Ready Your Workplace for Flu Season

By Roy Maurer Nov 11, 2014
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Concern over the deadly Ebola virus making landfall in the U.S. has dominated news coverage to such a degree that the start of the more familiar but still highly disruptive flu season passed unnoticed.

And if past years are any indication, this flu season is likely to cost employers nationwide millions of lost work days and billions of dollars.

Nearly 111 million workdays are lost due to the flu each year, according to, costing employers approximately $7 billion per year in sick days and lost productivity.

The influenza season, which can begin as early as October and last until May, costs businesses an additional $10.4 billion in direct costs for employee hospitalizations and outpatient doctors’ visits each year, according to the Centers for Disease Control and Prevention (CDC).

And that’s not even the worst of it.

“Every year thousands of people die from the flu,” said Dr. Derek van Amerongen, chief wellness officer at HumanaVitality, a Chicago-based wellness program sponsored by health insurance company Humana.

From 1976 to 2007, estimates of flu-related annual deaths ranged from a low of about 3,000 to a high of about 49,000, according to the CDC.

Are You Prepared for the Flu’s Impact?

The flu can dramatically upend your workforce. Nationwide millions of people take time off each year to care for themselves or sick family members. Or, they show up at work and spread the illness.

The CDC reports that, on average, 5 percent to 20 percent of U.S. residents get the flu each year and more than 200,000 are hospitalized.

Despite the numbers, fewer than half of Americans (45 percent) got a flu shot during the 2012-2013 flu season, with that number dropping to just 36 percent for adults ages 18 to 64.

“Last year was one of the worst flu seasons on record, with more than two-thirds of states reporting that the flu outbreak had reached ‘severe’ levels,” said John A. Challenger, chief executive officer of global outplacement consultancy Challenger, Gray & Christmas Inc. “These outbreaks and the resulting workplace absenteeism can have a significant impact on a company’s bottom line, particularly in smaller companies where illness can spread quickly and incapacitate large portions of a workforce.”

Despite 88 percent of managers encouraging sick employees to stay at home, 40 percent of those employees feel their workload keeps them coming into the office, and 31 percent show up to work sick because they think their boss appreciates it, according to the 2014 Flu Season Survey from office supply company Staples, which interviewed 1,500 managers and employees across the United States.

While a majority of survey respondents said that having sick employees at work is worse for office security than a data breach, 60 percent said they themselves go to work with the flu.

“Whether it’s motivated by job security or a desire to continue making a contribution in an overburdened workplace, presenteeism … only spreads illness to more workers and further damages the employer’s ability to maintain optimum business operations,” Challenger said.

Vaccinations Recommended

The CDC recommends that everyone six months of age and older receive a flu vaccination. A flu shot is especially important for people with medical conditions such as heart disease, asthma or diabetes, according to the CDC, and vaccinating pregnant women and health care professionals should be the first priority. The best time is right now, at the start of the active flu season, said Sean Gallivan, chief operating officer at Healthentic, an analytics company that measures population health and identifies cost savings for employers. “It only takes a few minutes and the benefits are tremendous. Employers can reduce health care costs and … employees can protect their health,” he said.

Immunity to the flu virus builds two weeks after vaccination, said van Amerongen.

But most employees never get around to it, according to data from Healthentic. Even large companies with active flu vaccination programs typically achieve employee vaccination rates of less than 40 percent, according to the data.

Health professionals say misperceptions about the flu vaccine keep people from getting flu shots.

A few of the myths around flu shots include:

I’ve never had a shot and never got the flu, so why should I get one now? Van Amerongen warns that those people “have just been lucky. And sooner or later that luck is going to run out.” He explained that because the flu virus differs from year to year, everyone needs a new vaccination annually.

I’ve heard you can get the flu from the flu shot. The vaccine is made from either an inactive flu virus or with no flu viruses at all, said Alan Kohll, founder and CEO for TotalWellness, a national wellness services provider. “It’s scientifically impossible to get the flu from a flu vaccine,” he said.

I’m really healthy and don’t need a flu shot. About 20 percent to 30 percent of people with the flu don’t show any symptoms, said Kohll. “As a result, you could pass along the virus to your child or other family member, a co-worker, or friend that is much more vulnerable to the illness. Don’t just get the flu shot for your health, but also for those around you.”

I’ve heard I can have serious side effects as a result of getting a flu shot. This is rare and a result of a serious allergic reaction to the vaccine, Kohll said. “Other reactions that can occur are generally mild and can include a low-grade fever and aches, usually beginning soon after the shot and lasting one to two days, and are much less severe than symptoms caused by actual influenza.”

It’s too late to get a flu shot. Flu season peaks in January or February of each year and can continue all the way through May, so “there’s no reason why you wouldn’t want to receive the benefits of the vaccine even if it’s late in the year,” said Kohll.

Setting Up Onsite Vaccination Clinics

Flu-vaccination clinics are becoming increasingly common in U.S. workplaces. To minimize absenteeism, employers can offer workers onsite seasonal flu vaccination at no cost or for a low fee. This option may work well if the business has an onsite occupational health clinic, or alternatively, health care providers can connect employers with pharmacies and community vaccinators to provide onsite flu shots.

“It’s a great way to demonstrate to your workforce that you care about and value them, and that you’re willing to invest resources and time to make sure that everyone is protected from something that is preventable,” said van Amerongen.

If you choose to host a flu-vaccination clinic, the CDC recommends:

  • Getting senior management buy-in.
  • Designating a flu-vaccination coordinator and/or team with defined roles and responsibilities.
  • Scheduling the clinic hours and location to maximize employee participation.
  • Measuring employee demand for flu vaccination.
  • Asking managers and supervisors to allow employees to visit the onsite clinic as part of their workday, without having to go off the clock.
  • Considering offering flu shots to workers’ families. “This has been a really positive trend,” van Amerongen observed. “If you can get everyone on the employee’s health plan vaccinated, that can have such a positive impact on the workforce.”
  • Giving workers incentives to get the flu vaccine, such as offering the shot at no or low cost, providing refreshments at the clinic, or holding a contest for the department with the highest percentage of vaccinated employees.
  • Promoting the clinic to employees.

Legal Considerations

This is also a good time for employers to review or develop legally compliant policies for minimizing the spread of flu.

To help keep the flu away from the workplace, employers should re-examine their leave policies to ensure that people can take time off when they’re sick. “Evaluating any attendance situation requires an employer to determine which statutes and employer policies apply,” remarked Joseph Lynett, a shareholder with law firm Jackson Lewis in White Plains, N.Y.

The Family and Medical Leave Act (FMLA) provides covered employees up to 12 workweeks of unpaid leave during any 12-month period if the individual has a “serious health condition.”

“In some situations, influenza-like illnesses may qualify as a ‘serious health condition’ under the FMLA, but the majority of flu-related absences will fall under state and local leave laws or employers’ absence policies,” said Lynett.

The Occupational Safety and Health Administration (OSHA) advises HR professionals to develop flexible leave policies that encourage workers to stay home—without penalty—if they are sick.

Some states and municipalities require covered employers to provide paid sick leave to employees, said Lynett, including California, Connecticut, New York City, Washington, D.C., and Massachusetts beginning in July 2015.

“Regardless of the law in your state, to minimize lost productivity during flu season, employers should consider implementing absence policies that encourage sick employees to stay home, including paid time off for short-term illnesses,” he said. HR should also communicate other related policies to staff, including administrative leave transfer between employees, the pay policy for sick leave, child care options and what to do when ill during travel.

Employers may want to allow more workers to telecommute when sick, said Challenger. “They may also want to postpone all meetings or at least change them to conference calls. These steps might help ensure that the flu doesn’t take down your entire staff.”

Some employers, generally hospitals and health care facilities, have implemented controversial policies making flu shots mandatory.

“Before implementing such programs … employers should consider possible disability and religious accommodation issues under the Americans with Disabilities Act [ADA] and Title VII of the Civil Rights Act, as well as analogous state and local laws,” said Lynett. An employee may be entitled to an exemption from a mandatory vaccination requirement based on an ADA disability that prevents the employee from taking the vaccine, and Title VII may exempt an employee whose sincerely-held religious belief, practice or observance prevents him or her from receiving the vaccine, he said. A collective bargaining agreement may also prevent an employer from unilaterally instituting this type of policy.

Employers do have the right to ask workers whether they are experiencing influenza-like symptoms, because this is not a disability-related inquiry and sick employees can be sent home if they display flu-like symptoms, he said.

Keep Your Workplace Clean and Germ-Free

According to the CDC, up to 80 percent of flu cases are spread by touching contaminated surfaces and by direct human contact. As cold and flu season ramps up, common breeding grounds for germs—such as telephones, elevator buttons, water fountains, computer keyboards, and bathroom faucets and door handles—show how easy it can be to come in contact with viruses that cause influenza.

Cleaning frequently touched surfaces is one way to cut down on the number of cold and flu germs that are passed from one co-worker to another, as is supplying employees with disinfectants and disposable towels to use in their workspaces, advised OSHA. The agency further recommended employers post signs outlining the steps for proper hand-washing hygiene and cough etiquette.

These steps include covering your nose and mouth with a tissue when coughing or sneezing, disposing of used tissues, washing hands often with soap and water, and avoiding shaking hands, or coming into close contact with co-workers and others who may have a cold or the flu.

Roy Maurer is an online editor/manager for SHRM.

Follow him at @SHRMRoy

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