Planning to reduce absenteeism in a Pandemic The risk of Pandemic Business Continuity Planning for the response to a Pandemic requires a different mind set to that of a ‘conventional’ seasonal flu disruption. We cannot be sure at what time of the year it will occur, it’s impossible to forecast its characteristics and because people have virtually no resistance to the new strain it can readily transmit between people. However given that the current H1N1 strain pandemic has already arrived and we have significant knowledge about its characteristics and capacity to transmit from human to human, should organisations not be in a better position to plan? It seems the dilemma is that history tells us we are likely to get a second and possibly a third wave of this particular flu virus as early as the autumn of 2009 and that it may have different characteristics and potentially more harmful consequences. To compound this, statistically we are just as likely to be subjected to yet another Pandemic (possibly H5N1, reputedly a far more dangerous strain) in 2010 as we were in 2009. Therefore planning a response is just as important as it was in the early part of this year. Absenteeism Business Continuity Planners therefore must not be complacent. Significant absenteeism in the workplace is still a serious threat. The estimates of absenteeism rates of between 25% and 50% are just a valid as they were. Understanding the drivers behind absenteeism will enable planners to prepare suitable and relevant plans.
For example:
- Fear of infection, particularly in those using public transport or where employees are in close proximity with the public or clients;
Illness whether actual or perceived;
- Issues around childcare, not just through school closures but also loss of child minders;
- Social responsibility, employees not wishing to spread infection (either to work colleagues or vulnerable clients) until they are sure they are no longer infectious and,
- The impact of bereavement, be it a member of the family, close friend or work colleague.
All of the above need careful consideration. It is essential that all employees are provided with up to date, relevant information relating to the type and nature of the potential illness. Where a rigorous hygiene campaign is being implemented then training in hand hygiene and reminders about government advice such as ‘Catch it Bag it Bin it’ must be given a high profile. Where plans have been prepared it is important to provide familiarisation sessions and either engage staff in tests or ensure that staff are made aware of the outcomes. Don’t forget; when plans are activated inform staff. There is nothing more de-motivating to staff than finding out through informal channels rather than directly from management. Any proposed changes to HR procedures, particularly relating absence from work or home working must be made clear with reminders and updates on what stage these changes are at. Antiviral Medication Many organisations have chosen to provide Antiviral medication to staff as part of a company scheme to target and reduce absenteeism. Antivirals can be taken in a number of different ways:
Prophylactic (preventative) measure; however Tamiflu for example is only licensed for six weeks continuous therapy. Evidence from epidemic flu suggests continuous preventive therapy is very effective, reducing the incidence of influenza by up to 90% in epidemic influenza outbreaks. The main problem with this method for pandemic (as opposed to seasonal influenza) is timing. Evidence from previous pandemics suggests that the first wave of a pandemic in UK will last around 15 weeks, probably in an overlapping spread of local epidemics of approx six week duration.
If the preventive courses are started as soon as local cases are reported [UK alert phase 6.3 or 6.4] this should offer significant protection, and a high proportion of those exposed to the pandemic virus will also develop protective antibodies to further infection by the same virus. If however the courses are started as soon as a pandemic is declared [at alert level 6.1 or 6.2] there is a significant risk of completing the courses before local outbreaks occur, and consequently being exposed and vulnerable to the virus at the peak of the pandemic.
Post exposure prophylactic (PEP) is when the person takes a preventive course of antiviral when in contact with a known or suspected case of influenza. This can be either a household contact or in an occupational setting. Using PEP in this way significantly reduces spread of illness in the workplace and (if provided for the household) in families and in particular children, and will, at least initially, have a significant impact on reducing spread of the disease in the community. An added bonus is that persons exposed to the pandemic virus and taking PEP, will in a significant proportion of cases [up to 80%] develop immunity to further infection with the same virus. Currently this is the UK Department of Health’s initial strategy to reduce the early spread of the disease.
Treatment Course is when the employee takes a treatment course as soon as influenza like symptoms develops. Effectiveness depends on starting the antiviral course as soon as symptoms develop. If taken up to 36 hours after symptoms develop reduces duration of illness by around one day. If taken within six hours of symptoms reduces duration of illness by up to four days.
Antiviral medication has the advantage of reducing the length an employee will be absent due to illness and, if used as a prophylactic treatment, reducing the level of absenteeism. To be successful in reducing absenteeism planners need to consider providing a little TLC. That is Tailored, Layered Containment combining antiviral provision with hygiene measures, social distancing and alternative working arrangements. Les Moseley MA, FICDDS, GI(Fire)E, MEPS < back | 
