HR MANAGERS GUIDE TO HEALTH AND SAFETY

1
HR MANAGERS GUIDE TO HEALTH AND SAFETY

• Cynthia KontraFilion Wakely Thorup Angeletti
  LLPSeptember November 2009
• Lecture 10
• H1N1 and Flu Pandemic

2
The Effect of a Flu Pandemic on the Workplace

• Should employers and workers be concerned?
• What type of legal and practical consequences can
  be anticipated?
• What steps should be taken to prepare?

3
In the beginning...
4
Should employers and workers be concerned?

• Be concerned, but dont panic!
• Medical experts told us that it was not a
  question of if a pandemic will occur, but
  when
• We need to prepare ourselves now to effectively
  deal with the current emergency.

5
Near Miss

• A near miss is an unplanned event that did not
  result in injury, illness, or damage - but had
  the potential to do so. Wikipedia
• Only a fortunate break in the chain of events
  prevented an injury, fatality or damage.
• Although human error is commonly an initiating
  event, a faulty process or system (including lack
  of preparation) invariably permits or compounds
  the harm, and is the focus of improvement.
• Also known as a "close call

6
Oxymoron?

• If you nearly miss something, don't you hit it?
• At first blush, "near miss" does seem to be a
  contradiction in terms, even though it's a
  popular phrase, especially applicable to health
  and safety
• Merriam-Webster's Dictionary of English Usage
  (1994), traces the phrase to World War II one
  can only imagine! and concludes that, despite
  its apparent lack of logic, it is not an error.
• Fowler's Modern English Usage defines a near miss
  simply as a miss that was nearly a hit.
• SARS in 2003 was both a near miss and a hit!
• What will H1N1 be?

7
Near Miss SARS 2003

• SARS (Severe Acute Respiratory Syndrome) was a
  large scale health emergency in the Spring of
  2003 that impacted countless workplaces,
  particularly in the health care sector
• SARS is a severe form of pneumonia, which is
  accompanied by a fever
• SARS is spread by close personal contact with a
  person who has SARS, through droplets from
  coughing or sneezing, or from direct face-to-face
  contact
• The disease initially surfaced in Canada in March
  of 2003 - by September 3, 2003 there were 438
  cases of SARS in Canada, and a total of 43 deaths

8
The Impact of SARS

• SARS was declared a provincial emergency on March
  26, 2003 the emergency status lasted nearly two
  months and was lifted on May 17, 2003
• During the height of the emergency, the Ontario
  Ministry of Health was advising anyone exhibiting
  symptoms to go into voluntary quarantine
• The unanticipated SARS emergency demonstrated
  that many employers were unprepared to deal with
  the complex array of health, financial and
  operational issues associated with fending off
  the threat
• Although it lasted only one season and is
  apparently under control, SARS or something worse
  could resurface at any time

9
Fear of a Flu Pandemic

• The potential of the current outbreak of H1N1 to
  become a global pandemic is what is known as a
  realistic threat
• As well, the growth in occurrences and mutations
  of strains of the Avian Flu or Bird Flu virus
  have scientists and medical experts believing
  that it is only a matter of time before the next
  influenza pandemic occurs

10
Flu Pandemics Recent History

• The risk of an airborne flu virus is very
  significant.
• Flu pandemics occur, on average, 3 times each
  century (according to the World Health
  Organization).
• 1918-19 Spanish flu 50 million deaths
• 1957-58 Asian flu 1 million deaths
• 1968-69 Hong Kong flu 1-4 million deaths
• It has been almost 40 years since the last flu
  pandemic many in the scientific and medical
  communities believe that we are overdue for the
  next one.

11
What is H1N1?

• H1N1 just like any other flu is a respiratory
  infection. It exploits a weakened immune system
  to attack major organs especially your lungs.
• The H1N1 flu virus is contagious and is spread
  the same way as regular seasonal influenza. This
  happens when an infected person coughs or sneezes
  and their germs enter the nose, eyes, or throat
  of another person. The germs can also rest on
  hard surfaces like counters and doorknobs, and
  can be picked up on hands and transmitted to the
  respiratory system when someone touches their
  mouth and/or nose. It is not possible to catch
  it by eating pork or pork products or through
  blood transfusions.

12
History of H1N1

• Mexican authorities in April 2009 reported they
  were investigating a new strain of swine
  influenza. The outbreak had spread quickly in the
  country, killing more than 100 people. Two months
  later, in June 2009, the World Health
  Organization declared a swine flu pandemic the
  first time a global flu pandemic had been
  declared in 41 years. humans, causing severe
  illness with high mortality
• As of October 2009 the World Health Organization
  reported roughly 6,750 deaths worldwide from
  H1N1, including roughly 250 in Canada.
• See http//www.canada.com/health/FactsFigures
  H1N1pandemic/2247891/story.html

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Impact on the Workplace

• The effects of an epidemic are unpredictable,
  BUT, expect high levels of absenteeism, illness
  and disability
• Many employees may become ill at the same time
• The illnesses may persist for long periods of
  time
• Workplaces may have to be quarantined (although
  quarantine likely would be medically ineffective)
• People may refuse to report for work for fear of
  contracting the influenza virus at the workplace
• There may be mass societal disruptions
• Employees may choose to stay home to care for
  their ill family members or if schools are closed

14
Wise Words from the Past

• By failing to prepare,
• You are preparing
• to fail.
• Benjamin Franklin

15
Employers Obligations

• Because of their role in society, employers can
  play a huge part in dealing with public health
  crises before and during
• Employers have legal obligations that arise from
  various statutes often conflicting
• Employers have an obligation determine the
  measures that need to put in place to protect
  workers from infectious diseases, including the
  H1N1 flu virus
• Canadian doctors have advised that employer stop
  requiring doctors notes for potential H1N1
  cases, as it is overburdening the health care
  system.

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Employers Role

• Good employers will want to find out
• What the public health issue is,
• Who is at risk,
• The causes,
• The symptoms and
• What should be done to protect the workforce.
• A key role for an employer is that of informed
  communicator.

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Health Legislation

• Occupational Health and Safety Determine the
  various duties of the employer and employees
• Consider the impact of possible work refusals.
• Workplace Safety and Insurance Benefits may be
  payable if H1N1 was contracted at the workplace
• Consider H1N1 as an occupational disease

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Focus onOccupational Diseases

• The Workplace Safety and Insurance Act provides
  compensation where,
• a worker suffers from and is impaired by an
  occupational disease that occurs due to the
  nature of one or more employments in which the
  worker was engaged
• The definition of occupational disease should be
  broad enough to encompass diseases such as the
  Avian Flu, West Nile, SARS, or H1N1, provided it
  can be demonstrated, on a balance of
  probabilities, that it was contracted at the
  workplace

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Who Could be Entitled to Benefits?

• In the case of SARS, the WSIB had advised that
  workers with symptoms of SARS who believed they
  were infected in the course of their employment
  may be entitled to WSIB Benefits. No
  announcement of this kind has yet been made with
  respect to H1N1.
• Each workers compensation case is assessed on
  the basis of its own individual facts the WSIB
  is reluctant to make sweeping pronouncements in
  respect of eligibility

20
Entitlement During Quarantine

• One has to be sick in order to get benefits
  workers who are symptom free, but are subject to
  quarantine or have been sent home as a
  precautionary measure, should not get benefits
• On the other hand, if symptoms develop during
  quarantine or voluntary isolation, the worker
  may be entitled to WSIB Benefits if the
  symptoms or illness are compatible with
  occupational exposure

21
WSIB Claims - SARS

• It can be fairly assumed that employers in the
  health care sector are at risk of increased
  workers compensation claims in the face of
  communicable diseases
• Since there appeared to be conclusive evidence of
  transmission of SARS in health care environments,
  it is likely that health care workers who became
  ill will SARS symptoms during the outbreaks would
  have WSIB claims approved
• It would be more difficult for an employee in a
  non-health care setting to establish a claim for
  benefits because of the unique nature of the
  disease
• In any case, it is not enough to be a worker who
  had SARS symptoms the disease must have arisen,
  on a reasonable analysis, from the workers own
  workplace

22
WSIB Claims West Nile

• The WSIB has also advised that workers who are
  infected with West Nile Virus in the course of
  their employment may be entitled to WSIB
  Benefits
• Employees required to work outdoors are at
  greater risk, but even an employee who does not
  work outdoors could be bitten by a mosquito
  carrying the West Nile Virus while at work or
  while sitting outside for lunch
• A lunch break taken at the workplace is a period
  of time that likely would be covered by the WSIA,
  so long as the worker is engaged in normal
  lunchtime activities

23
WSIB Claims H1N1

• By contrast with SARS or even West Nile Virus, a
  flu pandemic like H1N1 can be expected to hit in
  ALL workplace settings
• It may be true that health care settings will
  have the most employees affected by such an
  outbreak, but manufacturing plants and offices
  are likely to be as widely affected as the norm,
  not just in exceptional cases

24
WSIB Claims Flu Pandemic

• As with SARS or West Nile, it is fully expected
  that claims for WSIB Benefits during an H1N1
  pandemic will be treated on a case by case basis
• Workers making claims will have to prove that
  they not only contracted and suffered from a flu
  virus, but that it was contracted from the
  workers own workplace

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Employment Standards

• Emergency leave, section 50
• Up to 10 days of leave per year that can be used
  for personal use or caring for sick relatives.
• Family medical leave, section 49.1
• Up to 8 weeks of leave to provide care or support
  to a seriously ill family member who has a
  serious medical condition and who has a
  significant risk of death.
• A further leave of up to 8 weeks, if the family
  member does not die within the first period of
  leave.

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Human Rights

• Employees must be protected from discrimination
  and harassment (e.g. employees of an Asian origin
  during the SARS outbreak).
• Definition of disability includes diseases and
  other medical conditions such as SARS, and
  presumably would be expanded to include H1N1.

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Health ProtectionMobility Restrictions

• Health Protection and Promotion Act Medical
  officers have broad powers to restrict mobility.
• Powers of a medical officer of health include
• Closing premises, including workplaces
• Isolation of one or more persons (quarantine)
• Cleaning, disinfection or destruction of things
• Compulsory medical examination of individuals
• Restricting conduct of persons to ensure that
  others are protected from the possibility of
  infection
• Powers may be exercised without individual consent

28
Employment Insurance

• Employment Insurance (EI)
• The EI Act allows for up to 15 weeks of sickness
  benefits.
• Eligibility requires 600 hours of work in past 52
  weeks
• Amendments were made during SARS to allow claims
  for those quarantined.
• Usual requirement to produce a medical
  certificate relaxed.
• Special SARS grant for health care workers.
• Such amendments may also apply in the case of an
  Avian Flu outbreak.

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Quarantine for Travelers

• Updated Quarantine Act
• A traveler who enters or leaves Canada may have
  to undergo a health assessment
• if it is suspected that the person may have
  been exposed to a communicable disease.
• Travelers may be screened, examined, disinfected,
  and detained until any risk of infection has
  passed.
• Airplanes and other conveyances may be
  inspected, disinfected, and detained.

30
Privacy - PIPEDA

• Personal Information Protection and Electronic
  Documents Act (PIPEDA)
• Disclosure of personal information to 3rd
  parties.
• Does not deal directly with Ontario workplaces
• Employers cannot disclosepersonal information
  about employees without consent.
• Applies in Ontario and any other province
  without similar legislation.

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Privacy - PHIPA

• Ontarios Personal Health Information Protection
  Act, 2004 (PHIPA)
• Restrictions on the collection, use and
  disclosure of personal health information by
  medical professionals.
• Employers are limited in their access to
  information
• Employers are information custodians (and are
  subject to the limitations of the legislation)
• Issue confidentiality vs. health of other
  employees
• In 2003, Ministry of Labour advised employers to
  tell public health officials about SARS
  cases,but not to disclose information to the
  public.

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Planning on a National Level

• A May 3, 2006 United States Congress report
  entitled National Strategy for Pandemic
  Influenza provides proposals for how to prepare
  for and respond to an influenza pandemic
• The Strategy is intended to
• stop, slow or otherwise limit the spread of a
  pandemic to the United States
• limit the domestic spread of a pandemic, and
  mitigate disease, suffering and death and
• sustain infrastructure and mitigate the impact to
  the economy and functioning society
• For Canadas current plan with respect to H1N1 as
  well as information for employers, employees and
  the general public, visit http//www.fightflu.ca

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Responsibilities of the Private Sector
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Flu Control Prevention

• Employers should encourage workers to protect
  their health and engage in preventative measures
  such as
• Stay healthy eat well, get lots of rest and
  exercise
• Wash or sanitize your hands before touching,
  eating or preparing food and after sneezing,
  coughing or using the washroom
• Avoid coughing into your hands use the crook of
  your elbow if you dont have tissues
• Keep your hands away from your face the flu
  virus enters your body when germs get on your
  hands and you touch your eyes, nose or mouth
• If personal protective equipment is needed at
  work, make sure it fits properly and is being
  used
• If travelling overseas, be aware of any possible
  diseases and their prevention at the destination
• Encourage sick workers to stay at home
• COMMUNICATION IS KEY!

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Prevention Drugs

• There is currently a vaccine being offered for
  H1N1 that will provide individuals with some
  immunity to H1N1 within 10 days of receiving the
  vaccine.
• Generally, vaccines are safe. The dangers from
  vaccine-preventable diseases (like the flu) are
  many times greater than the risk of a serious
  reaction to the vaccine. However, individuals
  should consult their physicians.
• The H1N1 vaccine is not currently mandatory in
  Canada, however there is case law suggesting that
  employers in the health care sector (and
  potentially other sectors) can require their
  employees to be vaccinated.

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Make a Pandemic Business Plan

• If a pandemic occurs, all workplaces should have
  a plan in place to not only deal with the threat
  to the health of workers, but to address the
  inherent and serious business disruptions
• It is imperative that a plan identify what facets
  of the business and which workers are essential
  to business continuity
• Identification of the Core People and Core Skills
  required to maintain delivery of essential goods
  and services during a potential crisis is vital
• Back up essential business information and ensure
  it is readily available in the event of a
  pandemic crisis

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Planning for Large Absences

• Can employees work from home? If a pandemic
  occurs, protecting the health of employees while
  sustaining the operation of the business may
  depend on it.
• What portions of the business can be shut down?
  Who will make this decision?
• Are there back-ups in place? If a pandemic
  occurs, are there back-up workers who can perform
  the essential roles and who have the essential
  skills? Are there back-up decision makers?
• Are effective communication methods in place?
  There is a good possibility that many workers
  will be away from the workplace during a
  pandemic how will you reach them when
  necessary?

38
Communication and Partnerships

• Identify and set up essential communication
  networks with workers, suppliers,
  clients/customers, etc.
• Establish partnerships with other organizations
  like yours for dealing with a pandemic crisis
  this is particularly important for businesses
  providing essential services
• Set up shared access locations for contingency
  planning
• COMMUNICATION AND PLANNING IS KEY!

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Need for a Contingency Plan

• Can you afford NOT to have a plan?
• Business interruptions are expensive!
• Who will make decisions?
• The Human Resources Department should play a
  key role.
• Can you shut down?
• Can you re-start or ramp up quickly?

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Contingency Plan Components

• YOU HAVE TO DO THE WORK FROM SCRATCH you cannot
  download or buy a plan customize it!
• Identify essential duties and plan for those
  employees absence.
• Anticipate the potential of high levels of
  absenteeism.
• Consider the impact in a unionized environment.
• Negotiate emergency powers
• Keep the union in the loop, or
• Be prepared to deal with the grievances

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Contingency Plan contd

• Quarantined building Alternative location?
  Staff work from home? Quarantined staff operate
  the business?
• Leave policies Decide in advance
• What will be sick time?
• Paid time off granted?
• Human resource policies OT, scheduling issues,
  payment for cancelled shifts, payment of
  employees not permitted in the building, travel
  policies
• Organizing remaining staff

42
Contingency Plan contd

• Replacement workers
• Identify who to replace and how to do it.
• Working from home
• Travel and group meeting policies
• Communications who and how
• Health and safety train staff on protective
  equipment and their duties under the OHSA
• Counseling stress and grief

43
Plan Development 7 Steps

• Establish Committees and Chain of Command
• Identify and assess priorities develop
  sub-plans
• Communicate the plan internally and externally
• Train employees primary and back-up roles
• Make plan available in hard and soft copies
• Continuously review and improve Plan
• Once implemented, continuously test and improve
  Plan it will never be perfect

44
During an Outbreak

• Plan ahead and utilize a virtual office to the
  extent possible working from home
• Maintain lines of communication at all times
• Limit travel to places under advisory warning
• Re-schedule meetings
• Conference call, videoconference
• Healthcare workers ongoing staff training
• Limited right to refuse work

45
Steps Undertaken by Employers

• Some employers have made use of the valuable
  lessons learned from the SARS experience.
• O-I Canada manufacturing - has been proactive
  in developing an emergency protocol that
• Manages employees who have or are suspected of
  having a contagious disease whether on or
  off-site
• Supports the training of personnel in the
  screening of contagions and
• Required all plant visitors during the SARS
  outbreak to provide their name, business and
  home telephone numbers to allow for prompt
  follow-up.

46
More Steps

• The Regional Municipality of Halton is another
  proactive employer and community leader in
  providing up-to-date information on the growing
  influenza threat, including
• Creating a comprehensive public emergency health
  plan for the community
• Developing a protocol for allocating employees to
  essential services in order of priority
• Sharing information with other employers
• http//www.halton.ca/health/services/communicable_
  disease/pandemic_influenza.htm

47
Analogous Security Concerns

• 9/11, 7/7, Pandemic Are you prepared?
• Is there a protocol in place?
• Who is in charge of decision-making and
  communications?
• What backup exists if those in charge are out of
  the office, on vacation or incapacitated?
• Is there any off-site backup of decision-makers
  and critical information?
• Are there contingency plans in place and
  appropriate emergency equipment if there were a
  failure in regular or cell telephone networks,
  not to mention web-based communication and
  internal email?

48
Pandemic Preparedness Checklist - Overview

• The WSIB has a prepared a 4 page Pandemic
  Preparedness checklist that is a invaluable tool
  for workplaces in pandemic planning
• It provides detailed methods for ensuring
  responsible and proper planning on all levels,
  including
• Identification of Core People and Core Skills
• Plan for Large Absence (10 to 50)
• Protection of staff health
• Communications and Knowledge Management
• The checklist is a thorough model and can be
  found on the WSIBs website at http//www.wsib.on.
  ca/wsib/wsibsite.nsf/public/flu_resources

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Pandemic Preparedness Checklist - 1

• Identify a pandemic coordinator and/or team with
  defined roles and responsibilities for
  preparedness and response planning. The planning
  process should include input from labour
  representatives.
• Identify essential employees and other critical
  inputs (e.g. raw materials, suppliers,
  subcontractor services/ products, and logistics)
  required to maintain business operations by
  location and function during a pandemic.
• Plan for impact on financials.
• Train and prepare ancillary workforce (e.g.
  contractors, employees in other job titles/
  descriptions, retirees).
• Develop and plan for scenarios likely to result
  in an increase or decrease in demand for your
  products and/or services during a pandemic (e.g.
  effect of restriction on mass gatherings, need
  for hygiene supplies, travel restrictions).
• Implement an exercise/drill to test your plan,
  and revise periodically.
• Set up authorities, triggers, and procedures for
  activating and terminating the companys response
  plan.

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Pandemic Preparedness Checklist - 2

• Plan for Large Absence (10 to 50, perhaps more
  different phases)
• Forecast and allow for employee absences during a
  pandemic due to factors such as personal illness,
  family member illness, community containment
  measures and quarantines, school and/or business
  closures, and public transportation closures.
• Identification of Core People and Core Skills
• Establish policies for employee compensation and
  sick-leave absences unique to a pandemic (e.g.
  non-punitive, liberal leave), including policies
  on when a previously ill person is no longer
  infectious and can return to work after illness.
• Establish policies for flexible worksite (e.g.
  telecommuting) and flexible work hours (e.g.
  staggered shifts).
• Establish policies for employees who have been
  exposed to pandemic influenza, are suspected to
  be ill, or become ill at the worksite (e.g.
  infection control response, immediate mandatory
  sick leave).

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Pandemic Preparedness Checklist - 3

• Protection of staff health
• Find up-to-date, reliable pandemic info from
  community public health, emergency management,
  and other sources and make sustainable links.
• Implement guidelines to modify the frequency and
  type of face-to-face contact (e.g. handshaking,
  seating in meetings, offi ce layout, shared
  workstations) among employees and between
  employees and customers.
• Encourage and track annual influenza vaccination
  for employees.
• Evaluate employee access to and availability of
  occupational and mental health and social
  services during a pandemic, including corporate,
  community, and faith-based resources, and improve
  services as needed.
• Identify employees and key customers with special
  needs, and incorporate the requirements of such
  persons into your preparedness plan.
• Establish policies for preventing influenza
  spread at the worksite (e.g. promoting
  respiratory hygiene/ cough etiquette, and prompt
  exclusion of people with influenza symptoms).
• Provide sufficient and accessible infection
  control supplies (e.g. hand-hygiene products,
  tissues disposal receptacles) in all business
  locations.

52
Pandemic Preparedness Checklist - 4

• Develop and disseminate programs and materials
  covering pandemic fundamentals (e.g. signs and
  symptoms of influenza, modes of transmission),
  personal and family protection and response
  strategies (e.g. hand hygiene, coughing/sneezing
  etiquette, contingency plans).
• Anticipate employee fear and anxiety, rumours and
  misinformation and plan communications
  accordingly.
• Provide info for the at-home care of ill
  employees and family members.
• Communications Knowledge Management
• Establish an emergency communications plan and
  revise periodically.
• This plan includes identification of key contacts
  (with back-ups), chain of communications
  (including suppliers and customers), and
  processes for tracking and communicating business
  and employee status.
• Enhance communications and information technology
  infrastructures as needed to support employee
  telecommuting and remote customer access.
• Ensure that communications are culturally and
  linguistically appropriate
• Disseminate info to employees re pandemic
  preparedness response plan.

53
Pandemic Preparedness Checklist - 5

• Develop platforms (e.g. hotlines, dedicated
  websites) for communicating pandemic status and
  actions to employees, vendors, suppliers and
  customers inside and outside the worksite in a
  consistent and timely way, including redundancies
  in the emergency contact system.
• Identify community sources for timely and
  accurate pandemic information (domestic and
  international) and resources for obtaining
  counter-measures (e.g. vaccines and antivirals).
• Collaborate with insurers, health plans, and
  major local healthcare facilities to share your
  pandemic plans and understand their capabilities
  and plans.
• Collaborate with federal, provincial, and local
  public health agencies and/or emergency
  responders to participate in their planning
  processes, share your pandemic plans, and
  understand their capabilities and plans.
• Communicate with local and/or provincial public
  health agencies and/or emergency responders about
  the assets and/or services your business could
  contribute to the community.
• Share best practices with other local businesses,
  chambers of commerce, and safe workplace assocns
  to improve community response efforts.

54
Conclusion Be Prepared

• The key point for each workplace to absorb is
  GET READY AND BE PREPARED.
• Spending time and resources now enables
  workplaces to properly cope when an emergency
  hits.
• It will be too late to make it up on the fly in
  the middle of a chaotic and unsettling
  experience.
• Does your own workplace have a plan?

55
Reminder - Fighting Back

• Wash hands!
• Voluntary Vaccinations
• Provide them, or offer employees time off to
  get them.
• Encourage sick employees to stay home.
• Despite possible abuse of this policy, it is
  still worth it (snowball effect during a
  pandemic).

56
Final Thoughts

• Employers that are unprepared and ineffective
  will contribute to a dysfunctional community in
  the heart of any public health or security
  emergency - which is bad for all of us, and bad
  for business.
• There are significant legal issues for employers.
• At least as important as the law, I suggest that
  there is a fundamental responsibility for
  employers as primary participants in modern
  society to get ready in advance and to provide
  leadership and effective communication when it is
  most required.
• How are you going to command the time and
  resources necessary to prepare?
• How fast will your business bounce back?

57
Questions