Bird flu: Planning for the flu pandemic

The world is full of risk – and the media is full of scare-stories. So OH departments might be forgiven for giving pandemic flu planning a low priority. And the government is encouraging this laissez-faire approach – currently the Department of Trade and Industry (DTI) is leaving it to organisations to make their own decisions about contingency planning. But is this enough? Those who rely on their existing disaster recovery plans could be in for a nasty shock – once employees are being diagnosed with pandemic flu, it will be too late to work out what to do. Experts disagree about how to tackle a pandemic, and how severe its effects might be. But they do agree that the next world-wide flu pandemic is overdue, and it is a matter of when, not if, the next one strikes.

There were three flu pandemics in the 20th century: in 1918, 1957 and 1968. Up to a quarter of the UK population became ill each time, thousands died and the resulting social and economic disruption was huge. The 1918 epidemic was the worst. A quarter of a million people died in the UK, and 40 million worldwide.

A pandemic occurs when a new strain of flu emerges, to which people have not developed immunity. The obvious threat is currently from avian influenza virus H5N1, which has been affecting poultry in South East Asia since 2003. If avian flu mutates into a virus that can easily transmit from human to human, the resulting flu would sweep across the world. The first wave of a pandemic is likely to last for three to five months: subsequent waves may be weeks or months apart.

So what can organisations do about it? Forward planning can help, no matter how unpredictable a pandemic might be. Unlike other disaster recovery programmes that focus on dealing with a short, sharp shock, such as a terrorist attack, flu planning needs to take account of changed ways of working that may last for months.

Getting advice is not easy. Some industry sectors have more guidance than others – for instance, the energy sector already has contingency plans in place for disruptions to supply, and the Energy Emergencies Executive is discussing flu preparedness with the DTI. Other groups are less advanced. The Chartered Institute of Personnel and Development, for instance, has discussed the issue with business recovery organisation Survive, but has no specific guidelines yet.

Business continuity

“Planning for business is at an early stage,” says Lorraine Lane, chief executive of Survive. “There is plenty of information out there for the general public, but not much in-depth advice for businesses. This is something the government has overlooked completely.”

Survive has now launched a project designed to address the specific issue of business continuity during a global flu pandemic, with support from Roche Products. This initiative will carry out extensive research with employers from a wide range of industry sectors, and will publish the results of this research as guidelines, which will be made available to the public soon.

It is certain that there will be a significant role for OH practitioners when the pandemic occurs. This was the message from one of the individuals leading the response to pandemic influenza, Dr Jonathan Van Tam, when he spoke at the RCN Society of Occupational Health Nursing conference in December 2005.

“My view is OH will have to get involved,” said Van Tam, consultant epidemiologist at the Health Protection Agency’s Centre for Infections. Practitioners could have a role in controlling staff deployment, assessing staff returning to work after flu and monitoring the spread of the disease in organisations.

Although Van Tam said it was difficult to say whether OH practitioners would be enlisted to treat patients with anti-virals, he said there could be a role in administering vaccines when they are developed. “Vaccination is one area where OH could have a big role to play,” he said.

The main source of government information is the Department of Health’s (DoH) Pandemic Flu: UK Influenza Contingency Plan. Advice from the DoH includes:

  • Consider the implications of staff absence at a time when the workload for some may be increased.
  • Establish minimum staffing levels.
  • Identify a front-line group of essential staff.
  • Look at ways of redeploying staff to do jobs they may not be trained to do or are familiar with, or to recruit additional staff or volunteers.
  • Set up systems for vetting additional staff, including volunteers.
  • Look at overnight accommodation – for example, portable accommodation with bunks for people to rest between shifts when transport home may be difficult or disrupted.
  • Make sure that staff rosters allow for adequate break and leave periods to ensure a sustainable response over several weeks.

The DoH also stresses the need for adequate staff training for both regular staff and staff drafted in or redeployed. Key issues include the following:

Make sure that staff training is tailored to the unusual working conditions.

  • Plan and organise training for any volunteers.
  • Teach staff how to handle and work with volunteers.
  • Keep a database of former or recently retired clinical staff or local doctors who may be called upon to help.
  • Include the need for surge capacity in regular planning.
  • Plan for counselling or other forms of help for staff, who may need psychological or morale building support during what will be a difficult time at work and at home.

Equally important, workplace etiquette will need to change. Pandemic flu will usually be transmitted via coughs and sneezes. A colleague who doesn’t bother to use a handkerchief could be spreading a potentially fatal disease. Surgical masks made familiar in the SARS outbreak in Asia may not be needed, but consistent hygiene will be essential. As door handles and taps are another common breeding ground for infection, expect to enforce the mandatory use of antiseptic wipes to keep all common work areas germ-free. In the meantime, the advice is don’t panic – plan ahead.

For further information, download the Pandemic Flu: UK Influenza Pandemic Contingency Plan

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