Pandemic planning: lessons we've learned

The H1N1 flu has been by far the biggest health story of the past few years. According to the World Health Organization (WHO), H1N1 was the first pandemic in 41 years. For many employers, it was the first time they had to put their disaster recovery and emergency preparedness plans into action.

More than 1.5 million people missed work in Canada during the H1N1 and seasonal flu season in 2009/10, according to Statistics Canada (StatsCan). Now that we’ve emerged from the second wave of the H1N1 pandemic, it’s important for employers to reflect on what they’ve learned from the experience and what changes they should implement to ensure a better response if another widespread outbreak occurs.

Challenging times
One of the most significant issues that employers faced during the 2009/10 flu season was high employee absenteeism rates. The peak period of the outbreak in November 2009 acted as a reminder to employers of what could be expected in a pandemic.

StatsCan has compared the impact of H1N1 and seasonal flu on hours worked to that of the Ontario power outage in 2003. According to StatsCan, employee absenteeism resulted in 29.5 million hours of lost work time compared with 26.4 million hours during the 2003 power outage. Approximately 9% of the Canadian workforce missed work as a result of H1N1 and seasonal flu in November 2009.

CBC News confirmed that, as expected, absenteeism was higher among employees with children. Within that group, 12.4% of employees missed work during November 2009, compared with 6.9% of those without children. Female employees ages 35 to 39 were the most affected. Employees in healthcare were also significantly affected, resulting in 9.4% missing work. Their well colleagues worked an additional two million hours during the month of November to compensate. The highest rates of absenteeism were reported in the areas of social science, education, government services and religion.

Sick time taken was somewhat lower in December 2009, with 4.4% of the working population missing work due to H1N1 or seasonal flu, totalling 13.4 million hours lost. Approximately 471,000 healthy employees were left to pick up the slack, logging a total of 6.9 million hours.

Another major challenge that employers experienced was handling these increased absenteeism rates with their current policies and procedures, including reporting practices for infectious diseases. Absence reporting needed to be fair but also protective of employees, and the procedures related to return-to-work clearance proved difficult to manage. Some employers asked for medical notes while others, realizing that the overburdened healthcare system may not be able to assist, simply had return-to-work criteria that had to be met.

In a survey conducted by the Ontario Chamber of Commerce, the majority of employers indicated that preparedness plans were essential to successfully weathering the H1N1 pandemic. However, less than half of the respondents said they have a pandemic plan in place to protect their operations from business disruption. And even if employers do have good internal business continuity plans, they may not fully understand the limitations of their suppliers. The largest challenge lies with employers that have worldwide operations or international clients. Some employers found it difficult to be prepared without being viewed as alarmist. Moving forward, Canadian employers will be focusing on business continuity plans. Many resources have provided guidelines, tips and recommendations, and even samples of business continuity plans and critical paths to include in the planning process.

Top 5 lessons learned
Looking back on the H1N1 pandemic, there are some important lessons that will enable employers to deal with any upcoming waves of widespread illness or future pandemics more effectively.

1.Employer investments in pandemic planning and business continuity paid off.
If you did not panic following WHO’s announcement that we were officially in Phase 6—full pandemic mode—your organization likely had some form of pandemic or business continuity plan already in place.

Moving forward, ensure that your plan is updated on a regular basis and tested with each major change. Employers should also be aware of their suppliers’ business continuity plans and consider obtaining a pandemic mode backup supplier in another region to reduce the risk of supply and demand issues.

2. Government investments in vaccination clinics made a significant difference.
The widespread vaccination program had a major impact on the spread of H1N1 and the lack of a third wave of the virus.

3. Public health resources were extremely challenged and strained during the pandemic.
For example, it took several approaches to properly prioritize the vaccine recipients. Public health resources were challenged by individuals who did not follow the communicated guidelines as well as by sheer volumes. Yet within several weeks of the program’s implementation, all people at higher risk as well as the general population were vaccinated.

Some employers took the vaccination program a step further and offered on-site workplace vaccinations for their employees. Some employers even offered to vaccinate spouses and children, recognizing that employees will often miss work to care for an ill family member.

4. School closures had an impact on employers.
Employees with children exhibited increased rates of absenteeism compared with their childless counterparts. For this reason, employers may want to create and document policies regarding sick time and caregiver time in order to avoid awkward case-by-case treatment should widespread infection occur in the workplace.

5. Pandemic and business continuity plans must be adaptable and driven by facts.
Providing clear information regarding policies and procedures is essential for building trust and containing a virus. In conjunction with pandemic plans, the impact of clear communication should not be underestimated.
Guidelines and direction regarding basic principles such as hygiene and handwashing techniques will help to reduce the spread of a virus. Employees expect their employers to be informed and to provide them with a safe workplace—another reminder that pandemic or business continuity plans should be reviewed and revised on a regular basis to ensure that they are still relevant in meeting the organization’s needs.

Fortunately, the H1N1 pandemic was not nearly as lethal as healthcare experts and the media had initially projected: the Public Health Agency of Canada reported 426 deaths compared with Health Canada’s predictions of 11,000 to 58,000 deaths. However, the actual number of cases may never be known, since most people stayed at home when they suspected H1N1 or seasonal flu symptoms. Regardless of the actual impact, employers still need to find a balance between panic and complacency in order to successfully manage their organizations through any future pandemics. BC

Susan Novo is manager, health and disability, with Cowan Insurance Group.
susan.novo@cowangroup.ca

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