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Cleaning recommendations to prevent the spread of COVID-19 and other infectious diseases in schools, municipal buildings, and health care facilities

As a school, municipal, or health care administrator, you are responsible for keeping your staff as well as students, the public, or health care professionals safe and healthy. But these days, promoting social distancing at schools, municipal buildings, or hospitals is not enough.

You need also to follow proven cleaning recommendations to prevent the spread of infectious diseases, such as the coronavirus disease. In other words, it’s important now more than ever to effectively clean and disinfect surfaces.

Schools and municipal buildings have similar needs when it comes to cleaning and disinfecting. But health care facilities require more attention. So below we lay out proven cleaning recommendations for environmental cleaning and disinfection in these types of buildings to keep all stakeholders safe and healthy.

Cleaning recommendations for schools and municipal buildings

Busy schools and municipal buildings can be a challenge to clean. People constantly introduce high concentrations of germs to surfaces when they touch them with bare hands. And they don’t always practice good hand hygiene on their own.

The public often forget to adequately and regularly wash their hands with soap and water and tend not to use hand sanitizers without reminders. So germs easily find themselves everywhere and on all surfaces in schools and municipal buildings.

Focus cleaning on high-touch and high-risk areas

Contrary to popular belief, a total “deep” cleaning of all facilities and surfaces in schools and municipal buildings is often a waste of time, money, and resources. With a few exceptions, viruses that cause outbreaks in public buildings, such as the common cold, flu, and (notoriously) coronavirus, don’t live on hard surfaces for long—usually only for a few days at most.

For example, influenza A particles scattered on a doorknob on Friday afternoon will likely be dead by Monday morning. So particularly in the case of facility closures due to outbreaks, these germs typically clear themselves up before custodial staff can get around to disinfecting the surfaces they’re on.

Perhaps of greater concern is that indiscriminately and incorrectly using sanitizers, disinfectants, and antimicrobial soaps may help germs develop a resistance to them. According to a handbook from the California Department of Public Health,

incorrectly using a disinfectant—such as wiping or rinsing the solution off the surface before the recommended dwell time, not using the recommended dilution ratio, or using a combination disinfectant/cleaner when there is more dirt on a surface than the disinfectant can handle—may enable . . . bacteria that survive to mutate into . . . superbugs.

In effect, your custodial staff shouldn’t go overboard with deep cleaning. Instead, they should focus cleaning and disinfecting efforts in high-touch areas and high-risk areas.

High-touch areas

These are surfaces that many hands touch frequently throughout the day. They include water fountains, cafeteria tables, classroom desks, gym weights and machines, shared computers and keyboards, light switches, door handles, handrails, push bars, and so on.

High-risk areas

These are facilities that pose higher risks for infectious disease transmission. They include nurses’ offices, childcare centers, kitchens and cafeterias, athletic facilities, bathrooms (Check out this fun tutorial for cleaning tiled bathroom floors!), staff breakrooms, and so on.

Implement an environmental health program

While not itself a cleaning recommendation, putting an environmental health program into place is a great way to get all stakeholders involved in making a school or municipal building a cleaner place. So it’s worth a mention.

The Environmental Protection Agency (EPA) defines a school environmental health program as “a holistic, comprehensive, and actionable strategy that integrates preventive measures and addresses environmental health issues by fostering well-maintained school buildings and grounds.” Implemented correctly, such a program should protect the health of staff and students from infectious disease outbreaks.

The EPA has developed a road map detailing how school administrators can put an environmental health program into place. The EPA breaks the road map down into five key components addressing common environmental health issues in need of address:

  1. Practicing effective cleaning and maintenance
  2. Preventing mold and moisture
  3. Reducing chemical and environmental contaminant hazards
  4. Ensuring good ventilation
  5. Preventing pests and reducing pesticide exposure

Furthermore, each of the five components has a three-tiered set of actions, each tier detailing how a school can tackle a component based on its available resources:

  1. Tier one actions: these are low-cost actionable steps schools can start quickly.
  2. Tier two actions: these are essential actionable steps schools can take over time as they develop their environmental health programs.
  3. Tier three actions: these are enhanced actionable steps schools can take to improve existing environmental health programs.

Much of the EPA’s environmental health road map falls outside of the scope of this article. However, components one, four, and five outline actionable steps stakeholders can take to reduce the spread of COVID-19 and other infectious diseases.

The first component details actions custodial staff can take to maintain sanitary facilities. And components four and five detail actions custodial staff can take to (a) prevent the spread of infectious diseases from improper ventilation and (b) prevent the spread of infectious diseases from pests.

While the EPA designed the above environmental health road map for use in schools, municipal administrators can draft their own road maps using this one as a guide. In other words, they can retrofit much of the actionable steps in the above road map to suit the needs of their stakeholders.

Use safe, effective cleaning products in schools and municipal buildings

The most effective sterilizing and disinfecting agents, such as chlorine bleach (sodium hypochlorite) and quaternary ammonium compounds (“quats”), are readily available, inexpensive, and adaptable. Regrettably, they can also be harmful to environmental and human health if custodial staff use them incorrectly. (We offer guidelines on the safe and proper use of these cleaners in this article.)

School and municipal administrators are responsible for the health and well-being of all stakeholders, so the risks of using the most effective cleaners may outweigh the benefits. Thankfully, cleaning products such as hydrogen peroxide and soap and water are safe for cleaning and disinfecting schools and municipal buildings, though they’re not as effective as chemical cleaners.

Respecting cleaner dwell times (three to five minutes for hydrogen peroxide) and scrubbing surfaces with these products can help kill viruses and other germs while avoiding the typical short- and long-term health risks that the improper use of chemical cleaners poses.

In addition, administrators can encourage the public to practice good hand hygiene with safe cleaning products. For example, scrubbing hands with soap and water for twenty seconds can kill germs. So consider putting up Wash Your Hands signs around school or municipal property.

Hand sanitizer can also be a great tool to combat the spread of viruses and other germs. So consider installing hand sanitizer pumps around school or municipal property as well.

Due to the current prevalence of coronavirus disease, and in addition to advising regular hand washing and sanitizing, administrators should encourage cleaning service staff to wear personal protective equipment, such as disposable masks and gloves, while on the job.

Cleaning recommendations for health care facilities

Health care facilities are particularly challenging to clean and disinfect. Disinfection, infection control, and infection prevention are especially important because many of the people who visit health care facilities have weakened or vulnerable immune systems and are recovering from illness or surgery.

Hospitals, in particular, are difficult to clean and disinfect because they’re often very large, and sick people constantly bring germs into them. Custodial staff must clean up bodily fluids and waste, used medical equipment, soiled linens, and other items spreading diseases regularly.

Clean all surfaces and equipment rigorously and regularly

Unlike in schools and municipal buildings, every area in a health care facility is a high-risk area. Due to the nature of how and why people use health care facilities, custodial staff should consider that infectious germs contaminate most if not all surfaces.

Moreover, germs can recontaminate surfaces in health care facilities within hours after cleaning and disinfecting with a detergent, hydrogen peroxide, bleach, isopropyl alcohol, or other chemical cleaner or disinfectant. And germs can recontaminate surfaces in bathrooms even more quickly.

To mitigate the spread of infectious diseases, custodial staff should work throughout the day to clean and disinfect all surfaces—it isn’t enough to focus efforts only on areas that patients frequent. Custodial staff should opt for the more powerful, proven chemical cleaners like chlorine bleach to clean and sanitize room and equipment surfaces that bodily fluids have soiled.

If possible, direct custodial staff to wait until a soiled space is clear of patients and staff and to ventilate the space before using these cleaners to minimize the biohazardous effects of their use. In addition, invest in high-quality microfiber cloths and mops for your custodial staff to use. These are proven effective for capturing germs.

Finally, personnel who sterilize medical equipment and instruments should regularly use dry heat, steam, or chemical sterilizers before and after each use. Cleaning, disinfecting, and sanitizing regularly and thoroughly is critical for maintaining infection control.

Maintain infection control

One of the best ways to maintain infection control is also the simplest: reminding hospital staff that everyone is responsible for infection prevention. For example, staff should wear personal protective equipment at all times, especially when treating patients of coronavirus disease.

And as ever, all staff should practice good hand hygiene by regularly washing their hands with soap and water for at least twenty seconds, especially after visiting each patient. (Staff should also practice proper cough and sneeze etiquette.) If hand-washing stations are unavailable, disinfectant hand sanitizer will do in a pinch.

Cleaning recommendations to prevent the spread of coronavirus

Cleaning public spaces becomes tricky in the face of an outbreak, especially so in the face of coronavirus. Here’s why.

Infected individuals can spread coronavirus disease when they cough, sneeze, or talk. When they do, they project respiratory droplets carrying coronavirus particles out into the air, which can remain infectious with the aerosolized virus for up to three hours, according to Harvard Medical School research.

Ventilate public spaces to prevent airborne transmission

Since infected individuals can transmit coronavirus in the air, administrators of school, municipal buildings, and health care facilities may want to consider ventilation as part of a cleaning strategy.

According to the Centers for Disease Control and Prevention (CDC), facilities would need to consider room size and ventilation system design to make this work. Large portable drum fans might help shorten the time aerosolized coronavirus stays in the air of smaller to midsized rooms and confined spaces.

Use soap and water first, then disinfect

Aside from ventilating spaces as part of a cleaning strategy, the CDC stresses that the “cleaning of visibly dirty surfaces followed by disinfection is a best practice measure for prevention of COVID-19.” The CDC recommends cleaning dirty surfaces first with a detergent or soap and water, then disinfecting with an EPA-registered disinfectant.

Custodial staff can use diluted bleach to disinfect. The CDC recommends mixing five tablespoons of bleach per gallon of water to achieve a sodium hypochlorite–water dilution of 1,000 parts per million. Make sure custodial staff follow the manufacturer’s instructions and let the diluted bleach solution stand on surfaces for at least one minute prior to wiping. And never (a) use expired bleach and (b) mix it with ammonia or another cleanser.

Enforce the use of personal protective equipment

While cleaning and disinfecting, custodial staff must wear personal protective equipment, such as disposable gloves and a mask, to protect themselves from the coronavirus. In addition, remind them to regularly wash their hands with soap and water, use a commercial hand sanitizer, and stay home when they’re not feeling well.

Following the above cleaning recommendations can help stop the spread of COVID-19 and other infectious diseases in schools, municipal buildings, and health care facilities. To order cleaners, disinfectants, and other janitorial supplies, please visit our online store.

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