Planning for a pandemic

Planning for a pandemic will support your employees by offering them levels of protection, which in turn will limit potential liability, foster trust and loyalty from staff members, and likely reduce rates of illness, employee absenteeism and death. Such precautions may also stabilize corporate performance by protecting key revenue streams. While others fail to deliver during the emergency, you may be able to identify new market opportunities and optimize business processes. A robust pandemic plan will also strengthen your corporate reputation; prior to the pandemic, your firm will be recognized as a responsible and proactive organization.

After the decision is made to plan for a pandemic, there are a number of interventions to consider:

Vaccines

Although a vaccine specific to the pandemic strain is understood to be the most effective way to mitigate the spread of infection and provide protection against possible illness, it is likely that its availability will be delayed by several months because of the need to identify the pandemic strain and produce the vaccine for much of the population. Moreover, inadequate vaccine manufacturing capacity will likely restrict global vaccine access, at least during the first wave of the pandemic.

Despite these limitations, increased funding in the field of vaccine development has led to some promising research and the possibility of a “universal” vaccine to protect against all flu viruses. In the meantime, ensuring that your employees have access to the annual flu vaccine can act as a pandemic intervention by supporting the overall vaccine manufacturing capacity within Canada, which will be required to “ramp up” during a pandemic.

Antivirals

In the absence of an effective vaccine at the outset of a pandemic, many experts believe that antivirals will be an important component of our response. Therefore, governments around the world, as well as many companies in the private sector, have chosen to stockpile these drugs in anticipation of the next pandemic.

Currently, there are two types of antivirals available for influenza treatment and prophylaxis: M2 ion-channel inhibitors and neuraminidase inhibitors. The M2 ion-channel inhibitors, amantadine and rimantadine, are currently not recommended for influenza treatment as high levels of resistance to these drugs have developed over the past few years. There is ongoing debate as to whether these drugs ought to be reconsidered for use during a pandemic, given increased levels of resistance in annual flu seasons to other drugs. The neuraminidase inhibitors include oseltamivir (Tamiflu®) and zanamivir (Relenza®).

Oseltamivir is an oral medication that is now being used to treat the sporadic cases of H5N1 bird flu arising in humans. Zanamivir is an inhaled medication that is well tolerated and works reasonably well in treating the symptoms of influenza.

Although both types of neuraminidase inhibitors are being purchased by national governments, stockpiles generally contain a much higher proportion of Tamiflu than Relenza. However, because there has been a surge of Tamiflu-resistant influenza viruses this past flu season, the ratios of antiviral medications in national stockpiles are changing. There is always the risk that annual influenza drugs may not have any effect over a new pandemic flu strain.

Furthermore, stockpiling in a corporate setting will involve a great deal of resources and financial cost when it comes to the acquisition, distribution and dispensing of the drugs. As a result, organizations must understand the inherent need to ensure that such a program involves the oversight and direction of a physician, along with the support of other healthcare resources.

Social Distancing Measures

Social distancing measures may include isolation, quarantine, the cancellation of public gatherings, school closures or any other strategy that limits contact between people. Many social distancing measures are fairly easy to implement and have shown potential for limiting the spread of infection, particularly in the workplace (e.g., limiting the number of face-to-face meetings). However, these measures will disrupt business practices and require a high level of compliance by your workforce if they are to be effective.

Telecommuting

Telecommuting involves a range of critical infrastructure resources and IT requirements so that work is completed at a distance-based facility (i.e., from home), thus limiting human contact and ultimately the spread of infection in the workplace. Nonetheless, some offices may not have telecommuting capabilities or the capacity to handle such widespread use of IT resources. There is also no guarantee that employee homes will be any less infectious due to the mingling of individuals in a closed environment (e.g., spouses, children).

Infection Control and Education

Handwashing and respiratory hygiene (i.e., cough etiquette) should be strongly encouraged in the workplace at all times. The majority of research demonstrates the protective effect of hand hygiene in reducing upper respiratory infections; therefore, proper handwashing could markedly reduce the spread of infection during a pandemic. It is also recommended that hand hygiene stations be made available and that employees be made aware of proper hand hygiene.

N95 Respirators and Masks

There is limited research assessing the efficacy of the use of respirators and masks in preventing the spread of influenza. However, it is generally thought that mask and respirator use will be protective in the event of an influenza pandemic. Research conducted in Beijing and Hong Kong demonstrated that, during the SARS epidemic, wearing masks in public was independently associated with protection from the virus. However, there are costs associated with the education and fit-testing requirements for respirator use, as well as with the stockpiling and storage of such supplies.

With all of the above in mind, there are some simple steps that can be taken to further your company’s level of pandemic preparedness, including:
• Identify your company’s fundamental needs and gaps to help you devise a basic pandemic plan;
• Plan and test your strategy’s components, such as essential services, communications, telecommuting and emergency response measures. This will not only help assess the feasibility of your plan, but will also identify key gaps; and
• Examine other local plans and engage your local public health unit to ensure you understand how the pandemic response will take shape at the frontlines and how you can play a supporting role.

Whatever steps your company decides to take in planning for an influenza pandemic, it is important to realize that overall awareness is an important factor in an employee’s perception of threat. Therefore, the ability to engage in an effective response will depend on constant communication between stakeholders and ongoing employee education so that everyone is ready.

Matt Saunders is the manager of Policy, Planning & Analysis at Global Consulting. A division of Global Medical Services Ltd., Global Consulting is a national leader in emergency planning, training and exercising.

Kelsey Innes is a research analyst at Global Consulting.

You can visit Global’s Web site at www.global-consulting.ca

For a PDF version of this article, click here.

© Copyright 2009 Rogers Publishing Ltd. This article first appeared in the June/July 2009 edition of WORKING WELL magazine.