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Greenburgh Medical Advisory Committee -local Drs Recommendations: safety practices for businesses. encourages home deliveries and curbside pickups to safeguard customers and staff. address temperature checking. All recommendations in full text.
TOWN OF GREENBURGH RECOMMENDATIONS FOR BUSINESSES AND RESIDENTS DURING COVID-19 CRISIS (AS OF APRIL 20, 2020)
On March 7, the Governor issued an Executive Order Declaring a Disaster Emergency in the State of New York. On March 17, 2020, I issued the Town of Greenburgh Declaration of Disaster Emergency. The public health emergency necessitating my original Order still exists and the threat to our community remains extraordinary. As of April 18, over 23,000 residents of Westchester County have contracted the COVID-19 virus. Over 675 residents in the unincorporated section of the Town of Greenburgh, as well as over 500 residents of villages in the Town of Greenburgh, have contracted the COVID-19 virus. Greenburgh and two adjoining municipalities are among the five municipalities in the County with the highest number of cases.
It is essential that residents of the unincorporated section of the Town of Greenburgh and those who shop within the town have safe access to essential businesses for food, supplies and medicines, and that the owners and staff of those essential businesses are protected so that those establishments can remain open to safely provide their essential services.
On March 12, the Centers for Disease Control (“CDC”) issued Mitigation Strategies for Communities with Local COVID-19 Transmission. These include consideration of temperature screening of staff and, if feasible, visitors.
On March 20, the Governor announced NYS PAUSE, shutting down all non-essential businesses.
On March 31, Walmart and Sam’s Club announced they were implementing temperature checks of employees.
On April 6, the Governor of the State of New York announced the policy that one cannot “be cavalier or negligent with someone else’s life. *** Now it is up to local governments to begin cracking down.”
The Centers for Disease Control current published Recommendations in effect as of April 7 include maintaining 6-foot physical distancing and the use of simple cloth face coverings. The current New York Department of Health published Guidelines updated as of April 7 include keeping at least a 6-foot distance from others and taking special caution to avoid exposing the elderly.
On April 10, I formed a medical advisory committee, consisting of local doctors and other medical professionals. A list of the members of the medical advisory committee is attached below.
On April 10, the NYS Dept. of Agriculture and Markets issued Interim Guidance for Retail Grocery Stores During the COVID-19 Public Health Emergency (”NYS Guidelines for Grocery Stores”). The Building Department hand-delivered a copy to each grocery store in the unincorporated section of the Town of Greenburgh. Also, on April 10, a local pharmacy informed me that it has instituted a procedure for curbside pickup as a safety measure for both employees and customers.
On April 13, I received confirmation from the Governor’s office that local municipalities may enforce State directives of the Governor or State agencies during the COVID-19 public health crisis.
On April 14, I issued Recommendations to Pharmacies in the unincorporated section of the Town of Greenburgh. The Building Department hand-delivered a copy to each local pharmacy.
On April 16, the Governor announced the continuation of the shutdown of non-essential businesses until May 15.
On April 18, Amazon announced it was installing thermal cameras to take temperatures of employees.
Considering these circumstances, and upon the advice of the medical advisory committee, in my judgement it would be beneficial for residents, shoppers, owners and staff if businesses and residents in the unincorporated section of the Town of Greenburgh implemented and followed the safety measures addressed in the Governor’s directives and the NYS Guidelines for Grocery Stores, the safety measures recommended by the medical advisory committee, and to the extent feasible the practices of home delivery and curbside pickup.
Thus, I am posting the following Recommendations for Businesses and Residents in the unincorporated section of the Town of Greenburgh:
1. Safety Practices
Businesses should, to the extent they have not already done so, institute the following protective public health safety measures:
- institute the public health safety measures specified in the NYS Guidelines for Grocery Stores [https://agriculture.ny.gov/system/files/documents/2020/04/retailfoodstoreguidanceforseniors_1.pdf]
- institute the CDC Interim Guidance for Businesses and Employees to Plan and Respond to COVID19, to the extent feasible [https://www.cdc.gov/coronavirus/2019-ncov/community/guidance-business-response.html]
- provide face masks (surgical, if available) to all employees, and require their use covering both their nose and mouth when interacting with each other or with customers;
- provide a hands free no-touch receptacle, lined with a disposable bag, at all exits outside the store for the disposal of gloves and face masks/coverings (open top, or open sided, or foot-operated), labelled “for used personal protective equipment”;
- establish one-way aisles inside the store and separate entrances/exits for customers, if feasible;
- provide hand sanitizers or sanitizing wipes with at least 60% alcohol for staff and customer use at entrances, cash registers and credit card machines, if available;
- add plexiglass shields at each cash/credit card area, if feasible, for the protection of employees and customers;
- post signage at entrance doors reminding customers of the Governor’s directive to wear face masks/coverings and reminding customers that masks/coverings do not replace the need to maintain physical distancing with employees and with other customers while inside and outside the store; and
- post signage at exit doors (a) reminding customers of the Governor’s directive to use face masks/coverings in public, (b) encouraging customers to dispose of any used gloves in the receptacles provided outside, and (c) encouraging customers to exercise good hand hygiene by frequently washing their hands thoroughly, for at least 20 seconds at a minimum, with soap and warm or cold water, and not to touch their mouth, nose, eyes, ears or face with unwashed hands.
2. Home Deliveries and Curbside Pickups
Businesses should, to the extent feasible, institute a home delivery process and/or store curbside pickup process as an option. This is protective of both customers and staff, as it minimizes contacts.
Customers would be allowed to (a) order by phone and/or to order by website if the business has an existing website ordering system or can reasonably develop one, and (b) pay via credit card information supplied by the customer over the phone or website. Subject to the business validating the credit card, the items ordered would be delivered to the customer’s home or at the store’s curbside, during such hours and utilizing such delivery procedures as the business implements. The persons delivering the purchased items should wear a face mask (a surgical face mask if available). Businesses should encourage employees to wash hands or use hand sanitizer or wipes with at least 60% alcohol before and between direct contacts with the public.
Any order of prescription drugs would be subject to the customer providing the doctor’s prescription, as well as all laws, regulations and directives governing prescription drugs and the dispensing of prescription drugs.
3. Employee Temperature Checks
A. Employers should inform employees, and post notices in employee lounge areas, to take their own temperature at home daily approximately 2 hours before their work shift and not to come to work if they have fever of 100.4F or higher or if they have other COVID-19 infection symptoms such as coughing, sore throat, body aches or diarrhea. In such cases, the employee should notify her/his medical provider.
B. Each individual essential business operating in the unincorporated section of the Town of Greenburgh should make its own individual decision as to whether to temperature check employees.
While not making a recommendation for temperature checks for employees, if a business decides to do so, the medical advisory committee has advised that: (a) temperature should be taken with a no-touch temperature taking device upon employees reporting to work and also upon the request of an employee not feeling well during or after her/his shift; (b) any employee with a fever of or higher than the CDC guideline of 100.4F/38C should not be allowed to work and advised to notify her/his medical provider; (c) physical distancing of at least 6 feet should be maintained among employees having their temperature taken; (d) individual(s) taking temperatures of employees should wear personal protective equipment, including at least a surgical face mask and plastic face shield covering the front and sides of face, gloves and disposable Level 1 or 2 hospital body gown; (e) gloves should be changed and hands cleaned with soap or sanitizer between each encounter; and (f) no-touch receptacles (open top, open sided, or foot operated), lined with a disposable bag, should be provided for the disposing of the PPE. The business should make training manuals and/or videos available to the designated temperature takers on use of the devices and safe procedures for putting on/taking off the PPE. It must be emphasized that the medical advisory committee cannot confirm the protocol and procedures outlined above are totally sufficient to be reliable and safe to prevent infection spread.
4. Customer Temperature Checks
A. I considered suggesting that businesses designate specified hours each day for customers wishing to have their body temperature checked, with a no-touch device, before entering the store. The medical advisory committee advised me not to make that recommendation for the following reasons. The committee is concerned that this would give a false sense of security. Some individuals without fever can, in fact, be infected with the COVID-19 virus. On the other hand, fever may be reflective of a variety of medical reasons that are not respiratory infections. Moreover, the tests can be manipulated because the use of over-the-counter medications, such as acetaminophen or ibuprofen, can eliminate fever from someone who is infected. In addition, this process exposes one or more store employees (who are crucial to essential businesses) to many encounters and thus increases their risk of infection.
B. As noted, the medical advisory committee recommends against temperature checks for customers. If, however, a business does institute a temperature check process for customers, the medical advisory committee has advised that the business should post signage informing customers of risks and limitations, including at least the substance of the following: Temperature taking is an imperfect tool. The temperature takers are not medical professionals trained to use the temperature taking devices. The devices may have design or manufacturing flaws, may malfunction, or may not be calibrated correctly. Body temperature at a particular point in time is not a medically valid indication of whether an individual has or does not have the COVID-19 virus (an individual with body temperature below 100.4F may have the virus and, conversely, an individual with a fever of 100.4F or higher may not have the virus).
5. Experiences with Temperature Checks
Based on discussions I have had with business owners, I believe some businesses are proceeding with some form of temperature checks. It would be most helpful if they would email me with their experiences (positive, negative and practical) with no-touch temperature devices and/or thermal cameras. I may post additional information on temperatures checks, and/or recommendations (supportive or negative) regarding temperature checks, in the future.
Restaurants may want to consider a concept, which is developing in New York City and parts of Westchester County, of offering products available from their supply chains, such as meats and produce, for home delivery or curbside pickup. Some restaurants are offering pre-packaged “kits” with everything needed to prepare a meal at home. If any restaurants in the unincorporated section of the Town of Greenburgh institute services like these, it would be helpful if they email me.
7. Recommendations are Voluntary
These Recommendations, as updated from time to time, will be posted on the Town website. While the Governor’s directives are legally mandatory, these additional Recommendations are voluntary.
Businesses are requested to notify the Town Supervisor by email (email@example.com) if they are following these Recommendations (listing any exceptions), so the Town can post the names of these businesses on the Town website and residents can be aware of those establishments which are implementing the Recommendations.
Residents should take full advantage of all safety measures provided (e.g., one way aisles; separate entrances/exits; physical distance markings; hand sanitizers; no-touch receptacles; home delivery and curbside pickup). Residents should follow the Governor’s directives to use face masks/coverings in public and maintain physical distancing.
Also, residents utilizing home delivery and/or store curbside pickup are advised as soon as practicable to wash their hands thoroughly, for at least 20 seconds at a minimum, with soap and warm or cold water after touching the bags and delivered items, and not to touch their mouth, nose, eyes, ears or face before washing their hands.
Please remain vigilant. Even though hopefully the ”curve” is, or soon will be, flattening and ultimately decreasing, the virus still exists . . . and, if one contracts it, can be very painful and, in some instances, deadly. Please follow safety precautions for you and your family.
PAUL J. FEINER
Medical Advisory Committee:
Maura Frank, MD, Committee Chair
Clinical Associate Professor of Pediatrics
Weill Cornell Medicine
Medical Director, New York Presbyterian-Weill Cornell Pediatric Practice
David Kudlowitz, MD,
Assistant Professor, Dept of Medicine
NYU Internal Medicine Associates, NYU Langone Health
Marc Richmond, MD, MS
Associate Professor of Pediatrics,
Division of Pediatric Cardiology
Morgan Stanley Children’s Hospital of New York
Iris Schlesinger, MD
New York Medical College - Westchester Medical Center
Nitin Gupta, MD
Dongming Cai, MD, PhD
Associate Professor of Neurology
Icahn School of Medicine at Mount Sinai
Jitanda Barmecha MD, MPH, SFHM, FACP
Associate Professor of Medicine, CUNY School of Medicine
SBH Health System, Bronx, NY
Nicole Park, FNP, CDCES