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Guidance for Businesses and Employers To Plan and Respond to the 2009 – 2010 Influenza Season

This website is archived for historical purposes and is no longer being maintained or updated. For updated information on the current flu season, see the CDC Seasonal Flu website.

February 22, 2010 1:00 PM ET

This document provides guidance to help decrease the spread of influenza (flu) among non-healthcare workers during the 2009-2010 flu season. It recommends actions that non-healthcare employers should take now to decrease the spread of seasonal flu and 2009 H1N1 flu in the workplace and to help maintain business continuity during the 2009–2010 flu season.1 The guidance also suggests strategies to consider if CDC determines that the flu is becoming more severe and provides recommendations regarding when an employee who is sick with flu may return to work. The guidance in this document may change as additional information about the severity of the 2009-2010 flu season and the impact of 2009 H1N1 flu become known. Please check www.flu.gov periodically for updated guidance. This guidance represents CDC’s current thinking on this topic. It does not create or confer any rights for or on any person or operate to bind the public.

BACKGROUND

The U.S. Department of Health and Human Services’ (HHS) Centers for Disease Control and Prevention (CDC), with input from the U.S. Department of Homeland Security (DHS), has developed updated guidance for employers of all sizes to use as they develop, review, update and implement plans to respond to 2009 H1N1 flu during the 2009-2010 flu season. Businesses and employers, in general, play a key role in protecting employees' health and safety, as well as in limiting the negative impact of flu outbreaks on the individual, the community, and the nation’s economy. Employers who have developed flu pandemic plans should review and revise their plans to take into account the extent and severity of disease in their community as outlined in this guidance.2

Flu Symptoms, Transmission, and Risk:

Symptoms of flu can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue, and sometimes diarrhea and vomiting. People may be infected with the flu, including 2009 H1N1 flu, and have respiratory symptoms without a fever. Like seasonal flu, 2009 H1N1 flu infection in humans can vary in severity from mild to severe. Visit http://www.cdc.gov/H1N1flu/qa.htm for more information on flu symptoms.

Like seasonal flu, the 2009 H1N1 flu virus is spread mainly from person to person through coughs or sneezes of infected individuals. People may also become infected by touching something – such as a surface or object – with flu virus on it and then touching their mouth, nose, or eyes.

Some people are at higher risk than others for serious complications from flu.

These people include:

  • children younger than 5 years old, but especially children younger than 2 years old
  • people aged 65 years or older
  • pregnant women
  • adults and children who have:
    • asthma
    • neurological and neurodevelopmental conditions
    • chronic lung disease
    • heart disease
    • blood disorders
    • endocrine disorders (such as diabetes)
    • kidney, liver, and metabolic disorders
    • weakened immune systems due to disease or medication
  • people younger than 19 years of age who are receiving long-term aspirin therapy

For more information on people at high risk for flu complications, visit http://www.cdc.gov/h1n1flu/highrisk.htm.

Planning for Flu Season

Businesses may have already been affected by the April through December 2009 outbreaks of flu affecting their employees. The severity of illness that flu -- seasonal or 2009 H1N1-- will cause or the amount of illness that may occur cannot be predicted with a high degree of certainty. Therefore, employers should plan to be able to respond in a flexible way to varying levels of severity and be prepared to refine their pandemic flu response plans if a potentially more serious outbreak of flu evolves. More people and communities are likely to be affected as flu is more widely transmitted. The CDC and its partners will continue to monitor national and international data on the severity of illness caused by flu, will disseminate the results of these ongoing surveillance assessments and will make additional recommendations as needed.

Considerations of Appropriate Response Strategies

All employers must balance a variety of objectives when determining how best to decrease the spread of flu and lower the impact of flu in the workplace. They should consider and communicate their objectives, which may include one or more of the following: (a) reducing transmission among staff, (b) protecting people who are at higher risk for complications from getting infected with flu, (c) maintaining business operations, and (d) minimizing adverse effects on other entities in their supply chains.

Employers should expect to see a wide range of disease patterns across the country. Employers should base their strategies and response to flu outbreaks on local information from local and state public health authorities. Some of the key indicators that should be used when making decisions on appropriate responses are:

  • Disease severity (i.e., hospitalization and death rates) in the community where business is located;
  • Extent of disease (number of people who are sick) in the community;
  • Impact of disease on workforce populations that are vulnerable and at higher risk for flu complications e.g., pregnant women, employees with certain chronic medical conditions that put them at increased risk for complications of flu); and
  • Other factors that may affect employees’ ability to get to work, such as school dismissals or early childhood program closures due to high levels of absenteeism or illness.

Employers need to plan now to be able to obtain updated information on these indicators from state and local health departments in each community where they have a business presence and to respond quickly to the changing reality on the ground. Employers with more than one business location are encouraged to provide local managers with the authority to take appropriate actions outlined in their business pandemic plan based on the condition in each locality.

PREPAREDNESS AND RESPONSE RECOMMENDATIONS

Planning for 2009 H1N1 flu and the 2009–2010 flu season

Businesses should have an understanding of their normal seasonal absenteeism rates and know how to monitor their personnel for any unusual increases in absenteeism through the 2009-2010 flu season. Business continuity planners should assess their essential business functions now to determine at what threshold of absenteeism those functions would be threatened if absenteeism escalates. Planners can then prepare to take more aggressive measures to protect continuity as absenteeism escalates towards those thresholds.

All employers should be ready to implement strategies to protect their workforce from flu while ensuring continuity of operations. During a flu outbreak, all sick people should stay home and away from the workplace, respiratory etiquette and hand hygiene should be encouraged, and routine cleaning of commonly touched surfaces should be performed regularly. If the severity of illness increases, employers should be ready to implement additional measures while continuing to rigorously implement the interventions recommended for an outbreak similar to April through December 2009 of the 2009 H1N1 flu outbreak. If severity increases, public health officials may recommend a variety of methods for increasing the physical distance between people (called social distancing) to reduce the spread of disease, such as school dismissal, early childhood program closure, canceling large community gatherings, canceling large business-related meetings, spacing employees farther apart in the workplace, canceling non-essential travel, and recommending work-from-home strategies for employees that can conduct their business remotely.

Please remember: employers should develop capabilities to respond to both conditions and these two conditions serve only as a planning framework. Businesses and other employers should develop flexible capabilities to respond to either condition given the difficulties in accurately predicting the extent and severity of the 2009–2010 flu season. Individual businesses may implement additional actions if they experience high absenteeism or business continuity is compromised. In addition, employers should be aware that other emergencies such as hurricanes or other natural disasters are unpredictable and may occur with little notice, creating additional challenging problems for businesses and communities.

Work with State and Local Public Health Partners

Coordination with state and local health officials is strongly encouraged for all businesses so that timely and accurate information can guide appropriate responses in each location where their operations reside. Since the intensity of an outbreak may differ according to geographic location, local public health officials will be issuing guidance specific to their communities. Also, businesses could work with public health and community leaders to explore ways of improving accessibility of vaccination for the workforce and in the community.

Keep Sick Employees Home

One of the best ways to reduce the spread of flu is to keep sick people away from well people. However, it’s not always possible to quickly determine if employees who are sick have 2009 H1N1 flu, seasonal flu, or any number of other different conditions based on symptoms alone. Local and state health department surveillance information can be helpful to know when flu is circulating in the community, although the availability, timeliness, and amount of local information on when flu is circulating may vary substantially from community to community.

Employees who have flu-like symptoms are recommended to stay home and not come to work until at least 24 hours after their fever has resolved without the use of fever-reducing medicines.3 Regardless of the size of the business or the function or services that you provide, all employers should plan now to allow and encourage sick employees to stay home without fear of losing their jobs. CDC recommends this strategy for all levels of severity. Employers should plan now for how they will operate if there is significant absenteeism from sick employees. However, employers should know that some persons with flu, including those ill with 2009 H1N1 flu, do not have fever. Therefore it will not be possible to exclude everyone who is sick with flu from the workplace.

Be Prepared if Schools Dismiss Students or Early Childhood Programs Close

In some communities, schools may dismiss students and early childhood programs may close, particularly if flu severity increases.4 Officials will make these decisions to protect public health, but they will affect your business’s functioning, especially affecting absenteeism. Plan now to determine how you will operate if absenteeism spikes from increases in sick employees, those who stay home to care for sick family members, and those who must stay home to watch their children if dismissed from school. Businesses and other employers should prepare to institute flexible workplace and leave policies for these employees.

Actions Employers Should Take Now:

  • Review or establish a flexible flu pandemic plan and involve your employees in developing and reviewing your plan.
  • Conduct a focused discussion or exercise using your plan, to find out ahead of time whether the plan has gaps or problems that need to be corrected before flu season.
  • Have an understanding of your organization’s normal seasonal absenteeism rates and know how to monitor your personnel for any unusual increases in absenteeism through the 2009-2010 flu season.
  • Engage state and local health department to confirm channels of communication and methods for dissemination of local outbreak information.
  • Allow sick employees to stay home without fear of losing their jobs;
  • Develop other flexible leave policies to allow employees to stay home to care for sick family members or for children if schools dismiss students or early childhood programs close.
  • Share your flu pandemic plan with employees and explain what human resources policies, workplace and leave flexibilities, and pay and benefits will be available to them.
  • Share best practices with other businesses in your communities (especially those in your supply chain), chambers of commerce, and associations to improve community response efforts.
  • Add a “widget” or “button” to your company Web page or employee Web sites so employees can access the latest information on flu: www.cdc.gov/widgets/ and www.cdc.gov/SocialMedia/Campaigns/H1N1/buttons.html..

Important Components of a Flu Pandemic Plan:

  • Be prepared to implement multiple measures to protect employees and ensure business continuity. A layered approach will likely work better than using just one measure.
  • Identify possible work-related exposure and health risks to your employees. The Occupational Safety and Health Administration (OSHA) has developed tools to determine if your employees are at risk of work-related exposures and, if so, how to respond (see www.osha.gov/dsg/topics/pandemicflu/index.html).
  • Review human resources policies to make sure that policies and practices are consistent with public health recommendations and are consistent with existing state and federal workplace laws (for more information on employer responsibilities, employers should visit the Department of Labor’s and the Equal Employment Opportunity Commission’s websites at www.dol.gov and www.eeoc.gov).
  • Allow employees to stay home if they are sick, have to care for sick family members, or must watch their children if schools or early childhood programs close. 
  • Explore whether you can establish policies and practices, such as flexible worksites (e.g., telecommuting) and flexible work hours (e.g., staggered shifts), when possible, to increased the physical distance among employees and between employees and others if local public health authorities recommend the use of social distancing strategies. Ensure that you have the information technology and infrastructure needed to support multiple employees who may be able to work from home.
  • Identify essential business functions, essential jobs or roles, and critical elements within your supply chains (e.g., raw materials, suppliers, subcontractor services/products, and logistics) required to maintain business operations. Plan for how your business will operate if there is increasing absenteeism or these supply chains are interrupted.
  • Set up authorities, triggers, and procedures for activating and terminating the company’s flu pandemic plan, altering business operations (e.g., possibly changing or closing operations in affected areas), and transferring business knowledge to key employees. Work closely with your local health officials to identify these triggers.
  • Plan to minimize exposure to fellow employees or the public if public health officials call for social distancing.
  • Establish a process to communicate information to employees and business partners on your 2009 H1N1 flu pandemic plans and latest 2009 H1N1 flu information. Anticipate employee fear, anxiety, rumors, and misinformation, and plan communications accordingly.

Over the past several years, HHS, CDC, DHS, OSHA, EEOC, and other federal partners have developed guidelines, including checklists, to assist businesses, industries, and other employers in planning for a pandemic. Review these resources to assist in your planning efforts: www.flu.gov/plan/workplaceplanning/index.html.

The recommendations that follow are divided into two groups: 1) recommendations to use now, during the 20092010 flu season, assuming a similar severity to the flu outbreak seen during April through December 2009, and 2) recommendations to consider adding if a more severe flu season occurs.  Local conditions will influence the decisions that public health officials make regarding community-level strategies; employers should take the time now to learn about plans in place in each community where they have a presence.

Recommended strategies to use now, for flu conditions with severity similar to April through December 2009 of the 2009 H1N1 flu outbreak

  • Encourage vaccination against the flu: The best way to protect against the flu – seasonal or 2009 H1N1 – is to get vaccinated.
    • Encourage your employees to get vaccinated for seasonal flu. For information on groups prioritized for seasonal flu vaccines, please see http://www.cdc.gov/flu/protect/keyfacts.htm.
    • The five primary target groups for vaccination against 2009 H1N1 flu include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, people age 6 months through 24 years, and people age 25 through 64 years who have underlying medical conditions that put them at higher risk for flu complications. Due to increased vaccine availability, everyone, including those over age 65 years, can now be vaccinated. Visit http://www.cdc.gov/h1n1flu/vaccination for more information.
    • Offer opportunities at your worksite for flu vaccination. Consider granting employees time off from work to get vaccinated if not offered at the worksite.
    • Review the health benefits you offer employees and work with insurers to explore if they can cover the costs of flu vaccination.
  • Advise the sick to stay home:
    • Advise employees to be alert to any signs of fever and any other signs of flu-like illness before reporting to work each day, and notify their supervisor and stay home if they are sick. Employees who are sick should not travel while they are sick.
    • CDC recommends that employees with flu-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8° C] or greater), or signs of a fever, without the use of fever-reducing medicines.
    • Expect sick employees to be out for about 3 to 5 days in most cases, even if antiviral medicines are used.
    • Ensure that your sick leave policies are flexible and consistent with public health guidance and that employees are well aware of these policies.
    • Talk with companies that provide your company with contract or temporary employees about the importance of sick employees staying home and encourage them to develop non-punitive leave policies.
    • Do not require a healthcare provider’s note for employees who are sick with flu-like illness to validate their illness or to return to work, as healthcare provider offices and medical facilities may be extremely busy and may not be able to provide such documentation in a timely way. 
    • Employees who are well but who have a sick family member at home with flu can go to work as usual. However, these employees should monitor their health every day, and notify their supervisor and stay home if they become sick. Employers should maintain flexible policies that permit employees to stay home to care for a sick family member. Employers should be aware that more employees may need to stay at home to care for sick children or other sick family members than is usual.
  • Separate sick employees:
    • CDC recommends that employees who appear to have flu-like illness upon arrival or become sick during the day be promptly separated from other employees and be advised to go home immediately until at least 24 hours after they are free of fever (100° F [37.8° C] or greater when taken orally), or signs of a fever, without the use of fever-reducing medicines.
    • Those who become sick with symptoms of flu-like illness during the work day should be:
  • Emphasize respiratory etiquette and hand hygiene by both people who are well and those who have any symptoms of flu:
    • Flu viruses are thought to spread mainly from person to person in respiratory droplets of coughs and sneezes. Provide employee messages on the importance of covering coughs and sneezes with a tissue or, in the absence of a tissue, one’s elbow or shoulder. Place posters in the worksite that encourages cough and sneeze etiquette.
    • Provide tissues and no-touch disposal receptacles for use by employees.
    • Flu may be spread via contaminated hands. Instruct employees to wash their hands often with soap and water. If soap and water are not available, employees may use an alcohol-based hand rub. However, hand rubs should not be used when hands are visibly soiled. Place posters in the worksite that encourage hand hygiene.
    • Provide soap and water and alcohol-based hand rubs in the workplace. Ensure that adequate supplies are maintained. If feasible, place hand rubs in multiple locations or in conference rooms to encourage hand hygiene.
    •  Visit: http://www.cdc.gov/flu/protect/covercough.htm for more information on respiratory etiquette and www.cdc.gov/cleanhands for more information on hand hygiene.
  • Perform routine environmental cleaning:
    • Routinely clean all frequently touched surfaces in the workplace, such as workstations, countertops, and doorknobs. Use the cleaning agents that are usually used in these areas and follow the directions on the label.
    • No additional disinfection beyond routine cleaning is recommended.
    • Provide disposable wipes so that commonly used surfaces (for example, doorknobs, keyboards, remote controls, desks) can be wiped down by employees before each use.
  • Take measures to protect employees who are at higher risk for complications from the flu:
    • Inform employees that some people are at higher risk for complications from the flu and that if they are at higher risk for complications, they should check with their healthcare provider if they become sick. It’s very important that antiviral drugs be used early to treat flu in people who are very sick (for example people who are in the hospital) and people who are sick with flu and have a greater chance of getting serious flu complications. Other people may also be treated with antiviral drugs by their healthcare provider this season.
    • Encourage employees recommended for seasonal flu vaccine and 2009 H1N1 flu vaccines to get vaccinated. For information on groups prioritized for seasonal and 2009 H1N1 flu vaccines, please see http://www.cdc.gov/flu/protect/keyfacts.htm and http://www.cdc.gov/h1n1flu/vaccination/acip.htm.
    • Employees who become sick and are at higher risk for flu complications and sick employees who are concerned about their illness should call their healthcare provider for advice. Their healthcare provider might want them to take antiviral medicines to reduce the likelihood of severe complications from the flu.
    • See http://www.cdc.gov/h1n1flu/qa.htm for more information.
  • Prepare for increased numbers of employee absences due to illness in employees and their family members, and plan ways for essential business functions to continue:
    • Employers should plan to monitor and respond to absenteeism at the workplace. Implement plans to continue your essential functions in case you experience higher than usual absenteeism. Elevated absentee rates can be due to sick employees, those who need to stay home and care for others, or from employees with conditions that make them at higher risk for flu complications and who may be worried about coming to work.
    • Cross-train personnel to perform essential functions so that the workplace is able to operate even if key staff members are absent.
    • Assess your essential functions and the reliance that others and the community have on your services or products. Be prepared to change your business practices if needed to maintain critical operations (e.g., identify alternative suppliers, prioritize customers, or temporarily suspend some of your operations if needed).
  • Advise employees before traveling to take certain steps:
    • Advise employees to check themselves for fever and any other signs of flu-like illness before starting travel and notify their supervisor and stay home if they are sick.
    • Advise employees who will be traveling or on temporary assignment about precautions they may need to take to protect their health and who to call if they become sick.
    • Employees who become sick while traveling and are at higher risk for flu complications and others concerned about their illness should promptly call a healthcare provider for advice.
    • Ensure employees who become sick while traveling or on temporary assignment understand that they should notify their supervisor.
    • If outside the United States, sick employees should follow your company’s policy for obtaining medical care or contact a healthcare provider or overseas medical assistance company to assist them with finding an appropriate healthcare provider in that country, if needed. A U.S. consular officer can help locate healthcare services. However, U.S. embassies, consulates, and military facilities do not have the legal authority, capability, and resources to evacuate or give medicines, vaccines, or medical care to private U.S. citizens overseas.
    • See CDC’s Travel Website (www.cdc.gov/travel) for more information for travelers.
  • Prepare for the possibility of school dismissal or temporary closure of early childhood programs:
    • Although school dismissals or closures of early childhood programs are not likely to be generally recommended at this level of severity, they are possible in some jurisdictions. 
    • Be prepared to allow employees to stay home to care for children if schools are dismissed or early childhood programs are closed.
    • Strongly recommend that parents not bring their children with them to work while schools are dismissed.
    • Ensure that your leave policies are flexible and non-punitive.
    • Cross-train employees to cover essential functions.  
    • Read CDC’s Guidance for State and Local Public Health Officials and School Administrators for School (K-12) Responses, which can be found at http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm, to better understand the conditions under which schools may be dismissed.

Recommended strategies to add in the event of increased flu severity compared to April through December 2009 of the 2009 H1N1 flu outbreak

If 2009 H1N1 flu becomes more severe than during April through December 2009 of the 2009 H1N1 flu outbreak, absenteeism will likely be far greater, and additional protective measures to slow the spread of flu may be considered. CDC may recommend additional strategies to help decrease the spread of flu if global, national, or regional assessments indicate that flu is causing more severe disease. In addition, state and local health officials may choose to use additional strategies. Check with your local health department for the extent and severity of disease activity in your community and for recommendations for necessary measures. Decisions about what tools should be used during a severe 2009 H1N1 flu outbreak should be based on the observed severity of the event; its impact on specific subpopulations; the need to protect employees; the expected benefit of the interventions; the feasibility of success of implementing these measures; the direct and indirect costs of different interventions; and the effects on critical infrastructure, healthcare delivery, and society. The following are measures that should be considered if flu severity increases, and are meant for use in addition to the measures outlined above.

  • Consider active screening of employees who report to work:
    • If flu severity increases, at the beginning of the workday or with each new shift, all employees should be asked about symptoms consistent with flu illness,5 such as fever or chills AND cough or sore throat. If the severity or the impact of flu increases, CDC recommends that people with flu-like illness not come to work or travel and remain at home for at least 7 days, even if symptoms resolve sooner. Individuals who are still sick 7 days after they become sick should continue to stay home until at least 24 hours after symptoms have resolved. If flu severity increases, CDC recommends that people stay home at least 7 days whether or not antiviral medicines are used.
    • Make sure your sick leave policies are flexible and consistent with public health guidance, and that your employees are aware of these policies.
    • Do not require a healthcare provider’s note for employees who are sick with flu.
    • Continue to advise employees to check for any signs of illness before reporting to work each day.
    • Make contingency plans for increased absenteeism caused by illness in employees or illness in employees’ family members that would require them to stay home. Planning for absenteeism could include cross-training current employees or hiring temporary employees.
  • Consider alternative work environments for employees at higher risk for flu complications during periods of increased flu activity in the community:
    • Employees with an underlying chronic medical condition or who are pregnant should consider calling their healthcare provider for advice about how to reduce their risk of exposure to flu and, if they get sick, how best to get early treatment for flu.
    • If flu severity increases and if flu transmission is high in the community, employers may want to evaluate their work environment to see how they can reduce the number of people that employees at higher risk for flu complications come in contact with, such as exploring options for telecommuting from home (if feasible). Employers can also think about how employees at higher risk for flu complications could be reassigned to duties that have minimal contact with other employees, clients, or customers. If these employees cannot be reassigned duties to reduce contact with others, are concerned about their ability to avoid flu at the workplace, or will be in crowded conditions at work or while commuting to work, then consider allowing employees at higher risk for flu complications to stay home from work.
    • CDC recommends that sick employees at higher risk for flu complications seek early treatment if they become sick.
    • See http://www.cdc.gov/h1n1flu/qa.htm for more information.
  • Consider increasing social distancing in the workplace:
    • If flu severity increases, local public health officials may recommend that employers implement measures to increase the physical distance between people in the workplace to reduce the spread of flu. The goal should be for there to be at least 6 feet of distance between people at most times. This is not a simple or easy strategy and would typically require considerable flexibility. These measures may include avoiding crowded work settings, canceling business-related face-to-face meetings, spacing employees farther apart, canceling non-essential travel, increasing use of teleworking, and using staggered shifts to allow fewer employees to be in the workplace at the same time.6
    • If appropriate for your type of business and feasible, review or develop policies for teleworking including an assessment of the capabilities and gaps of your current computer systems and availability of technical support. Take remedial steps if needed, and test your system in advance to assure it can handle an increase in remote users.
    • Recommendations to increase social distancing may affect community functioning. Because supply chain issues may be affected, make sure you have plans for back-up suppliers.
  • Consider canceling non-essential business travel and advising employees about possible disruptions while traveling overseas:
    • If the severity of the outbreak worldwide increases, public health officials may recommend social distancing strategies, which include canceling non-essential travel, and travel restrictions may be enacted by some countries which may limit the ability of employees to return home if they become sick while on travel status.
    • If flu severity increases, travelers should also be prepared for travel delays, health screenings, and other activities targeted towards travelers. Provide information to travelers about contingency plans and how their travel can be rebooked for these possible delays.
  • Prepare for school dismissal or closure of early childhood programs:
    • School dismissals and closure of early childhood programs are more likely at higher levels of severity. Be prepared to allow employees to stay home to care for their children if schools are dismissed or early childhood programs are closed. If dismissal is needed, schools are being advised to dismiss students for at least 5 to 7 calendar days or longer if necessary.
    • Encourage employees who perform essential functions and who have children to plan for contingencies should local early childhood programs close or schools dismiss students.
    • Be prepared for prolonged absenteeism if schools dismiss students for an extended time. Make sure your leave policies are flexible and non-punitive.
    • Employers should strongly recommend that parents not bring their children with them to work while schools are dismissed.
    • Implement flexible workplace policies like teleworking and staggered shifts.
    • Read CDC’s school guidance, which can be found at http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm, to better understand the conditions under which schools may be dismissed.
  • Consider other issues:
    • As part of their comprehensive flu pandemic planning, some public and private sector employers have stockpiled or otherwise arranged for flu antiviral medicines to be available for their employees during an outbreak. To guide these efforts, HHS released guidance to businesses in 2008 entitled Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic (http://www.flu.gov/vaccine/antiviral_employers.html). See updated interim guidance on the use of antiviral agents for treatment and prophylaxis of 2009 H1N1 flu infection at http://www.cdc.gov/h1n1flu/recommendations.htm.
    • Employers should be aware that the severity of 2009 H1N1 flu could change rapidly; therefore, local public health recommendations to communities and businesses could be revised quickly. Planners should identify sources of timely and accurate information so they are aware of changes to recommendations and can promptly implement revised or additional measures recommended by local public health officials.

RESOURCES

Additional tools and guidance documents have been developed by the federal government to assist employers in their planning. These resources are available online at: www.flu.gov/plan/workplaceplanning/index.html.

One-Stop
www.flu.gov

2009 H1N1 Flu Information
http://www.cdc.gov/h1n1flu/

2009 H1N1 Flu Resources for Businesses and Employers
http://www.cdc.gov/h1n1flu/business/

Worker Safety and Health Guidance for a Pandemic
www.osha.gov/dsg/topics/pandemicflu/index.html

OSHA’s Guidance on Preparing Workplaces for a Flu Pandemic
http://www.osha.gov/Publications/influenza_pandemic.html

CDC/NIOSH Occupational Health Issues Associated with 2009 H1N1 Flu Virus http://www.cdc.gov/niosh/topics/h1n1flu/

References

  1. This guidance was developed for use by employers that do not provide healthcare services or have “high and very high exposure risk tasks and operations.”  Please see: https://www.osha.gov/Publications/influenza_pandemic.html#classifying_exposure for more information about levels of occupational risk and exposure. Special considerations need to be included for these employers. Resources for healthcare entities can be found at: http://www.cdc.gov/h1n1flu/clinicians/.
  2. In 2006, to help businesses and employers with pandemic planning, the United States government created response stages to guide actions for state and local government and the private sector. Until the April through December outbreak of 2009 H1N1 flu, the planning was based on the assumption that the next outbreak would start overseas and would be high in severity and therefore the stages served as a guide for planning and response. However, because of the unique characteristics of the April through December 2009 oubreak of 2009 H1N1 flu, the stages will no longer be used as a planning and response framework.
  3. Fever is usually described as 100°F [37.8°C] or greater.
  4. For more information about CDC’s recommendations for schools, see http://www.cdc.gov/h1n1flu/schools/schoolguidance.htm.
  5. Symptoms of flu can include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, and fatigue, and sometimes diarrhea and vomiting. People may be infected with the flu, including 2009 H1N1 flu and have respiratory symptoms without a fever.
  6. See this OSHA website for examples of protective social distancing methods for the workplace: https://www.osha.gov/Publications/influenza_pandemic.html#medium_exposure_risk

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