The swine flu pandemic has significant implications for businesses, who should have contingency plans in place to deal with any potential fallout from the influenza pandemic.
It pays to be prepared. Protecting the health and safety of employees or members of the public who may be affected by your activities is an essential part of risk management and this briefing outlines some of the implications for your business.
What is swine flu?What to do if you have symptomsThe effects of the virus around the world so farPrevious and present pandemics: comparisonsGovernment framework for responding to an influenza pandemicBusiness continuity planningInsurance issues for insured and insurersWorkplace Health & Safety issuesEmployee communication policiesKey employment issues in a pandemicFurther Information
It is a respiratory disease caused by influenza type A known as H1N1. It is the same strain which causes seasonal outbreaks of flu in humans on a regular basis.
But this latest version of H1N1 is different: it contains genetic material that is typically found in strains of the virus that affect humans, birds and swine.
Although the strain may have originated in pigs, it is now a wholly human disease. It can be spread from person to person by coughing and sneezing.
Symptoms are similar to seasonal flu. A sudden fever - which is a temperature of 38ºC (100.4ºF) - is the key symptom, combined with other complaints which may include:
If you suspect that you have contracted swine flu, stay at home, check your symptoms and contact your GP or NHS Direct on 0845 4647 for further advice.
As with normal flu, the severity of symptoms will depend on treatment and the individual. Many people have only suffered mildly and have begun to recover within a week.
People are most infectious soon after they develop symptoms, but they cease to be a risk once those symptoms have disappeared. The incubation period may be as little as two days.
Flu experts say that about one in every three people who become infected will not realise they have had swine flu because they will have had no or only very few symptoms, and that about 98% of people who get infected will recover fully without any hospital treatment.
Remember that antiviral drugs for treatment will only lessen the severity of the illness. They will neither cure it nor significantly reduce sickness absence.
The real fear is that the strain will mutate and become more virulent which would pose a greater threat. This has been the feature of previous flu pandemics.
If you have flu-like symptoms and are concerned that you may have swine flu, the advice is to stay at home and contact your GP who will be able to assess you. If appropriate, patients will be offered antiviral medication and vaccination jabs.
If you have been diagnosed with swine flu or you have had suspected swine flu, you should refrain from attending work until you are completely symptom free. Adults are most infectious soon after they develop symptoms and remain infectious while their symptoms continue, which is usually for up to five days. They can normally return to work within seven days.
This is the first influenza pandemic since 1968. The virus was originally identified in Mexico in April 2009. The first illness caused by a new influenza A virus was confirmed in the United Kingdom on 27 April 2009 and the World Health Organization (WHO) declared the situation a pandemic on 11 June 2009.
In most cases the virus has proved relatively mild. However, around the world hundreds of people have died and it is not yet clear how big a risk the virus is.
The situation in the UK
The UK formally moved from a containment to a treatment phase for swine flu on July 2 2009. Intensive efforts to contain swine flu, for example through automatic school closures, ended. This was to free up capacity to treat the people who are contracting swine flu daily.
As in other countries, most of the cases reported so far in the UK have been mild. Only a small number have led to serious illness, and these have often been in patients with existing health problems, such as cancer, that already weakened their immune systems.
Antiviral medicines Tamiflu or Relenza have been offered to all those confirmed with swine flu. On 21 October 2009 a swine flu vaccination programme was introduced and the vaccine has been given to those at the greatest risk first.
Swine flu: Country by country
Pandemics - global epidemics - occur when a new strain of flu emerges that is markedly different to previously circulating viruses. This means that few - if any - people have immunity, allowing the virus to spread rapidly, affecting hundreds of thousands of people across countries and regions.
There were three influenza pandemics in the 20th Century.
1918: The Spanish flu pandemic remains the most devastating outbreak of modern times. Caused by a form of the H1N1 strain of flu, it is estimated that up to 40% of the world's population were infected, and more than 50 million people died, with young adults particularly badly affected.
1957: Asian flu killed two million people. Caused by a human form of the virus, H2N2, combining with a mutated strain found in wild ducks. The impact of the pandemic was minimised by rapid action by health authorities, who identified the virus, and made vaccine available speedily. The elderly were particularly vulnerable.
1968: An outbreak first detected in Hong Kong, and caused by a strain known as H3N2, killed up to one million people globally, with those over 65 most likely to die.
Compared to seasonal 'flu all have shown:
The behaviour of the present pandemic virus so far is consistent with this: deaths are occurring at younger ages than in seasonal 'flu.
While the scientists cannot yet predict the future spread of the virus with much precision, the pandemics of 1957-58 and 1968-70 demonstrate that there will be more than one wave of infection.
The 1958 epidemic arrived in Britain in the month of June, but the number of cases did not start to increase rapidly until September when schools returned after their summer holidays. The initial autumn peak was then followed by a second peak over Christmas and New Year, which was associated with a higher mortality rate.
In 1968, the first cases arrived in this country in the month of August, but infection rates remained at a relatively low level until an initial peak in March 1969. It was not until Christmas 1969/1970 that a second, much larger peak occurred.
These features of previous pandemics suggest a much larger wave of infection (with more illness and death) in autumn or winter this year. It remains possible that the virus could change increasing its virulence.
There has been much speculation that the illnesses caused by the current influenza virus are "mild" and "like seasonal 'flu". Whilst it is true that most infections so far have not been severe, there have been hospitalisations and deaths. These have generally been in younger people and not all have had significant underlying illness. Moreover, the epidemiology is not like seasonal 'flu in that it is occurring out of the normal 'flu season and different age groups are being most affected.
There is still considerable uncertainty about the behaviour of the virus. It remains the case that for a doctor, faced with a previously healthy adult with symptoms strongly suggestive of H1N1 virus, there is no way to predict whether the course of their illness will be mild or very serious.
A national framework for responding to an influenza pandemic - this document describes the Government's strategic approach for responding to an influenza pandemic published jointly by the Department of Health and the Cabinet Office. It provides background information and guidance to public and private organisations developing response plans. A 'snap-shot' of the available scientific evidence underpinning the spectrum of possible strategies to respond to pandemic influenza is outlined in the Cabinet Office's document entitled "Overarching government strategy to respond to pandemic influenza".
The Government has since revised some of its assumptions having taken into account the spread of the disease, further information on the proposed vaccination programme and any new information about the virus. Further guidance.
In particular the guidance on absence from work has changed from the previous version. The worst case scenario is now up to 5% of the workforce to be off work in the peak week, down from 12% previously. As previously, this covers the proportion of the workforce who may be absent from work because they are ill themselves or because they are looking after ill children. This percentage is on top of the ‘usual’ absence rates businesses would normally expect to see during winter.
The starting point for any business should be its business continuity (BC) plan and Health & Safety compliance.
Now is a good time to review your business contingency plan and adapt it as the full effect of the pandemic becomes apparent. If you don't have one, contact the IoD Business Information Service for information about developing one.
It pays to know what you need to do should the worst happen, rather than hope that you will simply muddle through. It is expected that businesses with a business continuity strategy in place will have a better chance of working through the pandemic and of recovering quickly afterwards.
Research shows that majority of small firms do not have a continuity plan, as they hope to deal with problems as and when they arise. But the stark fact is that when problems arise, more needs to be done than what was anticipated, which in turn leads to business failures.
The smaller the business, the more important it is to have a contingency plan. A small business should keep it simple - planning does not have to be costly. The first stage should secure a small team (or a person) to manage the Business Continuity Planning (BCP) as an ongoing project. Next, the BCP person/team should identify relevant risks for your business to ensure that problem areas are dealt with at an early stage.
The next stage should focus on identifying the effects of potential disruption. Often referred to as a business impact assessment (BIA), this will help predict the likely sequence of events when the worst happens.
One of the main concerns in any business continuity planning against an influenza pandemic will be the number of employees that may be estimated as likely to be absent from work at the peak of the pandemic.
The level of staff absence from work during a pandemic will depend significantly on the spread and severity of swine flu. Therefore, a company's business continuity plan should have the flexibility to accommodate these ranges.
The UK Government has advised that, as a rough working guide, organisations employing large numbers of people, with flexibility of staff redeployment, should ensure that their plans are capable of handling staff absence rates of up to 15% over the 2-3 week peak of a pandemic (in addition to usual sickness absence levels). Small businesses, or larger organisations with small critical teams, should plan for level of absence rising to 30% at peak, perhaps higher for very small businesses with only a handful of employees.
However, business continuity planners should bear in mind there may be an uneven distribution of the virus across different areas, those infected may take longer to recover and there may be 'waves' of a pandemic to be dealt with.
Put in place measures to maintain core business activities for several weeks at high levels of staff absenteeism, including options for remote working and expanding self-service and on-line options for customers and business partners.
Identify those essential functions and posts, and perhaps individuals, whose absence would place business continuity at particular risk.
Identify which services could be curtailed or closed down during all, or the most intense period, of the pandemic.
Identify inter-dependencies between organisations and ensure they are resilient, for example by ensuring that supplier organisations delivering services under contract have appropriate arrangements in place themselves to sustain their service provision.
This particular guidance outlines:
Insurance issues for insured and insurers Workplace Health & Safety issues Employee communication policiesKey employment issues in a pandemic
Many relevant insurance policies - for example personal accident, travel insurance, contingency insurance and some business interruption cover - exclude liability arising out of an influenza pandemic. This may be by way of a general exclusion for all communicable diseases. Or it may be more specific. The exclusion may, for example, identify the types of illness for which cover is excluded.
Any pandemic is likely to bring into focus how those clauses should be interpreted. Will they cover the H1N1 virus (or indeed a mutation of that strain) which appears to have come from swine flu? Are they ambiguous, in which case they may be construed against the person who drafted the clause or the person who is seeking to rely on the clause? Or are they clear one way or another?
Insurers will want to be clear as to what their cover actually provides.
Insured will want to make sure they have policies which afford them the cover they require.
The London insurance market is the most flexible and commercial insurance market in the world. Brokers and insurers alike are well placed to respond to a potential crisis of this nature. Where cover for losses arising out of an influenza epidemic are excluded, cover can be obtained through either a buy back into the existing insurance policy or a bespoke insurance policy to cover the effects of the pandemic.
Health and safety legislation obliges employers to provide a safe as reasonably practicable environment for staff and visitors.
The Management of Health and Safety at Work Regulations 1999 require employers to undertake suitable and sufficient risk assessments of health and safety risks to employees and other persons affected by the work activities. These should be recorded where there are more than 5 employees. Employers are also obliged to develop procedures to deal appropriately with serious and imminent danger, and to nominate sufficient numbers of competent persons to activate those procedures.
All emergency procedures have to be written down and effectively communicated to all personnel on the premises. The person who has been designated as the competent person responsible for procedures should be clearly identified and his role, responsibilities and authority detailed.
Following the recent increase by WHO of the alert status of swine flu to level 6 (the highest pandemic alert phase), all employers must consider the impact of the pandemic on their organisation and the workplace measures they might need to implement to prevent, control and manage any outbreak that might occur.
The NHS's advice is that any employee who has had contact with someone diagnosed/suspected to have swine flu should continue to attend the office unless they have any flu like symptoms.The Health and Safety Executive has issued general guidance for employers, setting out key issues that all employers should have regard to, both in terms of preventing spread of flu in the workplace and also controlling possible spread of the disease if an employee is thought to have contracted it.
Prevention is better than cure! Employers must act by adopting basic precautionary measures in the workplace, even if they perceive the risks that swine flu poses to their particular organisation to be very low.
Seek to halt the spread of the virus by:
At this stage, it is not necessary for employers to require employees to wear facemasks as the number of people in public places who are displaying symptoms is likely to be limited. In certain occupations (such as healthcare workers) the risk of exposure to the virus will be higher and the HSE recommend that surgical face masks are used.
To help prevent spread of infection, the Department of Health recommend that people who are ill stay at home and suggest that relatives, neighbours etc collect food, medicines etc for them. This measure should help limit the number of symptomatic individuals in public places. Therefore it should not be necessary for workers to wear masks routinely when in contact with the general public. There may though be some situations when it will be advisable for a worker to wear a mask. Such a situation will depend on the nature of the work, where it is to be carried out and the outcome of the risk assessment that should, amongst other things, gauge:
Influenza viruses spread mainly through droplets of respiratory secretions in the air, typically generated by coughing and sneezing. They also spread through hand/face contact with surfaces contaminated with such secretions. Masks can provide a physical barrier but some precautions need to be observed. They should properly cover the mouth and nose and be used in combination with good personal hygiene.
Responsibility for providing advice on the use of masks for workers in general, including those in healthcare, rests with the employer or duty holder. Whether a mask will be required will depend on the nature of the work and the outcome of your risk assessment for the workplace.
More detailed guidance on the use of face masks can be found on the Department of Health website.
If a worker is working in an area where they are separated from other people by barriers such as glass screens etc, then this will act as a physical barrier to influenza transmission. For example, workers who deal with the public from behind glass screens (e.g. in a Post Office) could not be regarded as being likely to be sneezed or coughed upon by a member of the public, even if they were to have symptoms.
Whilst in the main, pandemic flu, such as swine flu, is a public health concern, there may be indirect health and safety consequences which impact on the duties placed on employers under Health and Safety legislation, such as the Health and Safety at Work etc Act 1974 and the Management of Health and Safety at Work Regulations 1999.
Where worker numbers are reduced due to sickness absence, there is potential for a number of health and safety issues to arise. In particular, the redeployment of workers to unfamiliar tasks or employees working alone due to the absence of colleagues caused by sickness will inevitably increase the risks to those workers. Employers must properly consider the impact of reduced worker numbers on their remaining employees and ensure that any risks as result of such changes are properly assessed and controlled to meet the duties placed on them by UK health and safety legislation.
Protecting the H&S of employees or members of the public who may be affected by your activities is an essential part of risk management and must be led by directors.
The HSE and the IoD have jointly produced guidance for the effective leadership and implementation of H&S. It is specifically designed for use by all directors, governors, trustees, officers and their equivalents in the private, public and third sectors, and applies to organisations of all sizes.
Businesses must consider their employee communication policies in the event that premises require to be closed due an outbreak of the virus amongst the workforce.
It is recommended that all businesses establish a "communications tree" which can be utilised in the event of an outbreak. The communications tree will set out how individual employees can be contacted - e.g. by mobile phone or email - to advise of immediate office closure. Communication of an outbreak in this way will be essential to reducing the risk of contamination to as low as reasonably practicable for those who are, as yet, unaffected by the virus.
It is recommended that the method of communication used in the event of an office close down is not restricted to one medium to ensure that if the initially selected method of communication fails (e.g. if email systems are down), there is an effective back-up communication system which the employer can use to make urgent contact with workers if required.
A full-scale pandemic will challenge all employers. Now is the time to anticipate your business needs so that employment issues can be resolved smoothly.
Employers should consider a number of issues when dealing with absences and adapting working arrangements to ensure the business can continue to function efficiently with a reduced workforce.
Absences during a pandemic will include genuine sickness absences, the taking of time off to look after dependants and absences for other reasons such as sheer reluctance to attend or travel to work.
Employers will need to review their sickness absence and sick pay policies to ensure these are appropriate. They should prepare for significant levels of sickness absence of at least 5-7 days per person. One priority will be to keep the genuinely ill away from work and changes in company policy may have to be made; for example employees should not return until it is safe for them to do so, rather than when they feel better. If attendance at GP's surgeries is restricted sickness may have to be self certified and employers should review their policies so that abuses can be managed.
Other absence issues may arise when employees take time off to care for sick dependants. Employers who currently pay for this may decide to review their policies so that payment is limited to a certain number of days. The statutory right to take time off extends to a 'reasonable period', which is likely to be longer than employers are currently used to. In light of this, employers should review their holiday policies to see if these allow them to require employees to take holiday at the employer's direction.
During a pandemic it is also likely that employees will be absent for a variety of other reasons, such as a reluctance to attend work in case they are infected. Actively insisting the sick stay at home should encourage the healthy to come to work, but employers will need to be sensitive to genuine concerns and may be able to agree different working arrangements, such as working from home. However any unreasonable refusal to work may lead to disciplinary action.
Another challenge for employers will be keeping services operating 'as usual' with a reduced workforce. Employers are likely to cancel or rearrange planned employee absence, consider recruiting temporary staff, seek more overtime and allow annual leave to be carried over to the next year.
Employers may redeploy staff who have either a wide range of skills to undertake several roles, if necessary, and/or retrain some of their staff to perform multiple tasks in emergency.
Employers must remain conscious of the difficulties of unilaterally imposing contractual changes and all changes should be undertaken within a framework of effective and, where possible, early consultation. Employers will have to decide whether there is sufficient flexibility within the employment contract to make the required changes or whether consent or other measures are necessary. The unilateral imposition of contractual changes is risky and can lead to claims for breach of contract and unfair dismissal.
Those UK businesses with overseas personnel may want to redeploy them from group operations. Aside from possible quarantine controls which may impact on freedom of movement in a full scale pandemic, the UK entity must ensure that any foreign employees have the necessary permission to work in the UK. Business visitors cannot undertake productive work in the UK without the employer running the risk of civil and criminal penalties and immediate redeployment of staff will not always be feasible.
Employers may want to limit where possible the amount of face-to-face contact by using various technology, such as video links, teleconferencing, Skype, etc. instead.
IoD Information and Advisory Service, +44 (0)20 7451 3100Directors' Information Gateway
NHS:
The Department of Health:
Health and Safety Executive:
The Cabinet Office:
Department for Business, Innovation and Skills (BIS)
World Health Organisation websiteThe Health Protection Agency (HPA) websiteEuropean Centre for Disease Prevention and Control websiteDirectgov - Everything you need to know about swine fluBusiness Link - Your business and swine flu
Published: March 2010To the best of our knowledge the information is correct at the time of publishing. Whilst every care has been taken to ensure that the information provided is accurate, the Institute of Directors cannot accept liability for any errors or omissions. The Institute of Directors is not responsible for the content of any external internet sites listed. All information included on the iod.com site is intended for information purposes only. We make no representations or warranties as to the accuracy of the information contained on the iod.com site, and you should take appropriate steps to verify it. Please see the full Terms and Conditions governing its use.
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