The first two categories include considerations for high risk individuals with the assumption that no member of the household has COVID-19 symptoms.
1. Personal controls to prevent transmission
This section describes considerations that apply to all households, as well as suggestions to protect people at increased risk (older adults or people with certain underlying health conditions). It includes recommendations that both individuals and organizations can take to support households in high-density urban areas.
Hand Hygiene
Personal controls
- Wash hands frequently with clean water as described above.
- Households should ensure they have at least one handwashing station with soap where water flows from a tap or spigot to allow for proper handwashing. The handwashing station may be located inside or outside the home. There should be a handwashing station near the toilet/latrine.
Materials, activities, and personnel needed for implementation
- Distribute handwashing station materials and soap where necessary for households that are unable to purchase.
- Distribute information, education and communication (IEC) materials on construction of handwashing stations and proper handwashing methods
- Conduct communication campaigns (via radio, newspaper, social media, or other platforms) describing guidance on proper handwashing technique and the key times for handwashing. Tips on communicating for hand hygiene during COVID-19 are found herepdf iconexternal iconpdf iconexternal icon.
Considerations and challenges for implementation
Some areas may face challenges with water quantity or water quality. If clean water is not available, the cleanest water available (e.g. not cloudy and from an improved source) should be used. In areas without access to an improved water supply, household water treatment may be considered for treating water for all purposes, including handwashing; however, priority should be given to treating drinking water where access to household water treatment products is limited.
Costs associated with the development and distribution of communications campaigns.
Costs for households to purchase and maintain handwashing stations and supplies (e.g. soap, water, drying materials). If a handwashing station is not affordable , use a bucket with cup or pitcher. However, this method does not allow individuals to scrub hands under water as recommended without the support of another household member to pour water.
Where individual handwashing stations are not possible, install public handwashing stations, as described below in administrative and engineering controls.
Accessing essential goods and services
Personal Controls
- Leave the household only when it is necessary to obtain essential goods and services. Stock up when possible to help limit the number of trips needed outside the household.
- Designate one person (who is not elderly and who does not have serious underlying medical conditions) to leave the house for essential goods and services.
- Clean hands as described above frequently when in public spaces and when returning home from a public place.
- Wear masks when in public settings where other physical distancing measures are difficult to maintain.
Materials, activities, and personnel needed for implementation
- Conduct communication campaigns (via radio, newspaper, social media, or other platforms) on when families should stay at home and to protect individuals at increased risk.
- Provide food aid and distribution of hygiene materials where necessary for households that are unable to purchase multi-day supplies of food, soap and cleaning supplies.
Considerations and challenges for implementation
Costs associated with the development of communication materials and with the purchase and distribution of food aid and hygiene materials (where needed).
Difficult to determine who qualifies for food aid and distribution of hygiene materials. Ideally, consult with community stakeholders and refer to existing social safety net lists.
Frequently touched surfaces
Personal Controls
- Clean and disinfect frequently touched surfaces and objects at least daily following the directions above and more often when heavily used. These include tables, door and window handles, and sanitation (bathroom/toilet/latrine) surfaces.
Materials, activities, and personnel needed for implementation
- Ensure access of or provide households water and bleach (or other disinfectants), cleaning materials, and personal protective equipment (rubber gloves, thick aprons, and closed toed shoes).
- Provide households communication materials describing how to mix disinfection solutions, how to clean and disinfect, and how to store disinfectants safely.
Considerations and challenges for implementation
Costs associated with purchasing bleach, soap, water, cleaning supplies, personal protective equipment, and printing communication materials. If water supply is not available on site, daily cleaning and disinfection will be more challenging and costly. If no rubber gloves are available, other non-permeable gloves can be substituted. If no aprons are available, people can wear protective clothing (such as long pants and long-sleeved shirts) and launder after use.
Constraints with supply chain and market on soap, bleach and PPE as demand increases with COVID-19 spread.
Ventilation
Personal Controls
- Open windows or doors to increase ventilation within living and sleeping areas. Improving ventilation helps to remove respiratory droplets from the air.
Materials, activities, and personnel needed for implementation
- Communication campaigns (via radio, newspaper, social media, or other platforms) informing households that increasing ventilation is a possible mitigation measure.
Considerations and challenges for implementation
Increased ventilation may not be possible in some households and during some seasons (e.g. when temperatures are cold or it is raining). Do not open windows and doors if doing so poses a safety or health risk to others (e.g. risk of falling or triggering asthma symptoms).
Using a fan without the window or door open may spread contaminated droplets to a safe area or to other occupants.
Increased ventilation may result in increased transmission of malaria or other vector-borne disease, and use of bed nets is recommended in areas where there is transmission of these diseases.
Visitation
Personal Controls
- Follow all local and government guidance on visitors. Limit time and number of guests inside households to essential visitors. Allow outdoor visits where possible.
- Encourage visitors to practice personal mitigation measures (hand hygiene, avoiding touching surfaces when possible, respiratory etiquette, wearing a mask, and physical distancing) and practice those measures when in other households.
- Persons at increased risk should not visit other households and should not receive visitors. If it is essential that a visitor enter a household with someone who is at increased risk, ensure that visitor wears a mask and maintains physical distance as much as possible.
Materials, activities, and personnel needed for implementation
- Conduct communication campaigns (via radio, newspaper, social media, or other platforms) informing households to limit visitation.
Considerations and challenges for implementation
Costs associated with the development and distribution of communication campaigns.
Risk reduction for individuals at increased risk within households
Personal Controls
- People at increased risk for severe illness (people who are elderly or who have serious underlying medical conditions) should stay at home and away from crowds or large gatherings as much as possible.
- Protect high-risk people in households where there is enough space (e.g. a separate bedroom or other room) through physical separation while they are still healthy. The high-risk person needs to stay inside the protected area, or “safe zone,” as long as there is active COVID-19 transmission in the surrounding community. Ideally, this zone would include its own sanitation facilities not used by other members of the household.
- If high-risk people need to use shared sanitation facilities, the high-touch surfaces within those facilities should be cleaned and disinfected before each use.
- All interactions between high-risk people and other members of the household should be at a safe distance of at least 2 meters, including sleeping areas.
- If separate sleeping areas are not available, consider sleeping head to toe.
- Other household members should wear masks when in the household with someone who is at increased risk and physical distancing is not possible.
- Avoid sharing personal items (such as dishes, cups, towels, bedding, etc.) between the household member at increased risk and others.
- High-risk family members should clean hands after coming in contact with high-touch surfaces, and all household members should clean hands before touching the high-risk person or anything in high risk-person’s area.
Materials, activities, and personnel needed for implementation
- Conduct communication campaigns (via radio, newspaper, social media, or other platforms) informing households about risk reduction for high-risk individuals.
- Ensure access or provide masks to other household members.
Considerations and challenges for implementation
Potential for depression and loneliness to household members at increased risk who, under this measure, would need to be isolated for a prolonged period of time (as long as there is active COVID-19 transmission in the surrounding community).
Difficult to maintain safe zone would be very difficult to maintain for all households, especially for people at increased risk who require care from other household members (unless those household members are able to isolate with them) and in households where there is no separate latrine or toilet.
It may be impossible for people at increased risk to stay at home, particularly if they earn money for the household or provide care for others. In these cases, consider financial and other support for these households to enable/encourage the person who is considered high risk to stay at home.
