Infectious Disease Outbreaks in the Workplace

1
Infectious Disease Outbreaks in the Workplace

• Designing an Organizational Recovery Strategy
• Ashley Pearson
• Director of Emergency ServicesEmergency
  Management
• Mental Health Services MA Dept. of Mental
  Health
• August 5, 2008

2
Getting Started - Overview

• Conduct a Hazard Analysis
• Plan for an outbreak
• Understand agency vs. state/local public health
  role
• State agencies are large organizations
• Review 1 organizations BCP strategy

-SARS pictures from Beijing Shanghai
3
Impact Example 1

• Viral outbreak Measles 2006
• 1,000 employee impact
• 1000150 suspected cases, 18 confirmed
• Suspected cases excluded for 21 days from the
  workplace
• All assessed, 2 doses MMR or documented immunity
• 42 days of surveillance after last rash
• 12,000 doses of MMR distributed250,000

4
Impact Example 2

• Hepatitis A 2004 Outbreak
• 1 confirmed case
• Discovered via local eatery
• 1,500 doses of 1G in 2 days

Over the last several years, Hepatitis A
litigation claims have been brought
against Carl's Jr.Chi-Chi'sD'Angelo'sFriendly's
Maple Lawn DairyMcDonald'sQuizno'sSilver
Grill Location CateringSubway
5
Infectious Disease Response

• Pandemic Planning has driven public health
  response to emergencies
• More benefit in planning for various infectious
  disease outbreaks
• What you do prior to an event is just as
  important as what you do in response to an event
  and after it

- Natl Geo, influenza virus particles (brown)
invade cilia (blue) in the airways of the human
lung
6
7 Key Areas to Build a Plan

• Establish Teams
• Planning
• Testing
• Resources
• Communication
• Actions
• Back to Work

7
Establish Teams

• Security Concerns
• Business/Operations Continuity BCP COOP
• Human Resources
• Communications
• Facilities Services
• Senior Management
• Service Units and Support Functions

- Natl Geo, Flu vaccine shortage in the 2004-'05
season
8
Planning

• Determine potential risks
• Develop relationships with helping orgs
• Police, Fire, Health, etc.
• Work with external resources
• MEMA, DPH, HRD, DCAM, EMS, SNS, etc.
• Pre-purchase and stage supplies
• Know where to get them in state system
• Develop Disaster Communications
• Pre-establish HR, Other Policies

9
Testing

• Conduct internal simulation exercises
• Participate in community desktops and drills
• Test communication systems
• Employee notification systems
• Employee Tracking systems
• Employee Message Centers

Natl Geo - Pneumonic plague, human lungs, x-ray
10
Resources

• Business Continuity EM Personnel
• On-site security Personnel
• On-site Facility Personnel
• Business Unit Support
• Site Emergency Managers (decision makers - senior
  management
• Site Emergency Coordinators
• Response Teams concept

11
Communication

• Keep individual contact information updated
  (maintain call trees)
• Maintain regional contract numbers
• Have pre-scripted announcement drafted
• Use multiple methods of communication
• Designate site communications officer
• Reassure employees that their health the health
  of their families is a priority

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Initial Actions

• Monitor international, national and local
  intelligence
• Implement local plans, as approved
• Establish access controlled health perimeter
• Conduct health checks
• Distribute Personal
• Protection Equipment

- Members of a rescue team from the U.S. Army
Medical Research Institute of Infectious Diseases
13
Actions Workplace Safety

• Implement increased Cleaning Protocols
• Implement Packaged Food Protocols
• Implement Social Distancing Protocols
• Emphasize Workplace Hygiene Programs
• Implement medication distribution if applicable
• Maintain contact with health consultants

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Actions - Ongoing

• Maintain contact with local health professionals
• Monitor CDC and WHO communications and alerts
  (state, via DPH MEMA)
• Implement alternative work actions
• Work from home,
• workload shifting,
• split operations
• implementation

-Natl Geo,Military medical personnel at Fort
Detrick in Frederick, Maryland, conduct
quarantine training as part of a biological
attack simulation
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Back to Work Initial

• Identify the index of employee
• Immediately exclude from work place
• Determine when symptoms occurred
• Determine last date in office
• Determine close contacts
• Determine initial diagnose, when it occurred and
  validate diagnosis

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Back to Work

• Personal Care Physician
• May not properly diagnose
• Reporting requirements
• No authority over Health Commission
• Health Commission Approval to return
• Clearance and action reports 2x a day
• Offer to fund/find additional resources

-Natl Geo, patient receiving care
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Back to Work Public Health

• Understanding Public Health Exclusions
• HR Listing for exposed group
• Exposure date clarification
• Incubation period
• Birth date exceptions (ex. Smallpox)
• Required documentation to return
• Cleaning requirements to reoccupy
• Engage medical advocate - negotiate

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Back to Work Things to Know

• Personal Care Physicians
• May not properly diagnose
• Reporting requirements
• No authority over Health Commission
• Health Commission Approval to return
• Clearance and action reports 2x a day
• Offer to fund/find additional resources

19
Back to Work Site Security

• Restrictions to site/facility
• Minimize exclusion impact
• Vacation, travel, access reports, partitioned
  space, access control, security officers
• Gather/Supply required documentation
• Employee to Public Health (fax)
• 3rd Party to Public Health (fax/other)

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Back to Work Ongoing Comm.

• Internal Communication Process
• HR Listing Contact with Employees
• Cleared
• Not cleared with reason
• Detailed requirements
• Manager Update on the
• status of employees
• Cleared
• No action
• In process

Natl Geo - As seen from Beacon Hill, the Back
Bay skyline and the State House dome speak to
several centuries of history
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Back to Work

• Demonstrate Commitment to public health
• Arrange and fund vaccination clinics
• Arrange and fund testing, if applicable
• Recommend consultation with PCP in cases of
  pregnancy or immune deficiency or for unique
  circumstances
• Keep teams and management informed
• Continue regular operations, continuity

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Back to Work - Lessons Learned

• Dont post mission accomplished too soon
• Monitor absences for incubation period
• Document your actions throughout event
• Conduct self-assessment and document process
  improvements
• Recognize accomplishments of those involved

Natl Geo-At daybreak, the citys bucolic side
comes to the fore as folks row the Charles River
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The Endor just the beginning?

• Thanks to
• Donna Lazorik, MDPH Adult Immunization
  Coordinator
• Stephen D. Baker, VP Deputy Chief Security
  Officer, Global Security, State Street Corp.
• NEDRIX
• OSHA

- From "Bostons North Enders," October 2000,
National Geographic magazine