Communicable or infectious diseases are those that spread from person to person, often easily, such as through handshakes or from breathing in airborne particles exhaled by an infected individual. Communicable diseases may be chronic (such as tuberculosis or hepatitis) or acute (such as the flu or coronavirus) and can spread quickly throughout a workforce if immediate and correction actions are not taken.
Step 1: Notification and Verification
HR must be notified immediately that a communicable disease risk may exist to limit additional exposure and to reduce risk and liability for the employer. Policies should be in place to require immediate notification from supervisors, the infected employee, and other employees who have been made aware of a disease risk.
For example, the Occupational Safety and Health Administration (OSHA) requires an exposure control plan to meet its bloodborne pathogens standard for employers that can reasonably expect a risk of exposure. Bloodborne pathogens are infectious micro-organisms in human blood that can cause disease. These pathogens include hepatitis B, hepatitis C and human immunodeficiency virus (HIV).
HR acting on behalf of the employer should:
- Confirm the source and verify the information.
- Obtain sufficient facts about the particular employee and their particular condition.
Employee Self-Notification and Protection Under the ADA
When an employee informs the employer that they have a communicable disease that may affect their performance on the job, the employer can require a medical exam or health certification to confirm the illness, just as it can with any other ADA disability. After the examination, if the employer determines that the disease poses "a significant risk" to the health of others, the employer must consider every reasonable accommodation to eliminate that significant risk.
If no such accommodation can be made, then the employer should take steps necessary to eliminate the significant risk. Some examples of reasonable accommodations include telework or leave of absence (FMLA or ADA). Employees have a reasonable expectation for privacy with all medical information. Throughout this process, the employer must keep the employee's medical information, as well as information on any accommodations or leaves, confidential.
Suspicion of Infection
If an employee does not tell their employer that they have a communicable disease, the employer's options are much more limited. Suspicion of a communicable disease is not enough to justify inquiry or a medical exam. However, the employer need not, and should not, make any decision that places its employees at significant risk of contracting a serious communicable disease.
Pro Tip: An employer must make sure that in its efforts to reduce the risks of contagion in its workplace, it does not violate the applicable laws. If there is suspicion of an employee being infected, employers should seek legal counsel immediately for the best response given the particular case.
Step 2. Understanding the Disease
Employers must understand the illness to respond appropriately. The particular areas to know regarding the contagion include:
- How the disease is transmitted.
- Probability of transmission and complications.
- Level of severity.
- Duration of risk.
To obtain information and medical expertise, employers can contact the Centers for Disease Control and Prevention (CDC), OSHA, state and local health departments, and employer resources such as in-house or contracted medical care facilities and the American Public Health Association publication Control of Communicable Diseases Manual.
Member Resource: Stop the Spread of Germs Poster
Step 3. Identifying Scope of Risk
Employers must determine who is at risk for contracting the illness and consider any possible contacts, including those outside of the office, plant, or any facility that is within employer control. Possible contacts include clients, the public, and vendors that may have been exposed or infected. Employers must answer questions such as:
- How many people may be affected?
- What is the severity of the disease?
- How is the disease contracted?
Step 4. Determining Employer Response
Based on comprehensive disease research, management can assess the severity with which to justify decisions such as an emergency shutdown, or if a limited threat, a review of a department or single area. If employers have developed emergency preparedness plans or disease management preparedness plans, many decisions will already be mapped out for quick and thorough processes. These business continuity plans help employers keep the business running during periods of high absenteeism.
Member Resource: Managing Through Emergency and Disaster Toolkit
Step 5. Planning External and Internal Communications
Communications include all internal or external contact with and notification to employees, the public, vendors, and clients as well as any communications with family members of anyone hurt on the job or hospitalized as a result of a communicable disease. Careful consideration in these areas — as well as a review of all communications by an employer's attorney, public relations department, or public relations consultant — will reduce the possibility of misunderstandings and properly guide employee and public perception of the employer and its actions.
Note: General notice is appropriate so that employees can monitor themselves for symptoms and seek treatment if needed.
Pro Tip: Constant communication to employees both in the office and at home will help alleviate concern, keep information truthful, and dispel rumors.
Step 6. Addressing Employee Privacy and Wellbeing
Employees have a reasonable expectation of privacy for all medical information and any leaves of absence or accommodation they receive. Employers must not provide names of those infected, divulge whether anyone is on Family and Medical Leave Act (FMLA) leave, or is receiving any ADA accommodations unless there is a business need to provide this information, such as to a specific manager of an employee who is infected.
Concern and compassion for those infected or in fear of being infected is the best course of action. Employees will be concerned for their own health as well as for the health of their own families. Employers must determine what disease management benefits they can provide and inform employees quickly. employees can monitor themselves for symptoms and seek treatment if needed.
Pro Tip: Employers may want to consider providing free employee screenings, time off to see their own doctors, the option to telecommute, or other options until the disease is contained and the threat eliminated.
Step 7. Consulting Legal Counsel and Ensuring HR Compliance
Employers should seek legal counsel to identify legal risks, develop a plan to minimize liability, and discuss any actions to include communications, employee response, and privacy issues.
HR has regulatory requirements when it comes to communicable diseases. Some diseases may be reportable under federal, state or local regulations such as OSHA or to the local health department. However, it is not required in some instances that the employer report the name(s) of the individual(s)infected.
Pro Tip: Before providing this medical information, employers should consult with legal counsel to determine if the name(s) must be provided and consult with the employee for permission to release their name to the agency.
There may also be OSHA standards the employer must follow to reopen the facility or to remain open, such as cleaning the site or a release from the agency to continue operations. An employer's attorney will need to advise the organization as to any specific requirements to reopen if applicable.
HR has the duty to notify the workers' compensation carrier of anyone wishing to file a claim related to the communicable disease and exposure. Some jurisdictions consider exposure of a communicable disease, such as measles, to be covered under workers' compensation, whereas others may not.
Step 8. Supporting Workforce Planning and Operations
HR should assist departments on the loss of workforce, any operations functions that need to be temporarily discontinued, and the ability to temporarily fill positions to keep the company from incurring financial losses related to communicable disease. Employers can reduce the effect of widespread absenteeism by:
- Cross-training employees to take over essential functions.
- Bringing back retirees as temporary workers.
- Partnering with employers in other industries (such as leisure, entertainment or recreation industries).
HR must also provide leadership to the organization by communicating internally with the management team and externally such as with the attorney, consultants, and any agencies that stipulate a requirement to contact or follow up.
In times of an emergency, decisions and actions must be taken quickly, however, careful consideration must be made at every step along the way. Employers are encouraged to develop a disease management preparedness plan to reduce their level of risk and liability and to provide a step-by-step action plan to handle the situation in the most efficient and effective manner.
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