Dr. David Sundwall of the Utah Dept. of Health discusses ways to reduce the spread of the H1N1 flu virus.

1. “Partnering With Business to
Reduce the Spread of H1N1”
David N. Sundwall, MD
Executive Director
Utah Department of Health
Oct. 6, 2009

2. Objectives
• Brief situational update
• Discuss strategies to decrease the spread
of H1N1 in the community and workplace
• Development of appropriate response
strategies
• Provide recommended action steps for
current and potential conditions
• Provide an outline for influenza planning in
your business
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3. Situation Update
• Outpatient influenza activity is below the epidemic
threshold for Utah, but greater than expected for
this time of year
• Rates of school absenteeism are elevated in Utah
• After several weeks with few cases, over the last
few weeks there has been an increase in the
number of hospitalized cases in Utah
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4. Situation Update
• Vaccine and vaccine supplies could be in the
state by the end of this week
– Estimated for national supply:
• 2-3 million available to order September 30th
• 45 million available to order in mid October
• 20 million available to order weekly thereafter
• Utah will receive approximately 1% of the national
supply
• Largest ever mass vaccination effort
• Completely voluntary
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5. General Prevention
• Get vaccinated against seasonal & H1N1 flu!
– H1N1 Vaccine should be available in the next two
weeks – will target priority groups initially.
– Visit www.immunize-utah.org for a list of locations
providing H1N1 immunizations
• Cover your coughs and sneezes with a tissue or
your shirtsleeve
• Wash hands often with soap and water or alcohol-
based hand sanitizers
• Stay home from work or school if you are sick
– For 24 hours after fever has subsided, without the help
of medication
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6. Response Strategies
• Must balance decreasing the spread of influenza
with minimizing impact to your business
• Communicate objectives clearly and regularly with
your employees. Objectives may include:
– Reducing transmission among staff
– Protecting those at increased risk of complications
– Maintaining business operations
– Minimizing adverse affects on other entities associated
with your business
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7. Response Strategies
• Base strategies and response on disease
indicators such as:
– Disease severity
– Disease circulation
– Worker absenteeism
– Workforce population that is “high-risk”
– Other factors that will impact employees’ ability to get to
work
• Plan now for how to obtain such information from
your health department
– Weekly updates on Wednesday afternoon at
www.health.utah.gov/h1n1 <#>

8. Action Steps
• Action steps are based on two possible
scenarios:
– Disease severity continues at the current level, similar
to what was experienced last spring
– A more severe outbreak develops
• Develop capabilities to respond to both
scenarios
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9. Current Action Steps
• Sick workers should stay home
– Stay home for at least 24 hours after they are free
of fever (100* F), without the use of fever-reducing
medications
– Sick employees will likely be out 3-5 days
– Ensure sick leave policies are flexible
– Do NOT require doctors notes for absences or as a
condition for returning to work – this could clog the
health care system
– Employees with sick family members should be
allowed to report to work as usual
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10. Current Action Steps
• Sick employees at work should be asked to
go home
– Be familiar with symptoms
– Promptly separate sick workers from other workers
until they can go home
– Keep sick workers isolated if they can’t
immediately get home
– Inform other employees of possible exposure – but
maintain confidentiality as required by ADA
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11. Current Action Steps
• Cover coughs and sneezes
– Cough and sneeze into a tissue or shirt sleeve
– Provide employee messages on the importance of
covering coughs and sneezes
– Place posters in common areas (available for download
at www.flu.gov)
– Provide tissues and no-touch receptacles
• Improve hand hygiene
– Instruct employees to wash hands regularly with
soap and water or alcohol-based hand sanitizer
– Provide soap and hand-sanitizer stations
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12. Current Action Steps
• Clean common surfaces frequently
– Workstations, countertops, doorknobs, etc.
– Routine cleaning is sufficient
• Encourage employees to get vaccinated
– Encourage seasonal and H1N1 vaccination
– www.immunize-utah.org
– Consider granting leave time for employees to get
vaccinated
– Review health benefits to ensure vaccinations are
covered by your policy
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13. Current Action Steps
• Prepare now for increased employee
absence and plan for continuity of
essential business functions
– Create mechanisms to monitor employee absence
– Increase rates may be due to sick workers, or
family members who are sick
– Cross-train personnel to perform essential
functions
– Be prepared to change usual business practices
(identify alternate suppliers, prioritize clients,
suspend some operations, etc…)
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14. Current Action Steps
• Advise traveling employees on how to
protect themselves
– Check themselves for fever and other symptoms
prior to departing – cancel travel if they are ill
– Ensure employees who become ill while traveling
notify their supervisors
– If traveling internationally, have policies for
obtaining health care or medical services overseas
– www.cdc.gov/travel for more tips
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15. Current Action Steps
• Prepare for the possibility of school
dismissal or closure of child care programs
– Unlikely if disease severity remains at levels similar
to spring
– Allow workers to stay home to care for children
– Recommend parents not bring their children to
work with them
– Ensure leave policies are flexible
– Cross-train employees to cover essential functions
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16. Potential Action Steps
• Consider active screening of employees
who report to work
– Ask employees about symptoms
– Do not require a doctor’s note
• Consider alternate work environments for
employees at high risk for complications
– Reduce contact with high-risk employees
– Allow such individuals to telecommute
– Potentially reassign such employees
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17. Potential Action Steps
• Consider social distancing in the
workplace
– Increasing the physical distance between people at
work
– Goal should be 6 feet of distance between people
• Consider cancelling non-essential
business travel
• Prepare for school dismissal and closure of
child care programs
– More likely if severity increases
– Closures could be 5-7 calendar days or longer
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18. Create a Pandemic Plan
• Review HR policies to ensure your plan is
consistent with state and federal law
• Plan should be about your employees and
your business:
– Allow employees to stay home if they are ill or to
care for ill family members
– Explore flexible worksite and work hour policies
– Identify essential functions and jobs
– Identify critical elements to maintain operations
– Plans for transferring business knowledge to key
employees
– Communicate plan to employees <#>

19. Other Resources
• www.cdc.gov/h1n1flu/business
• www.health.utah.gov/h1n1
• www.flu.gov
• www.cdc.gov/h1n1flu
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20. Thank You!
Adapted from “CDC Guidance for Businesses and Employers
to Plan and Respond to the 2009-2010 Influenza Season”