Is Your Business Ready For Flu Season?

Public health expert Meg Nash joins Danielle Ricci, Vice President of Marketing for AlertFind, to talk about how businesses can proactively prepare their businesses for flu season.

In our upcoming webinar, she’ll discuss what businesses can learn from last year’s severe flu season, what to expect this year and the best strategies that organizations can use to protect their employees and their operations.

Here are some highlights from their conversation:

Join Meg and Danielle as they discuss how companies can continue to improve their flu and pandemic preparedness in our new webinar, “Don't Let The Flu Disrupt Your Organization,” at 2 p.m. EDT on Wednesday, Nov. 28.

Danielle Ricci: What can we learn from last year?

Meg Nash: Last year's flu season was one of the more severe that we've seen. Not necessarily from infection rates, although those were up, but we had a dramatic increase last year in the number of deaths. So in the U.S., it was around 80,000, which is the highest we've seen in almost four decades.

So it really did have a bigger impact in the U.S. than the typical average flu, which is usually around 30,000 cases. Last year, we had some idea it was coming, because we get the heads-up from the Australian seasonal flu. Being opposite seasons from us, they tend to let us know how our flu is going to be.

Danielle Ricci: Why was last year’s flu so severe?

Meg Nash: The variants that were circulating last year were just harder for our immune systems to deal with. It was also another year of a not very effective flu vaccine combination, and it just was one of those flus that took its impact on both healthy people and people with compromised immune systems, which is somewhat unusual.

Usually, we see the elderly, the immune-compromised or very young children having an issue with the flu. Last year, it was a little less discriminating and healthier people were succumbing to it. And we've actually seen it this year, where I believe we're up to almost 200 healthy kids that have already died from the flu.

Danielle Ricci: What’s contributing to the deaths of these children?

Meg Nash: We are seeing that there are kids that are not being immunized. Reports show that 85% of the children who died weren’t vaccinated. Regardless of what your feelings are for yourself, those vaccinations are important for kids, and we need to make sure that those are on board before the flu season really gets started.

Danielle Ricci: What does the 2018 flu season forecast look like?

Meg Nash: The flu is going to be somewhat more mild than we've seen in past years. But, that said, we always have the opportunity for there to be variants that can emerge throughout the season.

The latest information that I've seen is that they think the flu vaccine is going to be about 20% effective, which is a lower coverage amount than typical years due to the variance of the flu from when they decided what to put in the vaccine to what actually is circulating.

So a milder flu, but a little less effective of a vaccine, so we may have significant absences both school and work just from people dealing with it. But hopefully we won't see anything like the deaths that we had last year.

Danielle Ricci: What’s keeping more people from getting a flu shot?

Meg Nash: Everyone will say, "Well, it's only 20% effective. I don't need to get a flu shot." But it's still one out of five people that are going to get sick who wouldn't have gotten sick if they had gotten the shots.

And it depends on what variants we see this year. The flu that predominantly will affect the people in the US may be more aligned with what's in the vaccine. We won't really know that for sure except in hindsight. We're just basing that on what we've seen elsewhere in the world.

The one thing that it does regardless of whether it's a perfect match for the strain is it does give you some protection, so it does help your immune system out. It may not prevent you from getting the flu but it would result in a much more mild flu. And again, that's key for how long you would be able to spread it to other people, which goes right along with missing school, missing work and having those impacts on other organizations when you start having a large number of similar absences.

And for some people that don’t like needles, they can get FluMist. It’s made of weakened live viruses and can be given to healthy people from age 2 to 49 who aren’t allergic to the flu vaccine or any of its components and have healthy immune systems.

Danielle Ricci: When is flu season predicted to start?

Meg Nash: Technically, it’s already started. In October, we start to see cases. If we have people that are traveling internationally, you'll see anecdotal cases over the summer. It's not unheard of.

We'll start seeing regular flu cases somewhere in October, and then more up into the November, and then peaking in February. People spend all their time inside at work and school, and it's easier to pass those germs back and forth, and so we typically see a rise then. And then as spring comes around, both with the change in the weather and change in people's social patterns, we see that taper off again.

Danielle Ricci: What actions should organizations take now to ensure they’re prepared?

Meg Nash: Businesses need to look at their flu policy, specifically the impact to productivity or what could they have done better, etc. They need to ask themselves if it really affected their business or if there was a better way they could have handled it. Then they need to start thinking about how they can put those new plans in place in time for flu season this year.

So we see flu start in October. Usually, it's kind of sporadic and then we really see a peak around February. They're asking everyone, I think the CDC recommends vaccines by the end of October but certainly, there's still time.

Flu season carries on through May, so you're looking at a large window of a year when a certain area is potentially going to be hit by large numbers of people with the flu. If it's person-to-person transmissible, likely your area is going to have a lot of people that are all affected at once, which has huge implications on businesses. Certainly, if you've got workers that are parents and they have a child that gets the flu, that's going to be additional time.

So it goes beyond just what can we do to protect our workers. We also have to look at just those ideas of people being out of the office, what can we do if they've got to be home with a sick child to keep them productive and keep them engaged, and at least to the best of whatever they're able to do, given their situation.

So we often suggest that the businesses start looking at remote work policies. How are you going to have certain people be able to work from home, what things can they do from home, etc. So a lot of those things can be done remotely, there are software applications that make collaboration much easier.

Now, if you're looking at a manufacturing organization, people often say, "Well, I can't let them work from home," but you also don't want everyone on a manufacturing floor to be sick at the same time. So maybe splitting shifts so you have people that are working further away from each other, not having common eating areas, etc.

One of the biggest things that I've seen recently, and a lot of hospitals and offices are doing this, is putting up hand sanitizer stands. This is a great idea for businesses. While it's not better than washing your hands, it is a good reminder to everybody about hand hygiene when they see it all over. Having that where people are going to eat and outside the bathroom is a great idea. There are also support from public health departments where they may have signs that you can put in the bathroom to remind people about washing their hands.

If you've got an area where people just can't stay home, you may want to do something similar to a doctor's office, where you provide paper masks that just loop over the ears. They're not uncomfortable, they don't get hot, but it does restrict the spreading of germs. So at least that way, you can have people keep their germs to themselves.

And if you've got an organization or a company that has multiple locations deciding how you're going to manage if one location isn't operating at a certain level, so if you've got manufacturing parts that go from one location to another as a supply chain, if you've got call center coverage that covers different hours of the day, whatever it is, just looking and saying, "Okay, if I lose this one center of this one office down to a certain percentage, then what's the rest of my business look like? What do I have to do about that?"

Danielle Ricci: Should businesses consider holding flu clinics?

Meg Nash: Yes - definitely. And the other thing we've really seen in the last few years is the abundance of flu shots available in the community. So the business has to decide if it makes sense to host a clinic or recommend people visit one in the community. If they don't have a health and safety person that's onsite or a nurse or a clinic, sometimes it can make more sense to refer them to the community clinics.

One thing to consider is just offering an incentive for employees to show that they have gotten a flu vaccine. I work with our health department, and we offer a free health clinic for flu shots in vulnerable populations. We try to hit those that are usually the lowest vaccination rates. And we set up the clinic this year with 500 vaccines available, and I think over the course of the day, we did a little over 300. And last year, we went through 300 in about two hours.

So we're really seeing a higher level of vaccination, just because people can get it at the grocery store, they can get it at a Minute Clinic, there are lots of places that are making it more accessible. So businesses need to look at these options and ask “How do I encourage and incentivize people to get their flu shot so I know that we've got a fairly good coverage across the population of employees?”

Danielle Ricci: How can businesses put together a list of local community clinics?

Meg Nash: That's something your local public health department may already have together. You can also talk to local pharmacies, drug stores and grocery stores with pharmacies

And one thing that's really helpful too is as the season goes on, you may have people that were resistant to get the flu shot or maybe they were sick and didn't want to get a flu shot on top of it. They may be looking for a shot later and those get harder and harder to find. Some people will wait until December or January to get a flu shot and sometimes supply dwindles by then, so just having resources to get that information to your employees, and make sure they know what those options are can be very helpful for them.

Danielle Ricci: What’s the best time to get a flu shot?

Meg Nash: The guidance out of CDC is by the end of October and we know that the flu shot loses efficacy once you've had it. Your primary protection is going to be the six months or so after you get the shot, and that's why we do it annually. I personally had the flu in May, and it was miserable.

Lots of organizations require it by a certain time, especially if you're working with kids, working in healthcare or anything like that. And also, if you've got people that are more likely to have a severe reaction to getting the flu - such as the elderly, babies or those who are immunocompromised.

You really want to think about making sure you're protecting yourself through the peak period in February. So regardless of when you get a flu shot once it's available, you're going to be covering that period of time.

Danielle Ricci: And what about those warrior employees who make it a point of pride to always come into work?

Meg Nash: A lot of people say, "I'm not going to waste my sick time on this. I feel like I could possibly get into work, and I'm not dying yet," or like you said, that warrior mentality of, "They can't do this without me, I have to be there," that's definitely part of it.

It comes down to enforcing that if you're sick, stay home. We've often seen somebody that comes into work, and they're sneezing and coughing and clearly unwell, and their manager does not send them home.

And I think it starts with really empowering management. If you're going to say, "Stay home," then you need to empower those managers to send those people home. And also looking at sick time.

Maybe there’s a certain amount of hours or days that employees get during a severe flu season.  Or if you can work from home and not spread it around, then maybe those don't become sick days. They're work from home days.

But really encouraging that culture from the top down of teaching people that you're not helping the organization by coming in on your deathbed, and we want you to go home. That's really an important part of it.

I know there were companies that last year just reset people's sick time and said, “OK, you can't use all your sick time for the flu, so we're going to just reset that so that everybody can take care of themselves.”

And the other challenge, like my husband, is that he only has paid time off. He doesn't have any designated sick time, and I think that leads a lot of people to think, well, “I'm giving up a vacation day to stay at home.”

We're seeing a big trend just in preparedness in general for emergencies, especially after the hurricanes that we've had for the last two years. Employers are starting to understand that they're more likely to rebound from an event if their employees are prepared to take care of themselves. And it helps the business and the employees.

And I think we're going to see that as the climate continues to change as international travel and people can cross the world in 24 hours. I think we're going to continue to see an increase in the sort of unusual diseases that are more than just, “I'm home for a day with a bad head cold.” I think businesses are really going to have to start encouraging that culture of wellness.

Danielle Ricci: What’s the financial impact of the flu?

Meg Nash: So the flu causes U.S. employees to miss approximately 17 million work days. This costs businesses $7 billion a year due to sick days and lost productivity.

As a company, you need to track when employees stay home sick, similar to how they do it in schools. So that you as a company know, "I'm losing X amount of days to flu of worker time, so what does that mean for next year? Are flu shots mandatory? What is it that we need to do about this?"

Keeping the data of what specifically is the reason that people are home sick allows them to make the appropriate decisions for the company so that it lessens the impact in future years.

Danielle Ricci: How can companies track this?

Meg Nash: Well, you can use an alerting system that allows your employees to send in a notification that they’re out sick with the flu. Managers should also be able to keep track of that and could note it within the company’s time tracking system. Instead of just noting that it’s a sick day, they could note “sick flu,” “sick cold,” “sick injury,” etc.

Danielle Ricci: So how does flu season play into pandemic awareness?

Meg Nash: A lot of organizations have people that are traveling frequently and/or to countries that may have very contagious diseases.

These companies can work with an infectious disease clinic to understand what the diseases are within that area and then ensuring that people are immunized appropriately. Yellow fever, malaria, there are lots of immunizations and stuff that people have to get. And often, to get a visa into that country, you have to show that you've had those vaccinations.

You can also create a protocol for how people respond when they come back from traveling abroad - whether it's staying home for two days or being required to monitor their temperature and record it if they're exhibiting an elevated temperature. They really have to look at those areas that they're going to.

I would recommend that they work closely with an infectious disease doctor. They often cover tropical medicine and they're going to know not just what's common in that area, but what's going on in that area now. They'll be in touch with the World Health Organization and the Pan American Health Organization so that they've got an understanding of the current concerns there. And by working with them, be able to get a report back that says, "Here are the things you should probably look for. Here's how infectious they could be," or what they can do to take care and then working on a policy so that people are protected themselves.

Travelers are certainly going to feel like that they're more valued if they're getting that support, not just what's required to get the visa and get the work done, but to keep themselves healthy when they return.

Danielle Ricci: What can we learn from the H1N1 flu variant in 2009?

Meg Nash: So we knew that the flu variance coming in 2009 was likely going to be a variant.  The H1N1 flu, frequently called swine flu, was something that was highly infective to people. But it was over stimulating healthy people and they were reacting to it very strongly. People in their 30s, perfectly healthy, had their lungs fill up with fluid because it created too big of an immune response. And we just had no idea what to do with it.

So it was a very different protocol of who was getting sick with it. And it was completely different than what was in the existing vaccine. So they were able to create the H1N1 vaccine and that was rolled out for priority groups. So it takes a lot of work to define how you're going to do the vaccine and then to create enough of it incubated in the eggs and be able to get that rolled out and decide who's the priority group, who are we seeing who has the most risk to this flu.

Mostly it was healthy kids, healthy adults, obviously pregnant women - there's a high concern when you're talking about flu. There were a lot of people that wanted to get the vaccine but weren't able to get prioritized. And that can often cause a lot of feelings of unfairness.

It’s important for businesses to understand people are prioritized, how they could make sure those people were able to get their vaccine as soon as possible, etc. Then they can create an information campaign that if you're not able to get the vaccine, here’s how you can protect yourself otherwise.

There was a lot of concern about the H1N1 vaccine because it was a live attenuated virus which is the same as what they use in FluMist, the nasal spray. It's a live virus but it can't reproduce. So it's not going to make you sick but it creates a strong immune response in people.

Danielle Ricci: What are the odds that the next major pandemic will be a flu variant?

Meg Nash: The flu definitely is one of the best well-known causes of an epidemic or a pandemic. What we want to do is keep in mind that certain diseases are endemic. So the common cold is endemic to the U.S. We've passed that around on a fairly regular basis. Malaria would be endemic in Africa. Epidemics are not just localized. It's moving beyond just the locality.

And then a pandemic is a worldwide or excessive break or spread of a disease outside that area. So the challenge with pandemics or the flu is because it is somewhat dependent on the season, you'll have a large number of people affected in a lot of areas, but you're likely not going to have the whole world affected at once.

We have certain variants of flus that we know are going to be much more difficult for us to control, much more infective. When we start talking about the combinations with the swine flus, the avian flus, we see those happening over in Asia and should they become more infectious to humans and combine with the flus that we normally have, then we likely are going to have a much broader outbreak, similar to what we did with the Spanish flu in 1918.

Danielle Ricci: How does the human-to-human transmission factor in?

Meg Nash: We're always looking at the Avian influenza. Right now, we typically see people that sleep with their chickens. I would sleep with mine if I could. I love my chickens. But people that are very close contact with their poultry and keep birds in general, they may get sick but they rarely transmit it to somebody else.

One of my favorite things that I may have mentioned is the model they use for how transmissible fluids is ferrets. Ferrets are the only animals that sneeze like humans. So they can see oh, if he sneezes, this is another ferret that picks that up from them.

So if the Avian flu does change, and that's what we're always concerned about, that's going to be a highly infectious, a highly fatal event and that likely will have a one-off flu vaccine that will be rolled out to immunize people as quickly as possible. I don't know for sure but I would think that they've probably already started figuring it out what the vaccine would look like so that they can roll that out pretty quickly.

Danielle Ricci: How can some of these flu precautions be used for other diseases?

Meg Nash: So following some of the common sense precautions of the flu also work for pandemic preparedness. Things like washing your hands, trying not to touch your face, staying away from people when you're sick or learning not to shake hands when you meet people when the sickness is going around. You cough into your elbow, not your hand, so that when you go open the door, you're not leaving virus on a door handle.

Just basic things like that and one of the biggest things is how do you convince people to stay home when they're sick? And if you can do that then I think you've got a much better handle on flu prevention.

Whether you’re talking about the flu or a pandemic, the effect is the same. You're going to have people missing work, you may have people potentially die, you have loss of productivity, and you need to figure out how to keep your business going and minimize any negative effects as much as possible.

Danielle Ricci: Are there any sites that you recommend for additional resources?

Meg Nash: There’s a good site - - that helps people locate flu vaccines around them. If they’re looking for a specific vaccine or have a special need, this site helps them find it. And, as flu season progresses and flu vaccines get harder to find, this site will help you locate a clinic with vaccines.

You can also visit the CDC’s FluView site to learn more about national flu trends and track the number of reported cases and fatalities.

Public health expert Meg Nash joins Danielle Ricci, Vice President of Marketing for AlertFind, to talk about how businesses can proactively prepare their businesses for flu season.

In our upcoming webinar, she’ll discuss what businesses can learn from last year’s severe flu season, what to expect this year and the best strategies that organizations can use to protect their employees and their operations.

You are well on your way toward protecting your staff and organization.

Take the next step toward protecting your organization by learning more about emergency notification systems and the vital role they play in your emergency preparedness plan.