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Now part of the water-cooler conversation: how to keep the flu away (or at least contained)

This article first appeared in the St. Louis Beacon, Sept. 24, 2009 - Business is booming for Brandon Dempsey, and he knows that's due in no small part to the coming fall flu season.

Dempsey works for a company called Suite Commute, which advices other businesses on how to set up remote work arrangements. As employers brace for what could be a prolonged period of workers infected with the seasonal flu or the H1N1 virus (commonly called swine flu), they are calling Dempsey to find out what it would take to allow ill employees to work from home.

"This fall, more companies are starting to look into it as an option," Dempsey said. "You can't overlook that people are going to be staying home or be sent home, so companies need to address this."

Managers like to focus on ways to keep the flu away from the office. There is, of course, the low-hanging fruit -- reminding employees to cover their mouths when they sneeze and putting hand sanitizer next to the water cooler.

But at many workplaces touched by the illness, the focus quickly shifts to damage control. Figuring out how to keep infected employees away from their colleagues is just one part of planning for the potential pandemic facing businesses and organizations around St. Louis.

Other concerns, magnified this fall because of the possible swine flu outbreak, include how to operate with a depleted staff and what to do about sick-leave policies that force employees to come back to work before they recover. All this comes at a time when some companies and organizations are already stretched thin because of layoffs and hiring freezes.

While businesses are used to planning for fires and other types of location-based disasters, they aren't as likely to consider the dangers of a health crisis, said Harlan Dolgin, president of Dolgin Consulting, a company that helps businesses with emergency management and pandemic planning.

"We're likely to have a pandemic flu season this fall and another flu season that lasts through early next year, so businesses have to think about preparing for this time," Dolgin said.

Out of Sight, But Very Much in Mind

The work-at-home option is attractive to employers because keeping sick people away from their colleagues -- a term pandemic planners like to call "social distancing" -- is a key piece of any office flu response.

Many managers have good intentions about letting their employees work from home while they are sick, Dempsey said. But he estimates that fewer than 5 percent of offices are actually equipped to make the arrangement work over a several-week period.

Companies often overlook a range of considerations, including whether their employees have a place to work from home that satisfies federal safety and health guidelines. Do they have reliable access to the internet, and how will they access confidential files? How will managers communicate with employees, and what about information technology staff who have to deal with off-location computers?

Dempsey said there are also unaddressed questions about who's responsible for tracking hours worked and who is paying for resources when employees use their own phones and printers.

"When it comes down to it, managers don't know how to manage from home, employers don't know what is expected of them," Dempsey said. "When you start looking at mass-scale deployment, companies just aren't ready."

He advises companies interested in the work-at-home arrangement to try it with some employees for one day a week so that if it becomes a necessity later in the fall people will have a better idea of what's involved.

Dempsey said remote work is only part of the pandemic planning. He looks at other pieces through his role as co-chair of PandemicPrep.org, a consortium of businesses, organizations, schools, hospitals and government agencies that focuses on helping the region -- and in particular businesses -- prepare for a range of pandemics.

The group formed more than three years ago largely as a response to concerns about a possible bird flu outbreak. Its website is a clearinghouse of information about planning for and responding to health crises. And the organization holds regular workshops with businesses, government entities and school leaders

.Preparing for Prolonged Absences

David Reddick, director of communications for Pandemic Prep.org, said companies should expect to be short-staffed at some time during the flu season.

"Every business needs to be prepared and have some business continuity plan in place in case there are dramatic outages for employees," Reddick said. "It's not only the potential for having ill employees who can't work, but employees who are afraid to come to work, and the potential for schools being closed and parents of young children wanting to stay home with sick kids."

Scott C. Jones, medical director of BJC Corporate Health Services, agrees that workers being out sick for prolonged periods "could have a big impact" on companies that are already understaffed because of the economy.

Offices that should be most concerned about the effects of flu season, Jones said, are those that rely on workers who can't be replaced and whose jobs require being on site, as well as those that call for regular business travel.

"If you have a line that makes products and it requires 10 people and half are out one day, that's a problem," said Jones, who is the liaison between BJC and employers who are seeking advice on how to maintain a healthy work environment. "In those cases, the companies should be prepared to continue their business elsewhere."

Reddick said companies should also consider that absences might not be spread out equally. Given how quickly viruses spread, one department could be hit particularly hard if an infected person stays at work.

His group encourages companies to train employees to take on other job responsibilities in the case of major absences. As Dolgin, also the executive director of PandemicPrep.org, puts it: "You don't want too much specialized knowledge in any one person."

But that can be a challenge for small businesses and organizations that are most likely to have one-person departments. Alice Foss, director of the Illinois Association of Public Health Administrators, said some health departments in Illinois already are short-staffed because of the state's budget troubles.

Foss said with the potential of a public health crisis this fall, health departments may have more leverage to ask lawmakers to keep people on staff or to bring on additional people to deal with the swine flu.

Some of the state's health agencies have a pool of retirees that can fill in if people are out with the virus, Foss said. Still, offices are considering what divisions can stop operating temporarily if there are major staff shortages.

"It's a matter of, 'maybe I don't do a restaurant inspection every month; I do it every seven weeks instead,'" Foss said.

Then there's the challenge of getting people who work at health departments located in rural parts of the state vaccinated, and finding nearby replacements should staff members get sick.

Municipalities are also dealing with the possibility of being understaffed. Tim Woerther, the mayor of Wildwood, said if many people in his office of fewer than 25 employees miss significant time with the flu, "we may have to pull back on some operations."

Wildwood outsources many of its essential services, however, and Woerther said employee absences wouldn't stop things like court operations from continuing.

"We can always borrow people from other parts of the county, but if it's getting bad for us, other areas are probably all in the same boat," said Woerther, who is also co-chair of PandemicPrep.org and works on disaster continuity for AT&T.

What's On the Books?

Jones, of BJC Corporate Health Services, said companies should review their sick-leave policies to make sure they allow employees to stay away from the office for as long as necessary. Some policies count sick days as vacation days, which Jones said can encourage workers to come back before they are healthy.

Other policies ask employees who are out for more than a short period of time to provide a doctor's note. That won't work in the case of a swine flu outbreak, Jones said, because doctors will be focused on handling patients and not paperwork.

Reddick said companies have to rely on their employees to tell the truth about when they have recovered from the flu. "There's always going to be some issue with people taking advantage of the system and staying home longer than they need to," he said. "But it's smarter to have a policy that protects the workforce as a whole."

And then there are companies that don't have sick-leave policies. Jones said that leaves managers scrambling to set the rules as they go.

He added that many employers are unsure of whether they can request that ill employees go home. The answer is yes, he said, so long as it applies across the board. Jones said businesses should follow guidelines provided by the Centers for Disease Control and Prevention about what symptoms should prompt a person to stay home -- having a temperature above 100 degrees, for instance.

Sarah Raischel, a spokeswoman for the consulting company Daugherty Business Solutions, said when the initial H1N1 concerns came about in the spring, her company sent a note encouraging sick people to stay home from work. It is continuing to follow that policy for the fall, she said.

Woerther said he sees plenty of companies and organizations taking steps to prepare for a possible outbreak, and also plenty that are taking a wait-and-see approach.

"It's a typical human response to think it has to hit home before people take action," Woerther said. "But because of how quickly viruses spread, that plan leaves an organization with little time to respond."

Getting the H1N1 vaccine

The countdown is on for the arrival of the H1N1 vaccine. Here's the latest from the federal government:


* The federal government has purchased 250 million doses of the vaccine, which it predicts will be enough for anyone who wants a vaccination.

* The U.S. Dept. of Health and Human Services estimates that the first shipment of 6 million to 7 million doses will come the first full week of October, with roughly 40 million more doses arriving by mid-October, and 10 million to 20 million more each week after.

* State health officials will determine where the vaccine shipments will go; the DHHS is asking that the vaccines be given for free and offered at places that help reach high-risk individuals.

* The groups recommended to receive the vaccine first are: pregnant women; caregivers for infants; health-care personnel; and people from 6 months through 24 years of age.

* The Centers for Disease Control and Prevention expects that one dose will be enough for anyone over 10. Children under 10 should have two doses.

* The vaccine begins protecting people 8 to 10 days after it's given.

* The seasonal flu vaccine is unlikely to provide protection against H1N1 flu.

* DHHS says that most people with flu symptoms don't need to see a doctor. The vast majority with the H1N1 flu recover on their own, though there have been hospitalizations and deaths.