Just when you thought it was safe to stop thinking about the potential influenza pandemic for one second comes a new survey that declares more than 40 percent of public health employees said they are unlikely to report to work during an influenza pandemic. Researchers at the Johns Hopkins Bloomberg School of Public Health also found that 66 percent of public health workers felt they would put themselves at risk of infection if they were to report to work during a pandemic. Granted, these are public health workers, and not healthcare workers at an acute-care facility, but it provides a good idea of the level of absenteeism to expect in a real pandemic-related emergency. But theres a bright spot; in the survey, clinical staff members such as physicians and nurses were more likely to say they would report for work; this is contrasted by technical or support staff which included clerical workers, who were the least likely to say they would report to work. According to the survey, the willingness to report to work was strongest among employees who perceived an importance in their work and responsibilities during a pandemic; less than one-third of all public health workers felt they would have an important role in the response to a pandemic.
The Bush administrations report, National Strategy for Pandemic influenza, issued November 2005, promulgates a pandemic response system strengthened by three pillars which are:
- Preparedness and Communication: Activities that should be undertaken before a pandemic to ensure preparedness, and the communication of roles and responsibilities to all levels of government, segments of society and individuals.
- Surveillance and Detection: Domestic and international systems that provide continuous situational awareness, to ensure the earliest warning possible to protect the population.
- Response and Containment: Actions to limit the spread of the outbreak and to mitigate the health, social, and economic impacts of a pandemic.
These pillars are supported by the responsibilities of the U.S. private sector and critical infrastructure entities, including:
- Establishing an ethic of infection control in the workplace that is reinforced during the annual influenza season, to include, if possible, options for working offsite while ill, systems to reduce infection transmission, and worker education.
- Establishing contingency systems to maintain delivery of essential goods and services during times of significant and sustained worker absenteeism. Where possible, establishing mechanisms to allow workers to provide services from home if public health officials advise against non-essential travel outside the home.
- Establishing partnerships with other members of the sector to provide mutual support and maintenance of essential services during a pandemic.
The Presidents report touches upon absenteeism, but it does not address in any detail what healthcare facilities can and should do to prevent a massive healthcare worker walk-out should a pandemic-related situation at a hospital become more demanding or dangerous than they can bear. It is up to facility administrators, risk managers, personnel directors, and yes, infection control practitioners (ICPs), to do the very best that they can to envision the worst-case scenarios that could confront them, and work backward from there to formulate a feasible plan of action. Theres no way to know in advance how many healthcare workers will jump ship if they perceive the ship is actually sinking, so hospitals are well advised to accept human behavior under duress, and anticipate what will have to be done to address surge-capacity issues. ICPs can, as the Presidents plan advises, Emphasize the roles and responsibilities of the individual in preventing the spread of an outbreak, and the risk to others if infection control practices are not followed, as the first step in guarding against a still-uncertain future. For a PDF of the National Strategy for Pandemic influenza, go to: http://www.whitehouse.gov/homeland/nspi.pdf
Dont forget to visit us at the annual APIC meeting, booth #924; well be giving out goodies related to our 10-year anniversary, and you can also register for a chance to win an American Express gift card. A $75 card winner and two $25 card winners will be drawn in a raffle at 1:30 p.m. on Tuesday, June 13 in our booth. See you there!
Until next month, bust those bugs!
Kelly M. Pyrek
Editor in Chief