7 Pandemic Planning—Workplace Preparedness

Pandemic Planning—Workplace Preparedness

Background
A severe pandemic (defined as a worldwide epidemic) in a vulnerable population, such as the 1918 flu pandemic, represents a worst-case scenario for pandemic planning and preparedness. Communities, individuals, employers, schools, and other organizations are being asked to plan for the use of interventions that will help limit the spread of disease. At this time, there is concern because of continued spread of a highly pathogenic avian influenza (H5N1) virus among animals in Asia, Africa, the Middle East, and Europe that has the potential to significantly threaten human health. If a virus such as H5N1 mutates and spreads easily from one person to another, avian influenza may break out globally. While there are no reports of sustained humanto- human transmission of avian influenza, governments and international health agencies are preparing for a possible pandemic. A pandemic can originate from any unknown source, such as the H5N1 virus.
Employers face several challenges in preparing their businesses for a possible pandemic:
• Section 5(a)(1) of the U.S. Occupational Safety and Health Act of 1970 requires that every working man and woman must be provided with a safe and healthful workplace.
• Absenteeism will increase due to illness of employees or their families.
• Changes in patterns of commerce may affect income and costs.
• Normal supply and delivery schedules will likely be interrupted.
Employers and employees should use this planning guidance to help identify levels of risk levels in workplace settings and apply appropriate control measures that include good hygiene, cough etiquette, social distancing, use of personal protective equipment (PPE), and staying home from work when ill. Other documents on these subjects are available through Risk Management.
Employee risks may range from very high to lower risk depending on the nature of the business enterprise and the employee responsibilities. The OSHA document referenced at the end of this fact sheet can provide additional information.

Overview
The best way to reduce the risk of becoming infected with influenza during a pandemic is to avoid crowded settings and other situations that increase the risk of exposure to someone who may be infected. If it is necessary to be in a crowded setting, the time spent in a crowd should be as short as possible. It is the employer’s obligation to consider and possibly provide additional methods of protection if employees and customers are required to be in close proximity to one another.
Incorporate Pandemic Planning into the Organization’s Business Continuity Plan
• Develop a disaster plan that includes pandemic preparedness (see
www.pandemicflu.gov/plan/businesschecklist.html.
• Make sure that your business continuity plan protects and supports your employees, customers, and the general public. Informed employees who feel safe at work are less likely to be absent.
• Prepare and plan for operations with a reduced workforce.
• Identify business-essential positions and the skills required to sustain essential business functions and operations. Be sure to cross-train three or more employees so they can function appropriately in these positions.
• Plan for downsizing services but also anticipate any scenario, that may require a surge in your services if they are critical in a pandemic situation.
• Organize and identify a central team of people or focal point to serve as a communication source so that your employees and customers can have accurate information during the crisis.
• Work with your suppliers to ensure that you can continue to operate and provide services.

Evaluate Personnel Risks and Concerns
• Identify possible exposure and health risks to employees. Will employees potentially be in contact with people with influenza? Are employees expected to have much contact with the general public or each other?
• Minimize exposure to fellow employees or the public. For example, can more employees work from home? This may require enhancement of technology and communications equipment.
• Develop a sick leave policy that does not penalize sick employees, thereby encouraging employees who have influenza-related symptoms (such as, fever, headache, cough, sore throat, runny or stuffy nose, muscle aches, or upset stomach) to stay home so that they do not infect other employees. Recognize that employees with ill family members may need to stay home to care for them.
• Recognize that, in the course of normal daily life, all employees will have nonoccupational risk factors at home and in community settings that should be reduced to the extent possible. Some employees will also have individual risk factors that should be considered by employers as they plan how the organization will respond to a potential pandemic (for example, immuno-compromised individuals and pregnant women).
• Assist employees in managing additional stressors related to the pandemic. These are likely to include distress related to personal or family illness; life disruption; grief related to loss of family, friends, or coworkers; loss of routine support systems; and other similar challenges. Assuring timely and accurate communication will also be important throughout the duration of the pandemic in decreasing fear or worry. Employers should provide opportunities for support, counseling, and mental health assessment and referral should these be necessary. If present, Employee Assistance Programs can offer training and provide resources and other guidance on mental health and resiliency before and during a pandemic.
• Work with DMBA and Risk Management as well as state and local health agencies to provide information to employees and customers about medical care in the event of a pandemic.

Employee Hygiene
• Develop policies and practices that distance employees from each other, customers, and the public (see the Pandemic Planning—Social Distancing fact sheet for more information). Consider practices to minimize face-to-face contact between employees such as e-mail, Web sites, and teleconferences. Policies and practices that allow employees to work from home or to stagger their work shifts may be important as absenteeism rises.
• Consider stockpiling items such as soap, tissue, hand sanitizer, cleaning supplies, and recommended PPE. When stockpiling items, be aware of each product's shelf life and storage conditions (avoid areas that are damp or have temperature extremes) and incorporate product rotation (consume oldest supplies first) into your stockpile management program.
• Encourage employees to wash their hands frequently with soap and water or with hand sanitizer if there is no soap or water available. Also, encourage your employees to avoid touching their noses, mouths, and eyes. Encourage employees to cover their coughs and sneezes with a tissue or to cough and sneeze into their upper sleeves if tissues are not available. All employees should wash their hands or use a hand sanitizer after they cough, sneeze, or blow their noses. See the Pandemic Planning—Personal Hygiene fact sheet for more information.
• Provide employees and customers in the workplace with easy access to infection control supplies, such as soap, hand sanitizers, PPE (such as gloves or surgical masks), tissues, and office cleaning supplies.
• Provide training, education and informational material about business-essential job functions and employee health and safety, including proper hygiene practices and the use of any PPE to be used in the workplace. Be sure that informational material is available in a usable format for individuals with sensory disabilities or limited English proficiency. Refer to fact sheets on hygiene, home preparedness, social distancing, and PPE for more information.
• Periodically disinfect work surfaces, telephones, computer equipment, and other frequently touched surfaces and office equipment.
• Discourage employees from using other employees' phones, desks, offices, or other work tools and equipment.
• Encourage employees to obtain a seasonal influenza vaccine (this helps to prevent illness from seasonal influenza strains that may continue to circulate).

Protecting Employees and Customers
• Educate and train employees in proper hand hygiene, cough etiquette, and social distancing techniques. Resource documents are available through Risk Management. Understand and develop work practice and engineering controls that can provide additional protection to employees and customers, such as drive-through service windows; clear plastic sneeze barriers; ventilation; and the proper selection, use, and disposal of PPE.
• Evaluate the types of measures that may be used to protect employees and customers (listed from most effective to least effective): engineering controls, administrative controls, work practices, and PPE.
• Employees should avoid close contact with their coworkers and customers (maintain a separation of at least 6 feet). They should avoid shaking hands and always wash their hands after contact with others. Even when employees wear gloves, they should wash their hands upon removal of the gloves in case their hands become contaminated during the removal process.
• Minimize situations where groups of people are crowded together, such as in a meeting. Use e-mail, phones, and text messages to communicate with each other. When meetings are necessary, avoid close contact by keeping a separation of at least 6 feet, where possible, and assure that there is proper ventilation in the meeting room.
• Reduce or eliminate unnecessary social interactions. This can be very effective in controlling the spread of infectious diseases. Reconsider all situations that permit or require employees, customers, and visitors (including family members) to enter the workplace.
• Promote healthy lifestyles, including good nutrition and exercise. A person's overall health impacts their body's immune system and can affect their ability to fight off or recover from an infectious disease.

Concerns When Living, Working, or Traveling Internationally
Employees living abroad and international business travelers should note that other geographic areas have different influenza seasons and will likely be affected by a pandemic at different times. The U.S. Department of State emphasizes that, in the event of a pandemic, its ability to assist Americans traveling and residing abroad may be severely limited by restrictions on local and international movement imposed for public health reasons, either by foreign governments and/or the United States. Furthermore, American citizens should take note that the Department of State cannot provide Americans traveling or living abroad with medications or supplies even in the event of a pandemic. These conditions will be similar to those found in most other countries. Each individual should contact their own country’s Department of State for information specific to their country’s policies and regulations. The U.S. Department of State has asked its embassies and consulates to consider preparedness measures that take into consideration that travel into or out of a country may not be possible, safe, or medically advisable during a pandemic. Guidance on how private citizens can prepare is available in the Church’s Pandemic Planning—Sheltering in Place fact sheet. Embassy stocks will typically not be made available to private citizens abroad. It is also likely that governments will respond to a pandemic by imposing public health measures that restrict domestic and international movement, further limiting the U.S. government's ability to assist Americans in these countries. As it is possible that these measures may be implemented very quickly, it is important that employers and employees plan appropriately.

Before any international travel:
• Consult the U.S. Government pandemic website at www.pandemicflu.gov or
www.travel.state.gov/travel/travel or the World Health Organization’s (WHO) Web site at www.who.int/csr/don/en/index.html to review countries with significant outbreaks of infectious disease.
• Find out how and where to get medical care in the country where you are traveling.
• Check your health insurance plan or get additional insurance that covers medical evacuation in case you become ill.
• Be sure your vaccinations are up-to-date at least 6 weeks before you travel.
• Assemble or purchase a travel health kit containing first aid and medical supplies. Be sure to include a thermometer and alcohol-based hand rub.

During travel:
• Avoid all direct contact with poultry or places where live poultry is raised or kept.
• Avoid handling surfaces contaminated with poultry feces or respiratory secretions.
• One of the most important preventive measures is careful and frequent hand washing. Please refer to the Pandemic Planning—Personal Hygiene fact sheet.
• It is important to understand that you might become infected in a country where the health care systems may be inadequate to cope with a serious infectious process.
• If you have an illness that requires prompt medical attention, a consular officer can assist you in locating medical services and communicating with your family and friends.

After your return:
• Monitor your health for 10 days.
• If you become ill with fever and develop a cough, difficulty breathing, or any illnesses during this period of time, consult a health care provider. Advise them of your symptoms, where you have traveled, and if you have had any contact with poultry or with a known case of any infectious disease.

References
www.osha.gov/Publications/influenza_pandemic.html
www.pandemicflu.gov
www.cdc.gov/niosh
www.cdc.gov
www.fda.gov/cdrh/ppe/fluoutbreaks.html