Pandemic Flu Plans at Forefront of Dialogue With Businesses: Employer Disaster Plans Crucial to Readiness

By Krisberg, Kim

Third in a series on public health preparedness in conjunction with APHA’s National Public Health Week, The April 2-8 event focused on preparedness, public health threats and vulnerable populations.

BUSINESSES often represent the lifebloodof a community; they can be the reason a community prospers or slowly disappears. As such, the effects of their destruction during a disaster can ripple far beyond the rubble of a hurricane or the ashes of a fire.

With detailed preparedness plans in place, however, employers can lessen a disaster’s aftermath, speed up the recovery process and ensure their employees’ safety – all of which mutually benefit both employee and employer. But besides traditional preparedness methods such as labeling fire exits and conducting fire drills, many employers – especially small businesses – remain unprepared to continue operations if a disaster strikes. According to the U.S. Small Business Administration, up to a quarter of small businesses do not reopen after a major disaster and, unfortunately, such businesses were found to have been unprepared with no plans or back- up systems in place. Statistics show many employers are also poorly prepared for one of the latest threats to monopolize public health circles: the possibility of a human flu pandemic triggered by a flu strain to which humans have little or no immunity. Though experts predict such a pandemic would cause untold death and illness as well as interrupt daily living tor weeks or months, a majority of U.S. businesses are not ready.

According to a December 2005 survey from the Deloitte Center for Health Solutions, while U.S. companies view a flu pandemic as a”real threat” to the nation, two-thirds said they were inadequately prepared. Also, 39 percent of those surveyed said there wasn’t much a company could do to prepare for a pandemic flu outbreak, and only 41 percent said there was something they could do to prepare. Inroads are being made, however, to partner with leaders in the business field and bring them into the pandemic preparedness fold. Unlike other disasters, such as hurricanes or tornadoes, a pandemic flu outbreak won’t be confined to a specific geographic area and everyone will be at risk of exposure.

“Businesses have a very important role in preparedness in terms of protecting the health qf employees and communities,” said Lisa Koonin, MPH, MN, director of business partnerships at the Centers for Disease Control and Prevention’s National Center for Health Marketing. “When a pandemic comes, we will likely not have a vaccine that’s well-matched with the virus and will depend on non- pharmaceutical measures to protect life until a vaccine is made and distributed. A key factor will be to keep sick people and well people apart.”

Koonin was a senior author of CDC’s “Community Strategy for Pandemic Influenza Mitigation” guidance, which was released in February and includes recommendations for businesses. If a pandemic does hit, employers will be pivotal in allowing sick people to stay home and in implementing social distancing techniques such as letting employees work from home and spacing workers apart from each other in the work place, Koonin said. In creating the guidance, Koonin and her colleagues worked with fellow federal agencies and met with representatives from businesses of varying sizes as well as business associations. She said a main concern employers voiced during the meetings was employee absenteeism, especially absenteeism related to school closings. In turn, businesses are encouraged to plan ahead by identifying employees with school-age children, cross- training other employees that may have to pick up extra work or making plans so that parents can work from home, she noted.

“Businesses were very surprised at how important it would be to ask people to stay home – they didn’t realize the power of that simple strategy,” Koonin told 7Vic Nation’s Health. “Businesses are going to struggle in being able to make allowances for that because it’s not easy, but it’s incredibly important.”

Koonin noted that businesses don’t necessarily have to start pandemic planning from scratch, but can begin by building upon emergency plans already in place. Still, sometimes it takes a disaster for emergency planning to push ahead full throttle. Such was the case at the American Legacy Foundation, a national non- profit organization located in Washington, D.C., which is dedicated to curbing and preventing tobacco use. With it.s offices located near the White House, the foundation began its comprehensive emergency preparedness plans after the terrorist attacks of Sept. 11, 2001.

Planning began with readying the offices in case an emergency made it unsafe for employees to leave, according to Cheryl Heallon, DrPH, the foundation’s president and chief executive officer. The foundation now has enough food and water stockpiled in its basement to feed its staff of 85 full-time employees for up to three days. In addition, sealed emergency containers are kept on each floor of the office, containing food and water as well as first aid kits, flashlights, face masks and eyewash. The supplies are checked periodically and expired items are rotated out and replaced.

“Employers play a huge part (in preparedness) because their employees are with them usually 40 hours a week or more,” Healton told The Nation’s Health. “They have a role to play in the health and well-being of their employees.”

The foundation has also planned extensively to continue its operations and keep workers safe if its employees should have to shelter in their homes, such as during a pandemic flu outbreak. In January and after much planning, the foundation began providing all of its employees with provisions to keep in their homes, according to Anna Stewart, senior director for the president’s office at the American Legacy Foundation. Employees are given enough home provisions to last six to eight weeks, and provisions are specifically tailored to meet the needs of each employee’s family. Stewart said the home provisions were ereated using CDC guidelines, and as such, include foods lower in sodium and fat as well as items such as vitamin C tablets – a nutrient not often found in nonperishable foods. Every employee also received a laptop computer with a video monitor to ensure visual contact, which Stewart noted could be especially important for employees who live alone. To partake in the at-home preparedness effort, foundation employees signed an agreement that the provisions were for an emergency only, and those who declined to take part signed a waiver. The preparedness initiative costs about $300 a year per employee.

“Obviously, I feel very valued as an employee,” Stewart said. “When I talk about it to my friends, they’re astounded by the level of detail that we’ve put into this plan. It’s very public health- oriented and I think more businesses should follow suit.”

Preparedness varies by business sector

While the American Legacy Foundation may be at the top of the preparedness ladder, many preparedness activities are a voluntary step and levels of readiness will differ greatly across sectors, said Andrew Levinson, MPH, a senior health and safety specialist at the U.S. Occupational Safety and Health Administration and an author of OSHA’s recently released guidance on pandemic tin preparedness in the work place.

OSHA has long been following the pandemic flu threat – releasing its first guidance document on the subject in 2004 – and with strong backing from the federal government, the “guidance is finally on the street and businesses are beginning to prepare for this in a serious way,” Levinson said. Many of the guidance’s recommendations are not new, but build on existing infection control policy and industrial hygiene methods, he said. While there are similarities between planning for more traditional emergencies and readying for pandemic flu, there are many differences as well. The entire world will be affected over a sustained period of time if a pandemic flu is triggered and keeping employees healthy will be pivotal to a community’s safety, especially at work places that provide critical services such as health care, energy, telecommunications and transportation.

“I would encourage public health officials to get out there and educate the business community,” Levinson told The Nation’s Health. “Infection control is something we deal with each and every day…and this is something we need to get people a little more familiar with. There’s been a lot of hype with pandemic flu, but now we’re getting to the point where there’s solid steps that people can take and as I’ve said before, the first step is the hardest.”

Pandemic flu preparedness is only the latest threat a famous employer in central Florida is undertaking. In fact, the organization has volumes of experience in preparing a work forces the size of a small town tor disasters ranging from hurricanes to explosions to tsunamis. Located on 140,000 acres in Cape Canaveral, Fla., NASA’s Kennedy Space Center campus is home to 18,000 employees, 700 buildings, six fire departments and a full complement of law enforceme\nt and security personnel. The center follows theNational Incidence Management System – a protocol developed after Sept. 11 – as well as a separate localized emergency plan, according to Wayne Kee, emergency management officer at NASA. Kennedy Space Center has 17 documented emergency procedures that are hazard specific, though the thickest plan on the shelf concerns hurricanes.

“Everything’s dynamic,” Kee told The Nation’s Health. “Circumstances dictate procedures, and as circumstances change, we rewrite and revise our plans.”

Every Kennedy Space Center employee receives some form of emergency training, with the option of participating in a more indepth emergency management course online, Kee said. Within each of Kennedy Space Center’s directorates, which can consist of between 200 and 600 employees, there’s also a network of emergency coordinators who are tied into the center’s electronic broadcasting system.

Beyond the confines of the space center, Kee is a voting member of the local emergency planning committee, and Kennedy Space Center participates in joint training exercises with its six surrounding counties. For example, Kee said, the space center recently took part in an exercise simulating an explosive device on a cruise ship in neighboring Port Canaveral, the second largest multi-day cruise ship port in the country. In addition, whenever a spacecraft launch is scheduled. Kennedy Space Center places one of its emergency officers with county fesponders and a county official is placed at the space center.

But perhaps the space center’s most exercised plan involves hurricanes. Within 72 hours of expecting 50-knot winds, an intricate emergency plan is activated that begins with notifying employees of weather conditions and putting up hurricane shutters – and if the storm continues as predicted – ends with preparing a 200-person “ride-out” team to hunker down in the launch control center during the storm. For the thousands of employees that may have to evacuate the area, the space center updates its Web site and toll-free information line every four hours. It also provides another toll- free phone line so employees can let their employer know their status. The methods for keeping in touch with employees forced to evacuate are fairly new, Kee said, stemming from lessons learned during previous disasters. For example, locating employees of Stennis Space Center in Hancock County, Miss., in the aftermath of Hurricane Katrina was a “tremendous task,” Kee said. In response, NASA has upgraded and implemented a network of redundant communication systems.

While it’s true that much of NASA’s emergency preparedness planning would be unnecessary for the average employer, Kee said there are many lessons businesses of any size could take away from NASA’s success.

“It doesn’t matter how big or small your organization is, the key ingredient is planning and taking lessons learned from disasters that have already happened,” he said. “We used to say ‘if you fail to plan, you plan to fail.’”

For more information on businesses and emergency planning, visit www.ready.gov or www. pandemicflu.gov.

– Kim Krisberg

A Small Business Administration worker helps a tornado victim in Hendersonville, Tenn., with loan infomation in April 2006. Tornadoes in the suite caused severe damage and 35 deaths.

A business in Melbourne Beach, Fla., shows the aftereffects of Hurricane Jeanne in September 2004. Businesses nationwide are being urged to ready themselves and staff for emergencies.

Business owners remove sandbags from their property after flood waters receded in Sultan, Wash., in November 2006.

Workers use pumps to remove water from the basement of a restaurant in the Union Square area of Phillipsburg, N.J., in June 2006. The region was flooded by the Delaware River.

Copyright American Public Health Association May 2007

(c) 2007 Nation’s Health, The. Provided by ProQuest Information and Learning. All rights Reserved.