HR's Pandemic Flu Plan For The 2009-2010 Season
This year's flu season may be particularly disruptive, as the regular seasonal flu is expected to be joined by the novel H1N1 flu. Find out what HR can and should do now to start preparing for the flu season, in order to keep your workforce safe and minimize disruption to your business operations. Also included are immediate steps to take should the flu strike your workplace.
In June 2009, Dr. Margaret Chan, Director-General of the World Health Organization, declared that the scientific criteria for an influenza pandemic had officially been met.
In July 2009, President Obama called on the nation to begin planning for the flu season, calling flu preparedness a "shared responsibility."
In August 2009, the Centers for Disease Control and Prevention (CDC) released new federal guidelines to help businesses plan for and respond to the upcoming flu season.
Planning: Determine An Appropriate Response
Since flu patterns can vary greatly across the country, the CDC's new guidelines advise employers to base their response to flu outbreaks on information from state and local public health authorities. Some of the key indicators to use when making decisions on how best to respond are:
- illness severity (i.e., hospitalization and death rates) in the community where your company is located;
- extent of illness (i.e., number of people who are sick) in the community;
- impact of illness on workforce populations that are vulnerable and at higher risk (e.g., pregnant women, individuals with certain chronic medical conditions); and
- presence of factors that may adversely impact employees' ability to get to work (e.g., school dismissals or closures).
CDC says: Employers need to plan now to be able to obtain updated information on these indicators from state and local health departments in each community where they have a business presence. Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions outlined in their business pandemic plan based on the condition in each locality.
Planning: Take it Step-By-Step
The CDC's new guidance states that all employers should review or establish a flexible pandemic flu plan and conduct a focused discussion and drill using the plan, to find out ahead of time whether the plan has gaps or problems that need to be corrected.
To assist employers in their planning efforts, the CDC and the Department of Health and Human Services (HHS) developed the Business Pandemic Influenza Planning Checklist, which is broken down into six steps. Track your planning progress by checking off completed suggestions.
Step 1: Plan for the impact of a pandemic on your business
_____ Identify a pandemic coordinator and/or team with defined roles and responsibilities for preparedness and response planning. The planning process should include input from labor representatives.
_____ Identify essential employees and other critical inputs (e.g., raw materials, suppliers, subcontractor services/products, and logistics) required to maintain business operations by location and function during a pandemic.
_____ Train and prepare ancillary workforce (e.g., contractors, employees in other job titles/descriptions, retirees).
_____ Develop and plan for scenarios likely to result in an increase or decrease in demand for your products and/or services during a pandemic (e.g., effect of restriction on mass gatherings, need for hygiene supplies).
_____ Determine potential impact of a pandemic on company business financials using multiple possible scenarios that affect different product lines and/or production sites.
_____ Determine potential impact of a pandemic on business-related domestic and international travel (e.g., quarantines, border closures).
_____ Find up-to-date, reliable pandemic information from community public health, emergency management, and other organizations, and make sustainable links.
_____ Establish an emergency communications plan, and revise periodically. This plan includes identification of key contacts (with back-ups), chain of communications (including suppliers and customers), and processes for tracking and communicating business and employee status.
Step 2: Plan for the impact of a pandemic on your employees and customers
_____ Forecast and allow for employee absences during a pandemic due to factors such as personal illness, family member illness, community containment measures and quarantines, school and/or business closures, and public transportation closures.
_____ Implement guidelines to modify the frequency and type of face-to-face contact (e.g., hand-shaking, seating in meetings, office layout, shared workstations) among employees and between employees and customers.
_____ Encourage and track annual influenza vaccinations for employees.
_____ Evaluate employee access to and availability of health care, mental health, and social services during a pandemic, including corporate, community, and faith-based resources, and improve services as needed.
_____ Identify employees and key customers with special needs, and incorporate the requirements of such persons into your preparedness plan.
Step 3: Establish policies to be implemented during a pandemic
_____ Establish policies for employee compensation and sick-leave absences unique to a pandemic (e.g., non-punitive, liberal leave), including policies on when a previously ill person is no longer infectious and can return to work after illness.
_____ Establish policies for flexible worksites (e.g., telecommuting) and flexible work hours (e.g., staggered shifts).
_____ Establish policies for preventing influenza spread at the worksite (e.g., promoting respiratory hygiene/cough etiquette, prompt exclusion of people with influenza symptoms).
_____ Establish policies for employees who have been exposed to pandemic influenza, are suspected to be ill, or become ill at the worksite (e.g., infection control response, immediate mandatory sick leave).
_____ Establish policies for restricting travel to affected geographic areas (consider both domestic and international sites), evacuating employees working in or near an affected area when an outbreak begins, and guidance for employees returning from affected areas.
_____ Set up authorities, triggers, and procedures for activating and terminating the company's response plan, altering business operations (e.g., shutting down operations in affected areas), and transferring business knowledge to key employees.
Step 4: Allocate resources to protect your employees and customers during a pandemic
_____ Provide sufficient and accessible infection control supplies (e.g., hand-hygiene products, tissues and receptacles for their disposal) in all business locations.
_____ Enhance communications and information technology infrastructures as needed to support employee telecommuting and remote customer access.
_____ Ensure availability of medical consultation and advice for emergency response.
Step 5: Communicate to and educate your employees
_____ Develop and disseminate programs and materials covering pandemic fundamentals (e.g., signs and symptoms of influenza, modes of transmission), personal and family protection, and response strategies (e.g., hand hygiene, coughing/sneezing etiquette, contingency plans).
_____ Anticipate employee fear and anxiety, rumors, and misinformation; plan communications accordingly.
_____ Ensure that communications are culturally and linguistically appropriate.
_____ Disseminate information to employees about your pandemic preparedness and response plan.
_____ Provide information for the at-home care of ill employees and family members.
_____ Develop platforms (e.g., hotlines, dedicated websites) for communicating pandemic status and actions to employees, vendors, suppliers, and customers inside and outside the worksite in a consistent and timely way, including redundancies in the emergency contact system.
_____ Identify community sources for timely and accurate pandemic information (domestic and international) and resources for obtaining counter-measures (e.g., vaccines and antivirals).
Step 6: Coordinate with external organizations and help your community
_____ Collaborate with insurers, health plans, and major local healthcare facilities to share your pandemic plans and understand their capabilities and plans.
_____ Collaborate with federal, state, and local public health agencies and/or emergency responders to participate in their planning processes, share your pandemic plans, and understand their capabilities and plans.
_____ Communicate with local and/or state public health agencies and/or emergency responders about the assets and/or services your business could contribute to the community.
_____ Share best practices with other businesses in your communities, chambers of commerce, and associations to improve community response efforts.
Planning: Spread Information, Not Germs
Knowledge is power, so empower your employees by sharing the following information on how to reduce the likelihood of contracting seasonal or H1N1 flu.
- Get vaccinated. It's the single best way to prevent contracting the flu, according to the CDC. There are two separate flu vaccinations; one for seasonal flu and one for H1N1 flu. Important: Different groups are prioritized for the H1N1 vaccine than are prioritized for the seasonal flu vaccine.
- Take an antiviral medication if the doctor recommends it. Antiviral drugs work best if they're started soon after getting sick, i.e., within two days of the onset of symptoms.
Note: A key difference between a vaccine and an antiviral drug is that the antiviral drug will prevent infection only when administered within a certain time frame before or after exposure and is effective during the time that the drug is being taken, while a vaccine can be given long before exposure to the virus and can provide protection over a long period of time.
- Cover your nose and mouth with a tissue when you cough or sneeze. Immediately throw the tissue in the trash after you use it; don't leave it on your desk, even momentarily.
- Avoid touching your eyes, nose, and mouth. Germs gain access to your body this way.
- Wash your hands often with soap and water for at least 20 seconds, especially following contact with commonly touched surfaces (e.g., phones, doorknobs, copiers, printers, fax machines).
- Keep an alcohol-based hand sanitizer at your workstation and mini-wipes in your pocket or purse, especially if you don't have ready access to a washroom.
- Try to avoid close contact with sick people.
- Eat healthily, exercise regularly, and get plenty of sleep. Being run-down makes you more vulnerable to germs.
- Be alert for symptoms of flu, which typically include: high fever, headache, extreme tiredness, dry cough, sore throat, runny or stuffy nose, muscle aches, and nausea, vomiting, and diarrhea (more common in children than adults). Contact a doctor, as necessary.
Tip: Download flyers, posters, and other educational materials from the CDC that you can post and distribute throughout your workplace. For facts and news updates on both seasonal and H1N1 flu, check out the federal government's newly centralized and expanded website.
Planning: To Travel Or Not To Travel
If the severity of a flu outbreak worldwide increases in the fall or winter, public health officials may recommend social distancing strategies, which include canceling non-essential travel. Plus, travel restrictions may be enacted by some countries, thus, limiting the ability of employees to return home if they become ill while on travel status, so rethink sending them in the first place, says the CDC.
If travel cannot be avoided, employees should be prepared for delays, health screenings, etc. Provide information to travelers about contingency plans and how their travel can be rebooked if necessary.
The CDC also advises employees who must travel for work to check themselves for fever and any other signs of flu-like illness before traveling. If they suspect they are ill, they should stay home.
Employees who become ill while on assignment should notify their supervisor and promptly call a health care provider. If outside the United States, a U.S. consular officer can help locate health care services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medications, vaccines, or medical care to private U.S. citizens overseas.
Planning: School's Out
If schools or child care programs must close, get ready for a flood of employees' requests to take time off. Be prepared to allow workers to stay home to care for their children. If closure is needed, schools are being advised to dismiss students for at least five to seven calendar days or longer, if necessary. The CDC's advice:
- Encourage employees who perform essential functions and who have children to plan for contingencies should local child care programs close or schools dismiss students.
- Make sure your leave policies are flexible and non-punitive, in case of prolonged absenteeism if schools dismiss students for an extended time.
- Strongly recommend that parents not bring their children with them to work while schools are dismissed.
- Implement flexible workplace policies like teleworking and staggered shifts.
- Cross-train employees to cover essential functions.
- Read the CDC's school guidance to better understand the conditions under which schools may be dismissed.
Responding: Practical Considerations
You're hoping it won't happen, of course, but if a pandemic flu strikes your workplace, two of the most important actions to take immediately are encouraging sick employees to stay home until the flu is completely out of their system and sending employees exhibiting flu-like symptoms home.
The CDC's new guidance explicitly states that sick persons should stay home. Employers should:
- Advise workers to be alert to any signs of fever and any other signs of flu-like illness before reporting to work each day, and to notify their supervisor and stay home if they are ill.
- Explain to employees that they should remain at home until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medications.
- Expect sick employees to be out for about three to five days in most cases, even if antiviral medications are used.
- Talk with companies that provide your company with contract or temporary workers about the importance of sick workers staying home and encourage them to develop non-punitive leave policies.
- Not require a doctor's note for workers who are ill with flu-like illness to validate their illness or to return to work, as doctor's offices and medical facilities may be extremely busy and may not be able to provide such documentation in a timely way.
- Encourage employees who are well but who have an ill family member at home with the flu to go to work as usual. However, stress that these employees should monitor their health every day, and notify their supervisor and stay home if they become ill.
The CDC's guidance also states that sick employees at work should be advised to go home. Employers should:
- Promptly separate from other workers employees who appear to have a flu-like illness upon arrival or become ill during the day. If they cannot be placed in an area away from others, give them a surgical mask to wear, if they can tolerate it.
- Advise employees to stay home until at least 24 hours after they are free of fever, or signs of a fever, without the use of fever-reducing medications.
- Inform fellow employees of their possible exposure to a flu-like illness, but maintain confidentiality as required by the Americans with Disabilities Act (ADA), i.e., do not state the names of those with the flu or a flu-like illness.
- Encourage co-workers to monitor themselves for symptoms of flu-like illness and stay home if they are sick.
Responding: Legal Considerations
Some of the actions you take, or consider taking, in response to a flu outbreak are governed by federal law. Here's a brief snapshot of the laws most likely to apply.
Family and Medical Leave Act (FMLA). The FMLA was not meant to cover ordinary illnesses such as the flu, common cold, and earaches. However, the flu can qualify for FMLA protections if it meets the criteria for a "serious health condition." The flu would meet the criteria if the employee or the employee's spouse/child/parent required:
- Inpatient care (i.e., an overnight stay) in a hospital, hospice, or residential medical care facility, including any period of incapacity (i.e., inability to work, attend school, or perform other regular daily activities) or any subsequent treatment in connection with such inpatient care; or
- Continuing treatment by a health care provider, involving a period of incapacity requiring an absence from work, school, or other regular daily activities of more than three consecutive, full calendar days, and any subsequent treatment or period of incapacity relating to the same condition involving: a) treatment two or more times by a health care provider, or b) treatment by a health care provider on at least one occasion that results in a regimen of continuing treatment under the supervision of the health care provider.
Examples of situations where leave relating to the flu would most likely not be covered by the FMLA include:
- An employee has a mild case of the flu and does not visit a health care provider.
- An employee takes leave to care for a spouse, child, or parent who is believed to have the flu, but the infected family member does not visit a health care provider.
- An employee is on leave as a precautionary measure because the employee has been exposed to the flu.
- An employee does not go to work for fear of contracting the flu.
Click here for more on pandemic flu-related leave under the FMLA from the Department of Labor's Wage and Hour Division.
Americans with Disabilities Act (ADA). Because the flu is an acute, short-term condition, it's unlikely employers would have to provide reasonable accommodations — that is, unless the flu resulted in the substantial limitation of a major life activity.
Of more concern than reasonable accommodations are the ADA's rules regarding medical examinations and disability-related inquiries of employees and applicants, which are only permitted if certain conditions are met. The Equal Employment Opportunity Commission (EEOC) issued a short technical assistance document that offers guidance on ADA-compliant pandemic flu preparation and response strategies for the workplace. Here are some highlights.
- You may gather personal information needed for pandemic preparation by asking employees broad questions — that are not limited to disability-related inquiries — about factors that may require them to miss work in the event of a pandemic.
- You may require entering employees to submit to a medical test to determine their exposure to the pandemic virus, as long as the test is administered post-offer to all entering employees in the same job categories.
- You may require employees to adopt infection control practices (e.g., regular hand washing, coughing and sneezing etiquette, and tissue usage and disposal) or wear personal protective equipment (e.g., face masks, gloves) designed to reduce the transmission of the pandemic virus. You may also require employees to telecommute as an infection-control strategy.
For the EEOC's guidance about exams and inquiries of employees, see EEOC Enforcement Guidance on Disability-Related Inquiries and Medical Examinations of Employees Under the Americans with Disabilities Act. For the EEOC's guidance about exams and inquiries of applicants, see EEOC Enforcement Guidance on Preemployment Disability-Related Questions and Medical Examinations.
Fair Labor Standards Act (FLSA). If employees who need to take time off because of the flu have already exhausted their sick leave allowance for the year, you have two options: Either permit them to take an unpaid leave of absence or allow them to use accumulated vacation, personal time, etc.
If accrued paid time is unavailable, consider paying sick employees to say home during a pandemic; it's likely a small price to pay to keep your healthy workers healthy. If, however, the company cannot afford to pay wages to sick employees who have exhausted their paid time off, understand these FLSA points:
Non-exempt employees do not need to be paid when on leave because of the flu if the employee does not perform any work. If the employee works from home, they need to be paid for all hours worked, including overtime, as applicable.
Exempt employees' salaries may only be reduced under limited circumstances. In general, therefore, exempt employees must be paid for absences due to the flu, even under the following circumstances:
- Full-day absences when an employee's spouse has the flu virus, and for precautionary reasons, the employer requires the employee to stay home during the incubation period.
- Full-day absences when the employer does not have a bona fide sick leave plan, an employee contracts the flu, and is absent from work, but the illness does not constitute a "serious health condition" under the FMLA.
Important: Exempt employees who have the flu but who have run out of sick time may try to come into work so that they don't have to take an unpaid leave of absence. In such situations, you can require that they stay home; however, you must pay them under the FLSA because they are able to work. Consider it a nominal price to pay to prevent them from infecting their co-workers.
Note: State law should also be considered when determining whether to pay employees who take leave for reasons relating to the flu or other contagious disease.
Click here for more on a pandemic flu's effect on wages and hours worked under the FLSA from the Department of Labor's Wage and Hour Division.
Occupational Safety and Health Act (OSH Act). Pursuant to the OSH Act, employers must comply with hazard-specific safety and health standards as issued and enforced either by the Occupational Safety and Health Administration (OSHA) or by an OSHA-approved state plan.
In addition, Section 5(a)(1) of the OSH Act, the General Duty Clause, requires employers to provide their employees with a workplace free from recognized hazards likely to cause death or serious physical harm. Employers can be cited for violating the General Duty Clause if there is a recognized hazard and they do not take reasonable steps to prevent or abate the hazard. See OSHA's Guidance for Preparing Workplaces for an Influenza Pandemic for more information.
Related Topic(s): Safety & Health