Dr. David McKeown

bh IN BRIEF

The City of Toronto is among the best-prepared jurisdictions in Canada for a pandemic, a caution bred from its deadly, expensive, and seriously disruptive exposure to SARS in 2003. That noted, a pandemic has important differences from almost any other public or corporate emergency, and so requires specific attention. Since his appointment in September 2004, Dr. McKeown has continued to build Toronto’s capacity to address infectious, chronic, and environmental disease. He notes the importance of advance preparation, and believes that once the business community understands its exposure, its inherent loathing of uncertainty and undue risk will make pandemic planning a natural outcome.

Q: Pandemic flu is obviously a health problem for the broader public, which includes business. What advice would you give our readers in terms of the three most important things they could do to prepare?

The importance of being well-prepared can’t be overstated. Businesses should: Look at the impact of absenteeism. Perhaps 35% of the population will be affected over the course of the pandemic, though not at any one time. What effect will such high absence rates have on basic business functions?

Ensure clear methods of communication. Since severity is unknown, plan for different scenarios, and include suppliers, customers and unions. Don’t take existing services for granted.

Educate on infection control. Identify reliable sources of information and supplies – now. Examine human resources policies to balance the need for productivity with the threat of having someone sick on-site. An extra day’s work at half-speed may be helpful, but not if someone infects 2 or 3 colleagues. Remember there are broader issues, contingencies and opportunities that should be included in emergency planning and risk management. A broader scope will make such an exercise worthwhile and a higher priority.

Q: Critics suggest an influenza pandemic is just another Y2K, a still-born threat that will encourage huge sums of money to be spent for no apparent gain. How and why is an influenza pandemic different?

There is an element of uncertainty inherent in all emergencies, but managing uncertainty is nothing new for business. Consider the very purpose of insurance: to help manage risks to the business and its people.

The differences? First, a pandemic will be an event measured in months, not hours, and the damage may not be immediately apparent. Second, pandemic is also a widespread event, unlike a tornado which is catastrophic but local. Companies will likely be unable to pull resources in from other regions or even countries. Who would want to travel at such a time?

Finally, flu is transmitted through both personal and casual contact. This latter characteristic tends to create a “fear factor”. Toronto had lots of direct experience with SARS, but the SARS virus was primarily a risk for hospital personnel. The impact of a pandemic will be felt in the broader community.

Q: Can you offer any guidance to employers to help them fairly and effectively manage absence and disability caused by this pandemic? How can employers manage the fear inherent in this crisis?

The City is working on this for its own employees, as are many other organizations. Companies need policies that generally try to discourage disease transmission. The best way to give people the confidence to come to work is with good infection control, and accurate and credible information so employees feel safe. Labour and management need to work together on this, in the interest of employees and their communities. Provide people with the ability to protect themselves, based on the best available science.

Q: We’ve heard of the ‘5-Ps’ of planning: Proper Preparation Prevents Poor Performance. How can business help prevent the spread of the flu virus? How can community business leaders get involved with public health initiatives?

TPH is making timely and credible information available to business. We are keen to learn from them too, and we continue to refine our material. While we acknowledge some competitive pressures, we believe business leaders should share their preparedness work with other companies. Alcan set a good example in making its plan widely available. If pandemic hits even one sector or community hard, then many others will be very quickly affected.

There is certainly a gap between knowing and doing. Pandemic preparation has generated a lot of interest, but business doesn’t necessarily say ‘this is an issue for us’. They do have a sense of the impact on our institutions, and generally on the state of the economy. We must find ways to generate more awareness and make clear their self-interest, balanced of course against their broader social responsibility.

HUMAN RESOURCE PRIORITIES (Source: City of Toronto Pandemic Plan)

Attendance – Public health advice that ill people stay home may conflict with existing employer policies that penalize absence. Physicians may not take time to write notes explaining absence – the health system will be overwhelmed with more critical issues.
Illness at Work – People experiencing symptoms at work must leave immediately and not return for the longer of five days after symptoms appear, or when they feel well enough to return.
Scheduling – Flexibility will be needed to change shifts, hours of work, compensation and overtime. Check collective agreements to ensure the most qualified (vs. the most senior) employees are available for critical tasks.
Support – Consider the role your senior leadership team, Employee Assistance provider, insurers, co-workers, family, and occupational health professionals will play to help people address the anxiety, fear, grief and personal crises related to the pandemic.