H1N1 - the swine flu - is back with a vengance. While the severity of this fall's H1N1 outbreak is unpredictable, the President's Council of Advisors on Science and Technology has described as "plausible" that 30-50% of the US population may be infected and as many as 1.8 million Americans may be hospitalized with H1N1. Because most of those who are infected will be employed, many employers may scrambling to keep their doors open with a reduced workforce. Later this week, we'll talk about disaster planning (disaster may overstate it - unless you're one of the employers who loses half of their workforce to the flu), but first, let's review what action the experts are suggesting employers take to help keep their workforce healthy.

Planning for the 2009 H1N1 Influenza: A Preparedness Guide for Small Businesses, published by the Department of Homeland Security, covers a number of topics from health tips to emergency planning suggestions. One section of the guide shares ten tips for keeping employees healthy during seasonal outbreaks of viruses like the flu:

• Develop policies that encourage ill workers to stay at home without fear of any reprisals.
• Develop other flexible policies to allow workers to telework (if feasible) and create other leave policies to allow workers to stay home to care for sick family members or care for children if schools close.
• Provide resources and a work environment that promotes personal hygiene. For example, provide tissues, no-touch trash cans, hand soap, hand sanitizer, disinfectants and disposable towels for workers to clean their work surfaces.
• Provide education and training materials in an easy to understand format and in the appropriate language and literacy level for all employees. See www.cdc.gov/h1n1flu/business.
• Instruct employees who are well but who have an ill family member at home with the flu that they can go to work as usual. These employees should monitor their health every day, and notify their supervisor and stay home if they become ill. Employees who have a certain underlying medical condition or who are pregnant should promptly call their health care provider for advice if they become ill.
• Encourage workers to obtain a seasonal influenza vaccine, if it is appropriate for them according to CDC recommendations (http://www.cdc.gov/flu/protect/keyfacts.htm). This helps to prevent illness from seasonal influenza strains that may circulate at the same time as the 2009 H1N1 flu.
• Encourage employees to get the 2009 H1N1 vaccine when it becomes available if they are in a priority group according to CDC recommendations. For information on groups recommended for seasonal and H1N1 vaccines, please see www.flu.gov. Consider granting employees time off from work to get vaccinated when the vaccine is available in your community.
• Provide workers with up-to-date information on influenza risk factors, protective behaviors, and instruction on proper behaviors (for example, cough etiquette; avoid touching eyes, nose and mouth; and hand hygiene).
• Plan to implement practices to minimize face-to-face contact between workers if advised by the local health department. Consider the use of such strategies as extended use of e-mail, websites and teleconferences, encouraging flexible work arrangements (for example, telecommuting or flexible work hours) to reduce the number of workers who must be at the work site at the same time or in one specific location.
• If an employee does become sick while at work, place the employee in a separate room or area until they can go home, away from other workers. If the employee needs to go into a common area prior to leaving, he or she should cover coughs/sneezes with a tissue or wear a facemask if available and tolerable. Ask the employee to go home as soon as possible.

In addition to the information above, there is also a set of tips tailored toward individual health maintenance within the CDC's guide. Employers might also share this information from the CDC's Germ Stopper site with employees. The CDC also has downloadable posters on how to "cover your cough" that you might post around your workplace - or the door to your kids' bedroom.

Hint: Cough into your elbow. Your coworkers (and your dry cleaner) will thank you for it. 

There are more extensive details on each of these tips on the www.flu.gov website.

The Occupational Safety and Health Administration's website contains a fact sheet titled What Employers Can Do to Protect Workers from Pandemic Influenza that explains a “hierarchy of controls” employers should address to limit workplace exposure to hazards of a pandemic flu outbreak. In order from most to least effective, OSHA lists

• engineering controls,
• administrative controls,
• workplace practices, and
• personal protective equipment.

When employees are out with flu-like symptoms, they shouldn't rush back to work. While the CDC has reduced the time that they recommend that those who appear to have recovered from the flu, they still recommend "that people with influenza-like illness remain at home until at least 24 hours after they are free of fever (100° F [37.8°C]), or signs of a fever without the use of fever-reducing medications." During the spring H1N1 outbreak, "most people with the 2009 H1N1 influenza virus who were not hospitalized had a fever that lasted 2 to 4 days; this would require an exclusion period of 3 to 5 days in most cases." Employers should communicate this to employees and encourage them be cautious about returning to work.

According to the Department of Human and Health Services testimony before Congress, about 25% of businesses do not reopen following a major disaster, so smart employers will take steps to minimize the effects on H1N1 on their employee populations.

Coming Wednesday: Disaster planning - what if half (or more) of your employees can't come into work?