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COVID-19 Q&A with Dr. Ken Kirton on Navigating Home Service Visits

Over the upcoming weeks, area businesses will implement new processes to provide services and employment for our community, while keeping in mind the need to protect the health and safety of the public and their employees. This week Ken Kirton, MD, Chief of Medical Staff at Freeman Regional Health Services responded to questions on how to navigate home service visits in the current COVID-19 situation. Although this guidance is geared to those who will conduct the service visit, it will shed light on what to expect when they plan to visit your home.
Is it safe to conduct home service visits?
First you need to decide if you are comfortable and feel the need to conduct business through a home service visit. This level of comfort may be affected by the prevalence of COVID-19 in the community so it is best to make an informed decision based on the presence of the virus, knowledge of how the virus is spread, and the measures that you will incorporate to protect yourself and the customer. 
What is currently known about the COVID-19 virus?
Recall that the virus that causes COVID-19 is a respiratory virus that is easily spread through air and by hand to viral contaminated surface to face. The further away a non-infected person is from the air space around an infected person, the lower the chance for virus transfer. However, this virus has high infection rates that may occur with limited exposure. Symptoms range from asymptomatic shedding of virus, to cold symptoms such as a runny or stuffy nose and sore throat, to fevers, chills, muscle pain, aching, loss of taste or smell, vomiting, diarrhea, cough, trouble breathing and occasionally weakness. A high percentage of individuals who contract the virus have the potential for developing a serious illness that carries a higher death/mortality rate.
What measures could be incorporated into the service visit? 
Your modified business transaction strategy should include plans for screening yourself and your customer, completing a pre-visit checklist, implementing visit precautions, utilizing safe payment mechanisms, and following safety measures after leaving the residence.
What advice do you have on a screening process?
Consider incorporating a screening process for you and your customer to determine the level of risk for transmitting the virus between each other. We have posted suggested screening questions on our freemanregional.com/news-and-events website and will continue to update them as the CDC and SD Department of Health issues new guidelines. These include questions on COVID-19 symptoms, diagnosis, and exposure risk. If the answer is yes to any of the screening questions, then call a health provider to determine if additional testing or intervention is required. If the business transaction is a service that requires immediate action, stress this point. When contacted, we at FRHS work to assess the situation and assist with the decision on how to provide the appropriate service. 
What should I include in my pre-visit checklist?
The more you plan and make decisions prior to the visit, the less time will be required at the home. Start by having a conversation about the nature of the transaction. Discuss the work and exactly where you will need to go on their property. Decide ahead of time if six feet of social distance can be maintained between you and the customer while performing the service. Determine all of the supplies you will need to bring with you since fewer trips in and out of a home will lessen the potential exposure opportunities. Plan to bring your supply of masks, hand sanitizer and gloves as part of your virus transmission prevention strategy. 
What precautions do you recommend during a home service visit?
The combination of good hand hygiene and an appropriately applied mask will greatly reduce the potential for you to be source of exposure for a customer. Wash your hands at work or home and then use hand sanitizer after arriving at the home prior to entering. Consider using gloves, after sanitizing hands to lessen the chance that you will contaminate the customers home if you are shedding virus. Wear a mask when entering a home while ensuring good technique taking the mask on and off and storing between uses. Maintain at least six feet of separation from the customer when doing the service. If you need to talk with the customer while at their home, it is preferable to avoid close proximity and instead conduct the discussion through a phone call. 
What is the safest way for handling payments?
The safest transactions will have the least direct touching of surfaces by multiple parties. Take care to maintain physical distance to avoid exposure when payment is at the time of service. If they pay by check or cash, remember that COVID-19 virus could be present on the surface for several days so handle them following good hand hygiene principles. Consider conducting your business electronically or alternatively placing the payments into a box for several days before processing. Remember to sanitize or wash your hands after the transaction and before touching your face or other surfaces.
What steps should I take after leaving the home?
After the service visit, there are several steps you could take to lessen the risk of spread of virus to you and your family. Be careful how you remove and store the mask that you used. Utilize hand sanitizer prior to getting into your vehicle and wipe down all potentially contaminated surfaces with disinfectant. Consider showering and washing your clothes if you were in close proximity of someone sneezing or coughing.