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Are you prepared for a reduced workforce caused by a pandemic?

With the increase in global transportation and urbanization, epidemics caused by a new influenza virus are likely to occur. As such, workforce continuity strategies should be a top priority to business continuity and emergency management practitioners. During a pandemic, absenteeism rates can climb to as high as 20-50 percent due to employee illness, caring for sick family members, fear of contagion, or lack of medical, public, or transportation resources. Employees are the revenue and profit drivers of most businesses, so early workforce continuity planning is essential as every person who becomes ill is likely to miss a few days to many weeks of work.

What are the differences between an outbreak, endemic, epidemic, and a pandemic?

Outbreak – It is when there are more than the number of cases of a disease in one area. The area could be a small community or extend to several countries. A single instance of a contagious illness new to an area or not seen for a long time is defined as an outbreak and can last for a few days, weeks, or several years. There are three types of outbreaks an endemic, epidemic, and pandemic.

Endemic – An endemic is an outbreak that occurs at a predictable rate in a particular population or area. Chickenpox is an example of an endemic because it occurs at a high but predictable rate among children. Endemics remain at a steady rate but don’t disappear from a population.

Epidemic – An epidemic is an outbreak that rapidly spreads amongst a large number of people in a defined population. It usually spreads in two weeks or less. The Ebola epidemic in West Africa killed 11,323 people during 2013 and 2016, and the SARS outbreak, which killed 744 people in 2003, are examples.

Pandemic – A pandemic is a worldwide spread of a new infectious disease. It stretches over several countries or continents, infects more people, and causes more deaths than an epidemic. Examples of past pandemics include smallpox, tuberculosis and the bubonic plague, which killed more than 75 million people in 1350 and the swine flu, which killed more than 14,000 people in 2009. A pandemic can cause higher social disruptions, economic loss, and hardships.

What is the worst-case scenario of a pandemic?

Defining the potential magnitude of a pandemic is difficult because of the significant difference in severity for the three 20th century pandemics.  While the 1918 Spanish flu pandemic resulted in an estimated 500,000 deaths in the U.S., the 1968 Hong Kong flu pandemic caused an estimated 34,000 U.S. deaths.  This difference in pandemics relates to the virulence of the virus, exposure to previous similar strains, the severity of infection, and the underlying health of the general public. Predicting specific characteristics of a future pandemic virus is difficult. No one knows how pathogenic a new virus would be, and which age groups it would affect.

Clinical severity and transmissibility of the virus determine the impact of a pandemic. When a new flu virus emerges, it can take at least six months before a pandemic flu vaccine is widely available. Issues with workforce continuity will put at risk the business operations needed for survival, such as acquiring raw materials, manufacturing, transporting finished products, delivering customer services, and invoicing.  Depending on the business type, a 30 percent absenteeism rate can potentially drive revenues and profits downward by the same amount or more because of fixed costs. Worst-case scenario effects might include:

    • Increased illness among all sectors of the population
    • Increased absenteeism in all areas of the workforce (police, fire, ems, healthcare workers, transit operators, essential public workers, gas station/retail personnel, etc.)
    • Duration lasting as long as 18 months with waves of severe illness lasting one to four months
    • Home quarantine
    • Closure of schools, theaters, and churches
    • Reduced manufacturing and availability of goods
    • Reduction in non-essential and community services
    • Transportation disruption of products (groceries, fuel, medicine, etc.)
    • Travel restrictions
    • Mandatory vaccinations
    • Non-traditional healthcare facilities
    • An embargo on goods and travel to and from other countries
    • Social disruption
    • Psychological trauma
    • Financial and economic loss

Are all employees at equal risk for exposure?

According to the U.S. Occupational Safety and Health Administration (OSHA), risks for exposure amongst employees can vary from very high to high, medium, and low categories. Determining a specific risk level of an employee or group depends in part on whether or not their job functions require close proximity to those potentially infected with a pandemic influenza virus. Or, whether they are required to have repeated or extended contact with known or suspected sources of the virus such as other employees, the general public, outpatients, school children, or other such individuals or groups.

OSHA’s Classifying Employee Exposure to Pandemic Influenza at Work:

Very high exposure risk: Occupations are those with high potential exposure to high concentrations of known or suspected sources of pandemic influenza during specific medical or laboratory procedures.

    • Example: Healthcare employees (for example, doctors, nurses, dentists) performing aerosol-generating procedures on known or suspected pandemic patients (for example, cough induction procedures, bronchoscopies, some dental procedures, or invasive specimen collection).
    • Example: Healthcare or laboratory personnel collecting or handling specimens from known or suspected pandemic patients (for example, manipulating cultures from known or suspected pandemic influenza patients).

High exposure risk: Occupations are those with high potential for exposure to known or suspected sources of pandemic influenza virus.

    • Example: Healthcare delivery and support staff exposed to known or suspected pandemic patients (for example, doctors, nurses, and other hospital staff that must enter patient rooms).
    • Example: Medical transport of known or suspected pandemic patients in enclosed vehicles (for example, emergency medical technicians).

Medium exposure risk:Occupations include jobs that require frequent, close contact (within six feet) exposures to known or suspected sources of pandemic influenza virus such as coworkers, the general public, outpatients, school children, or other such individuals or groups.

    • Example: Employees with high-frequency contact with the general population (such as schools, high population density work environments, and some high-volume retail).

Lower exposure risk (caution):Occupations that do not require contact with people infected with the pandemic virus, nor frequent close contact (within six feet) with the public. Even at lower risk levels, however, employers should be cautious and develop preparedness plans to minimize employee infections.

    • Example: Employees who have minimal occupational contact with the general public and other coworkers (for example, office employees).

What are some possible strategies to reduce workforce impact?

Employees often look to an organization for leadership and protection, including measures to minimize exposure during a pandemic. Each business will want to seek the optimum means to protect its employees from exposure by customizing strategies based upon transmissibility, job function, and work environment. Here are strategies you can consider incorporating into your pandemic plan to maintain workforce continuity during a pandemic.

1. Operations management

    • Involve executive leaders, communications, engineering maintenance, facilities, finance and payroll, information technology, human resources, legal and risk management, safety, security, supply and procurement, and other key stakeholders as part of the workforce continuity strategy
    • Encourage employees to get a seasonal flu vaccine at work or within the community
    • Host an on-site flu vaccination clinic
    • Track annual influenza vaccination of employees
    • Identify and prioritize critical business functions and departments
    • Identify essential and non-essential employees
    • Classify employees’ risk for exposure
    • Catalog employee skills for resource pooling
    • Cross-train employees and track additional skills including the percentage of individuals trained
    • Review contracts and consider utilization of outsourcing agencies
    • Develop a communications plan addressing both internal and external needs
    • Update contact information for key personnel, customers, and vendors including backups
    • Identify critical IT systems, any manual requirements, and ensure data is retrievable and backed up
    • Maintain system-wide Internet portals with secure access including management of anticipated needs
    • Establish flexible attendance, sick leave, and compensation policies that permit ill employees to stay home
    • Instruct employees to stay home if they are sick
      • CDC information/recommendations:
        • Persons with the flu are most contagious during the first three days of their illness
        • Persons with the flu should stay home until at least 24 hours after a fever of 100 degrees Fahrenheit or 37.8 degrees Celsius, or higher resolves without the use of fever-reducing medicines
        • Persons with suspected or confirmed flu, who do not have a fever, should stay home from work at least four to five days after the onset of symptoms
        • Persons should remain at home if exposed to a sick household member
        • Encourage persons to consult with their healthcare provider especially if they are at high risk for complications – be prepared to address health concerns and needs
      • Track all employee illnesses, affected departments, and absenteeism rates
      • Work with employee assistance programs, mental health, and public health services
      • Limit or restrict business travel
      • Perform situational monitoring and carefully follow emergency management and public health officials’ recommendations

2. Workplace hygiene

    • Wash your hands frequently with soap and water for 20 seconds or use a sufficient amount of hand sanitizer that contains at least 60 percent alcohol for 20 seconds when soap and water are not available
    • Avoid touching your nose, mouth, and eyes
    • Cover your coughs and sneezes with a tissue, or cough and sneeze into your upper sleeve; dispose of tissues in no-touch trash receptacles
    • Wash your hands or use a hand sanitizer after coughing, sneezing, or blowing your nose
    • Wash your hands after cleaning measures or handling trash
    • Wash your hands before preparing or eating food
    • Avoid shaking hands and always wash your hands after physical contact with others
    • Always wash your hands after removing protective work gloves

3. Social distancing

    • Increase space to least three feet and limit face-to-face contact (flu virus particles can travel through the up to six feet)
    • Minimize group meetings; use e-mails, phones, and text messaging; if meetings are unavoidable, avoid close contact (within 6 feet) with others and ensure adequate ventilation of meeting rooms
    • Modify, postpone, or cancel large meeting events
    • Limit unnecessary visitors in the workplace
    • Implement telework options and provide system access

4. Cleaning practices

    • Keep common surface areas and items (for example, door handles, desks, light switches, telephones, computer equipment, etc.) clean
    • Try not to use other employee phones, desks, offices, or equipment
    • Maintain a sufficient supply of cleaning and disinfectant agents, disposable gloves and other personal protective equipment, hand sanitizer, mops, paper towels, soap products, tissues, trash bags, etc.
    • Ensure housekeeping personnel are appropriately trained on cleaning and disinfection methods, wearing personal protective equipment, and being adequately supervised
      • Pay special attention to cleaning practices for door handles, light switches, handrails, glass, sinks, restroom toilets, urinals, drains, floors, countertops, microwave, cabinet handles, elevators, office and fitness equipment, lobbies, halls, offices, meeting areas, stairwells, etc.
    • Facilities-engineering maintenance to ensure HVAC filters and equipment are maintained and working correctly including building automation systems

5. Resources and training

    • Disseminate flu prevention supplies and public health education materials on seasonal and pandemic influenza that include symptoms of illness, transmission prevention, hand hygiene, respiratory etiquette, etc.
    • Provide awareness and training on company pandemic influenza plan and related policies
    • Offer resources for family emergency planning
    • Test, exercise, and revise plans and procedures as needed

Businesses cannot afford to ignore the workforce risks of a pandemic because of competitive, legal, and fiduciary reasons. Early workforce continuity planning could help reduce the transmission of a pandemic virus and decrease cases, hospitalizations, deaths, and the economic and social impact if it were to occur. Organizations may be skeptical about the time and resources needed to prepare its workforce for a pandemic that may never come, but consider this: What is the real cost of not preparing?


Keith Frederick

Keith Frederick, FBCI, CBCP, CHEP, is a thought leader, author, speaker, and solutions specialist in organizational resilience, incident management, business continuity, and disaster recovery. For 25 years, he has been serving, protecting, and defending organizations against risks and threats that pose a significant impact on every aspect of the business. Frederick previously served as the head of organizational resilience at Duke University’s Clinical Research Institute, director of emergency management, business continuity, infection control, and safety at Kaiser Permanente, and consultant of emergency management at SAIC. His prior background in 911 public safety, strategic and operational leadership, risk management, and consulting roles with biotech, financial, healthcare, insurance, technology, and the government lend itself to his unique perspective and deep understanding, knowledge, and appreciation about the importance of pandemic and workforce continuity planning.

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