancing and if COVID-19 positive, they could infect the adults at home.

Children have lower viral load levels than adults and they are less likely to transmit the SARS-CoV-2 coronavirus. They are more likely to get infected by adults at home and in the community. Infected children can, of course, infect the elderly, who may then have to care for them at home while parents are working. The elderly (60 years and older) are in the high risk category of developing serious/critical COVID-19 or death.

“We are not saying schools are absolutely safe, but I think schools may be safer than many homes’ Professor Haroon Salojee: Executive member of the South African Paediatric Association.”

A good resource is to listen to Kids don’t die from COVID-19, or spread it – SA Paediatric Association. It is available on www.capetalk.co.za

Each parent needs to make an informed decision, based on a risk assessment of their child’s daycare of preschool – as you would at the workplace – and assess the mitigating factors.

Another pediatrician is of the opinion that children do not get very ill with COVID-19, but a small percentage of children get serious complications some weeks later and might die. There is no clarity whether this is due to COVID-19.


Question 63: Can one spray disinfectant into a zip lock bag to disinfect the mask during the day before washing it in the evening?

It is not necessary, and will most likely weaken the material the mask is made of, thus compromising its effectiveness of the mask. You need to discard the used Ziploc bag in any event.


Question 64: Can body aches and pains be a symptom of Covid-19? 

Yes, they can.


Question 65: Disinfectant or sanitizer?

It depends what material/surface/type of item you need to sanitize. Follow manufacturer guidelines.


Question 66: While calling on customers is it a good idea to wear disposable gloves?

This is not necessary, as the SARS-CoV-2 virus enters the body via the mucous membranes of the mouth, nose and eyes. You can more effectively sanitize your hands without gloves than with gloves.


Question 67: If you feel that a company is not following safe COVID-19 practices, who can you report them to?

Consult the Occupational Health and Safety Representative or the COVID-19 dedicated person of the company regarding your concerns. Report the matter to your supervisor and record on your post-meeting assessment. There is a report form available on the Western Cape Health Department’s web page.


Question 68: How do you disinfect paper, as it will get wet and crinkle?

Put it in the sun and leave it there for 24 hours.


Question 69: What do you do if your client removes his/her mask while in a visit with you?

You ask them in a kind way to put their face mask back on while you are there. Also ensure that your two-meter social distance is in place. Report the matter to your supervisor and record on your post-meeting assessment


Question 70: What is the best course of action if we have to collect returns from a supplier? Some of the items are kept in boxes

Have a pair of industrial gloves handy in a packet in your vehicle if you need to physically protect your hands. With regard to COVID-19, wear your mask, don’t touch your face/mask and sanitize your hands after delivery/collection. If you use gloves, they need to be sanitized too.


Question 71: What special filters does the air-conditioner need to be using?

This information must be obtained from the supplier of the air conditioners. Research into whether air conditioners spread the coronavirus is ongoing.


Question 72: What do I do when I get to an outlet and I see one or two people not wearing masks. Do I enter or leave?

You should carry spare (disposable) face masks with you when you meet people. Ask them to wear their facemasks in your presence and if they do not have masks and you need to meet with them, provide each of them with a facemask. Leave the face mask with the person.


Question 73: Is it safe to take any type of multivitamin if you are a breastfeeding mum?

Ask your pharmacist or clinic to advise you which multivitamin to take whilst breastfeeding.


Question 74: There are disinfecting spray booths at some customers that a person must walk through. Is this healthy or more damaging to a person’s health and is it legal?

I can’t comment on the legality or generalize regarding the various types of disinfectant spray. But scientists say that while the disinfectants can kill the coronavirus on surfaces, the sprays tend to degrade quickly, so these efforts are far less important than personal hygiene and social distancing. Remember that an infectious person remains infectious after walking through the booth.


Question 75: If your wife is pregnant and tested positive for COVID-19, can it affect the unborn baby? 

There is currently no evidence that the unborn baby will be affected.


Question 76: Is kitchen towel sufficient to be used as a face mask if fitted correctly?

Paper towel is not recognized as a replacement for a three-layer cotton mask.


Question 77: What are your thoughts on sending children with type 1 diabetes to school?

There is currently very little evidence on the effect of COVID-19 on people with type 1 diabetes, let alone childhood type 1 diabetes. It is best you ask your doctor or clinic to advise you on your child’s specific needs.


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