What if …?

Pandemic flu is a frightening yet very real prospect, but you can take steps to reduce the effects at your company.

By William Atkinson

Fortunately they don’t happen that often, but when pandemics have broken out on the world stage, they sometimes have had a devastating effect on human life. But even in less severe cases that cause minimal loss of life, a flu pandemic could affect a significant part of the world population. And it could have a devastating effect on your business.

A “pandemic” is defined as a global outbreak that occurs when a new influenza virus spreads among humans. The three largest influenza pandemics in the 20th century were the 1918 Spanish Flu, which killed 50 million people worldwide; the Asian Flu in 1957 that killed 2 million people worldwide; and the Hong Kong Flu in 1968 that killed nearly 1 million people worldwide (about 34,000 in the United States).

While the world could experience any one of a number of new pandemic flus, the one of most concern is H5N1, avian influenza, also known as bird flu. To date it has infected mostly domesticated birds such as chickens, but also some wild birds and has spread to humans via contact with the birds. It has already infected more than 200 people in 10 countries, primarily in Asia and Africa, and more than 150 of these people have died. While it has not happened yet, there are concerns that H5N1 could adapt to humans in a way that makes it spread easily from person to person.

The Centers for Disease Control (CDC) predicts as much as 25 percent to 30 percent of the U.S. population could be affected, and Health Canada predicts similar results for Canada. CDC has recently created a Pandemic Severity Index (Category 1 – 5, similar to hurricane ratings): Category 1 (fewer than 90,000 deaths, comparable to seasonal flu); Category 2 (90,000 to 449,999 deaths): Category 3 (450,000 to 899,999 deaths); Category 4 (900,000 to 1.8 million deaths); and Category 5 (more than 1.8 million deaths).

According to Dalena Berrett, a vice president with Marsh, a risk consulting firm in Nashville, Tenn., a true pandemic could kill more than 200,000 U.S. citizens and make 35 percent of the population ill. If human-to-human contact begins with H5N1, it will spread around the world within three to eight weeks. About 25 percent of the population will become ill, and workplace absenteeism will be about 35 percent. The pandemic could last six months.

A report from the White House notes: “While a pandemic will not damage power lines, banks or computer networks, it will ultimately threaten all critical infrastructure by removing essential personnel from the workplace for weeks or months.”

In April 2006, President Bush outlined the U.S. strategy to safeguard against the danger of pandemic flu called the National Strategy for Pandemic Influenza. It has three critical goals. The first is to detect human or animal outbreaks that occur anywhere in the world. The second is to protect the U.S. population by stockpiling vaccines and antiviral drugs, and improving the capacity to produce new vaccines. The third is to be prepared to respond at the federal, state and local levels in the event that the flu reaches the United States, which is likely should a pandemic occur.

What should precast concrete employers do? There are several strategies.

Communication strategies
The first strategy is to begin communicating with their employees about H5N1. “Prior to a pandemic, you need to focus on internal communication, which is primarily with your own employees,” says Tim Tinker, M.P.H., senior vice president of Widmeyer Communications in Washington, D.C. Widmeyer teamed up with the Center for Risk Communications in New York City shortly after 9/11 to form the Consortium for Risk and Crisis Communication. “We have been working with government agencies, utilities, private companies and not-for-profit organizations,” he says. The organization specializes in high-concern, high-stress situations, helping clients assess potential threats and then helping them put plans into place to respond.

The two most critical aspects of employee communication relate to absenteeism, business continuity and personal hygiene. “Absenteeism is an important topic with the potential for 40 percent to 60 percent of the workplace being absent over a period of three to four months,” says Tinker. This leads to issues related to business continuity and how you will keep your business up and running. In addressing these topics, Tinker encourages employers to first review and reformulate as necessary policies, procedures and programs related to cross-training, sick leave and absenteeism (taking union contracts into account). This information should also be communicated to employees.

Second is to provide training on personal hygiene at home and work that employees can use now to prevent colds and seasonal flus. Examples include washing hands frequently and keeping safe distances from other people at work and even at home.

When should you begin your efforts? “Our recommendation, as well as that of the CDC and Homeland Security, is that companies should think from an ‘all hazards’ framework,” says Tinker. That is, start talking about the full range of emergency scenarios to which your organization might be subject, including pandemic flu. The focus here should be on low-likelihood, high-consequence events such as terrorist attacks. “As such, one way to begin preparing for pandemic flu is to review your existing emergency plans for other low-likelihood, high-consequence events,” he says.

Hygiene strategy
Amy B. Dixon, EMT, a sales representative and spokesperson for ARAMSCO in Thorofare, N.J., sounds an ominous note: “The H5N1 virus looks very much like the 1918 Spanish Flu virus.” ARAMSCO is a distributor of environmental safety products, including avian flu products. The company has been building its emergency preparedness and disaster recovery business for years. It was on the scene in New York on 9/11 the first day, and it set up an entire warehouse in New Orleans just after Hurricane Katrina.

“It is important to change the way your business thinks and the way you do your work every day,” says Dixon. “People say the bird flu will never materialize in the United States. However, we lose 36,000 people a year just to seasonal influenza, and these are not just old people and children. They include people in their 30s and 40s.”

Dixon emphasizes the importance of washing hands frequently, not just before meals. Anytime someone coughs or sneezes, and then uses a keyboard or phone or touches the desktop, germs are being spread, she says. “It takes very little to spread germs.” She shares some startling statistics:

• The average germ count on an office desktop is 20,961 per square inch;
• on a telephone is 5,127;
• on a keyboard is 3,295; and
• on a toilet seat is a mere 49.

The reason is because lots of people may place their hands on your desk, two or three might use your keyboard, and maybe only you use your phone. However, no one thinks to clean these surfaces, whereas toilet seats are cleaned and sanitized every day. “Have hand sanitizers at your desk,” she suggests. “Clean your workspace, your phone, and your keyboard.”

She also encourages employees to get flu shots. Each February, the CDC looks at the most virulent viruses in the United States – the ones that kills the most people. It then takes six months to develop a vaccine for that virus. By September of each year, that vaccine is available.

Looking longer term, Dixon recommends that employers look at respirator protection. “If a pandemic hits the U.S., our company will run out of respirators and masks,” she emphasizes. “That is guaranteed, because manufacturers simply won’t be able to keep up with demand.” The last pandemic that struck North America was SARS. It wasn’t very big, and it affected Canada but not the United States. “However, you couldn’t find a respirator in the entire U.S. – not even one,” she says. “As such, you need to think about stockpiling masks and respirators. Even if you don’t need them for pandemic flu, they can be used for other emergencies that arise, so they won’t be wasted.”

Dixon also suggests you ask your distributor to recommend hygienic products for employees to use at home and then arrange for volume discounts through your utility. “Employees can then go to a special Web site and order these products for themselves, but taking advantage of your negotiated discount,” she says.

Supply strategy
Talk with your suppliers that provide materials critical to your business. If you happen to find that a particular supplier has no intention of implementing emergency plans, you may not be able to get out of the relationship right away because of contractual obligations. However, you should take this into consideration when the contract comes up for renewal.

These days, many companies have gone to lower levels of inventories, called “just in time” supply. Financially, this is a good strategy. However, in light of the potential of H5N1 and other pandemics, you may want to think about stockpiling certain critical items. You don’t need to do this right away. You may want to wait until there is evidence that a pandemic may be a little closer to reality. Of course, the drawback to this strategy is that everyone else may begin stockpiling at the same time.

Overall solutions
Here is a list of general solutions to prepare and deal with the potential for H5N1:

• Appoint a person to coordinate the plans and strategies.
• Make it part of your overall emergency response plan.
• Develop a risk communication strategy.
• Educate the workforce.
• Prepare the workplace.
• Cross-train employees who perform critical jobs so they can cover for each other in the event of absences.
• Implement personnel policies related to sick leave and the importance of not coming to work if infected.
• Prioritize services.
• Contact your local, regional or state health office, which will have a key role in how a region functions during a pandemic.
• Coordinate your plans with the local community, health care facilities and emergency services agencies.
• Also consider the legal implications: If a worker contracts the flu and can show it was contracted at work, he or she may be eligible for workers’ compensation, disability coverage and related medical expenses.

“People often make fun of organizations and individuals that prepare for things like this,” said ARAMSCO’s Dixon. “However, consider the opposite scenario. If this does occur, all of the fingers of blame will be pointed at you because you didn’t prepare.”

History of the Avian Flu