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EMPLOYEE GUIDE TO A HEALTHY & SAFE

WORKPLACE

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Table of Contents

Texas State University Board of Regents ....................................................................................... 1 Introduction ....................................................................................................................................... 2

Purpose ........................................................................................................................................... 2 An Evolving Situation ....................................................................................................................... 2 Maintaining and Inclusive Community ............................................................................................. 2

Returning to the Workplace Guidelines, Expectations & University Operations ........................ 4 Guidelines ........................................................................................................................................ 4 Expectations .................................................................................................................................... 4 Status of University Operations ....................................................................................................... 5

Returning to the Workplace Guidance for Supervisors ........................................................................ 6 Guiding Principles to Bringing Your Team Back to the Workplace .................................................. 6

Health & Safety Guidance-Practices to Reduce Virus Transmission and Promote Wellness .... 8 Personal & Community Safety Practices ......................................................................................... 8 Keep Wellness in Mind .................................................................................................................. 14

Health & Safety Guidance-When an Employee or Student is Diagnosed with COVID-19 ......... 15 Expectations of Faculty/Supervisors .............................................................................................. 15 Expectations of Employees............................................................................................................ 16

Tools & Training ............................................................................................................................................ 17 Policies & Resources ................................................................................................................................... 17

Strategies for Excellent Remote Work ........................................................................................... 17 Time & Leave-COVID-19 ............................................................................................................... 17 Remote Work-COVID-19 ............................................................................................................... 17 Website Resources ........................................................................................................................ 18

Appendices ...................................................................................................................................................... 18

The Texas State University System Board of Regents William F. Scott, Chairman, Nederland | David Montagne, Vice Chairman, Beaumont | Charlie Amato, San Antonio | Duke Austin, Houston | Garry Crain, The Hills | Dr. Veronica Muzquiz Edwards, San Antonio |Don Flores, El Paso | Nicki Harle, Baird | Alan L. Tinsley, Madisonville | Katey McCall, Student Regent, Orange | Brian McCall, Ph.D., Chancellor

Texas State University, to the extent not in conflict with federal or state law, prohibits discrimination or harassment on the basis of race, color, national origin, age, sex, religion, disability, veterans’ status, sexual orientation, gender identity or expression. This information is available in alternate format upon request from the Office of Disability Services. Texas State University is a tobacco-free campus.

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INTRODUCTION

Purpose

Globally, institutions of higher education are facing unprecedented challenges related to Coronavirus Disease (COVID-19). Thus, Texas State University developed the Roadmap to Return for Summer II and Fall 2020. Informed by the latest public health guidance and research, as well as input from our university community, the Roadmap is designed to keep our community safe and our students advancing toward their educational goals. The Roadmap presents a phased approach, with built-in flexibility, to ensure access and quality for our students through the delivery of a combination of in-person, online, and hybrid instruction and support services.

This Employee Guide is integral to the Roadmap to Return. It supports faculty and staff, including undergraduate and graduate student workers with the resources, guidance, and processes to share in the responsibility of returning to some level of face-to-face instruction and student support services safely and successfully. We acknowledge that there will continue to be cases of COVID-19 on our campuses and in our communities. Texas State University’s policies and protocols outlined in this guide are rooted in the recommendations of the eight working groups established in the spring of 2020 and these four principles:

I. The health and safety of all members of the community are paramount. Special care and attentionmust be given to the needs of higher-risk populations.

II. We embrace the notion that all major dimensions of our university can benefit from being reimaginedto address the impact of the COVID-19 pandemic and beyond.

III. Our commitment to academic excellence must not wavier under these challenging circumstances.This commitment crosses all instructional modalities — face-to-face, online, and hybrid delivery,and research activity.

IV. Equity and inclusion are critical components of our response. The economic, health, academic, andoperational challenges are immense. It is incumbent upon us to engineer responses that serve andsupport the entire community

An Evolving Situation

Our knowledge and understanding of COVID-19 continue to evolve and the epidemiological situation continues to change. As such, our policies and plans will be updated accordingly. Please note the version date of this guide in the bottom left-hand corner of each page. The latest information, including the latest version of this guide, can be found at txstate.edu/coronavirus and will be shared by email and other communication channels with students, faculty, staff, parents, and constituents as conditions change.

Graphic A below illustrates some of the many facets that we are considering as our plans continue to evolve. Maintaining an Inclusive Community

Texas State University is committed to maintaining an educational, working, and living environment that is free of all forms of racism, discrimination, harassment, and sexual misconduct. For every member of our community to thrive—especially as we continue to navigate life and university operations during a global pandemic—all of us must seek to foster mutual respect, support, and inclusion.

During this public health event, where there are many unknowns, taking care of each other is just as important as taking care of ourselves. Making assumptions about or engaging in negative treatment of others based on perceived symptoms, medical conditions or abilities, national origin, racial and ethnic characteristics, or any other protected status hurts our community. Every person’s care, compassion, and empathy for each other makes a positive difference and represents a commitment to our shared values.

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Graphic A from www.opensmartedu.net

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RETURNING TO THE WORKPLACE | GUIDELINES, EXPECTATIONS, AND UNIVERSITY OPERATIONS

Guidelines

This guide is aligned and consistent the state of Texas’ Phased Reopening Plans issued by the Governor, as well as local orders and ordinances of the City of San Marcos, City of Round Rock, Hays County, and Williamson County. The University’s plans are based on research and recommendations from the federal Department of Education, Centers for Disease Control and Prevention (CDC), Texas Department of State Health Services, and the TXST COVID-19 work groups, and will continue to evolve.

Expectations

The success of our plans to mitigate the spread of COVID-19 requires us to adhere to a key set of expectations that should guide the actions of all students, faculty, staff, and visitors to our campuses and facilities. They are presented here in brief and described in greater detail later in this guide.

• Mask UpWear a cloth face covering indoorsand outdoors – IT’S REQUIRED.The useof two-ply cloth face coverings isthe cornerstone of our plan tocombat the spread of COVID-19.Face coverings need to becomesecond nature to all of us and wornat all times while on our campusesunless you are alone.

• Make SpaceMaintain social distancing of at least6 feet whenever possible.

• Wash UpPractice proper hand hygiene.

• Cover UpCover your mouth and nosewhen you cough or sneeze

• Clean UpHelp us keep our workspaces clean so that ourcustodial staff can focus on high-traffic areas.

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• Stay Home

Stay home if you are sick.

• Check Yourself

Conduct a daily self-assessment for symptoms of COVID-19.

• Request Modifications

Request additional modifications if you are at higher risk for complications from COVID-19.

• Be Flexible

Be ready to adjust plans based on the course of the virus, and health and university officials’ directives. 

• Be KindBe helpful and considerate; show genuine care - the current situation is adding significant anxiety and stress to an already stressful world.

• Show SolidaritySupport one another – no one person can completely prevent or control transmission of COVID-19 - we are all in this together.

• Show RespectDo your part to follow these guidelines and show respect to one another and to our community at large.

Status of University Operations

Post-Spring Break 2020

• COVID-19 cases were rapidly increasing; public health stay-at-home orders were in place.• Best practice measures for virus prevention were not known or widely in place other than the shelter-at-

home approach.• Everyone not needing to live in a residence hall or to provide critical services on the campuses

transitioned to remote teaching, learning, and work.• University was operating with critical services and facilities only.• All travel was canceled.Summer beginning July 6, 2020, and Continuing through Fall Semester 2020• COVID-19 cases still increasing in many areas, but public health systems rapidly increasing capabilities

for testing, contact tracing, and other prevention methods.• Best practice measures for slowing the spread of the virus known and mandated on our campuses.• Many work modifications and enhanced flexibility remain in place.• On a case-by-case basis, additional workplace modifications may be requested by employees who are at

a higher risk of severe illness from COVID-19.• Some face-to-face instruction resumes, either fully face-to-face following the 50% room capacity

guidance or as a mixture of face-to-face and online delivery.• Research facilities and activities resume with modified processes.• Campuses operate with reduced density of personnel, offering both face-to-face and remote delivery of

typical summer student services.

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• Remote work encouraged when possible to reduce workplace density. All units that normally provideface- to-face student services in the summer must continue to do so with appropriate modifications toenhance public health. An appropriate level of staff must be face-to-face to continue to provide face-to-face service.

• Use of cloth face coverings required on our campuses and in buses.• Student activities, employee meetings, and all other group functions must follow 50% room capacity

maximum. When possible, meetings should be held remotely.• Some travel will resume for critical research and mission-specific activities.• All face-to-face summer camps are cancelled.• Student extra-curricular and co-curricular outdoor activities are limited to no more than 250 people.

Fall Semester 2020 • Reduced density efforts continue, but all typical fall student services will be available with health and

safety modifications. All units that normally provide face-to-face student services in the fall mustcontinue to do so with appropriate modifications to enhance public health. An appropriate level of face-to-face staff must continue to provide face-to-face service.

• Additional gathering locations have been identified for students to complete online coursework whileappropriately social distancing if they choose not to return to their residence halls or apartments betweenclass periods.

• All offices will have continuity plans in place to ensure smooth and quick transition from face-to-faceto remote operations should the need arise. It is particularly important that academic units expect and arewell prepared to transition seamlessly to remote instruction, thereby ensuring uninterrupted teaching andlearning

RETURNING TO THE WORKPLACE | GUIDANCE FOR SUPERVISORS

Guiding Principles to Bringing Your Team Back to the Workplace

Texas State University’s mission is grounded in being student-centered. Students have come to expect that they will receive face-to-face instruction, service, and support. We have exceptional faculty and staff who thrive with this approach. We wholeheartedly believe in the superior value of face-to-face engagement for many topics, activities, and services.

Prioritizing health and safety will require creativity in the workplace. Some services may have to be delivered remotely, some employees may have to work in the early morning hours while others work in the evenings, and some departments will need all employees present to fulfill their mission. There is not a one- size-fits-all solution – we must emphasize the need to be flexible. Most of these adaptations will not be permanent, but we must adapt and be flexible in the short-term. When the pandemic passes, we will return to many of our traditional ways of doing things, having learned some new things and we will be stronger than ever. It is important to emphasize that, even while working in alternate ways during the short-term, we must deliver the highest possible quality of service, instruction, and support.

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Identify Operational Needs • What do your customers, clients, or students expect from your office and how can you deliver?• What aspects of your operations require a physical presence to be completed?• What aspects of your operation can be completed remotely?• Can operations be performed with creative scheduling such as some employees working early morning

hours, some late evening hours, or some on weekends?• How do you make equitable decisions about who works face-to-face and who works remotely?• What support does your team need to be successful?• What can you do to maintain employee morale?• What can you do to keep your employees healthy and safe while accomplishing the mission?

Communicate with Your Team • Be clear that we must continue to provide services, instruction, and support.• Reinforce that we must continue to provide services, instruction, and support because our students are

depending on us for their education; we have made commitments to many grantors; student tuition andfees pays the salaries of most of our employees; the university plays a vital role in the local community,and has a significant impact on the entire Central Texas economy.

• Discuss with employees the best work arrangements for your office.• Supervisors are expected to be flexible with those who have extenuating circumstances related to COVID-

19.

Develop & Communicate Your Plan • Great challenges, like a pandemic, call for creative solutions. Be open to feedback and ideas.• Take charge of the planning to best protect your employees and your customers. No one knows your

office and responsibilities as well as your own team.• Consider employee preferences, performance, duties, circumstances, and strengths in operational plans.• To limit the number of people in an area at a given time, consider plans for staggered schedules where

employees work remotely on some days, or portions of days, and/or on weekends, early morning hours,late evening hours, or a combination of these.

• Prepare a back-up staffing plan in case one or more people has to self-quarantine (e.g., cross-train staff,share lesson plans with a colleague, or create a roster of trained back-ups).

• Communicate your plan transparently. Give employees time to ask questions, make suggestions, or shareconcerns on an ongoing basis.

Implement, Assess, and Adapt • Acknowledge that plans will need to be flexible and will likely change.• Increase capacity and implement schedule changes slowly, when possible, with a focus on being ready

for fall operations while allowing time to build and test new protocols in your unit.• Check in with your team to see what problems arise as your plan is put into practice. Assess solutions as

a team. Meet with your employees more frequently than normal using Teams to ensure lines of communication stay open.

• Adapt with your employees’ physical and mental wellbeing in mind, communicating changes quickly to everyone involved.

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HEALTH & SAFETY GUIDANCE | PRACTICES TO REDUCE VIRUS TRANSMISSION & PROMOTE WELLNESS Personal & Community Safety Practices

Mask Up Cloth face coverings are required on Texas State campuses unless you are alone indoors or outdoors. Alone in an indoor space means in a discrete room by yourself. Being alone outdoors means that you are not part of a group, you are not in a crowded area, and you are going out of your way to ensure social distancing of at least six feet. Noncompliance with face covering requirements will be handled through existing employee discipline and student judicial processes. The use of face coverings is the most important piece of our plan to combat the spread of COVID-19. Studies continue to show that wearing a 2-ply cloth covering reduces the chance of spread more than any other practice. Masks need to become second nature to all of us.

Cloth Face Covering Do’s and Don’ts As we prepare together to return to face-to-face instruction, it is important that your face mask meets standards set by the Centers for Disease Control and Prevention (CDC). Before you purchase or make a cloth face covering, review this checklist of CDC recommendations:

Mask Do’s Launder your mask daily or rotate between at least two masks on alternating days. Wear face coverings that: • Have at least two layers of material• Have at least one layer of a tightly woven material, such as:

o Nylon, Canvas, or Cotton (200+ thread count)o Silk or synthetic silk (100% polyester, tight weave, not very stretchable)o Chiffon (90% polyester, 10% spandex)o Spandex (52% nylon, 39% polyester, 9% spandex)

• Cover the nose and mouth completely• Fit snuggly against the sides of the face and chin so there are no gaps• Are secured with ties or elastic to prevent slipping Mask Don’ts• Do not wear face coverings that have limited filtration effectiveness:

o Neck gaiters usually made of a single layero Single-ply bandanas that do not provide a good face sealo Scarves which tend to be made of porous material

• Face coverings with exhaust valves do not protect others from you as you exhale.

Make Space Maintain social distancing of at least six (6) feet when possible both indoors and outdoors. To promote social distancing, university operations will be guided by the following:

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Fifty Percent Capacity Rule: In shared indoor spaces, occupant density is limited to 50% of rated maximum. Occupancy signs indicate the total normal capacity of each space.

Instructional Delivery: Faculty will deliver different instructional modes, based on the occupant capacity of the facilities and the educational demands/requirements of the course. They will propose modes of delivery, which include face-to-face, remote, or a combination of the two approved by department chairs in consultation with Deans and the Office of the Provost.

• Face-to-face only courses may be delivered normally when the student enrollment is no more than 50% oftheroom’s rated maximum occupancy.

• A mixture of face-to-face and remote instruction is required when student enrollment is more than 50%of the room’s rated maximum occupancy. In these cases, students attend face-to-face a portion of thetime and remotely a portion of the time.

For example, if a class, with 100 students enrolled is scheduled to meet on Mondays and Wednesdaysin a classroom that holds 100 students, then 100 students may enroll in the class. The students will bedivided into two groups of 50. One group may meet face-to-face on Mondays and another group maymeet face-to-face on Wednesdays. On the day that students are not in class, they may receive theirinstruction remotely via synchronous or asynchronous online delivery or be provided with alternativeinstructional materials or assignments. The specifics of how this affects each class will be communicatedto students by the instructor/faculty member.

The Division of Information Technology (DOIT) will equip classrooms with technological tools tosupport synchronous and/or asynchronous content delivery, and dedicate resources for faculty to deliverhigh-quality, effective hybrid and online instruction and resources for students to ensure uninterruptedlearning.

Student Activities: Indoor co-curricular activities will limit the number of people who are present at one time to 50% of the space’s capacity. Outdoor co-curricular student activities will be limited to 250 people, though this limit is subject to change based on other factors.

Pre-registration is required for all co-curricular student activities or attendance must be recorded. Departments may use the Student Affairs Event Management System to electronically record attendance. Please contact Student Affairs Technology Services at satech@txstate.edu for more information. Students may use the SignUp Reservation System to pre-register for an event.

Furniture Reconfiguration: Furniture may be reconfigured, reduced, or marked to achieve social distancing in offices, classrooms, and shared spaces by the office or department who occupies the space.

• Labeling of classroom seats will be handled by the Office of Environmental Health Safety and RiskManagement. Faculty may ask students to follow alternative seating arrangements as necessary tosupport effective instructional delivery but are asked to have students return any moveable seats totheir original positions at the end of their use.

• Additional study locations will be available, allowing for many more students than normal tocomplete online coursework on our campuses while appropriately social distancing.

• The university has very limited storage capacity for furniture removal. Please contact FrankGonzalez, Director of Materials Management and Logistics for help with furniture reconfiguration.

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On-Campus Transportation: The shuttle bus schedule and occupancy has been modified to promote social distancing . Students who ride the bus will be notified to plan for longer commute times and encouraged to walk or ride bicycles.

Reduce face-to-face meetings: Whenever possible, employee meetings should be conducted remotely. DOIT offers a variety of resources and programs to hold meetings remotely. For IT support when holding meetings remotely, contact the IT Assistance Center at 512-245-4822, via email, or via LiveChat.

Breakrooms: Alter breakroom setups to increase social distancing. Limit the number of people who are present at one time to 50% of capacity. Encourage taking breaks outdoors.

High traffic areas and forming lines: Assess facilities and operational areas and make modifications in the following ways in high traffic areas and offices where lines form:

• Clearly demarcate (e.g., with blue painter’s tape) 6-feet of space in lines.

• Limit the number of people with a door monitor in large spaces like dining halls and the bookstore.

• When walking in corridors or hallways, stay on the right side according to the direction you are heading to maximize distance when passing others.

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Wash Up

Practice proper hand hygiene. Frequent hand washing is one of the most important things we must do to keep our community safe. When hand washing is not possible, hand sanitizer is a good substitute.

• Students will be issued personalhand sanitizer misters.

• Hand sanitizer refill stationswill be located throughoutthe campuses. Thesestations will be refillednightly with hand sanitizermanufactured by TexasState’s College of Scienceand Engineering.

• Hundreds of hand sanitizingdispensing stations will bedeployed at the entrance tobuildings and other high- traffic areas.

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Cover Up • Cover your mouth and nose when you cough or sneeze using a tissue or your elbow. Review the CDC guidance

for best practices on covering coughs and sneezes.

Clean Up • Help us keep our workspaces, classrooms, and breakrooms clean so that our custodial staff can focus on high-traffic

areas.• Custodial services will spray classrooms nightly with a hospital-grade sanitizer using an electrostatic sprayer. The

concentration is sufficient to kill the virus but low enough not to damage fabrics or corrode metal surfaces. Theproduct has a long track record of use in hospitals and is safe

• All classrooms will be equipped with surface sanitizing supplies, including sprayers, cloths, anddisposable gloves for instructors’ use. Instructors are not required to clean surfaces as the nightlycustodial cleaning is powerful, but the supplies will be there if an instructor would like to do so.Custodial services will clean and restock supplies as needed.

• Custodial services will focus manual cleaning and disinfecting efforts on high-touch areas.• At the Student Recreation Center, surface sanitizing supplies are available for users of high-touch

equipment to clean equipment regularly. Do your part to clean exercise equipment after each use.• In breakrooms, handles on refrigerators and microwaves, and control panels on microwaves and

vending machines, should be sanitized regularly.

Check Yourself All employees must conduct a basic self-assessment for symptoms of COVID-19 every day before they come to work— a critical step every Bobcat must take to keep our community safe.

Below are some, though not all, of the university facilities or departments that are requiring mandatory on-site assessments, which include COVID-19 symptom and temperature screening, for all staff every day:

• Child Development Center (twice per day for staff and children)• Student Recreation Center• All Athletics Facilities (including Bobcat Stadium, exercise rooms, etc.)• Dining Services Facilities• University Police Department• Student Health Center

Stay Home Conduct a daily self-assessment. Sick persons must stay home. This includes anyone exhibiting symptoms who is not yet diagnosed with an illness.

Employees must follow appropriate polices for providing notice when sick. The university provides several leave and benefit options for our employees, which have been enhanced with the Families First Coronavirus Relief Act provisions.

If an employee shows up to work and is symptomatic, their supervisor must direct them to leave the workplace immediately and report the incident. Employees who come on university property while they have been directed to self-isolate or self-quarantine will be subject to discipline.

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Optimize Ventilation Indoor ventilation is being evaluated and optimized across our campuses. Many university departments are collaborating with Facilities Operations to evaluate and identify spaces where indoor ventilation improvements are warranted, following a set of guidelines being used by many large universities across the country. This optimization involves:

• Maximizing the amount of outside air introduced into our buildings• Decreasing temperature while maintaining humidity control• Optimizing space pressurization• Increasing air changes per hour

Set Boundaries Facilities Operations is leading efforts to place physical barriers, such as plexiglass sneeze guards, in key areas where there is significant face-to-face interaction. Examples of facilities on-campus where new physical barriers have been installed include the Alkek Library, the Office of Financial Aid, and the Testing Center.

Request Additional Modifications Faculty and staff at higher risk for complications from COVID-19, as defined by the CDC, can request additional working or learning modifications. To request these accommodations, visit COVID-19 Employee Special Request for Additional Workplace Modifications. Employees who request and are approved for a modification to work remotely, are required to complete a remote or telecommuting work request form.

COVID-19 workplace modification requests are being received and reviewed by the ADA Compliance Coordinator (ADACC). The review and approval process is modeled after our ADA Workplace Accommodation process and is an interactive process between the employee, their chain of command, and a member of the modification review team. Medical-related information submitted in support of a workplace modification request is considered confidential and will be reviewed and maintained solely by the ADACC.

It should be noted that these COVID-19 related workplace modifications are not considered ADA Accommodations and that individuals who have a disability and require a workplace accommodation should reference the Workplace Accommodation Policy UPPS 04.04.60 for additional information.

Faculty and staff with questions about circumstances or conditions not listed above may consult with their department chairs/school directors/supervisors about safeguards and options for alternative arrangements. While they may not meet the CDC definition of being at higher-risk, they may still have valid concerns and challenges, such as being the care giver for someone who is at higher-risk or dealing with the lack of childcare options. The university is sensitive to these issues. Chairs/school directors/supervisors are asked to provide flexibility when considering alternate work or teaching arrangements for individuals in this situation. However, the work of the university must go on with every employee doing their part. Employees will also be able to work with Human Resources to utilize the expanded Family Medical Leave Act provisions or to consider a leave of absence. Transportation Cycle or walk across campus when possible as our buses will have reduced capacity and wait times will be longer than normal. Review the updated Bobcat Shuttle Service Schedule.

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Doors Interior doors can be propped open to prevent the need for touching doorknobs and to increase airflow. However, closed doors can help with maintaining access control and limiting occupancy at any given point in time. This will be a local decision. Exterior doors should never be propped open.

Using Elevators Take the stairs, when possible. Limit the use of standard-size elevators to three individuals at a time, creating a triangle to avoid close contact. Face coverings must be worn in elevators and all individuals should face the elevator doors. As appropriate, individuals subject to the Americans with Disabilities Act may ride the elevator alone or accompanied by the individual’s caregiver.

Take the Pledge Being part of our Bobcat community means we respect each other and commit to helping create a healthy and safe learning and working campus environment. Every student, faculty and staff member must take responsibility for practicing healthy behaviors and following the health and safety guidelines established by Texas State to prevent the spread of COVID-19 on campus and in the surrounding community. Take the Pledge, today!

Keep Wellness in Mind

Taking care of yourself is important, now more than ever. Access the multiple resources available to you as an employee to help you stay well and cope with the additional stress the pandemic may have brought on.

• Bobcat Balance, an employee assistance program, offers you and members of your household variousfree and confidential services and resources to help you through life’s challenges.

• Bobcat Balance also provides perspectives on pandemic-specific supervisor topics.Access mental health and wellbeing benefits from HealthSelect, including Virtual Visits.

• Live. Work. Be well. Manage every aspect of your wellness with WellCats, the Texas StateEmployee Wellness Program.

• Additional resources include: Supporting Your Well-Being during Times of Change andUncertainty, available FREE via LinkedIn Learning.

HEALTH & SAFETY GUIDANCE |

WHEN AN EMPLOYEE OR STUDENT IS DIAGNOSED WITH COVID-19

Expectations of Faculty / Supervisors Supervisors or faculty should be informed if an employee or student is diagnosed with COVID-19 or is in close contact with someone diagnosed with COVID-19.

• The staff member or student should self-isolate for 10 days from the start of symptoms or thepositive test result if no symptoms.

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• Anyone at the university that was in close contact (within 6 feet for 15 minutes or more withoutmasks) with an infected person during the infectious period (two days before symptoms started orthe date of the positive test if no symptoms) should quarantine for 14 days since their last contactwith the infected person, to account for the incubation period. They should also get tested.Employees should work remotely while self-quarantined to the extent possible.

• Wearing face masks makes it less likely that the infected person will spread the disease to others,but the quarantine and testing protocol may still be necessary.

• Other staff that may have had brief contact with the infected staff member do not have toquarantine— they will need to closely self-monitor for fever or symptoms of COVID-19 for 14days since last contact with the infected person.

• The supervisor must safeguard the privacy of the infected person. The supervisor may share withstaff that they may have been exposed to someone positive for COVID-19 and provide guidanceabout either quarantine or self-monitoring.

• The supervisor should instruct the employee or student to report the positive COVID-19 test, orthat they are a close contact to a person infected with COVID-19, to the Student Health Center athealthcenter@txstate.edu or 512-245-2161. The Student Health Center will do a risk assessmentand contact tracing to assist the supervisor with actions that they must take.

• If a supervisor has questions about how to manage a COVID-19 situation where a reportwas not submitted, they should contact the Student Health Center athealthcenter@txstate.edu or 512-245-2161.

• The workspace of the infected person should be left unoccupied and untouched for 24 hoursafter they leave and then cleaned and disinfected with a focus on high-touch areas. Any otherareas that the individual frequented while in the infectious period should be cleaned anddisinfected as well.

• We will provide additional details about COVID-19 reporting processes and contact tracing soon.

Expectations of Employees

Employees who exhibit symptoms, or are diagnosed with COVID-19, or are in close contact with someone diagnosed with COVID-19 should inform their supervisors.

• Employees who have two or more symptoms (i.e., fever, cough, or shortness of breath) of possibleCOVID-19 should notify their supervisor, contact their healthcare provider for an evaluation, andstay home.

• Employees with confirmed cases of COVID-19 should follow CDC-recommended steps, should useFFCRA leave (and sick leave after FFCRA leave ends), and should not return to work until thecriteria to discontinue home isolation are met, in consultation with a healthcare provider.

• Employees who are well but who have a family member at home sick with a confirmed case ofCOVID-19 should isolate from the member and notify their supervisor, follow CDCrecommended precautions, get tested, stay at home for 14 days even if the test is negative, andutilize FFCRA leave (and sick leave after FFCRA leave ends).

• Employees who are caregivers for a family member with a confirmed case of COVID-19, and havefrequent close contact while caring for them, should follow the CDC recommendations for Caregiversand quarantine for 14 days after last contact with the infected family member during their isolationperiod.

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• Employees who are notified that they are a close contact to someone who has testedpositive for COVID-19 should notify their supervisor and quarantine for 14 days since thelast contact with the infected person.

TOOLS AND TRAINING

• Remote Teaching and Collaborating Resources for Faculty• Remote Working and Collaborating Resources for Staff• CDC Print Resources• CDC COVID-19 Video Resources• From the Department of State Health Services:• Best Health Practices to Avoid COVID-19• How to Wash Your Hands

Policies and Resources Strategies for Excellent Remote Work For Employees

• Working Remotely - LinkedIn Learning• TXST Working Remotely (Canvas self-paced course)

For Supervisors

• How to Manage Remote Direct Reports - Harvard Business Review

• Managing Virtual Teams - LinkedIn Learning

Time and Leave | COVID-19 Families First Coronavirus Response Act (FFCRA)

• Effective April 1 through December 31, 2020• All Texas State employees, including part-time faculty, staff, and students are eligible if their

situation meets certain requirements. The Act provides:• Emergency Paid Sick Leave (Guide: Requesting Emergency Paid Sick Leave (FFCRA))• Emergency Family and Medical Leave Expansion Act (Guide: Requesting Expanded Family &

Medical Leave (FFCRA))• FFCRA Timekeeping guidance for COVID-19 Leave Reporting• FFCRA for Texas State Employees Details

Remote Work | COVID-19 • UPPS 04.04.01, which covers Remote Work and Telecommuting, was revised to expand these

alternate work arrangements just as the novel Coronavirus pandemic arrived in Texas. While thesepolicies are not specific to the pandemic, the 30 consecutive calendar day requirement is waivedas a key exception to normal policy in response to the COVID-19 pandemic.o This means you and your supervisor may extend your remote work agreement for periods of

time exceeding 30 consecutive calendar days until further guidance is determined by Universityleadership and communicated with employees.

o Remote Work/Telecommuting Request Form

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Website Resources • Texas State University Coronavirus (COVID-19) website• Human Resources Workplace Updates for COVID-19 website• Pandemic and Post-Pandemic Work Groups website• Texas Executive order• OSHA/HHS Guidance• Opening Up America Again• CDC Guidance for Higher Ed• Hays County Resources• University Response Tracker & Web Resources on www.opensmartedu.net• Governor's Strike Force to Open Texas

APPENDIX A – Operational Status Scenarios To simplify the range of operational approaches, we are using four COVID-19 scenarios to indicate the severity of COVID-19 transmission and implications for institutional operations. Given the fluctuating nature of the COVID-19 situation, decisions to adjust the scope of operations and the degree to which the campuses are open are based on the following framework.

Low Alert – the New Normal This status is characterized by institutions and communities operating with high-density environments. Vaccines and/or highly effective treatments are likely approved and widely available, and/or there is low circulation of the coronavirus. Institutional Operations Prevention practices can be gradually lifted more fully. It is likely that social interactions will remain changed and that reengineered processes and new technologies may persist for a duration of time so long as they are functional. For all intents and purposes, this is the highest level of opening – our campuses are reopened without restriction. Moderate Alert This status is characterized by institutions and communities operating with moderate-density environments (less than 100% and more than 50%). Institutions are widely open, and many protective measures are still in place. The underlying threat of outbreak remains, but prevalence of the virus is lower and testing and contact tracing capacities are robust enough to allow some policies to be relaxed. Effective treatments for the disease which lower the risk of severe outcomes are becoming available.

Institutional Operations Instruction remains a mix of face-to-face and remote instruction with a higher proportion of face-to-face instruction resuming. Some higher-risk students and faculty will still require special modifications.

• Easing of facility restrictions, rigorous cleaning & PPE protocols.• Density of face-to-face instruction may increase closer to the norm.• Shared offices distancing and other measures are eased.• Social distancing, face covering, and frequent hand washing recommended.

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High Alert This status is characterized by institutions and communities operating in very low-density environments (50% or less). The majority of universities are providing some level of face-to-face instruction, but there are significant prevention policies in place which may include limitations on meeting sizes, enforced PPE use, and continued elevated precautions for high risk individuals.

Institutional Operations Instruction is either remote or in limited capacity spaces with protections in place if face-to-face. Significant prevention policies in place which may include limitations on meeting sizes, enforced PPE use, screening, contact tracing, and selective quarantining/self-isolation.

o Limited access to facilities including use of alternate schedules, shifts and remote work for employees.o Classrooms are capped at 50% of normal occupancy.o Cloth face coverings are required.o Work modifications are liberally offered to higher-risk employees.o This situation is fluid; changes to university operations will be based on the location and severity

of the cluster or surge and are likely to be temporary or on a smaller scale.o Individual offices, classes, or locations may be at different operational levels based on local conditions.

Very High Alert This status is characterized by government-issued stay at home orders in place, schools and non-essential businesses closed and individuals expected to practice self-isolation. This is where we were at the height of Spring 2020.

Institutional Operations Non-essential businesses are ordered to close. Individuals are expected to practice self-isolation. Campuses and building access are restricted. Telework is the preferred choice for as many employees as possible in accordance with state/local mandates. Instruction is remote and face-to-face housing and face-to-face academic programs are cancelled other than for hardship cases or those with extenuating circumstances. This is the lowest level of opening of our campuses and resembles the university’s state this past March and April.

APPENDIX B - Factors in Determining Operational Status

The determination of the current Operational Status scenario and corresponding university operations is made by the President and President's Cabinet, in consultation with Chief Medical Officer Dr. Emilio Carranco and public health officials and is based on guidance from state and local government officials. The list below explains some of the factors that will be considered in making this decision. This is not a rank- ordered, nor a comprehensive, list of factors that will need to be considered.

Epidemiological Consideration Examples Incidence & Prevalence – The number of new and existing cases of COVID-19 at the campus, local, regional, national, and international levels will have implications for operating scenarios. Analysis of daily case numbers and deaths reported, as well as trends in reported numbers over time will also influence decision making.

Percent of Positive Tests – Understanding the percentage of positive tests, out of the denominator of total tests conducted for COVID-19, can help provide an indication of both the prevalence of disease in a community as well as the adequacy of testing capacity. WHO recommends that the percent of positive tests should be at or below 5 percent.

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Percent of Cases Linked to Other Known Cases – Data from testing and contact tracing can show what percentage of new cases are linked to other known cases. This provides an indicator of the amount of unrecognized and uncontrolled spread in a community. The higher the percent of cases linked to other known cases, the less risk of unrecognized spread.

Hospital Stress – Data related to hospital inpatient and ICU bed availability and the percent of hospital beds occupied by COVID-19 patients can provide good indicators of hospital stress due to COVID-19. Hospitals with low availability of beds and a high percent of COVID-19 patients would indicate that transmission in a community may be high and will be critical for informing decision-making.

INSTITUTIONAL CAPACITY CONSIDERATION EXAMPLES

Federal, State, and Local Policies – Regulations and operating protocols are being developed at federal, state, and local levels. The status of those protocols will undoubtedly impact the degree to which institutions may operate.

Prevention Methods – The capacity and degree of adoption for various prevention methods will impact our operating environment. Advancements in PPE, administrative controls, and engineering controls as well as increased adherence to prevention methods will be paramount.

Testing Capacity – Testing is a key measure to help reduce the impact of COVID-19. It is beneficial for institutions to have access to adequate testing, whether conducted by the institution or by other healthcare partners. At baseline, it is important that everyone with COVID-19 symptoms should be able to obtain a test. Testing should be done quickly and return results as quickly as possible in order to better inform medical decision making and decisions related to isolation and contact tracing.

Contact Tracing Capacity – Contact tracing is another key capacity to control the transmission of the virus.

Treatment Capacity – The degree to which local hospitals can support community outbreaks should be explored when considering reopening. The risk of reopening is increased severely if community members are unable to be treated. Colleges should create close collaborations with local public health officials in their cities or counties, as well as with local hospitals and EMT transport services.

Quarantine Capacity – The number of empty beds/rooms available to house students in self-isolation or quarantine. As the number of cases increase on campus the greatest risk is in the ability to safely quarantine students identified during testing and contact tracing. Think of this as a comparable metric to the number of available hospital beds in the community.

Therapies & Vaccines – As therapies improve, the consequences of contracting the illness may diminish, allowing for riskier decision making. If/when an effective vaccine is approved, accessibility will be the final barrier in the way of immune protection, which will allow for full reopening of entire communities.

Comparators – Observing the operating protocols of similar institutions and leading institutions is a helpful exercise to understand how other professionals are thinking about operating scenarios. In this exercise, it is important to understand the unique characteristics that influence institutional decision making and to consider your institution’s unique characteristics.

Reference: Johns Hopkins Center for Health Security, the Council for Higher Education Accreditation (CHEA), and Tuscany Strategy Consulting (TSC). “COVID-19 Planning Guide and Self-Assessment for Higher Education.”

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APPENDIX C – SARSCoV2 / COVID19 Information based on a Brief Review of the Literature

Credit to Rodney Rohde, PhD, MS, SV/SM/MB(ASCP), Chair, TXST Clinical Lab Science Program

I. Virus InformationCoronaviruses are everywhere. They are the second leading cause of the common cold (after rhinoviruses) and until recent decades, rarely caused any disease more serious than a common cold in humans. Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus, SARS- CoV-2, causes coronavirus disease COVID-19 and is thought to have originated in Wuhan, China in December of 2019. The first coronavirus was isolated in 1937. Some cause illness in people and others circulate among other animals, including camels, cats and bats. Since its discovery, related coronaviruses have been found to infect cattle, pigs, horses, turkeys, cats, dogs, rats, and mice. The first human coronavirus was cultured in the 1960s from nasal cavities of people with the common cold.

The four major categories of coronavirus are known by the Greek letters’ alpha, beta, delta and gamma. Only alpha and beta coronaviruses are known to infect humans. These viruses spread through the air and are responsible for about 10-30 percent of colds worldwide. Long known to cause upper respiratory infections, coronaviruses were not felt to significantly cause pneumonia until relatively recently. Seven human coronaviruses (HCoVs) have now been identified: HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1, SARS-CoV (which causes severe acute respiratory syndrome), MERS-CoV (Middle East respiratory syndrome), and now SARS-CoV-2. All appear to be established human pathogens with worldwide distribution, causing upper and lower respiratory tract infections with some mortality.

Coronaviruses are zoonotic, meaning they can be transmitted between animals and people, but most infect only their specific animal host. Rarely, animal coronaviruses can evolve to infect and spread among people. This was the case with Severe Acute Respiratory Syndrome Coronavirus (SARS- CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV). SARS killed nearly 10% of the 8,096 people who fell ill in 29 countries. A total of 774 people died, according to the World Health Organization. MERS is even more deadly, claiming more than 30% of people it infects. Since 2012, MERS has caused 2,494 confirmed cases in 27 countries and killed 858 people. SARS-CoV and MERS-CoV generally spread between people who were in close contact, which resulted in many fatalities of healthcare workers. In early through mid-January 2020, the SARS-CoV-2 epidemic in Wuhan had an Rt (reproductive rate) of 3 to 4. In other words, each case spread to an average of 3 to 4 others. Generally, it is believed that the Rt of SARS-CoV-2 is somewhere in the range of 1.4 to 6.49, with a mean of 3.28, a median of 2.79. As of June 16, 2020, the global number of cases for the ongoing SARS-CoV-2 pandemic is 8,063,488 with 437,532 deaths (fatality rate of 5.4%). In the U.S., there are currently 2,114,180 cases with 116,130 (fatality rate of 5.5%). Lastly, in Texas there are currently 89,108 cases with 1,983 deaths (fatality rate of 2.2%). Cases and mortality are at this time fluid and changing rapidly on a daily basis. It is important to point out that SARSCoV2 is a “novel” or new virus. In common terms, this means that the human population has never seen this particular virus immunologically. Thus, humans have no immune memory (naïve) of the microbe and the virus is able to transmit more efficiently between people and over geographic areas more quickly.

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II. MasksThe topic of facemasks to prevent microbial infection or transmission is a complex topic. I will present the general information and evidence surrounding the types and use of facemasks. At the beginning of this pandemic, there was some confusion over the use of masks. Viruses are some of the smallest known microbes known to humankind. It is important to understand the sizes of microbes and their mode of spread to begin a discussion about masks and their potential use in reducing transmission of infectious agents.

Most microbes are unicellular and not visible without some sort of magnification like a laboratory microscope. Some unicellular microbes (few) are visible to the naked eye, and some multicellular organisms that are microscopic (pinworms for example) are visible without a microscope. However, single bacteria and viruses are not visible without a microscope. An object must measure about 100 micrometers (µm) to be visible without a microscope, but most microorganisms are many times smaller than that. In fact, a typical animal cell measures roughly 10 µm across but is still microscopic. Bacterial cells are typically about 1 µm, and viruses can be 10 times smaller than bacteria (Figure 1).

Bacteria (micrometer range) can be viewed with a typical compound light microscope that one uses in most high school and college science labs. Viruses, on the other hand, are so small (nanometer range) that they cannot be viewed unless one uses an electron microscope. There are a diverse number of masks that one can use in the healthcare or community setting. For the purposes of this paper, I will try to keep it brief regarding the evidence of mask use in the university (community setting). Per the FDA and CDC, N95 respirators and surgical masks are examples of personal protective equipment (PPE) that are used to protect the wearer

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from airborne particles and from liquid contaminating the face. The Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) also regulate N95 respirators. It is important to recognize that the optimal way to prevent airborne transmission is to use a combination of interventions from across the hierarchy of controls, not just PPE alone. Cloth masks are not meant to be regulated although research may change this stance going forward.

As mentioned earlier, at the beginning of the SARSCoV2 pandemic many experts in healthcare and public health were not recommending the use of masks for the public (non-healthcare). Generally, the reasoning for this early assessment is that N95 masks, which are a high-grade healthcare PPE, are for healthcare use only. N95 masks (as the name states are about 95% effective in protecting the user) filter out most viruses so it protects the user in healthcare from becoming infected. These masks have a requirement for a “fit test” so that the seal around the face is complete. They are not easily used in public and can be ineffective if not fit tested or used properly. These masks are also in short supply and are prioritized for healthcare personnel and others (public health) who may need them daily.

N95 Mask However, as the pandemic continued to grow in case counts, evidence of asymptomatic / pre- symptomatic transmission, mortality and geography, the scientific community began to study the use of other types of masks that could potentially help with filtering the larger respiratory droplets during exhaling to protect others in the community. These types of masks (surgical and cloth) are used in healthcare and community settings at times.

Surgical masks (also sometimes referred to as isolation, dental, or medical procedural masks) are a loose fitting (not fit tested), disposable device that creates a physical barrier between the mouth and nose of the wearer and potential contaminants in the immediate environment. They are not to be shared and may come with or without a face shield. These are often referred to as facemasks, although not all facemasks are regulated as surgical masks. Worn correctly, surgical masks can reduce large-particle droplets, splashes, sprays, or splatter that may contain germs (viruses and bacteria), from being inhaled by the user. They can also help reduce exposure of the user’s saliva and respiratory secretions to others. Surgical masks, while more comfortable and simpler to use by anyone, are still primarily recommended by CDC for healthcare use.

Surgical Mask With the N95 and surgical / medical mask in mind, the CDC now recommends that members of the public use simple cloth face coverings when in a public setting to slow the spread of the virus,

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since this will help people who may have the virus and do not know it from transmitting it to others (asymptomatic). Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure. Therefore, what happened along the way for the CDC (and others in the healthcare, public health, and scientific community) to change their position regarding the use of face masks in public? As the pandemic evolved over the first few months, we learned from several (and a growing number of) studies many people who have COVID19 lack symptoms (“asymptomatic”) and even those who eventually develop symptoms (“pre-symptomatic”) can transmit the virus prior to becoming sick or even showing symptoms. In other words, this means there is a very high likelihood that SARSCoV2 (and other respiratory agents) may spread between people interacting in close proximity—like laughing, singing, speaking, coughing, or sneezing—even when they are not sick.

There is a growing amount of evidence that cloth face masks can provide protection to others and ourselves. While we believe they will never reach the level of N95 mask (or higher-grade masks), there is now scientific proof that wearing a cloth mask or surgical masks can significantly reduce the transmission of SARSCoV2 and likely other respiratory agents. I will briefly mention three such studies but there are numerous other published studies. One recent example of two math models published in the Proceedings of the Royal Society A predicts widespread use of facemasks in public combined with social distancing or periods of lockdown provides a way to manage the pandemic and reopen the economy while reducing 2nd and future waves of the pandemic. It suggests we should not restrict masks to airplanes, subways, cruise ships and other places of physical distance difficulty. Outbreaks usually start to fade when the reproductive number (average number of other people that a person with the virus infects) – known as the “R’ number, or R0 – falls below 1. The models predicted that if the masks were 75% effective, wearing them could bring the ‘R’ number to below 1 from a high starting point of 4. Further, if the masks were only 50% effective, the “R’ number could fall to below 1 from a lower starting point of 2.2.

In another study, researchers found in their work that even a homemade facemask made from a cotton T-shirt is at least 90% effective at preventing transmission to other people. The research demonstrated that home fabrics substantially block droplets, even as a single layer and that using two layers, the blocking performance can reach that of surgical masks without significantly compromising breathability.

Finally, a new study out of Texas A&M University in the journal Proceedings of the National Academy of Sciences suggests that among all the strategies for reducing transmission, wearing facemasks may be the central variable that determines the spread of the virus. The research analyzes various mitigation measures put in place in the three major centers of the outbreak—Wuhan, Italy, and New York City— from January 23 to May 9, 2020. Two main takeaway points from the authors is (1) that when paired with the data on how the curve changed in response to the mitigation methods, facemasks are likely the major determinant of how the infection spreads or slows; and, (2) results clearly show that airborne transmission via respiratory aerosols represents the dominant route for the spread of COVID-19.

It is critical to remind everyone that cloth masks do not completely protect us from inhaling this virus or any other virus. We must still practice social distancing of at least 6 feet or more, maintain hand washing / hand hygiene, and other precautions with mask use (staying home when sick, avoiding others who may be sick, proper air exchange in closed rooms / spaces, and not traveling to high impact areas, etc.)

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III. Physical or Social Distancing

The CDC has taken the stance that the 6-foot rule should be thought of as a minimum when outdoors but maybe even further apart if indoors with limited air exchanges (most research states a minimum of 12 air exchanges is necessary to reduce transmission of airborne aerosols). Limiting face-to-face contact with others is the best way to reduce the spread of coronavirus disease 2019 (COVID-19). Physical distancing, also called “social distancing,” means keeping space between yourself and other people outside of your home. To practice physical or social distancing stay at least 6 feet (about 2 arms’ length) from other people.

The WHO has traditionally had a three-foot social distancing recommendation, which originates from a 1930’s study by Wells, a Harvard researcher who studied tuberculosis. He found that droplets—bits of spit, mucus, and sputum (aka phlegm) expelled as we breathe, cough, or sneeze—tend to land within three feet of where they are expelled. This study has hung on for almost a century and many global experts disagree with it.

In 2003 during the 1st SARS outbreak, scientists believed the three-foot cutoff may not be relevant because of the prevalence of SARS infections within a single flight and concluded that droplets of the virus could actually travel between passengers six feet apart—not three. The study, which looked at just over 100 people and was published in the New England Journal of Medicine, was allegedly the basis for the CDC updating their message to say that people should stay six feet apart to prevent transmission.

IV. Hand Washing / Hand Hygiene Hand hygiene has a long history of strong infection control and prevention data. Without going into the extensive amount of literature to support hand hygiene, I will utilize the CDC primary data and statements regarding this topic.

One would expect that most people understand how critical and important it is to practice hand hygiene at all time, not only during a pandemic. However, even within healthcare we find poor compliance (sometimes with rates around 40-50%) if stringent controls are not in place (observation, professional peer pressure, ongoing education, etc.). By washing our hands, we can help prevent the spread of most germs including transmitting them from one person to the next. We tend to spread germs when we touch our eyes, nose or mouth (common portals of entry for most microbes) with our unwashed hands. One should also wash your hands before preparing food or drinks, after contact with high touch surfaces (think elevator buttons, hand shaking, phones, public touch pads, etc.), and after you blow your nose, sneeze, or cough into your hands. I hope that we understand how critical it is to wash our hands after going to the bathroom too.

To wash your hands wet them with clean, running water (warm or cold and apply soap). Lather your hands by rubbing them together with the soap. Lather the backs of your hands, between your fingers, and under your nails. Scrub your hands and fingers for at least 20 seconds. Rinse your hands well under clean, running water and then dry them with a clean paper or cloth towel. The CDC and others have great training videos for this routine.

Hand hygiene is critical in our response to the ongoing COVID-19 pandemic, especially as we begin to reopen the economy. Practicing hand hygiene, which includes the use of alcohol-based hand rub (ABHR) or handwashing, is a simple yet effective way to prevent the spread of pathogens and infections in healthcare settings. CDC recommendations reflect this important role. Washing hands with soap and water is the best way to get rid of germs in most situations. If soap and water are not readily available, you can use an ABHR sanitizer that contains at least 60% alcohol. You can tell if the sanitizer contains at least 60% alcohol by looking at the product label.

V. Summary Statement

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I have attempted to compile some primary literature regarding the SARSCoV2 virus and the disease it causes, COVID-19. I chose to discuss what I and many experts consider three of the main prevention methods – the use of facemasks, social distancing, and hand hygiene – surrounding the ongoing pandemic. It is important to mention that there are many other infection control and mitigation strategies. Likewise, there is a great degree of complexity in utilizing the different mitigation strategies and tools for any infection control and prevention. This is especially true as we consider the diverse populations and communities we are trying to protect. I also have attempted to utilize a strong science communication writing style to help communicate some of the topics to the public in a way that would be helpful and understood. This paper is not intended to be an all-inclusive literature review or recommendation effort for this ongoing and evolving pandemic.

*While I have cited some primary literature, I have also utilized the CDC resources to a great extent, and I may not have linked every single statement.

Literature Regarding Asymptomatic / Pre-symptomatic Carriers Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV Infection from an Asymptomatic

Contact in Germany. The New England journal of medicine. 2020;382(10):970-971.

Zou L, Ruan F, Huang M, et al. SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients. The New England journal of medicine. 2020;382(12):1177-1179.

Pan X, Chen D, Xia Y, et al. Asymptomatic cases in a family cluster with SARS-CoV-2 infection. The Lancet Infectious diseases. 2020.

Bai Y, Yao L, Wei T, et al. Presumed Asymptomatic Carrier Transmission of COVID-19. Jama. 2020.

Kimball A HK, Arons M, et al. Asymptomatic and Presymptomatic SARS-CoV-2 Infections in Residents of a Long-Term Care Skilled Nursing Facility — King County, Washington, March 2020. MMWR Morbidity and mortality weekly report. 2020; ePub: 27 March 2020.

Wei WE LZ, Chiew CJ, Yong SE, Toh MP, Lee VJ. Presymptomatic Transmission of SARS-CoV-2 — Singapore, January 23–March 16, 2020. MMWR Morbidity and mortality weekly report. 2020;ePub: 1 April 2020.

Li R, Pei S, Chen B, et al. Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV2). Science (New York, NY). 2020.

Valentyn Stadnytskyi, Christina E. Bax, Adriaan Bax, Philip Anfinrud. The airborne lifetime of small speech droplets and their potential importance in SARS-CoV-2 transmission. Proceedings of the National Academy of Sciences Jun 2020, 117 (22) 11875-11877; DOI: 10.1073/pnas.2006874117

Literature of Effectiveness of Mask Use in Prevention of Transmission CDC. The National Personal Protective Technology Laboratory (NPPTL). Respiratory Protection Videos.

June 17, 2020. Accessed from https://www.cdc.gov/niosh/npptl/RespVideos.html

Kai et al. (prepublication). Universal masking is urgent in the COVID-19 pandemic: SEIR and agent based models, empirical validation, policy recommendations– Apr 22

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Over 100 prominent health experts call for cloth mask requirements. Masks4All – May 13

Renyi Zhang, Yixin Li, Annie L. Zhang, Yuan Wang, Mario J. Molina. Identifying airborne transmission as the dominant route for the spread of COVID-19. Proceedings of the National Academy of Sciences Jun 2020, 202009637; DOI: 10.1073/pnas.2009637117

Richard O. J. H. Stutt, Renata Retkute, Michael Bradley, Christopher A. Gilligan and John Colvin. A modelling framework to assess the likely effectiveness of facemasks in combination with ‘lock-down’ in managing the COVID-19 pandemic. Proceedings of the Royal Society A: Mathematical, Physical and Engineering SciencesVolume 476, Issue 2238. Published:10 June 2020. https://doi.org/10.1098/rspa.2020.0376

Onur Aydin, Md Abul Bashar Emon, M Taher A Saif. Performance of fabrics for home-made masks against spread of respiratory infection through droplets: a quantitative mechanistic study. medRxiv 2020.04.19.20071779; doi: https://doi.org/10.1101/2020.04.19.20071779 Literature of Social Distancing

Bourouiba L. Turbulent Gas Clouds and Respiratory Pathogen Emissions: Potential Implications for Reducing Transmission of COVID-19. JAMA. 2020;323(18):1837–1838. doi:10.1001/jama.2020.4756

Guidance for Building Operations During the COVID-19 Pandemic. April 8, 2020. Accessed from https://www.jm.com/en/blog/2020/april/guidance-for-building-operations-during-the-covid-19-pandemic/

Sonja J. Olson, et. al. Transmission of the Severe Acute Respiratory Syndrome on Aircraft. N Engl J Med 2003; 349:2416-2422, December 18, 2003, DOI: 10.1056/NEJMoa031349

W. F. WELLS, ON AIR-BORNE INFECTION: STUDY II. DROPLETS AND DROPLET NUCLEI., American Journal of Epidemiology, Volume 20, Issue 3, November 1934, Pages 611–618, https://doi.org/10.1093/oxfordjournals.aje.a118097

Literature of Hand Hygiene CDC. Hand Hygiene Recommendations. Guidance for Healthcare Providers about Hand

Hygiene and COVID-19. Accessed on June 16, 2020 from https://www.cdc.gov/coronavirus/2019-ncov/hcp/hand- hygiene.html

CDC Core Practices for Infection Prevention in All Healthcare Settings (2017).

Centers for Disease Control and Prevention. Guidelines for hand hygiene in healthcare settings

(2002). CDC Handwashing Videos. Accessed June 17, 2020 from

https://www.cdc.gov/handwashing/videos.html Food and Drug Administration. Safety and

effectiveness for health care antiseptics: Topical antimicrobial drug products for over-the-counter human use (final rule).

Kampf G, Todt D, Pfaender S, Steinmann E. Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents. J Hosp Infect. 2020.

Kratzel A, Todt D, V’kovski P, Steiner S, Gultrom M, Thao TTN, et al. Inactivation of severe acute respiratory syndrome coronavirus 2 by WHO-recommended hand rub formulations and alcohols. Emerg Infect Dis. 2020 Jul [date cited]. https://doi.org/10.3201/eid2607.200915

Rohde, R.E. The Coronavirus Pandemic Isn’t Over: Keep Washing Your Hands As Economies Reopen. June 10, 2020. Accessed from https://www.forbes.com/sites/coronavirusfrontlines/2020/06/10/the-coronavirus- pandemic-isnt-over-

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keep-washing-your-hands-as-economies-reopen/#74c6e99354f0

Siddharta A, Pfaender S, Vielle NJ, Dijkman R, et al. Virucidal activity of World Health Organization recommended formulations against enveloped viruses include Zika, Ebola, and emerging Coronaviruses. J Infect Dis. 2017

General (other literature)

ACHA Guidelines: Considerations for Reopening Institutions of Higher Education in the COVID-19 Era. June 17, 2020. Accessed from https://www.acha.org/documents/resources/guidelines/ACHA_Considerations_for_Reopening_IHEs_in_the_C OVID-19_Era_May2020.pdf

CDC. Coronavirus Disease 2019 (COVID-19): Reopening Guidance for Cleaning and Disinfecting Public Spaces, Workplaces, Businesses, Schools, and Homes. June 17, 2020. Accessed from https://www.cdc.gov/coronavirus/2019-ncov/community/reopen-guidance.html

Guidelines: Opening up America Again. June 17, 2020. Accessed from https://www.whitehouse.gov/openingamerica/

Jeffrey D. Smith et al. Effectiveness of N95 respirators versus surgical masks in protecting health care workers from acute respiratory infection: a systematic review and meta-analysis. CMAJ, May 17, 2016,188(8):567-674.

Lewis J. Radonovich Jr. et al. N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial. JAMA. 2019;322(9):824-833. doi:10.1001/jama.2019.11645

Neeltje van Doremalen et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS- CoV-1. N Engl J Med 2020; 382:1564-1567. DOI: 10.1056/NEJMc2004973 https://www.nejm.org/doi/full/10.1056/nejmc2004973

Rodney E. Rohde. SARCoV2 and COVID19 resource page. June 17, 2020. Accessed from https://rodneyerohde.wp.txstate.edu/sarscov2-covid19-resources/

Texas DSHS. Opening the State of Texas. June 17, 2020. Accessed from https://dshs.state.tx.us/coronavirus/opentexas.aspx