The severity and amount of illness that will be caused by H1N1, as well as regular seasonal influenza, are difficult to predict with certainty. Employers should be prepared to respond in a flexible way to varying levels of severity.

The Centers for Disease Control (CDC) issued guidance to help employers respond to two possible conditions: (1) a continuation of the severity observed during the spring and summer of 2009; and (2) a more severe outbreak. Below is a summary of the CDC’s recommended action steps; for full details, visit http://www.cdc.gov/h1n1flu/business/guidance/.

Conditions similar to spring/summer 2009. If the severity of illness in the fall and winter is similar to that observed in the spring and summer of 2009, the effects of H1N1 influenza may not have a substantial impact on absenteeism, though some increase in absenteeism over the spring season is anticipated. When larger numbers of people become ill, correspondingly larger numbers of people will become seriously ill and may require hospitalization. Consider the following:

• Sick persons should stay home.
• Sick employees at work should be asked to go home.
• Cover coughs and sneezes.
• Improve hand hygiene.
• Clean surfaces and items that are more likely to have frequent hand contact.
• Encourage employees to get vaccinated.
• Take measures to protect employees who are at higher risk for complications of influenza.
• Prepare for increased numbers of employee absences due to illness in employees and their family members, and plan ways for essential business functions to continue.
• Advise employees to take certain steps before traveling.
• Prepare for the possibility of school dismissal or temporary closure of child care programs.

Conditions with increased severity. If H1N1 becomes more severe than during spring/summer 2009, absenteeism will likely be far greater, and additional protective measures to slow the spread of influenza should be considered. Check with your local health department for the extent and severity of disease activity in your community and recommendations for necessary measures. Decisions about what tools should be used during a severe H1N1 outbreak should be based on the observed severity of the event; its impact on specific subpopulations; the need to protect workers; the expected benefit of the interventions; the feasibility of success of implementing these measures; the direct and indirect costs of different interventions; and the effects on critical infrastructure, health care delivery and society. The following measures should be considered if influenza severity increases, and are meant for use in addition to the measures outlined above:

• Consider active screening of employees who report to work.
• Consider alternative work environments for employees at higher risk for complications of influenza during periods of increased influenza activity in the community.
• Consider increasing social distancing in the workplace.
• Consider canceling nonessential business travel and advising employees about possible disruptions while traveling overseas.
• Prepare for school dismissal or closure of child care programs.

Source: CDC Guidance for Businesses and Employers to Plan and Respond to the 2009-2010 Influenza Season, issued August 19, 2009.