For many years, Retirement Communities have done a great job of cleaning and sanitizing their facilities. There are myriads of sanitizers, sprays, wipes, and other products that have allowed operators to keep their facilities clean. However, the current situation with COVID-19 raises many concerns for facility operators. Questions surround the following issues:
- Safety: How do we know we are providing a safe environment using the same products we have always used?
- Frequency: Do we need to increase the frequency of our cleaning practices?
- Products: Should we source new products, or do we just use more of the existing products?
- Levels: To what level of cleaning should we strive to guarantee a safe environment for our residents?
These are questions I imagine most, if not all, facility operators are asking themselves right now.
To begin answering these questions, I went to the CDC Website to learn the differences between cleaning, sanitizing, and disinfecting. Here is what I found they have to say:
Cleaning is the first and most important step in controlling the spread of infectious germs.
Sanitizing is a step up from cleaning. Sanitizing is about removing visible contamination and debris, and dramatically lowering the number of germs on a surface. To be considered a sanitizer, according to the CDC, a product must reduce bacteria on a surface by at least 99.9%.
Disinfecting is the destruction of viruses, bacteria, and fungi that have come into contact with surfaces or skin. Proper disinfection renders a surface highly unlikely to transmit infection or cause disease. According to the CDC and the EPA, a disinfectant must kill pathogens by at least 99.999%.
Here is where I introduce some science. Log Reductions, or logarithmic reduction, is omnipresent in the world of disinfection and cleaning. This is the basis upon which science measures reductions in bacterial and viral contaminations. A log reduction stands for a 10-fold (one decimal) or 90% reduction in numbers of live pathogens.
Based on this, to be labelled a sanitizer, the product will kill at least 99.9% of germs and pathogens, which, until recent times, has proven sufficient. Sanitation at this level is equivalent to a log reduction of 3.
In comparison, disinfection requires a minimum log reduction of 5. A level 5 log reduction reduces pathogens and viruses by 99.999%. Note here that each step in log reduction has a factor of 10. Where sanitizers’ pathogen destruction rates are increased by 1000 times, disinfectants are increased by 100,000 times.
It is apparent that, with the arrival of COVID-19, our “new normal” will require disinfecting over sanitizing from now on. I do not foresee that new safe practices implemented during this crisis are temporary, where we then fall back into old practices once the threat has “passed.” In fact, it seems evident that these new, safe disinfection methods are establishing our new normal.
The following steps outline a best practice approach for Retirement Facility in this new era of disinfection.
Step One—Products and Processes: Establish which products or processes fulfill a log 5 level of pathogen destruction. Refer to what the regulatory agencies (EPA, CDC, etc.) confirm as proving effective against COVID-19 with log 5 reduction levels.
Step Two—Safety: Measure safety levels for each of the products/processes identified in the above step by asking the following:
- Is the product “green” with low, or no, environmental impact?
- Is it safe to use in abundance around humans, including, patients and children?
- What are its toxicity levels, especially considering long-term use?
- Do staff need PPE (Personal Protection Equipment) when handling the disinfection product?
- Is it safe for residents to use inside the facility?
- Are there products that are so non-toxic they can be used to clean surfaces and sanitize hands as well?
Step Three–Comparisons: The following questions can be used to further narrow your choices.
- Which product and process will work best in your facility and why?
- Which product will be available to buy, given current and future supply/demand constraints?
- Does it make sense to continue buying liquids and sprays produced by others? Or is it better to invest in a system where you can produce your own solutions on demand as needed?
- Which product and process is the most cost effective? Sprays and liquids offer a more straightforward comparison; however, when considering the investment into your own production process, as with SAO (Stabilized Aqueous Ozone) and HOCL (Hypochlorous Acid) , amortizing over time against other disinfection products in your short list will establish the payback period. Once the equipment is paid for, the cost typically drops dramatically.
Step Four—Application: These questions allow further consideration.
- Will your processes change?
- Do you introduce fogging of the entire facility, and if so, how many times per day?
- Do new products or processes require you to increase the number of times per day you wipe down equipment or mop the floors?
- Will you provide personal protective sprays to residents for application on workout equipment, locker rooms, and doorknobs, and to use as hand sanitizers to keep themselves safe while in their public spaces?
- Will you go with a different product for each application, or will a single disinfectant solution work for all applications inside the facility?
Step Five—Product and Process Selection: The questions above are important, as they inform the type of disinfectant products or systems that will work best in your environment. These are the bases upon which sound decisions can be made. Make your product and process selection and implement it accordingly.
Step Six—Promote: Sell your new process to your residents.
Once you have made your product and process selection, how will you assure your residents that you have stepped up your practices from sanitizing (level 3) to disinfecting (level 5)? With the exception of fogging and frequency, residents will likely not notice a difference in what you are doing. Perception is key!
It is vital to share your game plan with your residents so they can see how serious you are, how you have stepped up your disinfection processes, and how they can ultimately feel safe returning to their public spaces in the community. They will appreciate the changes you have made. Education is an important component to achieve the member confidence you seek.
Here are promotion steps you can consider:
- Post notices around your facility that explain some of the science involved.
- Use your social media platform to explain the changes in your practices.
- Keep residents informed of your changes every step of the way, so their confidence builds during their absence, and so they notice the changes upon their return. Social media, emails, newsletters, and even texts are all great platforms to use for this kind of message!
In summary, though the new normal is very likely here to stay, perhaps it is not such a bad thing. Finding new and different ways to destroy pathogens, while keeping people safe from the very things we are using, seems like a benefit. The products are out there, and they work. They may even produce a positive change on budgets, time, and processes. Retirement Communities focus on and are about health. What better places for people to experience the benefits of clean, disinfected surfaces that are safe for everyone? At the end of the day then, our new normal becomes a win/win for all.