Business Preparedness Guide for Pandemic Flu

Transcription

1 Business Preparedness Guide for Pandemic Flu Tarrant County Public Health Safeguarding our community s health

2 Business Preparedness Guide for Pandemic Flu May 2006

3 Public health, government, health care and private-sector entities all face daunting and complicated questions about how to prepare for a pandemic. A pandemic is a global outbreak of a new influenza A virus that will affect a large number of people because they will have little or no immunity (protection). The possibility of a disease that could render millions ill prompts questions regarding the ability of business, the health care system, and economy to cope with a pandemic. Tarrant County Public Health has committed itself to educate the public about the difference between seasonal flu and pandemic flu, and to provide the business community and decision makers with tools and tips they can use to prepare for the possibility of a pandemic. As we undertake these efforts, we are asking for your assistance. In order to ensure maximum preparedness, businesses should develop their own specific plans for protecting their employees and maintaining operations during a pandemic. Companies that provide critical infrastructure services, such as power and telecommunications, also have a special responsibility to plan for continued operation in a crisis. As with any catastrophe, having a contingency plan is essential. Most health experts agree that there is a growing and significant threat of a global pandemic, but there is no way to predict exactly when it might occur or the severity of its impact. As with any of the risks we face as a country including natural disasters and the ongoing possibility of another terrorist attack all segments of society must be prepared for such a threat. For this reason, Tarrant County Public Health is encouraging businesses to prepare for pandemic flu. In addition to the threat that a pandemic poses to human health world-wide, few industries will be insulated from the economic effects of absenteeism in the workplace, or downstream effects on the supply-chain, and travel disruption. It is important that business owners and leaders are knowledgeable about the risks associated with pandemic flu and the significant social and economic costs that may result. In the event of a pandemic, planning by business leaders will be critical to protecting employees health, limiting the negative economic impact, and ensuring the continued delivery of essential services such as food, medicine, water and power. Government alone will not be able to provide answers to all of the issues facing society. Businesses must plan for pandemic and be aware of local, state and federal plans. Here are some questions to consider before planning begins: How will you maintain your business operations when as much as 30 percent of the workforce falls ill at one time? How can you adapt your existing continuity of operations plans to reflect this kind of human resources impact? How will you cope when other businesses and your suppliers have similar absentee rates? How will you adapt to disruptions in the supply chain for the raw materials you need and how will you get your product to the consumer if your distribution network has high absentee rates and travel is restricted? How can existing return-to-work and travel policies be adapted to control the spread of a virus among employees? How will you limit the economic impact of a pandemic flu on your business? This guide is designed to help businesses minimize the risk a pandemic poses to employees and the bottom line. 1

4 What can I do to Prepare My Business for Pandemic Flu? Learn as much as you can and stay up to date on the latest information. Plan for the impact of a pandemic on your business. Identify essential employees and other critical elements required to maintain operations. Determine the potential impact of personnel, supply and distribution disruptions resulting from a pandemic. Establish an emergency communications plan. Test your pandemic flu plan with periodic drills. This is the only way to know if the plans you have in place actually work and if your employees know what to do during an emergency. Plan for the impact of a pandemic on your employees and customers. Forecast and allow for employee absences for personal illness, family member illness, community containment and quarantine measures, school and business closures and public transportation closures. Improve employee access to health care, mental health, and social services. Establish ways to limit face-to-face contact among employees and customers during a pandemic to reduce the risk of disease transmission. Establish policies to be implemented during a pandemic. Develop sick-leave, return-to-work and travel policies unique to a pandemic. Establish policies on telecommuting and staggered shifts that can help limit person-to-person spread of disease within your workplace. Determine other measures your business can put into place to prevent the spread of flu at work. Allocate resources to protect your employees and customers during a pandemic. Provide infection-control supplies including hand sanitizer, antibacterial soap, tissues and waste receptacles. Enhance your telecommuting abilities and infrastructure. Establish availability of emergency medical consultation. Communicate with and educate your employees. Provide updated, accurate materials covering basic pandemic flu facts and personal protection and response strategies. Encourage good hand hygiene and coughing/sneezing etiquette. Educate employees about your pandemic flu plan. Provide information on at-home care of ill employees and family members. Develop ways to communicate status and actions to employees, vendors, suppliers and customers. Coordinate with external organizations and help your community. Share plans with insurers and health care providers to understand one another s plans and capabilities. Collaborate with local public health departments to participate in planning, understand your community s capabilities and offer your business services. Exchange best practices with other businesses. (This checklist was adapted from information on Visit the Web site for a complete list.) 2

5 What is Tarrant County Public Health doing to address pandemic flu? Tarrant County has made a major committment to pandemic flu planning. A pandemic flu response plan has been developed providing a template for dealing with this issue. The plan includes: 1. Surveillance through: a. local sentinel physicians in strategic geographic locations b. hospitals c. nursing homes d. local independent school districts. 2. The use of public health s North Texas Regional Laboratory, which can accurately test for the flu virus within 24 hours, as well as many other agents that could possibly be used in a terrorist attack 3. Drugs and supplies through the Strategic National Stockpile 4. A rapid distribution system 5. Development of a local volunteer force to assist in a crisis (the Medical Reserve Corps) 6. Risk communication and education This plan is updated continually as new information becomes available. Tarrant County Public Health is also leading public information efforts to raise awareness of this issue and to help the county residents better understand the complex issues that will arise if pandemic flu becomes a reality. These include prioritizing who will receive scarce medications and vaccine and how a pandemic will impact the daily activities we all take for granted, such as having to close schools or cancel sporting events and large public gatherings. Tarrant County Public Health will also: work with local groups, state and federal government. discourage exposure to infected individuals. administer vaccines as they become available. distribute medication. invoke stringent containment measures if the pandemic flu carries a high mortality rate. 3

6 What risks does Tarrant County face if there is pandemic flu? If a new and severe strain of flu were to begin spreading across the globe, Tarrant County would not be spared from its impact. The severity of the next pandemic cannot be predicted, but modeling studies suggest that its effect in the United States could be severe. In the absence of any effective treatment measures (vaccination or drugs), it has been estimated that in the United States a medium level pandemic could cause: 89,000 to 207,000 deaths 314,000 to 734,000 hospitalizations 18 to 42 million outpatient visits 20 to 47 million people becoming sick An economic impact ranging between $71.3 and $166.5 billion In Tarrant County, pandemic flu impact estimates include: 500 to 1,300 deaths 2,500 to 6,000 hospitalizations 130,000 to 315,000 outpatient visits 250,000 to 600,000 people becoming sick How will a pandemic impact my business? No one knows exactly how widespread or severe the impact will be. However, concerns for employers will be many; it will not be business as usual. The large number of sick and incapacitated people will include a significant segment of your workforce up to 25 to 40 percent for a period of several weeks. Limitations on public gatherings and fear among healthy people could limit the number of customers who access your services. Key supply and distribution networks could be significantly impacted. Close quarters and large gatherings (such as crowded office spaces or large meetings) may encourage person-to-person spread of the disease. Ill children and family members may cause employees to miss work. These are just some of the unique impacts that a pandemic may have on business. Employers need to think about and plan in advance personnel policies to limit the spread and impact of illness among the workforce. Businesses may also have to think creatively about how to supply, distribute and market their products and services during a pandemic. 4

7 What elements should I include in my business preparedness plan? Start by considering the people who would be absent from work. Who would you miss and still keep the company going? Identify staff with key skills, vital to continued functioning. Remember that specialists can cover either technical skills (e.g. IT, production) or extensive knowledge. Do not forget to look at all levels of the company, not just junior and middle management. It is important to look throughout the company so clerical and maintenance employees are not overlooked. Also assess whether employees can work from home. Look at your suppliers too - which ones are really critical to continued operations. Are they prepared? Work out how you would cope if the suppliers were not available. Then complete the loop - is the strategy your company intends to adopt actually going to be workable during a pandemic flu outbreak? Finally, factor in any situations where the government may look to companies for help. Make sure you know the Tarrant County plans and provide employees with information on pandemic flu preparedness. What steps should you take to limit the spread of flu in the workplace? Tell people, including senior managers, that they should not go to work if they have flu-like symptoms (that is, real flu-like symptoms, not just colds). If they do, they are not helping the company or themselves, and they are spreading the disease. Have them stay home and get well. Follow recommended procedures to prevent transmission of flu-like symptoms: cover coughs and sneezes wash hands frequently with warm soapy water remain at home while experiencing flu-like symptoms. Would the Health Authority close schools, daycare centers, and airports during an outbreak to prevent greater spread of infection? These are possible interventions Tarrant County Public Health would consider. The severity of the pandemic would determine whether controlling mass gatherings and school closures would be effective. What Tarrant County Public Health is doing at the moment is weighing the pros and cons of each control measure. How much would shutting schools slow the spread of the disease? What would be the effect on society? On working parents? On the ability of essential services to keep functioning (e.g., if nurses have to stay at home to look after their children). These interventions would not be implemented until there is increased and sustained transmission to humans and an indication of the pandemic spreading across countries. 5

8 Am I required to report an employee identified with a suspected or confirmed case of influenza? No, the employer is not required to report a suspected or confirmed case of influenza. It is important that the employees have access to primary care. However, Tarrant County Public Health recommends that any employee with flu-like symptoms stay home until the symptoms are gone, and seek medical care if they cannot manage their symptoms at home. What is the difference between quarantine and isolation? Who can impose these measures, and what are the requirements? The goals of community containment measures are to reduce the risk of exposure to and transmission of disease by separating and restricting the movement of people with confirmed or suspected disease. Quarantine is the restriction of movement of WELL persons presumed to be exposed. Quarantine may be voluntary or forced, and can be either at home or in a dedicated quarantine facility. Isolation is the restriction of movement of SICK persons. The individual should follow infection control guidelines. When under home isolation or quarantine, the individual should not leave the home, go to work, go to school, go to church, or go to any other public areas. Isolation may be voluntary or forced. Any agency or physician who suspects pandemic flu and places a patient on home isolation must contact the local health department. Any forced isolation or quarantine must be initiated by the Tarrant County Health Authority. How will the public be informed about specific guidelines on how to reduce infec- tion risk, use of Personal Protective Equipment, and quarantine guidelines? Tarrant County Public Health has specific guidelines available for the public. Current and up-to-date information can always be found at the Tarrant County Public Health Web site ( the Texas Department of State Health Services (DSHS) Web site ( and a statewide hotline. For English speakers, the number is ; for Spanish speakers, the number is TTY callers use During a pandemic, the service will be available 24 hours a day, seven days a week. Throughout the evolvement of a virus and its spread, Tarrant County Public Health will issue updated guidelines and recommendations using local media. 6

9 Are there any existing guidelines for food preparation staff? The World Health Organization (WHO) has developed guidelines for handling food potentially contaminated with the H5N1 strain of the flu. The recent cases of H5N1 influenza in poultry in Asia and Europe have prompted questions about the source of infection and the risk to humans. Based on present evidence, the vast majority of human cases have acquired their infection following direct contact with infected live or dead poultry. Tarrant County officials are aware of recent concerns that the virus could also spread to humans through contact with contaminated poultry products. To date, no epidemiological data suggest that the disease can be transmitted to humans through properly cooked food (even if contaminated with the virus prior to cooking). However, in a few instances, cases have been linked to consumption of dishes made of raw contaminated poultry blood. Conventional cooking (temperatures at or above 160 F/ 70 C in all parts of a food item) will inactivate the H5N1 virus. Properly cooked poultry is therefore safe to consume. The H5N1 virus, if present in poultry meat, is not killed by refrigeration or freezing Home slaughtering and preparation of sick or dead poultry for food is hazardous Eggs can contain H5N1 virus both on the outside (shell) and the inside (whites and yolk). Eggs from areas with H5N1 outbreaks in poultry should not be consumed raw or partially cooked (runny yolk); uncooked eggs should not be used in foods that will not be cooked, baked or heat-treated in other ways There is no epidemiological evidence to indicate that people have been infected with the H5N1 virus following consumption of properly cooked poultry or eggs The greatest risk of exposure to the virus is through the handling and slaughter of live infected poultry. Good hygiene practices are essential during slaughter and post- slaughter handling to prevent exposure via raw poultry meat or cross contamination from poultry to other foods, food preparation surfaces or equipment Protect your business and employees Practice good health habits, including eating a balanced diet, exercising daily and getting sufficient rest and take common-sense steps to stop the spread of germs. Stop the spread of germs Cover your nose and mouth with a tissue when coughing or sneezing Wash hands thoroughly and often. Use alcohol-based hand sanitizers when hand washing is not possible Avoid touching eyes, nose or mouth Stay home when you are sick 7

10 Business Pandemic Influenza Planning Checklist In the event of pandemic flu, businesses will play a key role in protecting employees health and safety as well as limiting the negative impact to the economy and society. Planning for pandemic flu is critical. To assist you in your efforts, this checklist has been developed for businesses. It identifies important, specific activities that businesses can do now to prepare. Many of these steps will also help you in other emergencies. Further information can be found at and business. 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, sub-contractor 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 sources 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. Implement an exercise/drill to test your plan, and revise periodically. 8

11 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 (refer to CDC recommendations). Encourage and track annual flu vaccinations for employees. Evaluate employee access to and availability of healthcare services during a pandemic. Evaluate employee access to and availability of mental health and social services during a pandemic, including corporate, community, and faith-based resources. Identify employees and key customers with special needs, and incorporate the requirements of such persons into your preparedness plan. Establish policies to be implemented during a pandemic: Establish policies for employee compensation and sick-leave absences unique to a pandemic (e.g., nonpunitive, 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 worksite (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, and prompt exclusion of people with influenza symptoms). Establish policies for employees who have been exposed to pandemic flu, 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 (refer to CDC travel recommendations). 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. 9

12 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. 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 and 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). Vaccines and drugs will be distributed by TCPH as they become available. 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 city and county public health agencies and/or emergency responders to participate in their planning processes, share your pandemic flu preparedness 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. 10

13 Internet Resources for Pandemic Flu: Tarrant County Public Health Official U.S. government web site for avian and pandemic influenza information The Centers for Disease Control and Prevention U.S. Department of Health and Human Services World Health Organization Trust for America s Health

14 Tarrant County Public Health 1101 S. Main Street Fort Worth, TX