Infection Response Center

Exhaled respiratory droplets landed on surfaces (such as textiles) are largely unproven as a COVID-19 contagion source. Research has focused greatly on variations in the path droplets follow from the breath of an infected person to be directly ingested. Scientists agree the virus’ viability on surfaces is likely limited and it appears difficult to transfer from these to human hands, so these possibilities are not being extensively studied. But they remain possibilities, necessitating vigilance to handwashing and not touching your face.

In a study published in 2021, U.K. researchers found that a model coronavirus for COVID-19 survived on 100% polyester fabric for up to 72 hours. On 100% cotton, the virus lasted for 24 hours, while on polycotton, only six hours. The researchers, from De Montfort University, Leicester, concluded that if nurses and healthcare workers take their uniforms home, they could leave traces of the virus on other surfaces. The study also looked at the most reliable wash method for removing the virus from 100% cotton fabric. Water was enough to remove the virus in all of the washing machines tested when it was added in droplets but not when scientists soiled the fabric with an artificial saliva containing the virus. In these cases, detergent and water temperature of 40°C (104°F) or above eliminated the virus. Using temperature alone, 67°C (153°F) was required.

Standard hygienically clean laundering processes kill the COVID-19 virus, preventing it from infecting you or others. When dealing with hard surfaces, a simple disinfectant should suffice-the EPA has posted a list of cleaners that should be effective at sanitizing surfaces after exposure to COVID-19. While the CDC doesn’t specifically outline any changes to your typical laundry routine, they do provide a list of best practices when doing laundry for someone who’s ill:

1. Ideally, wear disposable gloves and discard them after each use. When using reusable gloves, only use those gloves for cleaning and disinfecting surfaces infected with COVID-19—do not use them for any other household purpose. Wash your hands immediately after using the gloves. If you aren’t using gloves when handling dirty laundry, be sure to thoroughly wash your hands afterwards.
2. Try to not shake the dirty laundry. Shaking the laundry carries a possibility of dispersing the virus through the air.
3. If possible, use the warmest water setting on your washer and ensure items are dried completely afterwards.
4. Dirty laundry from an ill person can be washed with other people’s items.
5. If possible, consider placing a bag liner in your hamper that’s disposable or can be laundered. Otherwise, ensure the hamper itself is washed and sanitized.
6. Additionally, consider having the clothes you wear around the house separated from clothes you’ve worn while you were outside to protect the environment inside your home.

TRSA does NOT advocate for the incineration of linens. TRSA recommends following CDC and OSHA guidelines for the handling of COVID-19 linens. The directive is to follow Standard and Universal Precautions. Please refer to our video, Six Cs of Handling Soiled Linen in a Healthcare Environment, for guidance on handling soiled healthcare linen. We are closely following updates from the CDC, WHO and others. If this changes, we will certainly provide an update.

Most often people catch COVID-19 by inhaling exhaled droplets from someone who has the virus. These droplets from the nose or mouth can become airborne when a person with COVID-19 coughs, sneezes, breathes, sings or talks (exhales). Droplets cause infection when they are inhaled by someone else or are propelled directly to this receiver’s mucous membranes, such as those that line the inside of the nose and mouth. Less often, droplets land on objects and surfaces around someone else and this person touches these objects or surfaces, then touches their eyes, nose or mouth, and inhale droplets. This reinforces the need to follow OSHA’s requirement for handling contaminated textiles and fabrics with minimum agitation to avoid contamination of air, surfaces, and persons (36, 293, 355, 356). Category IC (OSHA: 29 CFR 1910.1030 § d.4.iv).

Treat all linens as contaminated with the COVID-19 virus. Use standard PPE (gloves and gowns, and bag linen) to protect employees. These linens do not have to be washed separately. According to OSHA standards, normal laundry cycles should be used according to washer and detergent manufacturer recommendations.

For the laundry industry, CDC hasn’t recommended changes in normal laundry handling and processing of textiles. Appropriate time, temperature, chemical and mechanical action will kill the virus. CDC also hasn’t recommended changes in textile handling regarding employee exposure risk in sorting. Viruses usually do not live outside a live host for long periods, especially on porous surfaces like textiles, limiting the potential exposure risk to laundry personnel who will be handling the laundry hours or days after use.

Linen providers who support the healthcare market handle potentially infections materials daily. It’s always been understood that every piece of soiled linen be treated as if it were potentially infectious. In serving other markets, similar precautions like those implemented for the healthcare market are suggested. Also vital to infection control are standard transmission-based precautions (proper hand hygiene, PPE, handle textile and laundry carefully, clean and disinfect environment surfaces, etc.).

Existing OSHA regulations specify that any linen saturated with blood or other potentially infectious materials (OPIM) should be placed in impermeable bags. Learn more about what OSHA says about handling contaminated healthcare linen here.

Catalina Dongo, Director of Human Resources  for UniFirst Corporation, offers this advice:

“Essentially, we have relaxed our attendance policy so that no absences related to COVID-19 will be counted against the employee. We give employees the option in regard to pay replacement. They are able to select from their PTO banks such sick pay or vacation pay, or unpaid leave if none available or if they prefer.

We work with our managers to implement flexible schedules. Meaning, some employees may not be able to come to work during the day because of school closures. However, they may be able to come in in the evening. Some managers implement second and third shifts in order to get the work done. Other employees have been willing to pick up extra hours, which also helps. We may have employees who experience reduced workloads due to customer closures. For example, sales reps. These employees should be invited to help in areas where we are experiencing high absenteeism.”

You should send home all employees who worked closely with an infected employee to ensure the infection does not spread. Before the infected employee departs, ask them to identify all individuals who worked in close proximity (within six feet) for a prolonged period of time (more than a few minutes) with them in the previous 14 days to ensure you have a full list of those who should be sent home. When sending the employees home, do not identify by name the infected employee or you could risk a violation of confidentiality laws. If you work in a shared office building or area, you should inform building management so they can take whatever precautions they deem necessary. The CDC provides that the employees who worked closely to the infected worker “should then self-monitor for symptoms (i.e., fever, cough, or shortness of breath).”

How long should the employees who worked near the employee stay at home? Those employees should first consult and follow the advice of their healthcare providers or public health department regarding the length of time to stay at home. If those resources are not available, the employee should at least remain at home for three days without a fever (achieved without medication) if they don’t develop any other symptoms. If they develop symptoms, they should remain home for at least seven days from the initial onset of the symptoms, and three days without a fever (achieved without medication).

The CDC also provides the following recommendations for most non-healthcare businesses that have suspected or confirmed COVID-19 cases:

• It is recommended to close off areas used by the ill persons and wait as long as practical before beginning cleaning and disinfection to minimize potential for exposure to respiratory droplets. Open outside doors and windows to increase air circulation in the area. If possible, wait up to 24 hours before beginning cleaning and disinfection.
• Cleaning staff should clean and disinfect all areas (e.g., offices, bathrooms, and common areas) used by the ill persons, focusing especially on frequently touched surfaces.
• To clean and disinfect:
  • If surfaces are dirty, they should be cleaned using a detergent or soap and water prior to disinfection (Note: “cleaning” will remove some germs, but “disinfection” is also necessary).
  • For disinfection, diluted household bleach solutions, alcohol solutions with at least 70% alcohol, and most common EPA-registered household disinfectants should be effective.
  • Diluted household bleach solutions can be used if appropriate for the surface. Follow manufacturer’s instructions for application and proper ventilation. Check to ensure the product is not past its expiration date. Never mix household bleach with ammonia or any other cleanser. Unexpired household bleach will be effective against coronaviruses when properly diluted.
  • Cleaning staff should wear disposable gloves and gowns for all tasks in the cleaning process, including handling trash.
  • Gloves and gowns should be compatible with the disinfectant products being used.
  • Additional PPE might be required based on the cleaning/disinfectant products being used and whether there is a risk of splash. Follow the manufacturer’s instructions regarding other protective measures recommended on the product labeling.
  • Gloves and gowns should be removed carefully to avoid contamination of the wearer and the surrounding area. Be sure to clean hands after removing gloves.
  • Employers should develop policies for worker protection and provide training to all cleaning staff on site prior to providing cleaning tasks. Training should include when to use PPE, what PPE is necessary, how to properly don (put on), use, and doff (take off) PPE, and how to properly dispose of PPE.
  • If you require gloves or masks or other PPE, prepare a simple half-page Job Safety Analysis (JSA): list the hazards and the PPE (gloves, masks, etc., as needed), and the person who drafts the JSA should sign and date it.

If employers are using cleaners other than household cleaners with more frequency than an employee would use at home, employers must also ensure workers are trained on the hazards of the cleaning chemicals used in the workplace and maintain a written program in accordance with OSHA’s Hazard Communication standard (29 CFR 1910.1200). Simply download the manufacturer’s Safety Data Sheet (SDS) and share with employees as needed, and make sure the cleaners used are on your list of workplace chemicals used as part of the Hazard Communication Program (which almost all employers maintain).

Take the same precautions as noted in Question #15.

Treat the situation as if the suspected case is a confirmed case for purposes of sending home potentially infected employees. Communicate with your affected workers to let them know that the employee has not tested positive for the virus but has been exhibiting symptoms that lead you to believe a positive diagnosis is possible.

No, you do not have to quarantine the entire plant. Consult the CDC guidelines on cleaning and disinfecting community facilities.

Operators on our Healthcare Market Sector Call suggested:

• Split into shifts so that the entire workforce is not in at one time
• Stagger start and end times so that not everyone comes in at once.
• Set break times and limit the amount of seating available so that people maintain 6’ while on break
• Designate an outdoor break area so that people get the fresh air and are able to more easily maintain 6’
• Change into workplace clothes AT WORK instead of bringing them home – limits exposure
• Mark 6’ on the production floors with tape such as by the washers, dryers, and folders so that employees can easily see the 6’
• Avoid job rotation

The CDC recommends 6 feet for social distancing as that is past how far most respiratory droplets from coughs and sneezes travel in the air, typically spreading from 3 feet to 5 feet. Newer research determined that infection can be spread by exposure to virus in small droplets and particles that can linger in the air for minutes to hours and travel further, reaching people who are further than 6 feet from an infected person who is infected or after that person has left the space. In these cases, transmissions occurred within enclosed spaces that had inadequate ventilation and sometimes the infected person was breathing heavily, while singing or exercising, for example.  Available data indicate that it is much more common for the virus that causes COVID-19 to spread through close contact with a person who has COVID-19 than through such airborne transmission.

See links below for documents the TRSA Human Resources Committee received from professionals at UniFirst as well as talking points from the law firm Fisher & Phillips LLC. Stay current by visiting TRSA’s On Demand Learning center under COVID-19 and the Education and Training section of this page.

Employee Health and Temperature Screening Template
UniFirst Daily Team Partner Screening
UniFirst Coronavirus Self-Screening
UniFirst HR COVID-19 Presumptive or Positive Case Intake
Fisher & Phillips LLC Taking Employees’ Temperatures

All Hygienically Clean Certified Facilities MUST follow the transportation guidelines for their specific segments. You may find these recommendations on the HygienicallyClean.org under the market-specific certifications standards.

Below is the recommendation for Healthcare under section 5.1.3.4. Transportation:

• The QA manual must describe in detail procedures for the following functions:
  • The process for servicing accounts must be designed and executed to prevent cross-contamination.
  • Service reps must be trained on pick-up/delivery.
  • Items must be covered during transportation to prevent cross-contamination.
  • Items shall be transported in designated and covered containers.
  • Service trucks shall be cleaned on a regular basis to minimize infection and contamination.
  • Trucks shall be swept out daily and decontaminated at least twice a month.
  • Reusable cart covers must be cleaned after every use.
  • Proper PPE and gloves must be worn at all times when handling soiled linen.
  • All linen retrieved from a customer location and delivered to the soiled processing area must be cleaned prior to delivery to the customer.All clean and unused linen retrieved from a customer that maintains proper functional separation and is delivered to the clean processing area may be used for redelivery to the customer. Prior to redelivery, the linen must be rotated and restocked.
  • A designated transition area with stated process controls must be identified to remove potentially soiled cart covers prior to delivering exchange carts to the clean processing area1

Visit here for the U.S. Centers for Disease Control and Prevention (CDC) guidance on surface transmission in indoor environments.

According to the CDC, coronaviruses like COVID-19 can survive on surfaces anywhere from a few hours to a few days. While it’s more likely to catch COVID-19 from person to person contact and from hard surfaces that are frequently touched, like door knobs or railings, washing your laundry can help clean away COVID-19, preventing it from infecting you or others.