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Planning for the Bird Flu
By MONA BUCK
Current information suggests the avian flu H5N1 could
in all likelihood mutate into a communicable virus among humans. Rather
than the limited geographical targets of a natural disaster or terrorism,
where the majority of the damage would be to infrastructure and physical
equipment, bird flu would hit the workforce en masse.
Should this event occur, absenteeism will become an issue of major
proportion.
The United Kingdom’s (UK) Influenza Pandemic Contingency Plan
(which can be found at http://www.dh.gov.uk/assetRoot/04/12/17/44/04121744.pdf
) suggests that if this scenario plays out, planners can assume 7 percent
absenteeism in the work place for a period of three to five months,
with 25 percent of all employees being absent at some point.
The absentee rate can be expected to be even higher in healthcare and
education fields, due to higher expected infection rates. It is also
possible there could be periodic spikes where the absenteeism would
be greater than 7 percent. Absenteeism will also impact the life cycle
of any potential vaccine, as employees are affected in all aspects
of vaccine production, slowing distribution to the community.
Vaccination cannot be depended upon to reduce these rates, since it
takes between four to six months to develop a vaccine for a new virus.
On top of that, this does not include the time to obtain FDA approval,
time for drug companies to ramp up production, and time for distribution
to reach a saturation point in the community. Even in a “normal” year,
localized shortages are common. During an epidemic, shortages would
exacerbate stress in the population as people perceive others to be
receiving their vaccine. With the rapid mutation rate of H5N1, which
has recently begun showing resistance to Tamiflu, it is possible there
will not be an effective and widely available vaccine until the end
of an 18-month-long epidemic.
Another major business impact would be expected quarantines and travel
restrictions. A reasonable expectation during an outbreak would be
to request that large meetings and non-essential travel be cancelled.
This would possibly be the death knell of already taxed airlines and
Amtrak. Convention and hospitality businesses would experience both
a lack of employees and a lack of customers. Employees could also be
affected if they live in a different town, county or state than their
workplace, and quarantines are put into effect. Quarantines and travel
restrictions are not sure methods of preventing infection. According
to the UK plan, even a 99 percent travel ban inbound to Great Britain
would only delay entry of the virus by two months. For meetings that
cannot be cancelled or handled via audio/video conferencing, usage
of a N-95 mask should be used for the duration of the meeting, and
discarded when the employee is no longer in congested surroundings.
So, what can we do as planners? We can’t prevent the coming pandemic,
but we can help our companies prepare for it.
What we can do now:
- Define the most
critical processes and the minimum staffing levels to maintain the
business from the business impact analysis (BIA), and maintain an
inventory to support those processes for a period of weeks. This
may involve renting temporary storage space, since many companies
have reduced their available warehouse space. This is not the time
for “just
in time inventory.”
- Develop a triage plan of what sections of
the business can be shutdown and available headcount redeployed to
more critical areas. Consider cross-training employees to handle
critical jobs in other departments. Again, consult your BIA and decide
what core business processes absolutely must continue.
- Maintain a
list of retired employees who might be available in a crisis. Contact
them before the crisis, not after its manifestation.
- Explore working
from home strategies for appropriate jobs; make sure employees have
the equipment they need to telecommute, such as laptops and DSL/cable
modems to access company resources, before the outbreak.
- Many states
anticipate using a “snow day” approach;
closing schools and government offices, asking business to close
or significantly scale back the on site workforce, and either canceling
or severely restricting public transportation. Identify employees
who are critical and depend on public transportation, to determine
if they can telecommute or ride-share with other employees.
- Develop
remote procedures now for employees who routinely travel to possible
hot zones, such as South East Asia or China. They could be a vector
to introduce the virus directly into your employee population, or
they could be trapped overseas if travel bans and restrictions are
put in place.
- Have educational sessions with employees. Discuss
their need to have adequate supplies of food and medicine at home
in case of quarantine or interruption of supply. Explain the difference
between being isolate and quarantined; isolation is for those already
ill, quarantine is for those exposed to the virus but not showing
signs of infection. Also cover topics such as how hands should be
washed for a period of at least 15-20 seconds, using alcohol hand
sanitizers if hands are soiled and water is unavailable, and procedures
to follow if an employee falls ill at work.
- Discuss attendance policies
with your HR department; ill employees should feel that they can
stay home without jeopardizing their job, rather than coming to work
and exposing other employees to the virus. Also, parents with young
children may have childcare issues since schools and daycares are
expected to be closed.
- Some hospitals have a “work/home” restriction
planned, where employees will be told to go only to their homes and
their workplaces, nowhere else. Consider implementing this for critical
employees (also understanding that you will need to provide them
with food and supplies if the conditions last longer than the employee’s
personal resources).
- At some point, an employee could become ill at
work. Identify a containment area, such as family bathroom or large
handicapped bathroom to confine an employee until EMS arrives, preferably
a bathroom with easily cleaned tile surfaces. The sick employee and
anyone attending to them should be given N-95 masks to wear; masks
should be discarded after the employee is taken to the hospital.
All masks, tissues, towels or other materials used by the sick employee
treated as a medical waste, and not thrown into any handy wastebasket.
(Please note that an N-95 mask is classified as a respirator and
should be used in accordance with OSHA and local state regulations.)
- Employees
should be given cleaning and disinfection materials, such as chlorine
wipes and hospital style disinfecting sprays. Employees should be
told to use them on shared surfaces such as phones, door knobs, fax
machines and copiers before use. Cleaning crews for the building
should be given instructions that all common non-porous surfaces
such as light switches, elevator buttons, etc., are to be wiped down
nightly with a chlorine bleach solution. Porous surfaces (curtains,
chairs, cubical walls) should be sprayed with an EPA registered hospital
disinfectant spray.
- Most states in the United States have pandemic
plans available online at the website www.pandemicflu.gov. Read the
plan for your state. Some states propose turning schools and other
large public venues into surge capacity locations if the local hospitals
are overwhelmed. Depending on your campus or work site, you could
have the dual problems of an ill workforce and a workforce too frightened
to come to work due to the proximity of infected people at the worksite.
This could necessitate relocation to a hot site.
The comprehensive effects of H5N1 are as yet unknown but precautions
should be considered now considering its potentially wide reaching
impact. Hopefully, these steps will help planners mitigate the impact
of an outbreak in the workforce.
Mona Buck’s interest in pandemics was sparked when she discovered
the Spanish flu outbreak caused the death of her grandmother’s
older brother. She is currently a planner in the southeast.
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