Pandemic Preparedness for Veterinarians - AVMA

 

December 15, 2009 
The Occupational Safety and Health Administration (OSHA) has made a statement on its web site that "Employers are responsible for recording cases of 2009 H1N1 illness if all of the following requirements are met: (1) the case is a confirmed case of 2009 H1N1 illness as defined by CDC; (2) the case is work-related as defined by 1904.5; and (3) the case involves one or more of the recording criteria set forth in 1904.7 (e.g., medical treatment, days away from work). Per CPL-02-02-075." This applies to all establishments covered by PART 1904, which includes the majority of veterinary practices. Prior to this notice, 2009 H1N1 was not reportable. Seasonal flu illnesses remain non-reportable.
This is the only information we have at this time. If you have questions about this regulation, please contact your OSHA Regional or Area office.​
 
Veterinarians face unique challenges with regard to pandemic preparedness. In addition to personal/family preparedness and small business preparedness issues, veterinary practices will also be expected to address health concerns of their patients and clients. Although veterinarians may not be classified as critical infrastructure by local governments, continuing to provide health care for animals is critical to community health.
 
Veterinary practices should be prepared to address employee absenteeism due to illness, either of the employee or one or more of their family members. In addition, if regional schools are closed, employees with school-aged children will need to address child care issues.
 

Employees will be concerned about balancing their health and their families' health against absenteeism that could negatively affect household income and job security. In addition to concerns about their health and their family's and employee's health, employers will be concerned about employee absenteeism and potential staff shortages, decreased revenue, financial stability and interrupted service from pharmaceutical, service and equipment suppliers.

In-depth guidance and resources for pandemic planning are available at PandemicFlu.gov. Some basic guidelines are described below, and their implementation should be based on the level of risk associated with the state of the pandemic. The primary goals of planning are to reduce the number of people who become ill and to preserve the continuity of your practice.

  1. Assess the exposure risks of all staff, based on their level of potential exposure to the general public
    • Front desk staff, veterinary technicians/assistants and veterinarians are likely to be at highest risk because of their frequent interactions with clients.
    • Immunocompromised individuals and pregnant women should be considered at high risk of infection and their exposure to the general public and other staff should be minimized.
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  2. Establish, implement and enforce strict sick leave policies for employees presenting influenza-like symptoms such as fever, cough, body aches, and sometimes vomiting and diarrhea.
    • Develop a sick leave policy that addresses the possibility of prolonged absence from work (with regard to continued employment, salary and wages, insurance, liability issues, etc.) and make all employees aware of the policy.
    • Avoid penalizing sick employees.
    • Consider implementing an expanded leave policy for pandemic flu.
    • Emphasize to all employees the importance of taking proper measures to protect themselves and others from illness.
    • Encourage employees to stay home for 7-10 days if they are showing any symptoms of respiratory illness, even mild ones.
    • Most ill people can be managed with voluntary home quarantine. Employees with flu-like symptoms may be encouraged to consult a medical provider if the symptoms persist for more than 3 days or if disease becomes more severe. Work with your insurance providers and state and local health agencies to provide information to employees about medical care in the event of a pandemic.
    • Keeping in mind that viral shedding can occur prior to the onset of symptoms, request that employees notify the practice manager if members of their household develop flu-like symptoms or are confirmed infected with flu; or if the employee has been in contact with any ill person.
    • Identify cross-trained employees who can work in multiple areas of the practice if employee absences occur. When possible, provide basic cross-training of all employees for critical tasks so there is minimal lapse in animal care or business function if one or several employees are ill.
    • Identify those employees who will be affected by school closures, and communicate with those employees to establish a policy and encourage these employees to prepare their own family's response to the situation.
    • Organize and identify a person or central team of people to serve as a communication source so that your employees and customers can have accurate information.
      
  3. Discuss your options for social distancing to minimize human contact where practical
    • Increase communication by telephone or computer/social media when possible.
    • Postpone staff meetings or gatherings or hold meeting via conference call or web.
    • Encourage staff to avoid large community gatherings for the time being, and to avoid mass transit when practical.
    • Consider staggering staff hours to provide adequate coverage of duties with minimal staff in the facility.
    • Keep in mind that isolation and social distancing can have negative effects on people, including depression. Establishing a means of regular social contact via telephone or computer-based social media could provide a valuable employee service. Consider establishing or outsourcing an Employee Assistance Program.
      
  4. Minimize traffic flow and face-to-face contact through work areas
    • Limit the entry of clients into work areas; if possible, restrict client access to waiting areas and examination rooms.
    • Restrict employees to specific areas of the facility unless their duties require them to be in other areas.
    • Allow as much flexibility as possible for staff working hours.
    • Ask clients and employees to keep a minimum 6-foot distance from each other when possible.
    • Where possible, develop a plan to allow the employee to work from home.
    • Discourage employees from sharing equipment (including phones, computer keyboards, etc.) or personal items unless absolutely necessary. If sharing is necessary, encourage proper hygiene and immediate cleaning of the equipment with appropriate cleaners.
     
  5. Business continuity considerations
    • Prepare and plan for operations with a reduced workforce. This may include altering business hours, temporarily eliminating nonurgent procedures, etc.
    • Contact your suppliers to discuss pandemic planning and continuity of service.
    • Identify positions essential to the daily function of the business and identify the staff members essential to maintaining these functions. Prepare to cross-train or develop ways to function in the absence of these positions. It is recommended that employers train three or more employees to be able to sustain business-necessary functions and operations, and communicate the expectation for available employees to perform these functions if needed during a pandemic.
    • Plan for downsizing services but also anticipate any scenario which may require a surge in your services.
     
  6. Ensure client security
    • Communicate to all clients the importance of postponing non-urgent appointments if they are ill or have recently been exposed to an ill person.
    • If practical, consider keeping one examination room designated for examination of animals brought in by clients showing symptoms of illness. Keep furnishings and equipment in the room to a minimum, and sanitize the room as thoroughly as possible after the client has left.
    • Minimize the amount of time an obviously ill client is allowed to remain in high traffic areas.
    • Minimize the number of employees who come in contact with clients showing symptoms of illness.
    • Ask clients and employees to keep a minimum 6-foot distance from each other when possible.
      
  7. Implement the use of personal protective equipment (PPE) where applicable.
     
  8. Enforce basic hygiene practices and encourage good health
    • Emphasize the importance of proper hygiene and sanitation, the use of personal protective equipment, and proper nutrition and general health management in the prevention of disease.
    • Address proper etiquette for coughing and sneezing: cover their coughs and sneezes with a tissue, or to cough and sneeze into their upper sleeves if tissues are not available. All employees should wash their hands or use a hand sanitizer after they cough, sneeze or blow their noses.
    • Encourage employees to get a seasonal flu vaccination.
    • Recommend frequent hand-washing of employees, in barns and kennels, and in offices. Employees should wash their hands immediately after contact with another person. Hand shaking should be avoided.
    • Stockpile items such as soap, tissue, hand sanitizer, cleaning supplies and recommended personal protective equipment. When stockpiling items, be aware of each product's shelf life and storage conditions (e.g., avoid areas that are damp or have temperature extremes) and incorporate product rotation (e.g., consume oldest supplies first) into your stockpile management program. Ensure all employees and clients have easy access to these items.
    • Develop a plan to provide mental support (including grief counseling and counseling for depression, stress, etc.) for employees.

Resources:

www.flu.gov

OSHA: Recording and Reporting Occupational Injuries and Illnesses

OSHA Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers

OSHA Employer Guidance: Reducing All Workers' Exposures to the 2009 H1N1 Flu

OSHA FactSheet: What Employers Can Do to Protect Workers from Pandemic Influenza

(CDC) Guidance for Businesses and Employers to Plan and Respond to the 2009-2010 Influenza Season

(CDC) Preparing for the Flu: A Communication Toolkit for Businesses and Employers

(National Institute for Occupational Safety and Health) Occupational Health Issues Associated with H1N1 Influenza Virus