Small business H1N1 Flu planning
In September, 2009, Janet Napolitano, U.S. Secretary of Homeland Security called on small business owners and managers to become "a valuable partner in our nation's defense against a wide H1N1 influenza outbreak." According to Napolitano, small businesses should plan to be able to respond in a flexible way to varying levels of severity and be prepared to take additional steps if a potentially more serious outbreak of influenza evolves during the fall and winter.
 About the 2009 H1N1
The new influenza virus, now called 2009 H1N1 influenza, or 2009 H1N1 flu, first caused illness in Mexico and the United States in March and April, 2009. On June 11, 2009, the World Health Organization (WHO) signaled that a global pandemic of 2009 H1N1 flu was underway by raising the worldwide pandemic alert level to Phase 6. This action was a reflection of the spread of the new 2009 H1N1 flu virus across the globe, not the severity of illness caused by the virus. At the time, more than 70 countries had reported cases of 2009 H1N1 flu infection and there were ongoing community level outbreaks of 2009 H1N1 flu in multiple parts of the world. Since June, this new H1N1 virus has continued to spread. The Centers for Disease Control and Prevention (CDC) anticipates additional cases, hospitalizations and deaths associated with this pandemic in the United States during the U.S. 2009–2010 influenza season.
Community strategies that delay or reduce the impact of a pandemic (also called nonpharmaceutical interventions) may help reduce the spread of disease until a vaccine is available. Over the past several years, the Department of Health and Human Services (HHS), the CDC, and the Occupational Safety and Health Administration have developed guidelines, including checklists, to assist businesses, industries, and other employers in planning for a pandemic outbreak as well as for other potential disasters.
 Planning for the 2009 H1N1 Virus
Here are some recommendations from federal preparadness and health officials:
Name a Workplace Influenza Coordinator: They will be respon¬sible for dealing with 2009 H1N1 flu issues and their impact at the workplace, including contacting local health department and health care providers in advance and developing and implementing protocols for response to ill individuals. The coordinator should not wait for flu season to start in order to establish those contacts and relation¬ships, and check online resources of local public health officials immediately to learn what you should be doing. Determine who will be responsible for assisting ill individuals in the workplace, and make sure at least one person can serve as the “go to” person if a worker becomes sick at the workplace.
Review workplace policies: Examine your company's policies for leave, telecommuniting, and employee compensation and review with all employees so they are up-to-date on sick leave policies and employee assistance services that are covered under any of your employee-sponsored health plans. Leave policies should be flexible, non-punitive, and well-communicated. They should allow workers who have the flu to stay home and away from co-workers. Also, plan to have workers stay home if they have to care for sick family members. Be pre¬pared, in the event that there are school closures, to allow workers flexible schedules or other accommodations so they can mind their children and keep them safe at home. Explore the possibility of some of your workers working from home with appropriate infrastructure support.
Identify essential employees and essential busi¬ness functions: Also review critical inputs (e.g. raw materials, suppliers, subcontractor services/products, and logistics) required to maintain business operations should there be disruptions during the 2009 H1N1 flu outbreak – and make plans on how to communicate with people that perform essential tasks to provide them assignments and work direction. Explore other ways you can continue business operations if there are supply chain or other disruptions. Share your pandemic plans with employees and clearly communicate expectations. It is important to let your employees know your plans and expectations when 2009 H1N1 flu outbreaks occur in communities where you have a workplace. Consider ways to communi¬cate with employees who do not speak English or those with disabilities.
Prepare business continuity plans: If there is significant absenteeism or changes in the way you need to conduct business in the workplace during this outbreak, you need to be able to maintain operations. School dismissals and childcare provider closures may increase absenteeism in the workplace. Health officials may also advise that workplaces take multiple steps to increase the space between people and decrease the frequency of contact among people, also known as “social distancing” to reduce the spread of illness during a more severe outbreak.
Establish an emergency communications plan: This plan includes identification of key contacts (with back-ups), chain of communications (including suppliers and customers), and processes for tracking and com¬municating business and employee status.
 Tips for keeping your workplace healthy
Employees are a crucial resource at any business, and especially small businesses. There are steps you can take now, and during the flu season, to help protect the health of your employees.
1. Develop policies that encourage ill workers to stay at home without fear of any reprisals.
2. Develop other flexible policies to allow workers to telework (if feasible) and create other leave policies to allow workers to stay home to care for sick family members or care for children if schools close.
3. Provide 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 workers to clean their work surfaces.
4. Provide education and training materials in an easy to understand format and in the appropriate language and literacy level for all employees. See www.cdc.gov/h1n1flu/business.
5. Instruct employees who are well but who have an ill family member at home with the flu that they can go to work as usual. These employees should monitor their health every day, and notify their supervisor and stay home if they become ill. Employees who have a certain underlying medical condition or who are pregnant should promptly call their health care provider for advice if they become ill.
6. Encourage workers to obtain a seasonal influenza vaccine, if it is appropriate for them according to CDC recommendations (http://www.cdc.gov/flu/protect/keyfacts.htm). This helps to prevent illness from seasonal influenza strains that may circulate at the same time as the 2009 H1N1 flu.
7. Encourage employees to get the 2009 H1N1 vaccine when it becomes available if they are in a priority group according to CDC recommendations. For information on groups recommended for seasonal and H1N1 vaccines, please see www.flu.gov. Consider granting employees time off from work to get vaccinated when the vaccine is available in your community.
8. Provide workers with up-to-date information on influenza risk factors, protective behaviors, and instruction on proper behaviors (for example, cough etiquette; avoid touching eyes, nose and mouth; and hand hygiene).
9. Plan to implement practices to minimize face-to-face contact between workers if advised by the local health department. Consider the use of such strategies as extended use of e-mail, websites and teleconferences, encouraging flexible work arrangements (for example, telecommuting or flexible work hours) to reduce the number of workers who must be at the work site at the same time or in one specific location.
10. If an employee does become sick while at work, place the employee in a separate room or area until they can go home, away from other workers. If the employee needs to go into a common area prior to leaving, he or she should cover coughs/sneezes with a tissue or wear a facemask if available and tolerable. Ask the employee to go home as soon as possible.
 2009 H1N1 flu Frequently Asked Questions
 What is 2009 H1N1 flu?
2009 H1N1 flu is a new influenza virus causing illness in people. Most people do not have immunity to this virus, so it spreads quickly. People with the flu spread the virus through coughing or sneez¬ing near others. Sometimes people may become infected by touching something with flu viruses on it and then touching their eyes, mouth, or nose.
Those currently at higher risk of serious flu-related complica¬tions from 2009 H1N1 flu include children younger than five years old, pregnant women, people of any age with certain chronic medical conditions (such as asthma, diabetes, heart disease), adults and children who have a weak immune system, residents of nursing homes and other chronic-care facilities and persons aged 65 years or older. See http://www.cdc.gov/h1n1flu/qa.htm for more information about high risk groups.
 What are the signs and symptoms of 2009 H1N1 flu in people?
The symptoms of seasonal and 2009 H1N1 flu virus in people include fever or chills AND cough or sore throat. In addition, symptoms of flu can include runny nose, body aches, headache, tiredness, diarrhea, or vomiting. Like seasonal flu, 2009 H1N1 flu may cause a worsening of underlying chronic medical conditions. In adults, emergency warning signs that need urgent medical attention include:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Severe or persistent vomiting
- Flu-like symptoms improve but then return with fever and worse cough
In children, emergency warning signs that need urgent medical attention include:
- Fast breathing or trouble breathing
- Bluish or gray skin color
- Not drinking enough fluids
- Severe or persistent vomiting
- Not waking up or not interacting
- Being so irritable that the child does not want to be held
- Flu-like symptoms improve but then return with fever and worse cough
Severe illness (pneumonia and respiratory failure) and deaths have been reported with 2009 H1N1 flu infection in some people.
 How long should a person stay out of work if they have an influenza-like illness?
Workers who have symptoms of influenza-like illness (see above) should stay home and not come to work until at least 24 hours after their fever has resolved. You should plan now to allow and encourage sick workers to stay home.
 When will it hit my community and how serious will it be?
The 2009 H1N1 flu influenza virus may affect different com¬munities at different times and in different ways. The flu may make many more people sick then usual, or it may not. We will likely see a re-emergence or continued outbreak in communities as the regular 2009–2010 flu season begins this fall.
 Why should small business owners plan for 2009 H1N1 flu?
Small businesses are especially susceptible to the negative economic impacts of a flu pandemic. An estimated 25 percent of businesses do not reopen following a major disaster, according to the Institute for Business and Home Safety. Planning from the outset can help offset business losses, and protect your business and your employees when this flu hits. Benefits of planning are:
- Minimize disruption to business activities
- Protect employees’ health and safety
- Limit the negative impact to the community, economy and society
 What steps should you be prepared to take when the H1N1 flu hits your community?
CDC recommends that sick people stay home and away from the workplace. The best way to slow the spread of the disease is to keep sick people away from well people, given that the 2009 H1N1 flu virus is a new virus and most people will not have prior immunity to protect them from acquiring infection. If sick people come to work, they may infect other workers, and this has the potential to lead to a high rate of absenteeism in the workplace.
Your business’s actions should be tied to the extent and severity in your local area. Choose someone to be responsible for flu issues at the workplace. They should contact the local heath department for guidance and monitor the level and severity of 2009 H1N1 flu illness in your business’ community and region.