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AFD - Employer Obligations for Preparedness - Keeping the Covenant

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  • AFD - Employer Obligations for Preparedness - Keeping the Covenant

    Keeping The Covenant

    # 2071

    There is an expectation by employees that their employers will provide them a safe workplace. This covenant, in many countries, is enforced by both civil and criminal law.

    In fact, here in the United States, OSHA (Occupational Safety & Health Administration) created the following statement of worker's rights nearly 40 years ago.


    Employers take note. If you haven't spoken to an attorney about your responsibilities and liabilities during a pandemic, it might be prudent to do so.

    I'm not a legal expert, so take what follow's with a grain of salt. . .

    But after nearly 3 years of governmental warnings, I would think it would be hard to argue that a pandemic isn't a `serious recognized hazard'.

    And while the OSHA guidelines on pandemic preparedness are currently only recommendations and don't have the force of law, I can envision that a failure to adopt them might be seen by a civil jury as `reckless disregard for employee safety' during and after a pandemic.

    Just saying . . .

    Of course, aside from the liability, the main reason employers need to prepare for a pandemic is so they can keep their doors open, and their businesses running.

    A pandemic could consist of multiple waves over one, or perhaps two years. There will be serious interruptions in commerce and cash flow. The option to simply close their doors for the duration may not be available to a lot of businesses.

    Many companies will need to find ways to stay solvent and continue to provide goods and services during this tumultuous time. Not only for their company's welfare, but for the welfare of the nation.

    And for that to happen, they need to keep their employees as safe as possible, and willing to work, during a pandemic.

    Not all employees, and all work environments, will be at the same risk level. Employers need to carefully assess the risk for each employee, and act accordingly.

    At the very top of the risk pyramid come health care workers and first responders. Many other types of employees will fall into the medium or lower risk categories.

    Notice, there is no LOW RISK category, only a `lower risk'.

    Occupational Risk Pyramid for Pandemic Influenza

    Very High Exposure Risk:
    • 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).
    • 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:
    • Healthcare delivery and support staff exposed to known or suspected pandemic patients (for example, doctors, nurses, and other hospital staff that must enter patients' rooms).
    • Medical transport of known or suspected pandemic patients in enclosed vehicles (for example, emergency medical technicians).
    • Performing autopsies on known or suspected pandemic patients (for example, morgue and mortuary employees).
    Medium Exposure Risk:
    • 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):
    • Employees who have minimal occupational contact with the general public and other coworkers (for example, office employees).

    The level of employer/business preparedness will vary depending on the type of business and the risk levels encountered.

    For some with only low risk employees, it may simply involve staggering work hours, moving desks to promote social distancing, putting up sneeze guards between employees and customers, and providing hand sanitizers and disinfectants.

    For those with medium risk or higher employees, the burden may be much higher. For the very high and high risk employees, it may include N95 and surgical masks, along with prophylactic antivirals.

    This decision chart comes from the Proposed Considerations for Antiviral Drug Stockpiling by Employers In Preparation for an Influenza Pandemic released early last week by the HHS.

    Right now, these are just proposed guidelines.

    As you can see, it is recommended that employers stockpile antivirals for high and very high risk employees, and that companies or agencies that are part of the critical infrastructure strongly consider prophylactic drugs for employees essential to their operations.

    Obviously the protection of employees will require that employers accept a tremendous burden. It will be costly, and those costs must be borne now, before a pandemic threat becomes imminent.

    There will be, quite naturally, some reluctance on the part of some employers to follow through. The costs of preparing will be high, and returns on the investment may be years away.

    But failing to properly prepare a workplace for a pandemic not only puts their employee's lives at risk, it can threaten the existence of the business itself.

    The bottom line here is that all businesses, large and small, need to have a serious pandemic plan in place. If appropriate, they need to be stockpiling those items (masks, gloves, prophylactic antivirals) that they will need to maintain (relatively) safe operations during a crisis.

    It is, after all, incumbent upon business owners to provide a safe workplace. Those that do so are more likely to keep their doors open during and after a pandemic.

    Those that don't. . . probably won't.

    posted by FLA_MEDIC @ 12:25 PM

  • #2
    Re: AFD - Employer Obligations for Preparedness - Keeping the Covenant

    October 2, 2008

    More Workers Will Be Essential During A Pandemic Than You Might Think

    # 2350

    It's not a new concept, of course.

    But today we get a report from the Johns Hopkins Berman Institute of Bioethics which stresses that we need to rethink who we should consider `essential' during a pandemic.

    If you've followed the talks and writings of Dr. Michael Osterholm of CIDRAP (Center For Infectious Disease Research & Policy) over the past three years, you've heard a lot of these points made before.

    While healthcare workers and first responders are most certainly essential workers, they won't be able to do much good if the power grid is down, or if the water supply is compromised. Transportation, coal mining, natural gas refining, food production, and utility generation are all essential to keeping the wheels on the track during a pandemic.

    From time to time over the past 32 months, you've even read similar warnings in this humble blog, although I credit the writings and speeches of Dr. Osterholm with much of my education in this area.

    The full report is by subscription, but we can get a pretty good feel for where it is going from the summary provided below.

    You'll note that these authors also recommend that members of the public who can afford to should stockpile essential supplies in order to offset some of the supply chain impacts during a pandemic.

    They even go on to say:

    It is important for leaders to communicate to the middle class and the wealthy that it is their responsibility to prepare for self-sufficiency in order to free up scarce supplies and allow first responders to direct their attention towards those too poor or vulnerable to prepare themselves.

    My, oh my! With that kind of talk, these authors could have a future as flu bloggers.

    That, by the way, is high praise.

    I've reparagraphed and highlighted portions of this summary to increase readability.

    Wednesday, October 01, 2008
    Rethinking Who Should Be Considered 'Essential' During a Pandemic Flu Outbreak
    Not only are doctors, nurses, and firefighters essential during a severe pandemic influenza outbreak. So, too, are truck drivers, communications personnel, and utility workers.

    That's the conclusion of a Johns Hopkins University article to be published in the journal of Biosecurity and Bioterrorism. The report, led by Nancy Kass, Sc.D, Deputy Director of Public Health for the Johns Hopkins Berman Institute of Bioethics, provides ethical guidance for pandemic planning that ensures a skeletal infrastructure remain intact at all times.

    Dr. Kass says, ?when preparing for a severe pandemic flu it is crucial for leaders to recognize that if the public has limited or no access to food, water, sewage systems, fuel and communications, the secondary consequences may cause greater sickness death and social breakdown than the virus itself.?

    The authors represent a wide-range of expertise in several areas of pandemic emergency planning both at the state and federal levels. After examining several accepted public health rationing strategies that give priority to all healthcare workers and those most susceptible to illness, the authors propose a new strategy that gives priority to a more diverse group.

    ?Alongside healthcare workers and first responders, priority should be given to the people who provide the public with basic essentials for good health and well-being, ranging from grocery store employees and communications personnel to truck drivers and utility workers,? says Dr. Kass.

    The report recognizes that given the widespread and sustained nature of a pandemic, federal assistance will be spread thin and local jurisdictions must develop their own preparedness plans to ensure they are capable of sustained self-sufficiency. Encouraging and working with local businesses to develop their own response plans can help reduce the burden on local governments during a pandemic.

    Similarly, individuals and families who can afford it should do their best to prepare for any disaster. The paper notes, the more initiative the general public exercises in stockpiling several weeks' worth of food, water, paper goods, batteries medicines, and other needed supplies, the less vulnerable they will be to a break in the supply chain.

    In fact, the report emphasizes, it is important for leaders to communicate to the middle class and the wealthy that it is their responsibility to prepare for self-sufficiency in order to free up scarce supplies and allow first responders to direct their attention towards those too poor or vulnerable to prepare themselves.

    The article lays out a set of ethics rules and principles to help guide and frame a pandemic response strategy that is evidence-based, transparent, fair, and recognizes the burdens the public may face. Dr. Kass points out the ?consideration of ethics are critical not only in having respectful and inclusive discussion and engaging with the public fairly, but it also improves the likelihood of public health and medical success through increased cooperation and understanding of government plans.?

    Other authors of this paper include: Jean Otto, DrPH, Senior Epidemiologist, Department of Defense, Global Emerging Infections Surveillance and Response System, Armed Forces Health Surveillance Center, Walter Reed Army Institute of Research; Daniel O'Brien, JD, Principal Counsel, Office of the Maryland Attorney General, Department of Health and Mental Hygiene; and Mathew Minson, MD, Senior Medical Officer for Strategic Initiatives, Office of the Assistant Secretary for Preparedness and Response, U.S. Department of Health and Human Services.
    Click Here to read report.
    Ethics and Severe Pandemic Influenza: Maintaining Essential Functions through a Fair and Considered Response
    Nancy E. Kass, Jean Otto, Daniel O'Brien, Matthew Minson. Biosecurity and Bioterrorism: Biodefense Strategy, Practice, and Science. September 1, 2008, 6(3): 227-236. doi:10.1089/bsp.2008.0020.