Handwashing with soap and water should last at least 20 seconds. Handwashing with an alcohol-based sanitizer (at LEAST 70% Isopropyl Alcohol) is acceptable in situations where hands are not visibly soiled. On set I recommend carrying a small travel-sized bottle of hand sanitizer for convenience. When using hand sanitizer, dispense enough to cover all hand surfaces adequately and rub hands together vigorously making sure to cover all hand surfaces until dry. Everyone on set should wash their hands with soap and water rather than sanitizer after using the bathroom, blowing their nose, sneezing, or coughing, before preparing food, and before and after eating food.

2. Proper use of PPE

On set, the only piece of PPE I recommend wearing regularly is a mask. This can be a fabric mask, a surgical mask, or a N-95 mask. I’m saying this for everyone: masks MUST cover your nose and mouth securely. Having a mask over just your mouth with your nose exposed does nothing to prevent droplets or aerosols contaminated with the coronavirus from entering your respiratory system. Your nose and mouth are connected to the same body system! Masks should be worn by all crew members and talent when not shooting (i.e. rehearsing, blocking, setting lighting, etc). If you feel the need to remove your mask for fresh air or to readjust, please remove yourself from set (preferably in an isolated area outside) and, after sanitizing or washing your hands, remove or adjust your mask. Breaks and lunch should be in a well- ventilated area and should include physical distancing of at least 6 feet since masks will be removed to eat. It is also important to remember that while wearing a mask is important for your own personal protection, masks are more important as a preventative step to mitigate potentially infecting those around you. I do not recommend gloves for preventing COVID-19 spread because they can cause a false sense of security and because it is not recommended to use hand sanitizer or soap and water on gloves. Case in point, I saw an employee at a grocery store use her gloved hands to pull her mask down, pull a piece of chocolate from her pocket and unwrap it, then pop the morsel into her mouth potentially infecting herself with COVID-19. I do, however, recommend using gloves when cleaning high-touch surfaces on set because of the potential health hazards of some cleaning agents.

3. Respiratory hygiene & cough etiquette

Coughing and sneezing create what are called droplets and aerosols. Droplets can travel through the air briefly and infect individuals within approximately 6 feet of distance before falling to the ground, hence the need for 6-feet of physical distancing in public. Smaller respiratory droplets called aerosols (think squirt gun versus hair spray bottle) are more worrisome and potentially infectious because they are too light to drop immediately to the floor as droplets do and can therefore linger in the air for longer periods of time. On a set, which is usually an enclosed environment, this can pose a very serious risk of infection and this is why proper mask-wearing is so essential in preventing the spread of the coronavirus. Respiratory hygiene includes proper mask-wearing and handling as well as proper containment of coughs and sneezes and disposal of contaminated tissues. When coughing or sneezing without a tissue, try to cough or sneeze into the bend of your elbow. When using a tissue, cover your mouth/nose and then dispose of the tissue into an appropriate trash receptacle. Wash your hands afterward with soap and water using proper handwashing techniques.

4. Properly handle and disinfect equipment and environment

From lavaliers to camera gear to lighting equipment to props, there is no shortage of equipment that is moved between crewmembers and talent on set. Because shoots can move at lightning speed, it’s very easy to overlook potential hazards that could result in infection. Equipment should not be shared between individuals on set. Each piece of equipment to be used and handled should have only one person assigned to it. Equipment must be sanitized at the end of each shoot day or before the piece of equipment is stowed or reassigned.

5. Use disposable or dedicated equipment

When possible, equipment should be either disposable or, as mentioned above, assigned to a user who will exclusively handle the equipment (lavs, props). Understandably, there isn’t much production equipment that’s disposable, so assigning and sanitizing are important to prevent infection spread. All craft services should be in single-serve containers or individually packaged containers.

WE’RE ALL IN THIS TOGETHER
(No, this isn’t a reference to High School Musical!)

Stopping the spread of COVID-19 is a team effort. In a healthcare setting, infection control is second-nature to everything that happens during patient interactions. While the stakes for a production aren’t typically life or death, COVID-19 presents a very real threat to the health and safety of everyone involved in a production. As mentioned above, this month an assistant director on a production died as a result of COVID-19 complications, and age-wise he wasn’t in the demographic for those most at risk of severe complications. The truth is, we don’t know everything about what will make the coronavirus just a ‘cold-like illness’ for some and what will make it deadly for others. COVID-19 Compliance Officers assigned to film sets fill an important role in this unprecedented period of film production, but keeping everyone safe and healthy requires buy-in from everyone on the cast and crew.

“WHY WOULD HE DO THAT? Does he realize how much money we’ve put into this? I called him-I CALLED HIM to remind him to quarantine. I said, ‘DON’T go see your girlfriend, because she hasn’t been taking this seriously, she’s been hanging with friends every day. Just please, while we’re shooting, PLEASE stay home.’ Did he do that? NO!” one of the crew recounted.

Afterward, as an extra precaution, I recommended that everyone retest in a week and self-monitor for the development of any symptoms. Of course, after all was said and done, his girlfriend had a false positive test and he ended up being negative. But that’s not the point.

The aftermath

A major flaw in the implementation of a COVID 19 safety protocol for film productions is that it relies heavily on the honor system and it depends on everyone’s trust in the medical science regarding COVID 19. Everyone must be honest with both themselves and with the other members of the team.

If you’re feeling symptomatic, you should report it. If you’ve been unsafe or broken quarantine, you should be honest about that. Not just for your safety, obviously, but for the safety of the rest of the cast and crew and their families, friends, and anyone they may encounter. Everyone must accept that this virus is a real, tangible, and potent threat.

As a C19CO, I can do every part of the recommended process and follow protocols perfectly and someone could still potentially become infected or infect others if honesty is not the policy. I’ll admit that even I was seduced, at least partially, by the belief that because there was familiarity, that they were all friends and have known each other for years, the risk was somehow mitigated. That their trust was unbreakable. Their word was their bond. The set was someone on the crew’s apartment. But in order to be as effective as possible as a C19CO, I needed to remind myself of one very important adage related to infection control and mitigation: treat everyone with whom you come into contact as though they have something that can make you sick.

On set, I don’t care if the mask is uncomfortable. I’m also not concerned about whether you just did your makeup. I don’t care about literally any inconvenience to your appearance, your comfort, or your ability to sip a beverage. I don’t even want to know whether you believe COVID-19 is a real threat or not. All I care about is the health and safety of everyone so that lives aren’t affected or lost unnecessarily and that production isn’t shut down. Period.

Whatever doubts or insecurities I previously held about my ability to handle a situation were quickly dispelled. I owe my ability to stay calm and collected to my 10+ years of experience as a healthcare worker (radiologic technologist in an ER as well as a Radiology Practitioner Assistant). In that moment and in the aftermath, I was humbled to be able to bring calm and allay fears.

After that incident, everyone wore their masks perfectly and religiously and sanitized so often it smelled like a vodka bar. I was and am so grateful for the training and knowledge I received as a healthcare worker, especially as it relates to infection control and pathophysiology.

Through it all, I learned that if I give myself time to critique myself, EVER, I’ll find that I’m an impostor every time. But when I don’t have time to think and I react on instinct . . . I’m LESS of an impostor.

To get a better baseline around how I came to best approach this issue, read my Insights and Advice from a COVID-19 Compliance Officer for Pre-production and Production article.

Editor’s Note: Please be aware that the information contained in this article does not establish a standard of care, nor does it constitute legal advice. The information is for general informational purposes only and is written from a risk management perspective to aid in reducing professional liability exposure. Recommendations from the CDC are changing rapidly. You are encouraged to stay up to date with those details as specific liabilities and legal requirements may vary from state to state. ProVideo Coalition assumes no responsibility for the contributor’s statements of fact or opinion.

Because this is essentially protected health information (PHI), this information is subject to the health information portability and accountability act (HIPAA) and should not be shared or discussed openly. PHI should also never be included in the production wrap book. It is important to note that any development of symptoms or a positive testing result within 14 days of wrapping should be reported to the producer or other designated point of contact (could be C19CO) by the cast/crew member. It is then the production company’s responsibility to notify all personnel who may have been exposed and they should notify the local health department if more than 3 individuals receive a positive COVID-19 test as a result of work on the production.

Any individual exhibiting symptoms or a higher than 100-degree temperature with a contact-less thermometer during the shoot should be removed from set, production should be halted for a minimum of 24 hours, the set should be deep cleaned by a professional janitorial service, and all persons who may have had potential close contact should be notified. Positive and symptomatic personnel may return to set only if they have been asymptomatic for 3 days (in addition to the 10 days post onset of symptoms.)

Note: updated guidelines have reduced the asymptomatic requirement period to 24 hours. Use your own discretion.

If someone required hospitalization, they may return to set with a doctor’s note. Asymptomatic positive individuals may be allowed to return to set after isolating for a minimum of 10 days after receiving the positive test result. Individuals in close contact with positive personnel should self-isolate for 14 days, seeking medical advice if necessary if serious symptoms develop.

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For anyone who wants a better understanding of how to implement these processes and procedures, you can take one of these classes to become a C19CO. But there are a few things you should know before going into it.

First off, the class itself wasn’t overly in-depth and the quiz wasn’t overly complicated, which makes sense given how many possible scenarios and settings you have in production as well as the gamete of individuals who may become C19COs. Infection control was a significant component in the training, with emphasis on proper hand sanitizing and other such preventive measures.

As with most health-related occupations, learning the basics in a class setting is invariably different that application in the field. I did find the guidelines to be robust enough to mitigate the potential for outbreaks on an actual set and loose enough to apply to really any film set. I couch that by also stating that I feel one must be organizational, willing to adapt, able to lead and be direct, be an effective communicator, and I also feel strongly that prior healthcare experience is incredibly valuable.

The years-long training I received in the health-occupation classroom, the clinical training setting, and in various jobs gave me the ability to remain calm when we had an unexpected potential infectious individual on-set and the knowledge of pathophysiology that allowed me to really understand the likelihood of viral transmission to others on set in a given window of time since the individual’s potential infection. I also knew, based on that same information, that while this individual planned to have a rapid COVID-19 test performed the following day, that the result of that test would not be reliable to gauge HIS infection (because of a small theoretical viral load since his presumed infection time), but would be helpful in determining the risk to the rest of the cast and crew.

To clarify, I don’t necessarily believe this is information or skills that anyone operating as a C19CO NEEDS to have on set. But when faced with a director or a team who have devoted time, money, and effort to making a production happen, and you have a situation that may cause production to be shut down, bedside manner and the ability to allay fears based on that training is invaluable.

The position is not without its pitfalls, which are predominantly external to the actual C19CO. While film productions can implement safety protocols on set and have everyone test prior to coming to set, there will honestly never be a 100% safe and secure method of production, especially where production budgets are tight.

For example, a production could, in theory, mandate that all the cast and crew test then quarantine in a hotel for 2 weeks and then stay in this hotel for the duration of the production, where everyone would be isolated and monitored to prevent infection. Obviously this is an extreme method, but in a scenario where all those involved would be agreeable to such an arrangement, AND cost were not an issue, this would be an airtight method of preventing COVID-19 infection. In the real world though, this sort of thing typically isn’t an option. Many productions are on the smaller scale, both in terms of size and budget, so we are at the mercy of the honor system.

It’s also important to reiterate that the C19CO is a standalone department head with the authority to shut down production. This may come as a surprise to some production staff, and one may make the theoretical argument that this may cause some cast or crew to go ‘rogue’, in one way or another, by either choosing to operate without the use of a Compliance Officer or by ignoring the authority thereof. If the C19CO is in any way swayed from performing their duty either by threat or manipulation, this jeopardizes the importance and legitimacy of the role. The addition of the C19CO to the production team works best when there is a mutual understanding, respect, and adherence to a shared responsibility of maintaining a safe set. Everyone must be on board with this from the start of production planning.

Unfortunately, there isn’t a perfect solution to this unprecedented time of film productions during a global pandemic, and it’s important for those planning productions to understand that this is in no way a complete resolution of the risk of COVID-19, but risk mitigation. Aside from purely Draconian methods to ensure a totally safe production, the C19CO is a valuable asset to the production team as long as everyone understands that honesty (as with life) is the best policy.

To get a sense of how these lessons and insights were applied on a real production, read my Production During a Pandemic: Working as a COVID 19 Compliance Officer for a Film Production article.