By Sarah Sipek
Nov. 24, 2014
Don’t start fitting your employees for hazmat suits just yet.
Yes, the first confirmed cases of the Ebola virus have trickled into the United States. Yes, Ebola kills 60 percent of those who contract the virus.
But that’s only part of the story — one employers should know from start to finish.
Ebola is contagious, but only when someone comes into direct contact with the bodily fluid of an individual showing symptoms, said Dr. Jeffrey Drazen, editor in chief of the New England Journal of Medicine.
“We have very strong reason to believe that transmission occurs when the viral load in bodily fluids is high,” Drazen wrote in an email. “This recognition has led to the [assertion] that an asymptomatic person is not contagious.”
A viral load is a measurement of the amount of a virus present in the human body, according to the American Center for Microbiology. It is determined by taking a blood sample from an individual who has been exposed to the virus. The sample is then put through a process called a polymerase chain reaction to duplicate the cells and verify the presence and quantity of the virus in the blood. If entire virus particles number in the millions, the individual is deemed highly contagious.
All this adds up to the conclusion that forced 21-day quarantines, the maximum length of the virus’s incubation period, are an overreaction.
“It’s like driving a carpet tack with a sledgehammer: It gets the job done, but overall is more destructive than beneficial,” Drazen wrote.
Know What You’re Up Against
Most people know that Ebola kills. Fewer know how.
Ebola is a virus. When contracted it attacks the body’s cells and overcomes the immune system, effectively hijacking the cells typically used to fight infection to travel throughout the body and attack almost every major organ and tissue, according a December 2003 article in the Journal of Infectious Diseases.
Once inside the blood vessels, Ebola causes abnormal clotting and bleeding simultaneously, which leads to internal and external bleeding. Bleeding into the skin creates a red rash that appears all over the body. Bleeding will also occur from the eyes, ears and nose. The collective stress this places on the body causes the organs to fail.
Symptoms include a fever of 101.5 degrees or higher, muscle pain, weakness, diarrhea, vomiting, stomach pain and bleeding or bruising, according to the U.S. Centers for Disease Control & Prevention. Though it shares many symptoms with the flu, which alone kills anywhere from 3,000 to 49,000 people annually in the United States, sneezing is not a symptom of the Ebola virus.
In addition to wasting resources, forced quarantines can get employers into legal trouble.
According to Gabrielle Wirth, a partner at the law firm Dorsey & Whitney, employers who attempt to force their employees into quarantine after potential exposure to the Ebola virus risk violating both the Americans with Disabilities Act and Title VII of the Civil Rights Act, which protects against discrimination on the basis of race, color, national origin, sex and religion.
Instead of enforcing quarantines or cutting off travel to the West African countries of Guinea, Sierra Leone and Liberia — the current Ebola hotbeds — Wirth recommends developing an emergency response plan based on an Occupational Safety & Health Administration hazard assessment. This will determine a particular employer’s level of risk regarding exposure to Ebola or other deadly viruses.
If an employer is deemed at-risk, policy should be put in place that both protects employees from exposure while traveling and determines the criteria that must be met before the employees can return to work.
Include procedures about whether employees should wear protective equipment when in high-risk areas. There should also be a protocol put in place for how to report infection.
“You need to be confidential with their medical records, but you also need to notify employees that there has been an exposure,” Wirth said.
Given the early stages of Ebola’s presence in the United States, Wirth does not recommend putting a mandatory quarantine in place. Instead, she said it is often more cost effective to suspend a potentially infected employee with pay for 21 days.
“There is much more liability associated with letting someone who has Ebola come into the workplace than the 21 days’ worth of pay,” Wirth said. “Now if it became something where we were seeing it rampantly spreading throughout the United States, that might not be something that an employer can afford.”
She also recommends using family leave as a means to keep potentially infected employees out of the workforce.
Above all, employers should train their employees on what to do regarding the hazard.
“Training is always the best,” Wirth said. “The issue with not just Ebola, but any contagious disease is if you understand how it is transmitted and how it is not transmitted provides a measure of comfort to people and allows them to identify when there has been a risk.”
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