Pandemic concern increases: Fighting a virus that could hit one in four workers

By: Stephenie Overman

Companies have IT managers to protect them from attack by computer viruses. It will be up to the people managers to protect them from viruses that may sicken as many as 25% to 30% of their workforce.

Government officials around the world are warning of the danger of a pandemic, which occurs when a new influenza virus appears in the human population and then spreads across populations. Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said in September that spread of influenza A (H5N1), commonly known as bird flu, is a "time bomb waiting to go off." Human infections of bird flu have been reported in Asia, and the U.S. government has taken steps to buy $100 million in bird flu vaccine.

Because flu viruses mutate quickly, experts don't know exactly what form the next pandemic will take. The critical questions with any new virus is how virulent is it and how easily can it be transmitted, says Dr. Donald Law, microbiologist-in-chief Toronto Medical Laboratories/Mount Sinai Hospital.

"If it comes in highly virulent and easily transmitted, we can't control it; we can only manage the consequences. With the influenza virus, by the time we recognize that somebody has the disease, it can be transmitted to someone else. It's a recipe for disaster. It comes down to just how bad is this going to be? If [a new strain] just causes runny eyes and runny nose, everybody will survive that. But if it's like in Indonesia - people are dying" as a result of the H5N1 strain.

During a pandemic, companies may have to cope with 25% absenteeism, says Low. He notes that Toronto businesses learned some lessons about preparing for such a crisis from the SARS (Severe Acute Respiratory Syndrome) outbreak in 2003. SARS killed 800 people around the world; 44 died in Toronto, where the illness caused widespread suspensions of clinical services and quarantines.

Different kind of crisis

A pandemic requires a different response than other crises such as a terrorist attack or a hurricane, says Dr. Myles Druckman, vice president for medical assistance for International SOS, a medical assistance, international health care and security services provider.

"Those events are sudden, and the aftermath is dealt with," he explains. "A pandemic is a more of a phased process. The ability of organizations to respond in an effective manner is linked to how a pandemic evolves."

A pandemic typically spreads in a wave, Druckman says. "It starts at ground zero and spreads around the world. It may be one area for months, resolve there and go on to another area. It will affect different parts of the world differently. Different health authorities may have different responses as well." For example, local health officials may make different decisions on when to quarantine people.

That means that human resource and benefits managers must be prepared with a phased response based on varying circumstances. "The situation for people working in the U.S. and Canada may be very different from China. You have to understand the local health environment and manage HR issues locally in those countries."

Policies and procedures need to be in place ahead of time, "with specific trigger points of when to do certain things," Druckman says. These should address questions such as: When should expatriate dependents leave? When should expatriate employees leave? What if third-party nationals request assistance? If people are evacuated, where should they be sent? How will they receive health care and benefits at the alternate location?

Benefits managers should give employees information about the nature and spread of infectious diseases, including symptoms and signs to watch for, as well as required steps to be taken in the event of an outbreak. They'll also want to give employees clear guidelines regarding the circumstances under which the sick leave policy compensates employees for absences due to quarantine.

Allene Mares, regional health officer for Seattle and King County, Wash., is working with businesses in northwest Washington State to help them prepare for a possible pandemic.

"Most businesses think about an emergency as having their software down or a natural disaster. They're not thinking about having 25% to 30% of their workforce at random down for six to eight weeks," Mares says.

And while "normally people can expect a drug or treatment, it's not going to be like that with a pandemic. In six to eight months after a pandemic starts, a vaccine most likely will be developed, but not at the time of the first case. And anti-viral drugs might not work," she adds.

The public health office sent informational letters to area employers in August and a forum was scheduled in October. Washington Mutual, a large bank in Seattle area, will use its open enrollment in November to inform employees.

Employers should teach employees about the dangers and about the basics of "good health manners," says Mares. "Teach them about washing their hands, about covering their mouth when they cough, about not coming to work if they're ill. Give them alcohol hand gel at their desks."

Mares also suggests giving employees information about links such as the CDC's "Stop the Spread of Germs" site: www.cdc.gov/germstopper/home_work_school.htm.

Companies may try "social distancing," she says, setting up shifts so people don't come into contact with each other and allowing employees to telecommute. "Every business is different. We haven't found a one-size-fits all. What are your policies? What if an employee needs to care for a child? Can work be done remotely?"

The employee assistance program will be crucial during a pandemic, she emphasizes. "This will be an extremely stressful time. People will be afraid. People will be ill. It could be a deadly virus. People will really need to have assistance to get through such a difficult time."

Protecting, isolating employees

Benefits managers may want to buy masks for employees at work, but "if people are sick they shouldn't be there," says Low. Besides, "it's probably not logistically possible to have everybody at work wearing a mask at all times. It loses effectiveness after a certain number of hours."

Some companies are talking about buying anti-viral drugs. "They're not waiting for the government. They're saying, we're going to buy anti-virals to keep our workforce going, to give to essential workers.'"

During the SARS outbreak, Low notes that some businesses "created pools of workers who didn't have contact with each other, so if one pool was contaminated, they wouldn't give it to each other," Low says. "With SARS, that was a practical approach. The trouble with influenza is that the virus is pervasive. It's not just in institutional settings. How do you protect people at work when they're at risk when they leave the building?"

Low says companies might try keeping key workers in isolation from everyone else, "but will people tolerate that for six to eight weeks? And what happens when their family members get sick?"

This year's vaccine

Even an "average" flu season can be costly. The Centers for Disease Control and Prevention estimates that about 36,000 people in the United States die from flu each year, more than 200,000 people are hospitalized from flu complications and 70 million workdays are lost.

Vaccine distribution delays or shortages occurred in the United States in three of the last five influenza seasons. This year's supply is expected to reach more than 90,000,000 doses from four drug makers. The vaccine contains three strains of flu: H1, H3 and one B strain, according to Dr. Julie Gerberding, CDC director.

The vaccine will be made available first to people in high-risk groups: people 65 and over, those with autoimmune diseases and chronic conditions, pregnant women and health-care workers. Hurricane Katrina evacuees living in shelters will also be given top priority. If there is a shortage again this year, the CDC will make allocation plans for what is available, according to Dr. Jeanne Santoli, the associate director of science at the CDC's Immunization Services Division.

A federal vaccine advisory committee recommends expanding the use of nontraditional settings for vaccine distribution, places such as workplaces, churches and shopping malls.

Offering the flu vaccine in its workplace now gives a company a head start in preparing for the eventual crisis, says Mares. "You're a step ahead if you have a distribution system already in place" before a full-blown pandemic occurs.

"We don't have a crystal ball that tells us when a pandemic will strike or who be most affected by it," she says. "This kind of planning will do you well regardless of the emergency. Even if it's five years before we have a pandemic, it is helpful to be thinking about this." - E.B.N.