Guidance on preparing workplaces for a pandemic

Posted on March 20, 2020 by Jorie Helms

Introduction

In the event of a pandemic, employers have a key role in protecting the safety and health of their employees as well as in limiting the impact on the economy and society. A business may experience employee absences and interrupted supply and delivery schedules. Good planning will allow employers in both the public and private sectors to better address issues that will arise.

While there is a difference between seasonal flu and a pandemic respiratory virus, symptoms and response can be the same or similar. Seasonal flu is an annual occurrence. Many get sick and unfortunately, deaths do occur. Vaccines are available and many have some immunity. A “new” virus such as COVID-19 may have worldwide implications. Initially there is no immunity and there are no vaccines; this may result in higher levels of illness, death, social disruption, and economic loss.

Implications in the workplace and for your business can vary widely depending on the product or service you provide. Many “critical” industries are already mandated to have pandemic plans in place. This list includes: Government Facilities, Dams, Commercial Facilities, Nuclear Power Plants, Critical Infrastructure, Food and Agriculture, Public Health and Healthcare, Banking and Finance, Chemical and Hazardous Materials, Defense Industrial Base, Water, Energy, Emergency Services, Information Technology, Telecommunications, Postal and Shipping, Transportation, and National Monuments and Icons.

How a Pandemic Can Affect the Workplace

While your business may not be considered a “critical industry”, implications for being unprepared may have significant impacts on your business and employees as follows:

Absenteeism - A pandemic could affect a large percent of the workforce. Employees could be absent because they are sick, they must care for family members, they are afraid to come to work, or unbeknown to the employer, the employee may have died.
Change in patterns of commerce – Consumer demand for items related to infection control is likely to increase, while interest in other goods may decline. They may change the ways they shop. They may try to shop at off-peak hours to reduce contact with others, or show increased interest in home delivery services, or drive-through service, to reduce person-to-person contact.
Interrupted supply/delivery - Shipments from geographic areas severely affected may be delayed or canceled. We live in a global economy so this may greatly affect business.

Employee risks of occupational exposure to a virus during a pandemic may vary from very high to high, medium, or lower (caution) risk. The level of risk depends in part on whether or not jobs require close proximity to people potentially infected with the virus, or whether they are required to have either repeated or extended contact with known or suspected sources of pandemic virus such as coworkers, the general public, outpatients, school children or other such individuals or groups.

Pandemic planning resources are based on past pandemic scenarios and would apply to COVID-19 pending further information. It is unlikely that any significant changes will be made to this guidance.

Additional guidance information and documents specifically for pandemic planning and response for business as bulleted below can be found on OSHA's Pandemic Influenza website, and on the CDC website.

Specific checklists for business planning including those with overseas operations can be found on the CDC website.

Maintaining Operations During a Pandemic

As an employer, you have an important role in protecting employee health and safety and limiting the impact of an influenza pandemic. OSHA recommends a systematic approach to planning.

Develop a Disaster Plan That Includes Pandemic Preparedness

Issues to consider and plan for:

Be aware of and review federal, regional, and local health department pandemic plans, and integrate into your plan.
Prepare and plan for operations with a reduced workforce.
Develop a sick leave policy that does not penalize sick employees, thereby encouraging those who are sick to stay home. Recognize that employees with ill family members may need to stay home to care for them.
Identify possible exposure and health risks to your employees.
Minimize exposure to fellow employees or the public.
Identify business-essential positions and people required to sustain business-necessary functions and operations. Prepare to cross-train or develop ways to function in the absence of these positions.
Plan for downsizing services but also anticipate any scenario which may require a surge in your services.
Recognize that, in the course of normal daily life, all employees will have non-occupational risk factors at home and in community settings.
Stockpile items such as soap, tissue, hand sanitizer, cleaning supplies & recommended PPE.
Provide employees and customers with easy access to infection control supplies.
Develop policies and practices that distance employees from each other, customers and the general public.
Identify a team to serve as a communication source so that employees and customers can have accurate information during the crisis.
Work with employees & their union(s) to address leave, pay, transportation, childcare, absence & other human resource issues.
Provide training, education and informational material about business-essential job functions and employee health and safety.
Work with your insurance companies, and state and local health agencies to provide information to employees and customers about medical care in the event of a pandemic.
Assist employees in managing additional stressors related to the pandemic.

Protecting Your Employees

For most employers, protecting their employees will depend on stressing proper hygiene (disinfecting hands and surfaces) and practicing social distancing. Social distancing means reducing the frequency, proximity, and duration of contact between people (both employees and customers) to reduce the chances of spreading the virus and illness from person-to-person.

OSHA, and the safety profession at large, recognizes and encourages the framework called the "hierarchy of controls" to select ways of dealing with workplace hazards. An expanded discussion of these 4 levels of control can be found on the OSHA website referenced above however, in brief, there are 4 levels of control:

Work Practice Controls
Engineering Controls
Administrative Controls
Personal Protective Equipment.

Work Practice and Engineering Controls

Historically, infection control professionals have relied on personal protective equipment (for example, surgical masks and gloves) to serve as a physical barrier in order to prevent the transmission of an infectious disease from one person to another. This reflects the fact that close interactions with infectious patients is an unavoidable part of many healthcare occupations. The principles of industrial hygiene demonstrate that work practice controls and engineering controls can also serve as barriers to transmission and are less reliant on employee behavior to provide protection.

Work practice controls are procedures for safe and proper work that are used to reduce the duration, frequency or intensity of exposure to a hazard. When defining safe work practice controls, it is a good idea to ask your employees for their suggestions, since they have firsthand experience with the tasks. These controls should be understood and followed by managers, supervisors and employees. When work practice controls are insufficient to protect employees, some employers may also need engineering controls.

Engineering controls involve making changes to the work environment to reduce work-related hazards. These types of controls are preferred over all others because they make permanent changes that reduce exposure to hazards and do not rely on employee or customer behavior. By reducing a hazard in the workplace, engineering controls can be the most cost-effective solutions for employers to implement.

Coronavirus disease is NOT known to spread through ventilation systems or through water.

During a pandemic, engineering controls may be effective in reducing exposure to some sources of pandemic influenza and not others. For example, installing sneeze guards between customers and employees would provide a barrier to transmission. The use of barrier protections, such as sneeze guards, is common practice for both infection control and industrial hygiene. However, while the installation of sneeze guards may reduce or prevent transmission between customers and employees, transmission may still occur between coworkers. Therefore, administrative controls and public health measures should be implemented along with engineering controls.

Examples of work practice controls include:

Providing 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 employees to clean their work surfaces.
Encouraging employees to obtain a seasonal influenza vaccine (this helps to prevent illness from seasonal influenza strains that may continue to circulate).
Providing employees with up-to-date education and training on influenza risk factors, protective behaviors, and instruction on proper behaviors (for example, cough ettiquette and care of personal protective equipment).

Developing policies to minimize contacts between employees and between employees and clients or customers.

More information about protecting yourself, your coworkers and employees, and your family can be found at www.pandemicflu.gov.

Examples of engineering controls include:

Clean frequently touched surfaces and objects: use soap and water, a bleach and water solution, or approved products to clean items such as handrails and doorknobs (always follow product label directions)
Installing physical barriers, such as clear plastic sneeze guards.
Installing a drive-through window for customer service.
Coronavirus disease is NOT known to spread through ventilation systems or through water.

Administrative Controls

Administrative controls include controlling employees' exposure by scheduling their work tasks in ways that minimize their exposure levels. Examples of administrative controls include:

Developing policies that encourage ill employees to stay at home without fear of any reprisals.
The discontinuation of unessential travel to locations with high illness transmission rates.
Consider practices to minimize face-to-face contact between employees such as e-mail, websites and teleconferences. Where possible, encourage flexible work arrangements such as telecommuting or flexible work hours to reduce the number of your employees who must be at work at one time or in one specific location.
Consider home delivery of goods and services to reduce the number of clients or customers who must visit your workplace.
Developing emergency communications plans. Maintain a forum for answering employees' concerns. Develop internet-based communications if feasible.

Personal Protective Equipment (PPE)

While administrative and engineering controls and proper work practices are considered to be more effective in minimizing exposure to the influenza virus, the use of PPE may also be indicated during certain exposures. If used correctly, PPE can help prevent some exposures; however, they should not take the place of other prevention interventions, such as engineering controls, cough etiquette, and hand hygiene (see www.cdc.gov/flu/protect/stopgerms.htm).

Examples of personal protective equipment are gloves, goggles, face shields, surgical masks, and respirators (for example, N-95). It is important that personal protective equipment be:

Selected based upon the hazard to the employee;
Properly fitted and some must be periodically refitted (e.g., respirators);
Conscientiously and properly worn;
Regularly maintained and replaced, as necessary;
Properly removed and disposed of to avoid contamination of self, others or the environment.

Employers are obligated to provide their employees with protective gear needed to keep them safe while performing their jobs. Check the www.pandemicflu.gov website for the latest guidance.

Steps Every Employer Can Take to Reduce the Risk of Exposure to a Pandemic in Their Workplace

There is currently no vaccine to prevent COVID-19 infection. The best way to prevent infection is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory viruses, including:

Encourage sick employees to stay at home.
Encourage your employees to wash their hands frequently with soap and water or with hand sanitizer if there is no soap or water available. Also, encourage your employees to avoid touching their noses, mouths, and eyes.
Encourage your employees to cover their coughs and sneezes with a tissue, or to cough and sneeze into their upper sleeves if tissues are not available. All employees should wash their hands or use a hand sanitizer after they cough, sneeze or blow their noses.
Employees should avoid close contact with their coworkers and customers (maintain a separation of at least 6 feet). They should avoid shaking hands and always wash their hands after contact with others. Even if employees wear gloves, they should wash their hands upon removal of the gloves in case their hand(s) became contaminated during the removal process.
Provide customers and the public with tissues and trash receptacles, and with a place to wash or disinfect their hands.
Keep work surfaces, telephones, computer equipment and other frequently touched surfaces and office equipment clean. Be sure that any cleaner used is safe and will not harm your employees or your office equipment. Use only disinfectants registered by the U.S. Environmental Protection Agency (EPA), and follow all directions and safety precautions indicated on the label.
Discourage your employees from using other employees' phones, desks, offices or other work tools and equipment.
Minimize situations where groups of people are crowded together, such as in a meeting. Use e-mail, phones and text messages to communicate with each other. When meetings are necessary, avoid close contact by keeping a separation of at least 6 feet, where possible, and assure that there is proper ventilation in the meeting room.
Reducing or eliminating unnecessary social interactions can be very effective in controlling the spread of infectious diseases. Reconsider all situations that permit or require employees, customers, and visitors (including family members) to enter the workplace. Workplaces which permit family visitors on site should consider restricting/eliminating that option during an influenza pandemic. Work sites with on-site day care should consider in advance whether these facilities will remain open or will be closed, and the impact of such decisions on employees and the business.
Promote healthy lifestyles, including good nutrition, exercise, and smoking cessation. A person's overall health impacts their body's immune system and can affect their ability to fight off, or recover from, an infectious disease.

These are everyday habits that can help prevent the spread of several viruses. They are the same guidelines that can help prevent the spread of seasonal flu and the common cold.

Workplaces Classified at Lower Exposure Risk (caution) for Pandemic: What to do to protect employees

If your workplace does not require employees to have frequent contact with the general public, basic personal hygiene practices and social distancing can help protect employees at work. Follow general hygiene and social distancing practices recommended for all workplaces. Also, try the following:

Communicate to employees what options may be available to them for working from home.
Communicate the office leave policies, policies for getting paid, transportation issues, and day care concerns.
Make sure that your employees know where supplies for hand hygiene are located.
Monitor public health communications about pandemic flu recommendations and ensure that your employees also have access to that information.
Work with your employees to designate a person(s), website, bulletin board, or other means of communicating important pandemic flu information.

More information about protecting employees and their families can be found at: www.pandemicflu.gov.

Workplaces Classified at Medium Exposure Risk for Pandemic: What to do to protect employees

Medium risk workplaces require frequent close contact between employees or with the general public (such as high-volume retail stores). If this contact cannot be avoided, there are practices to reduce the risk of infection. In addition to the basic work practices that every workplace should adopt, medium risk occupations require employers to address enhanced safety and health precautions. Below are some of the issues that employers should address when developing plans for workplace safety and health during a pandemic.

Work Practice and Engineering Controls

Instruct employees to avoid close contact (within 6 ft/2m) with other employees and the general public. This can be accomplished by simply increasing the distance between the employee and the general public in order to avoid contact with large droplets from people talking, coughing or sneezing.
Some organizations can expand internet, phone-based, drive-through window, or home delivery customer service strategies to minimize face-to-face contact. Work with your employees to identify new ways to do business that can also help to keep employees and customers safe and healthy.
Communicate the availability of medical screening or other employee health resources (e.g., on-site nurse or employee wellness program to check for flu-like symptoms before employees enter the workplace).
Employers also should consider installing physical barriers, such as clear plastic sneeze guards, to protect employees where possible (such as cashier stations).

Administrative Controls

Work with your employees so that they understand the office leave policies, policies for getting paid, transportation issues, and day care concerns.
Make sure that employees know where supplies for hand and surface hygiene are located.
Work with your employees to designate a person(s), website, bulletin board or other means of communicating important pandemic flu information.
Use signs to keep customers informed about symptoms of the flu, and ask sick customers to minimize contact with your employees until they are well.
Your workplace may consider limiting access to customers and the general public, or ensuring that they can only enter certain areas of your workplace.

For More Information

Federal, regional, and local government agencies are the best source of information should a pandemic occur. It is important to stay informed about the latest developments and recommendations since specific guidance may change based upon the characteristics of the eventual pandemic influenza strain, (for example, severity of disease, importance of various modes of transmission).

Below are several recommended websites that you can rely on for the most current and accurate information:

www.cdc.gov

Centers for Disease Control and Prevention website

https://www.cdc.gov/coronavirus/2019-nCoV/summary.html

CDC Coronovirus Disease 2019 (COVID-19) Situation Summary

www.pandemicflu.gov

U.S. Department of Health and Human Services; offers one-stop access, including toll-free phone numbers, to U.S. government avian and pandemic flu information.

www.osha.gov

Occupational Safety and Health Administration website

www.cdc.gov/niosh

National Institute for Occupational Safety and Health website

www.fda.gov/cdrh/ppe/fluoutbreaks.html

U.S. Food and Drug Administration website

https://www.canada.ca/en/public-health.html

Public Health Agency of Canada

Summary

Diligence, Prevention, & Mitigation are Key

Following recognized practices to avoid exposures common to any respiratory virus will help to keep the threat posed by Coronavirus Disease (COVID-19) in check.

Proper planning can help protect your employees, customers, and your business.

HUB International is also monitoring developments in order to offer assistance and guidance to our clients as they weigh their potential responses to this developing situation.

Additional information on managing a public health emergency in the workplace can be found at https://www.hubinternational.com/blog/2016/11/preparing-your-business-for-a-pandemic/.

Please reach out to your local HUB service team if you have any questions or if we can be of any assistance.

For Additional Information:

Centers for Disease Control and Prevention

CDC Travelers’ Health: Novel Coronavirus in China

CDC Health Alert Network Advisory Update and Interim Guidance on Outbreak of 2019 Novel Coronavirus (2019-nCoV) in Wuhan, China

CDC Health Alert Network Advisory information for state and local health departments and health care providers

CDC Information on Coronaviruses

Nonpharmaceutical interventions

Symptoms associated with COVID-19

Guidance to help in the risk assessment and management

CDC guidance on how to reduce the risk of spreading your illness to others