Preparing for pandemic flu — guides for families, businesses,
1 May 2009
Trust for America's Health (TFAH) has re-issued its series of
It's Not Flu As Usual guides on pandemic flu preparedness for
families, businesses, medical providers, and community groups.
"Worry and fear will not protect us — knowing the facts and planning
ahead will," said Jeff Levi, PhD, Executive Director of TFAH. "All
of us want to do the right things to protect ourselves and our families
in the event of a health emergency. These guides provide information
that can help prepare for not just for a potential pandemic flu
outbreak, but also for many other types of health emergencies."
The It's Not Flu As Usual guides provide recommendations in
case a major pandemic breaks out. In the event that high levels of
illnesses develop and worries about the disease spread, "business as
usual" may cease. Public health officials may recommend to closing
schools, limiting public gatherings, and staying home from work or
During a severe pandemic, experts predict that businesses and
organizations may face cumulative absentee rates of 10% at any given
time or 40% over three to four months. Absentees could include
sick employees, those who are caring for others who are sick, and
individuals who may want to avoid the workplace for fear of being
exposed to the virus.
RECOMMENDATIONS FOR INDIVIDUALS AND FAMILIES:
- Learn about common-sense precautions to prevent the spread of
flu and teach them to your children or other family members. Avoid
close contact with people who are sick, stay at home when you're
sick or have flu symptoms, cover your mouth and nose with a tissue
when coughing or sneezing, clean your hands, avoiding touching your
eyes, nose, or mouth, and practice general good health habits.
- Practice other good health habits. Get plenty of sleep, be
physically active, manage stress, drink plenty of fluids, eat
nutritious foods, and avoid smoking.
- Discuss important health issues with your family and loved
ones. Ask them about how/where they would want to be cared for if
they become ill and discuss what would be needed to care for them at
home. Think about who will care for children/people with special
needs if all adults in the household are ill, and determine if there
are other family members available to help. Make plans now and
communicate with all who need to know.
- Have generic medical and health supplies on hand. Examples
include supplies like soap or alcohol-based hand wash, medicines for
fevers, fluid with electrolytes, and tissues.
- Anticipate shortages of common prescription drugs and plan
accordingly. If you or a family member has a chronic disease and
regularly takes prescription drugs, talk to your
physician/pharmacists/insurance provider about having several weeks
of medications stockpiled at home.
- Anticipate shortages in perishable foods, water, and common
household emergency supplies. The federal government recommends
stockpiling non-perishable food items, water, portable radios,
batteries, flashlights, garbage bags, and manual can openers.
- Anticipate social disruption and make back up plans. Schools
may be closed for an extended period of time, so consider pooling
child care resources with neighbors and learn if there will be
community-designated child care facilities for those who are not
ill. Since being able to go to work may be difficult or impossible,
talk to your employer about the possibility of telecommuting or
working from home. Transportation services may be disrupted, so
consider carpooling options to go to work, schools, and supermarkets
to reduce your reliance on public transportation. Other public and
community services may be disrupted. These could include services
provided by hospitals and other healthcare facilities, banks,
stores, restaurants, government offices, and post offices. Think
about how you and your family might compensate if you are cut off
from these services.
- Understand your company's sick leave and family and medical
- To fight the annual flu, get a flu shot.
- Do NOT go to work, school, or to any public place if you become
RECOMMENDATIONS FOR BUSINESSES:
- Check that existing business continuity contingency plans
address long-term absenteeism rates. In particular, check to see if
core business activities can be sustained over several weeks with
only a minimal workforce available.
- Identify your company's essential functions, which might include
accounting, payroll, and information technology, and the individuals
who perform them. The absence of these individuals could seriously
impair business continuity. Cross-train employees to perform
essential functions to ensure resiliency.
- Plan for interruptions of essential government services like
sanitation, water, power, and transportation, or disruptions to the
food supply. For example, employees may need back-up plans for car
pools in case mass transit is interrupted.
- Determine which outside activities are critical to maintain
operations and develop alternatives in case they cannot function
normally. For example, what transportation systems are needed to
provide essential materials? Does the business operate on ‘just in
time' inventory or is there typically some in reserve?
- Update sick leave and family and medical leave policies and
communicate with employees about the importance of staying away from
the workplace if they become ill.
- Establish or expand policies and tools that enable employees to
work from home with appropriate security and network access to
- Collaborate with insurers, health plans, and major healthcare
facilities to share your pandemic contingency plans and to learn
about their capabilities and plans.
- Maintain a healthy work environment. Ensure adequate air
circulation. Post tips on how to stop the spread of germs at work.
Promote hand and respiratory hygiene. Ensure wide and easy
availability of alcohol-based hand sanitizer products.
- Tell your employees about the threat of pandemic flu and the
steps the company is taking to prepare for it. Establish an
emergency communications plan and revise periodically. The plan
should include key contacts (with back-ups), a chain of
communications (including suppliers and customers), and the
processes for communicating pandemic status and actions to
employees, vendors, suppliers, and customers inside and outside the
worksite in a consistent and timely way.
RECOMMENDATIONS FOR COMMUNITY- AND FAITH-BASED ORGANIZATIONS:
- Determine the possible impact of a pandemic on your
organization's regular activities and services. Take into account
the possibility of high rates of absenteeism or mandatory closings,
consider circumstances that may require you to increase, decrease,
or stop the services your organization delivers.
- Identify your organization's essential functions and the
individuals who perform them. Cross-train staff and volunteers in
other jobs so that if someone is ill, others are able to carry on
- Plan accordingly for interruptions of essential government
services like sanitation, water, power, and transportation or
disruptions to the food supply.
- Update sick leave and family and medical leave policies so
staffers will not be penalized for personal illness or for caring
for sick family members during a pandemic. Volunteers and employees
should remain home until they are well.
- Determine whether your volunteers and staff have "cross over
skills" like nursing or mental health counselling that could be used
during a health crisis, and make that information known to local
health authorities. Your local health department may already be
compiling rosters of individuals in the community who can be called
upon to help during an emergency.
- Evaluate your organization's activities and services that
involve close person-to-person contact, including child care, elder
care, and religious rites, especially those that involve
hand-holding or sharing food and drink from common dishes or
glasses. Establish policies to modify these activities to prevent
the spread of pandemic flu and communicate them to your staff,
volunteers, and people you serve.
- Determine supplies needed to promote respiratory hygiene and
cough etiquette, like tissues and alcohol-based hand sanitizer
products, and develop a plan for how to obtain them.
- Share information about your pandemic preparedness and response
with volunteers, staff, congregants, and the people you serve. You
may consider activating phone chains, distributing flyers and
sending mass emails to get your message out. During times of
anxiety people turn to those they trust, so clear and frequent
communication is essential.
- Ensure that what you communicate about pandemic preparedness is
appropriate for the cultures, languages, and reading levels of those
you serve. Identify those with special needs and be sure to include
their needs in your preparedness and response planning.
RECOMMENDATIONS FOR MEDICAL PROVIDERS:
- Be sufficiently educated about pandemic influenza and
- Be vigilant about the possibility of severe or emerging
respiratory disease, especially in patients who have recently
- Plan for how to manage high-risk patients and communicate the
plan to your staff.
- Develop a plan to prevent contagion, including use of
close-fitting surgical masks in isolation areas, and for patients
and staff. Distribute alcohol-based hand rubs to all sites of
- Review staff infection control procedures and train staff in the
use of personal protective equipment.
- Get vaccinated against annual influenza each year and urge all
staff to be vaccinated annually, too.
- Plan accordingly for possible interruptions of essential
services like sanitation, water, power, and disruptions to the food
- Work to ensure that the practice or clinic has access to
adequate supplies of antibiotic and antiviral medications, as well
as commonly prescribed drugs like insulin or warfarin, in the event
of a disruption to the pharmaceutical supply chain.
More information on pandemic flu preparedness
The It's Not Flu As Usual guides were funded by The Pew
Charitable Trusts, a supporter of the Pandemic Preparedness Initiative,
and they are available on TFAH's Web site:
WHO Influenza A(H1N1) web site
WHO guidance for Epidemic and Pandemic Alert and Response (EPR) — a
complete list of WHO documents:
EU Public Health — influenza news
UK Health Protection Agency swine influenza page
US National Institute of Allergy and Infectious Disease, National
Institutes for Health
Bookmark this page