A Prescription for Avoiding H1N1s Worst

By Meg Breslin

Nov. 20, 2009

If there’s any doubt about the importance of a plan to handle widespread absenteeism this flu season, Dr. Mark Dworkin wants to put it to rest.

“I think this is going to be an extremely difficult influenza season. In fact, it already is,” says Dworkin, associate professor of epidemiology and biostatistics at the University of Illinois at Chicago. “We’re seeing mostly H1N1 now, but as the season continues, we expect there’ll probably be an increase in the regular flu as well.”

Employers, he says, “should expect substantial absenteeism.”

Dworkin advises business owners to consult government sources such as the Centers for Disease Control and Prevention, which has posted on its Web site,, guidelines for preventing the spread of the flu at work.

Among the most important advice: limiting gatherings of staff in close quarters whenever possible by setting up phone conferences, and encouraging employees to work from home, Dworkin says.

Basic sanitary measures and a high-profile employee educational campaign also are vital.

Employees need reminders to wash their hands frequently, cover their mouths when they cough and stay home when they have a fever. Some additional, oft-ignored advice:

Workers should remain home for a full day after the fever has subsided.

“While there’s no hard science on how long someone is supposed to stay home after a fever, at least 24 hours is a good practice,” Dworkin says.

He is especially concerned about businesses that employ a large number of hourly workers with no paid sick time. He sees a strong incentive in those settings to report to work regardless of health. That can be especially dangerous for restaurants, where there’s the potential for viruses to spread and even cause food-borne illness.

For businesses with a few employees, keeping a staff healthy can be critical. The U.S. Small Business Administration advises owners to consult its Web site,, for a guide on dealing with the pandemic.

“The very best practice and the most important thing we’re emphasizing is to have a written plan,” says Marianne O’Brien Markowitz, the SBA’s regional administrator in Chicago. “Businesses also need to have contingency planning and to cross-train employees now” to cover for their sick colleagues.

“We can’t control everything that’s going to happen, but what we can control is our level of preparedness,” Markowitz says. “If I’m sitting in California and a wildfire is a few miles away, I’d better be preparing for that.”

She also advises businesses to assign a workplace coordinator to handle questions and concerns. The coordinator also can be in charge of advising an obviously sick employee to go home.

Forcing sick employees to stay home could be the toughest advice to execute if employers haven’t thought things through, says Jennifer Benz, owner of San Francisco-based Benz Communications, a consulting firm focusing on employee benefits communications.

But even healthy employees could face difficult situations if an outbreak closes their children’s schools or day care centers. Beyond that, there’s often a work culture of long hours and high expectations that might be tough to navigate in a pandemic.

“Many of my clients are high-tech companies, where the expectation is to work 24/7,” Benz says. “So you really need to understand the business culture. A lot of it comes down to how well the manager is trained, and are they really managing groups consistent with wellness practices.”

Meg McSherry Breslin is a writer based in the Chicago area.

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