Attachment J-1b Appendix B.pdf

Federal Aviation Administration Return to Workplace: COVID-19 Daily Wellness Check (1 of 1) Published on February 12, 2021 by FAA’s COVID-19 IMT

COVID-19 Daily Wellness Check

In order to help mitigate the spread of COVID-19, it is imperative that we all continually monitor and assess our health, on a daily basis.

Before you leave for a facility1, each day you are expected to review the following health questionnaire.

If you answer “YES” to any one of these FOUR (4) questions, you must NOT enter any facility. CALL your manager or sponsor for further guidance and available options.

1. Is your temperature at or above 100.4 degrees F (38.0 degrees C)?

2. Have you experienced any of the following symptoms recently?

• Fever or chills

• Cough, congestion, or Shortness of breath

• New loss of taste or smell

• New or unexplained Sore throat, Muscle or body aches, or Headache

• Nausea, Vomiting, or Diarrhea

• Fatigue2

3. Have you had a positive COVID-19 test3 within the last 14 days or are you awaiting a COVID-19 test result?

4. Within the last 14 days:

a. Have you been in close contact (within 6 feet for at least 15 minutes) with someone who is known to have COVID-19; or

b. Have you been in close contact (within 6 feet for at least 15 minutes) with someone who has any of the above symptoms of COVID-19; or

c. Have you received instructions from a public health authority or healthcare provider to self-observe, self-isolate, or self-quarantine?

When you call your manager or sponsor to discuss next steps, be prepared to provide specific information regarding when you last physically accessed any facility, for contact tracing, risk assessment, and case management for workplace protection.

1 Facility is any FAA facility, third-party facility, other federal facilities, suppliers or any other location where an employee performs work such as site audits, site inspections, investigations, and property management.

2 Fatigue is very common and a normal physiological response to sustained or intense activity. Before answering YES to fatigue it should be unusual and not responsive to rest.

3 Employees must report all positive COVID-19 test results as soon as possible after receipt. You must provide the written lab report to your manager.

APPENDIX B

EMPLOYEE COVID-19 SELF ASSESSMENT QUESTIONNAIRE

Please respond to each of the following questions truthfully and to the best of your ability. If you answer yes to any questions, please immediately notify the designated FAA representative and do not enter the facility.

Name:

Phone Number (mobile/home):

Company:

Representations

Are you currently experiencing, or have you experienced in the past 14 days, any of the following symptoms? (Please take your temperature before you answer the first question.)

Yes ☐ No ☐ Is your temperature at or above 100.4 degrees F (38.0 degrees C)?

Yes ☐ No ☐ Do you have Fever or Chills?

Yes ☐ No ☐ Do you have a Cough Shortness of breath?

Yes ☐ No ☐ Do you have Muscle Pain?

Yes ☐ No ☐ Do you have a Headache?

Yes ☐ No ☐ Do you have a sore throat?

Yes ☐ No ☐ Do you have a new loss of taste or smell?

Yes ☐ No ☐ Within the last 14 days, have you been in close contact (within 6 feet for at least 15 minutes) of someone who has an active case of laboratory-confirmed COVID-19?

Yes ☐ No ☐ Within the last 14 days, have you been in close contact (within 6 feet for at least 15 minutes) of someone who is ill, or demonstrates any of the above symptoms?

Yes ☐ No ☐ In the last 14 days, have you received instructions from a public health authority to self-observe, self-isolate, or self-quarantine?

Certification

I hereby certify that the responses provided above are true and accurate to the best of my knowledge.

Signature: Date:

The information collected on this form will only be used to determine if access to the FAA facility is permitted. It will not be shared with other entities and it is the employee’s responsibility to report symptoms or any other health related issue to the appropriate Federal, State or Local health agency.

Using the https://globalepidemics.org COVID Risk Levels Dashboard in Project Restart Decisions

COVID Key Indicator AJW-2 uses the https://globalepidemics.org COVID Risk Level key indicator of new cases per 100K people (based on a 7 day rolling average) to assess the COVID risk levels at a specific location/county.

Table 1: COVID Key Indicator

Key Indicator What Does it Tell us? How is it Calculated? Gating Color Gating Thresholds

New Cases per 100k people

Colors indicate risk levels for the county based on a 7 day rolling average

7 Day Rolling Average of New Cases/ (Population/100k)

<1 >=1 and < 10

>=10 and < 25 >=25

COVID Project Gating Criteria The COVID project gating criteria has been adjusted to account for what has been learned over the last year about COVID, project implementation, and the increased awareness and practice of standard COVID prevention protocols. ES managers, in coordination with facility/district management, must assess the risk of an activity to ensure that it can be performed safely and standard COVID prevention protocols (e.g., social distancing, face coverings, etc.) can be followed. The following is a summary of the gating criteria.

Table 2: COVID Gating Criteria by Phase <1 >=1 and < 10 >=10 and < 25 >=25

Ph as e

1A Phase 1A activities are allowable as long as the work can be conducted safely with employees following local COVID guidelines and practicing established COVID prevention protocols including social distancing, face coverings, and hand washing/hand sanitizer

Other Phases Other phase activities are allowable when the project site maintains less than 25 new cases per 100k for 7 consecutive days AND all considerations in Table 3 are evaluated

By exception with

DM/ESM/TSM

approval

*These are guidelines to support your decision making. They do not override managerial judgment and expertise. As situations warrant, make the best decision based on your expertise, judgment, and data available.

Project Considerations For projects requiring additional review and consideration, the Front Line Manager (FLM) and Group Manager should consider the project details, circumstances, COVID trend data, and applicable safety and prevention guidelines to determine how/when to proceed with the project.

Considerations include (but are not limited to)*:

Table 3: Project Considerations for Project Restarts Topics Considerations

Trend data for the county

• Is the trend in the county going up or down?

• Are local COVID conditions trending down?

Activity Risk • Is the activity relatively low risk? Can it be performed safely?

Nature of the activity • Is the nature of the activity relatively short in duration with limited interaction with others (e.g., site survey at a remote site that will take a few hours vs construction that will take several weeks and interaction/coordination with others)?

o Short duration in high risk area – can we accomplish it safely?

o Long duration activity - if we have to stop the project will it leave the facility in vulnerable state?

Crew Considerations • Is the crew size relatively small? Can proper COVID prevention protocols (e.g., social distancing) take place?

Travel Considerations • Traveling by POV or GOV: Can the employee be the sole occupant of the vehicle?

o Best practice is for employee to be the sole occupant of the vehicle and he/she must practice COVID prevention best practices at stops (social distancing, face coverings, handwashing/hand sanitizer)

• Traveling by air: Are employees able to fly on commercial air carriers to the job site? Airports and air carriers have proper COVID protocols in place

• Lodging: Are employees able to stay at reputable national hotel chains near the job site?

• Meals: Are meals generally available in the area?

Personnel Interaction Can the activity be done with limited interaction with facility personnel and/or the local community?

*Throughout the initial restart and execution of the activities, it will be important to monitor the situation closely and consider these factors throughout the project.

Detailed How-To Steps

Step 1: Identify the county for the project

• If you do not know the county, you can find it in the CWP Phases Tableau Report (https://tableau.faa.gov/#/site/_CWP/views/Phases/Download?:iid=1)

Step 2: Go to the https://globalepidemics.org COVID Risk Levels Dashboard

• https://globalepidemics.org/key-metrics-for-covid-suppression/

Step 3: Find your county and identify the color for the county

Step 4: Assess the color for the county (and trend data); make a restart decision per the phase gating criteria (Table 2) and project considerations (Table 3)

• The Front Line Manager (FLM) and Group Manager should consider the project details, circumstances, and COVID trend data to determine how/when to proceed with the project.

Step 5: Document the rationale for the decision you make

• Be sure to document the county color, new cases per 100k employees, and rationale upon making the restart decision. It is recommended to maintain this documentation throughout the duration of the activity as circumstances evolve.

Step 6: Monitor the project and COVID status throughout the duration of the project

Additional Considerations and Resources

• Locate county COVID data at:

• https://globalepidemics.org/key-metrics-for-covid-suppression/

• https://tableau.faa.gov/#/site/_CWP/views/Phases/COVIDNewCasesper100K?:iid=1

• Ensure the COVID-19 Considerations Checklist is completed and approved

• Ensure the Wellness Checklist is completed daily before the employee reports to the job site

• Ensure employees and team adhere to the ES COVID-19 Jobsite Exposure Prevention, Preparedness and Response Plan

• Be sure to coordinate with facility personnel to ensure the facility can support the employees (e.g., escort the employees at the facility) at the job site

• Be familiar with the local conditions and accessibility of where the employees are going. While the local COVID data may not be nationally available, often local officials or websites will be able to provide additional information and data on the status of COVID in that area.

o This is particularly relevant for large geographic areas with small population densities. Local conditions could vary significantly from the overall county conditions. For some large geographical areas with small population counts, the New Cases per 100K indicator may not be as informative regarding the COVID conditions in the local area. If the county has a population density less than 1.0 (less than 1 person per square mile), you may choose to rely on COVID data obtained from official local sources such as local officials and/or city/borough websites.

o County Population density data can be found at:

https://tableau.faa.gov/#/site/_CWP/views/Phases/COVIDNewCasesper100K?:iid=1

Note: The population density threshold is consistent with the Census Bureau categorization of county population densities. The Census categorizes population density in 6 different ranges; less than 1 is the lowest category used by the Census.

https://globalepidemics.org/key-metrics-for-covid-suppression/ https://tableau.faa.gov/#/site/_CWP/views/Phases/COVIDNewCasesper100K?:iid=1 https://tableau.faa.gov/#/site/_CWP/views/Phases/COVIDNewCasesper100K?:iid=1