Businesses Should Plan for a Flu Pandemic August, 2009 - Richard J. Reichert, M.D., M.P.H. U.S. HealthWorks Medical Group

The world is currently in the middle of an influenza pandemic. After an initial scare in the spring of 2009, the Novel Influenza A H1N1 virus (commonly referred to as the "swine flu") has thankfully turned out to be relatively mild, but this should not lead to complacency. This event has given employers a valuable opportunity to evaluate the effectiveness of their pandemic plans and prepare for the next event, which could be more serious. In the short course of a few months, the "swine flu" spread from an initial total of 19 cases affecting two countries to more than 180,000 cases spread over 170 countries across the globe. The World Health Organization (WHO) rapidly moved its alert from Pandemic Phase 3 to a full-blown Pandemic Phase 6 status based on the relative easy transmission of this virus between humans. At least for now, the virus has caused relatively mild disease in most cases and has resulted in a low mortality rate below 0.5%. However, there is no guarantee that this virus will remain so mild or that others more potent will not surface in the future. In fact, the potential for a serious outbreak at some point remains high. The expected mortality rate of the avian flu (H5NI virus) that surfaced a few years ago was expected to be in the range of 40-50 percent. Because no one is as able to predict the future severity of the current virus or future viruses, every company should take this opportunity to audit the strengths and weaknesses of its pandemic plan.

Recently, even companies with very good pandemic plans found that they were unable to activate components of them due to limited availability (in some cases, no availability) of essential supplies such as face masks, hand sanitizers, cleaning agents and anti-viral drugs. Many other companies found that they had not done enough homework in developing their plans and felt less than prepared in the early stages of this pandemic, when the situation was evolving daily and the level of information was low and uncertainty was high. Inadequate communication processes within organizations came to light during this period.

So what should an employer do now to take advantage of lessons learned from the early stages of this pandemic? Appropriate Travel. Evaluate travel policies for associates both internationally and domestically. Although no specific areas were quarantined by the WHO in the spring of 2009, many employers restricted travel to Mexico or the U.S. because these were outbreak "hot spots." Companies need to have a process in place to determine when, where and how travel is appropriate. Social Distancing. Be prepared to address the issue of social distancing - avoidance of close contact between individuals. Does a company have the technology to allow individuals to work from home? When should this be initiated? When should group events such as those that occur in meeting rooms and cafeterias be avoided? What about shaking hands? Are there policies for dealing with employees who have been exposed to someone who is sick? What about returning travelers? How should a company deal with an associate who is potentially infected but not displaying symptoms? What about an employee who becomes sick while at work? How will that employee be removed while protecting others? What about protection of key personnel? Cleanliness. Employers can change cleaning schedules to protect against transmission of the virus particles. This includes use of disinfectants to frequently clean common contact surfaces including doorknobs, table surfaces, keyboards, telephones and other objects in the workplace. Education is a key to prevention, and there are multiple sources of information that can be posted for employees to explain the importance and proper methods of cleaning hands, wearing a face mask and implementing other sanitary measures.

Vaccination. Seasonal influenza is different from a pandemic influenza, and the vaccines given yearly for seasonal influenza are not effective against quickly emerging pandemic strains. However, vaccination against seasonal influenza is recommended to provide personal protection against human influenza, and to reduce the potential for "reassortment" of the human influenza virus with a pandemic virus. It can also enable earlier diagnosis and isolation of true pandemic patients. A vaccine is being developed for the H1N1 virus. It is currently expected to be available beginning in mid October of 2009. However, initial supplies may be limited and directed primarily to the most at-risk populations until adequate supplies can be produced. The mild nature of this early stage of pandemic has afforded all employers an opportunity to address some very important issues which will need to be in place if a more dangerous wave of this epidemic or another pandemic hits in the future. Now is the time for companies to act. Information is available from the CDC at its website,

www.cdc.gov/h1n1flu/ [http://rs6.net/tn.jsp?et=1102665470076&s=12060&e=001pG-3OlqtC1m29UCxvaxVCexhHCsuxyshTqDBvlAfNnbW_YSe8gLMKAnieB0sLg1STrIX5ruekupu2Hcyv_pokCyIEnUreCMMAy7FaYMYEhrjtCU7XQV75UJz8QYQbsCK]