General guidelines
People walk in and out of every building, but are you able to ensure they keep the necessary distance when they cross paths? Separate incoming and outgoing flows. Another option may be to create separate entrances and exits by temporarily opening an unused door or emergency exit. Leave doors open as much as possible to avoid contact with handles.
 

In the case of non-urgent care, it is assumed that the patient/client has no symptoms indicating a corona infection when entering the organisation/practice. Persons with symptoms may not enter and will be referred to a physician. If in doubt, you may speak to your patient/client about this.
 

Specifically for hospitals

Depending on the number of new registrations, a triage of Covid and non-Covid patients will take place at the emergency department. Ideally, each patient should be given a surgical mask pending medical confirmation.
 

Specifically for residential care centres

A facility may have only two entrances: the main entrance and a supply access entrance. Both entrances remain closed. Those who wish to enter the facility must therefore ring the doorbell. All deliveries - including from the pharmacy - are handed in at the entrance.
 

In this document, Zorg en Gezondheid Belgium lists all the measures.
 

Specifically for outpatient care
First of all, during a telephone consultation, you determine whether the patient/client's request for care is urgent or necessary. After all, non-urgent care must be postponed. Via Sciensano, you will find specific information about this.
 

With patients/clients who need to come for consultation, make an appointment to prevent infections in the waiting room. Only minors and persons in need of care may be accompanied by one person. All other patients/clients come to the practice on their own. Refer people with Covid symptoms immediately.
 

It goes without saying that visit guidelines are strictly observed. Communicate these measure clearly to family members and other visitors. You can do this via the website of the care institution, your newsletter, posters, the website of the city or municipality, the local press, and so on.

When in contact with colleagues, patients, clients, visitors, suppliers, etc, make sure there is always enough distance. Place a physical barrier or markings at an appropriate distance, or provide Plexiglass screens. Also, limit the number of people who are in the same room at the same time.
 

Tip: Hang this poster in clearly visible places to remind employees, patients, clients and visitors of the basic rules. This is because people also have to adhere to the rules in dressing rooms, toilets and the staff cafeteria.

During contact with external parties, try to minimise the exchange of documents and objects. For example, your receptionist can complete the logbook and allow visitors to pick up their visitor’s badge themselves. Confirmations and receipts can be emailed or placed in a letterbox.

The doors of your facility are locked, so suppliers can't simply walk in and out to deliver their goods. It is also important to avoid direct contact with external parties as much as possible. This step-by-step plan can help to keep deliveries on the right track:
 

• Step 1: the supplier rings the doorbell or contacts the person in charge by telephone.
• Step 2: the delivery is placed at the door, preferably shielded (e.g. under an awning, in a letterbox, in a plastic box).
• Step 3: your employee brings the delivery inside and does a visual check.
• Step 4: your employee verbally confirms that the delivery has arrived correctly and reports any shortcomings.
• Step 5: if necessary, your employee will inform you of the delivery via email (i.e. shortcomings).

Remind employees and visitors of the hygiene measures as often as possible. Did you know you can use our ready-made posters about coughing and sneezing, hand hygiene and general precautions against coronavirus for this?
 

Important: Your employees should always have enough handkerchiefs to cover their nose and mouth while blowing their nose, sneezing and/or coughing. They must throw the used handkerchief away into a closeable bin immediately, and then wash their hands straight away.

Only receive external parties (e.g. suppliers, contractors, representatives) physically in your organisation for essential activities. In addition, limit their presence in terms of the number of people, duration, and spaces visited. External parties in contact with patients/clients should preferably wear a surgical mouth mask.
 

Tip: make agreements about this before restarting, and email your instructions to all concerned.

It is important you receive the necessary instructions from your client before your first visit or starting work.

Respect all hygiene measures during a consultation and try to keep as much distance as possible.
 

Sciensano developed detailed proceduresfor hospitals, general practitioners, specialists and other health care providers to implement a Covid triage, take a sample, confirm a death and so on. For measures and points of attention for your childcare centre, please refer to Child and Family.

If a patient/client needs to come to you for consultation, this is only possible by appointment. After all, you must avoid patients/clients infecting each other while they are waiting in your waiting room.

Hang the guidelines to which your patients/clients must adhere in clearly visible places.

You can limit the spread of the coronavirus by ventilating your rooms properly. Opening the windows regularly is the message. If you have a ventilation system, ensure regular maintenance and have the filters replaced or cleaned when they are due.
 

Do not use individual fans that can spread the virus.

Check which doors can be left open. These may be able to provide extra ventilation, for example, or act as an additional entrance or exit. Always take fire safety into account, as well as the risk of unwanted visitors or theft. Close doors that must stay permanently closed.
 

Important: Place a notice on all closed doors. This will prevent people grabbing the door handle to feel if it is actually locked.

To guarantee social distancing, ensure there is a clear layout of the workplace: use floor markings, pictograms, barrier tape and so on. Physical barriers can be placed between work stations which are close to one another. Instruct your employees not to enter rooms in which they are not required.
 

Covid and non-Covid patients are treated in physically separated wards. Using signage, you clearly indicate where the Covid department begins and you illustrate clearly which safety guidelines apply.

When restarting work activities, always check for employees who are out of sight or hearing range of colleagues. If this is the case, these persons must have an alarm device (e.g. mobile phone, telephone, walkie-talkie, fire alarm, etc.). Work activities in dangerous conditions must never be entrusted to a single isolated employee. There should always be a second person in the vicinity who can quickly raise the alarm and has the proper protective equipment for urgent assistance.

Only essential meetings that cannot be organised remotely may take place on location. In this case, choose a space where you can respect social distancing, and keep the number of participants to a minimum. Keep an attendance list of each physical meeting for one month.

A lift is an essential tool in transporting heavy goods efficiently from one floor to another. However, it is a small space and maintaining a sufficient distance is not always easy.
 

Tip: motivate your employees to choose the stairs as much as possible by hanging this poster in a highly visible place.

Motivate your employees to always grab the banister when using the stairs. They can use their sleeve or a tissue to grasp the handrail. Provide bins with foot pedal in the staircase; at the beginning, at the end or in different overflows and inform workers to throw the tissue into the trash immediately after use. In addition, you can also provide a hand alcohol gel per floor in a holder so that employees can disinfect their hands before and after using the stairs. Also make sure that the cleaning of banisters and handles (of the doors that lead to the staircase) is included in the cleaning program.

It is also no easy task to keep your distance in vehicles. This is why your staff should only make essential trips and limit themselves to one person in a vehicle. Try to ensure each vehicle is linked to one employee. If this is not feasible, the vehicle must be thoroughly disinfected after each use.
 

Ambulance personnel protect themselves with surgical masks and also ask the patient to use one. For interventions with a risk of aerosol formation (i.e. intubation, aspiration of the respiratory tract, resuscitation), the emergency workers wear FFP2 masks. Suspected Covid patients are always transported individually. After the intervention, the vehicle is completely cleaned and disinfected.
 

Transportation of persons requiring assistance is permitted, provided that the driver only transports one person at a time.
 

If you come by public transport (train, tram, bus), follow the instructions of the transport companies. As from 4 May and from the age of 12, wearing a mouth mask or an alternative covering mouth and nose is compulsory in public transport in the stations, on the platforms and on board of the trains.

Social distancing is also relevant during breaks. Therefore, remove chairs until the necessary distance between employees is guaranteed. Have them sit diagonally across from one another at a table, organise lunch breaks in shifts, or set up additional break rooms. Taking breaks or lunch outdoors is also an option if the weather and infrastructure allow it. 
 

TIP: Cups, plates and cutlery should preferably be cleaned in the dishwasher. In this case, the virus has no chance of survival. If there is no dishwasher on the work floor, make sure you clean everything manually with a clean sponge.

What kind of measures can you implement when you have changing rooms and showers in your company?

It is beyond dispute that everyone must adhere to the prescribed instructions in the event of a fire. If you cannot guarantee social distancing at your existing muster point during an evacuation, provide an additional location. 
 

All further guidelines remain in force:

• Step 1: carry out a visual check immediately after notification via the fire detection system.
• Step 2: if there is a fire, apply horizontal evacuation. In concrete terms: switch on the building's extensive compartmentalisation facilities and close fire doors.
• Step 3: call the emergency services on 112.
   

Please note: your fire-fighting team must also respect the social distance rules as much as possible during interventions. Reserve necessary personal protective equipment for interventions.

If water sources (for example, taps, sprinklers, showers, humidifiers) or pipe sections connecting them do not have fresh water flowing through them for more than a week, legionella can develop in them. This bacteria is the leading cause of Pontiac fever and Legionnaires’ disease.

When cleaning, absolute priority is to be given to surfaces, door handles, switches, telephones, printers, coffee machines, keyboards, and so on. Work equipment and aids (i.e. lifts, baths, wheelchairs) must be disinfected after use with a 1000 ppm chlorine solution. To reinforce this, your cleaning programme may need to be reorganised, both in terms of frequency and cleaning equipment.
 

Check the instructions for the maintenance of hospital and rest home rooms.
 

TIP: Cups, plates and cutlery should preferably be cleaned in the dishwasher. In this case, the virus has no chance of survival. If there is no dishwasher on the work floor, make sure you clean everything manually with a clean sponge.

Ask your employees not to wear jewellery or watches. Hang clearly legible instructions about hand hygiene at every washbasin. Hand washing is mandatory:
 

• before and after any care contact with a patient/client,
• prior to a sterile or invasive treatment,
• following contact with the immediate environment of the patient/client,
• after removing gloves.
   

After contact with bodily fluids (i.e. blood, mucous membranes), hands must be washed and disinfected. Gloves should be changed after each treatment, after which hand hygiene is applied.
 

Hang clearly legible instructions about hand hygiene at every washbasin. Inform employees to close the water tap with a paper towel or close the tap with the elbow after washing and drying hands. Also underline the importance of good toilet hygiene. Specifically: leave the toilet clean, flush and close the toilet lid.
 

Tip: Points for attention for bleach as a cleaning agent and disinfectant.

Provide sufficient quantities of soap – preferably in soap dispensers – paper towels and closable bins, if possible with pedal control. Provide sufficient hand alcohol gel on the nursing carts and soap with disposable towels in the washrooms.
 

Avoid using electric hand dryers or towels.

First and foremost: the risk of corona contamination via waste is minimal. Correct, efficient waste collection is crucial to avoid additional hygiene and health risks. Remove full bins or bin bags from the work floor immediately. Waste collectors must wear gloves.
 

Important: uncontaminated personal protective equipment (i.e. gloves, masks, aprons) are not medical waste.
 

In this info sheet, you can read how to handle these materials correctly.

There are also specific guidelines for the processing of linens in the Covid departments.

Emergency services belong to a risk group for corona infection, and Covid-19 is therefore eligible for occupational illness recognition. The application for compensation must, however, include a lab test result confirming the infection.

Kitchen staff will of course continue to work according to the HACCP regulations. In addition, they are given a surgical mouth mask and gloves as personal protective equipment.

If an employee feels ill and exhibits flu-like symptoms (e.g., fever, cough, shortness of breath, runny nose, sore throat, headache, muscle aches, fatigue), send him/her home immediately to contact the doctor. Anybody with respiratory complaints must not come to work.
 

Important: healthcare workers may continue to work if they only show mild symptoms of Covid-19 and wear a protective mouth mask. In the government's corona FAQ you'll find more details.

Your employee can come to work, even if a housemate is ill. It is important that this employee follows the same instructions as other employees

The government is going to trace those who have been in close contact with a corona patient. If your employee has been in contact with a corona patient he may receive a phone call from a contact tracer working for the government. They will advise him what measures to take depending on the nature and the length of the contact. Provided your employee receives no guidelines (government, doctor, etc.) and shows no symptoms he may go out to work.

Employees who are mentally troubled (for example, stress, workload, work-life combination), feel anxious or are mourning the loss of a loved one can contact the Mensura psycho team during office hours for a confidential conversation.
 

We can also activate a 24/7 helpline for your staff. Would you like to know more about this? Send an email to psychosociale-aspecten@mensura.be.
 

In these exceptional times, it is crucial that we all take good care of each other. With our posters you put that in the spotlight.

Even if your non-Dutch speaking employees have mastered our language reasonably well, they may still lack certain nuances. This can lead to misunderstandings. Therefore, provide basic information in the native language of your employees.

Your emergency responders are trained to provide first aid to victims, but their own health must also be guaranteed. If a victim can take care of their own injuries, the emergency responder can give instructions from a safe distance. If this method is not feasible, then the care must be provided as quickly as possible while wearing a face mask and gloves. Since the coronavirus is transmitted through saliva drops, talking must be kept to a minimum while care is being provided. During resuscitation, the emergency responders must only use chest compressions or an AED, not mouth-to-mouth resuscitation. Bystanders must vacate the area or remain at a safe distance.

Face masks are part of the lockdown exit strategy. It is important that we wear them, but it is crucial that we continue to respect the hierarchy of the prevention measures. Specifically: when the first measure in the hierarchy cannot be respected, only then does the measure in the level below come into force.
 

Face masks are at the bottom of the ranking and are only recommended if all other measures are not feasible.
 

Preventive measures according to hierarchy 

1. Stay home, especially if you are sick. 
2. Work from home whenever possible if the job allows for this. 
3. Maintain a distance of at least 1.5 metres, indoors and outside. 
4. Wash your hands often with soap and water. 
5. Wear a mouth mask on public transport and when social distancing cannot be guaranteed.
6. Limit your physical social contacts.
    

Infographic: 'How to wear a face mask safely'

Employees who come from abroad need extra follow-up to prevent the spread of the Corona virus. Mensura developed a procedure for this:

• Suggest your employee to be quarantined for 14 days before the first working day at the workplace. Please note: you cannot enforce such a measure, so in practice this voluntary self-isolation may not occur often.
   
• If your employee does not like the quarantine period, ask him or her to complete this medical questionnaire. Based on this, our employees provide you with customized advice.
  • Questionnaire for province of Antwerp
  • Questionnaire for province of Limburg
  • Questionnaire for province of East- and West-Flanders
  • Questionnaire for province of Flemish and Walloon Brabant
  • Questionnaire for province of Hainault, Namur or Liège
  • Questionnaire for province of Luxembourg

Would you like to know more about this procedure? Please contact your contact person or your regional Mensura office.