The current economic downturn has hit hard and fast. However, the credit crunch is not the only cloud on the horizon nature has its own surprises in store.
We have been hearing for some time about pandemic flu. This natural phenomenon occurs in 30- to 50-year cycles, and one may be just around the corner. Fortunately, the history of flu viruses suggest that while there will be many fatalities, we are unlikely to experience the catastrophic mortality rates associated with avian flu (often quoted above 60%), or the doomsday scenario depicted in the recent BBC drama Survivors. What we may face, however, is a high morbidity rate. Should the affected group be in the adult population, as we are experiencing with the current ‘Brisbane’ flu strain, then our economy and workplaces may not fare well.
So what can occupational health (OH) do?
The most important role is educating your employer as to what they should be doing. It will not be enough to assume that the OH nurse will give out a few Lemsips. Yes, there might be a bit of an update on the importance of respiratory hygiene and getting across the message that you should not come to work if you have the flu. The main target, however, is management.
You need to get the idea accepted that pandemic flu is not solely a ‘health issue’, and therefore should and can be planned for and managed on an organisational basis. OH practitioners are in a good position to advise or lead on this.
Key questions in developing a plan are: how would service delivery be affected by 20%, 30% or 50% absence? Which tasks are non-essential? What about transporting people or goods?
Many organisations are some way down the road to having well-developed contingency plans which may involve unprecedented co-operation between competitors to ensure essential services continue. I am told that some major food supply chains have agreed to share transport to deliver essential food products. If co-operation is possible at this level, then it is surely possible within organisations. Whoever is leading on the contingency plan must involve local department heads and ensure they take ownership of the issue and a corporate view of which resources can be spared or are non-essential in the short term.
Employers need to understand the significant timescales associated with pandemic flu, which may have several waves. The main threat is falling staff attendance levels. It is important therefore to consider all solutions available, and remember that usual measures such as agency staff may not be available.
Training in specialist areas for employees from other parts of the organisation may be useful as a few key staff being absent may bring operations to a halt. A useful resource may be recently retired staff, and it may be prudent to keep a register of willing retirees who may be able to fill the gaps.
The natural organisational response to any major challenge is to fall back on the old faithful ‘team meeting’. But this should be considered carefully. While good communications are essential, gathering all your key people together in a small stuffy boardroom may not be the best way to deal with a virus which thrives in such conditions. So the alternatives of e-mail, telephone and teleconferences are much more desirable.
Keeping your company advised on these issues may be the greatest service you can provide during a pandemic.
Back at the OH department, there will be demands on your time, too.
Much emphasis has been placed on respiratory hygiene measures, segregation of patients with respiratory illness in healthcare facilities, and of course personal protective equipment. These certainly have their place in delaying the onset of the virus and ensuring that the country does not come to a standstill in the first two weeks.
Unlike severe acute respiratory syndrome (Sars), where successful healthcare interventions were implemented throughout many healthcare organisations in 2002-03, the very nature of pandemic flu is that it is ‘unstoppable’. It is important that OH practitioners do not assure their clients that using face masks or other such equipment will protect them from something that will sweep through the population.
Anxiety may also play a part in whether or not people come to work, particularly if they work in areas where the risks of infection are perceived to be high. So it is important to provide as much information as possible. Many staff may have experienced the loss of family members or even colleagues as a result of the virus. This will be a difficult time for all, and support and specialist help will be invaluable.
There will be clinical issues as well, such as vaccinations or dealing with antiviral medication. These might call for some thought for practitioners in industries where mechanisms to deliver medication, such as refrigeration and cold chains, are not in place.
Although much emphasis has been placed on the current Avian Flu (H5N1), it is by no means certain that this virus will cause the next pandemic. What we do know is that there will be a further pandemic, and that its effects are unpredictable. Having a contingency plan will not prevent it, or stop you becoming infected. What it will do, is improve the chances of you and your organisation surviving the single biggest threat we have seen in many years.
Kev O’Connor RNLD RGN SCPHN(OH) BSc MSc Advanced Nursing, is also an NMC/HLSP reviewer of occupational health nursing courses.