1. Swine Flu: Key Steps for Business Continuity Presented By Workplace Safety Awareness Council

2. Introduction This material was produced by the Workplace Safety Awareness Council, a 501(c)(3) not-for-profit organization dedicated to safety in the workplace. For further information about the council or upcoming safety related training, please visit our website at www.wpsac.org David A. Casavant CFM (863) 537-4053 david@wpsac.org Larry D. Riley Compliance Consultant (561) 350-8913 Larry@wpsac.org 2

3. What We’ll Cover Today :: Pandemic history, triggers and actions :: Hierarchy of Control as a method to reduce exposure :: Building systems and the spread of influenza :: Cleaning and maintenance protocols during an outbreak :: Security considerations during a pandemic :: Conducting the Business Impact Analysis (BIA) :: Key components of an emergency response plan :: The importance of local, state & federal health agencies :: Steps to create an effective response team :: List of important websites to bookmark 3

4. Swine Flu (H1N1) Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A influenza virus that regularly causes outbreaks of influenza in pigs. 4

5. Swine Flu: Transmission to Humans Through contact with infected pigs or environments contaminated with swine flu viruses Through contact with a person with swine flu Human-to-human spread of swine flu has been documented also and is thought to occur in the same way as seasonal flu, through coughing or sneezing of infected people 5

6. Swine Flu Symptoms The symptoms of swine flu inpeople are expected to be similar to the symptoms of regular human seasonal influenza and include fever, lethargy, lack of appetite and coughing. Some people with swine flu also have reported runny nose, sore throat, nausea, vomiting and diarrhea 6

7. Swine Flu: Treatment No vaccine available (including seasonal flu vaccines) Antivirals for the treatment and/or prevention of infection: Oseltamivir (Tamiflu) or Zanamivir (Relenza) Use of anti-virals can make illness milder and recovery faster They may also prevent serious flu complications For treatment, antiviral drugs work best if started soon after getting sick (within 2 days of symptoms) 7 Source: CDC

8. Guidelines for General Population Covering nose and mouth with a tissue when coughing or sneezing Dispose the tissue in the trash after use. Hand washing with soap and water Especially after coughing or sneezing. Cleaning hands with alcohol-based hand cleaners Avoiding close contact with sick people Avoiding touching eyes, nose or mouth with unwashed hands If sick with influenza, staying home from work or school and limit contact with others to keep from infecting them 8 Source: CDC

9. CDC Updates http://www.cdc.gov/h1n1flu/ 9

11. Drive through business

12. Foot-operated trash receptacles

14. Social distancing

15. Hand washing procedures

17. Surgical mask

18. GlovesRemember – PPE is a last line of defense! 10

19. Types of Protective Masks Dust Masks – often called comfort masks. Will not be NIOSH certified, not fitted to the users face and provide very little protection against small airborne contaminants. Surgical masks - Easily available and commonly used for routine surgical and examination procedures however not designed to prevent inhalation of small airborne contaminants. High-filtration respiratory mask - Microstructure filter disc to flush out particles bigger than 0.3 micron. The mask numbers indicate their filtration efficiency. For example, a N95 mask has 95% efficiency in filtering out particles greater than 0.3 micron under normal rate of respiration. 11

21. Plastic, stainless steel

22. Recoverable for > 24 hours

23. Transferable to hands up to 24 hours

24. Cloth, paper & tissue

25. Recoverable for 8-12 hours

26. Transferable to hands 15 minutes*Humidity 35-40%, Temperature 28C (82F) 12 Source: Bean B, et al. JID 1982;146:47-51

28. Elevator buttons

29. Door knobs

30. Light switches / thermostats

31. Controls (machinery / equipment)

32. Vending machines

33. Cabinets and file drawers

34. Copier / printer / fax13

36. Replace silverware with plastic wrapped disposable utensils

37. Suspend offering “buffet line” items or place such items behind a serving counter

38. Suspend items that are not pre-cooked

39. Place trays, utensils, cups etc behind a serving counter

40. Assign cafeteria personnel to continuously sanitize hard surfaces common touched by patrons

42. Is eating pork safe during epidemics? Swine influenza viruses are not spread by food. Eating properly handled and cooked pork products is safe. Cooking pork to an internal temperature of 160 degrees F kills bacteria and viruses 15

44. Increase frequency at which waste paper is collected

45. Increase frequency at which faucets and sinks are wiped down

46. Install signage with hand washing remindersThese ideas are courtesy of: http://www.ifmafoundation.org/pandemic.pdf 16

48. Open windows if applicable

49. Use HEPA filters (but understand the additional load this creates)

50. Increase frequency of filter change outs

51. Insure preventative maintenance is performed17

53. Business Impact Analysis (BIA)

54. Business Continuity Plan (BCP)

55. Employee Training

56. Testing the Plan

57. Revising the Plan (Lessons Learned) 18

58. Sample Risk Assessment Risk Assessment Influenza viruses have threatened the health of animal and human populations for centuries. Their genetic and antigenic diversity and their ability to mutate rapidly make it difficult to develop a universal vaccine or highly effective antiviral drugs. A pandemic occurs when a novel strain of influenza virus emerges with the ability to infect and efficiently spread among humans. Because humans lack immunity to the new virus, a worldwide epidemic, or pandemic, can result. Each of the three pandemics in the last century resulted in the infection of approximately 30% of the world’s population and the death of 0.2%-2% of infected individuals. Conversely, this indicates that 98%-99.8% survived the pandemics. 19

60. Dams

61. Commercial Facilities

62. Nuclear Power Plants

63. Food and Agriculture

64. Public Healthcare

65. Banking and Finance

66. Chemical and Hazardous Materials

67. Defense Industrial Base

68. Water

69. Energy

70. Emergency Services

71. Information Technology

72. Telecommunications

73. Postal and Shipping

74. Transportation

75. National Monuments and Iconshttp://www.pandemicflu.gov/plan/pdf/cikrpandemicinfluenzaguide.pdf 20

77. Lower work productivity

78. Change in patterns of commerce (web based, drive through, off-peak hours)

79. Interrupted supply / delivery

80. Work stressors

81. Negative PR

82. Quarantine / Curfews

83. Travel Issues

84. Security IssuesDeclining Workforce Productivity 100% Of Workforce Before An Outbreak 30%-50% Of Workforce During An Outbreak 21

85. Online Planning Checklist http://www.pandemicflu.gov/plan/pdf/businesschecklist.pdf http://www.pandemicflu.gov/plan/businesschecklist.html 22

86. State & Federal Planning http://www.pandemicflu.gov/plan/states/index.html http://www.pandemicflu.gov/plan/states/stateplans.html 23

88. Refuse Collection May Be Impacted

89. First Response Times May Be Impeded

90. Schools May Close For Extended Periods

91. Necessities And Utilities May Become Intermittent

92. Groceries/Drugs May Become Unavailable As Supply Chain Slows

93. Rolling Brownouts And Blackouts Are Possible

94. Water Supply May Become Limited

95. Telephone Service May Become Unavailable 24 Source: Department of Homeland Security

97. Outgoing/Incoming Mail/Parcel Services/Shipping Impeded

98. Incoming Gasoline, Chlorine, Food Drug Deliveries Impacted

99. Small/Medium Manufacturing Businesses Cease/Cut-Back Operations; Lack Of Parts For Autos And Other Durable Goods Stops Production On Assembly Lines

100. America’s Economy Impacted25 Source: Department of Homeland Security

102. In China, 14 million people were screened for fever at the airport, train stations, and roadside checkpoints, but only 12 were found to have probable SARS

103. Singapore reported that after screening nearly 500,000 air passengers, none were found to have SARS

104. Passive surveillance methods (in which symptomatic individuals report illness) can be important tools26

105. School Closings School Closures: Preemptive school closures will just delay the spread of disease, once they reopen (as they cannot be closed indefinitely), the disease will spread again. Furthermore, this would put unbearable pressure on single-working parents and would be devastating to the economy Closure after identification of a large cluster would be appropriate as the absenteeism rate among students and teachers would be high enough to justify this action 27

107. Roles and Responsibilities of each member is key

108. External Communications

109. Internal Communications28

110. The Emergency Management Team [Add phone number, cell phone number, and work location] Title Name Phone Cell Emergency Director Business Continuity Manager Risk Management Manager Logistics Manager Procurement Manager Media Relations Human Resources Facilities Manager Legal Counsel Chain of Command In the event of an emergency [Insert your answer here] will be in command. In the event this person is unavailable, [Insert your answer here] will take command. 29

111. Drills, Table Tops and Inspections Date of last evacuation drill [Insert your answer here]  Partial (Which areas) [Insert your answer here]  Full Scheduled frequency [Insert your answer here] Next scheduled evacuation drill [Insert your answer here] Date of last tabletop exercise [Insert your answer here] Scheduled frequency [Insert your answer here] Attended by [Insert your answer here] Topics discussed [Insert your answer here] Next scheduled table top exercise [Insert your answer here] Date of last inspection by fire department [Insert your answer here] Scheduled frequency [Insert your answer here] Attended by [Insert your answer here] Next scheduled fire department inspection [Insert your answer here] 30

113. Supplies (hand sanitizer, food & water, fuel for generators, etc)

114. Insurance Coverage

115. Generator maintenance schedules

116. Critical data access (hard copy, off-site, digital etc)

117. Evacuation procedures (staging areas, evacuation captains)

118. Shelter-in-place procedures

119. Key people in the organization (see next slide)31

121. Rumor control hotline (web based, Twitter, YouTube etc)

122. Promote proactive mitigation steps employer is taking

123. Work-from-home issues

124. Leave policies (without penalty)

125. Day care concerns

126. Employee assistance programs (stressors)

127. Minimize face-to-face contact and large gatherings

128. Web-based meetings / conference calls32

129. H1N1 Resources http://www.cdc.gov/h1n1flu/ Current counts of swine flu by State http://www.pandemicflu.gov/plan/pdf/businesschecklist.pdf http://www.pandemicflu.gov/plan/businesschecklist.html Helpful checklist (online or .pdf) for pandemic BIA and planning http://www.ifmafoundation.org/pandemic.pdf Great resource on pandemics – geared to facility managers http://www.pandemicflu.gov/plan/pdf/cikrpandemicinfluenzaguide.pdf Excellent BIA resource for Critical Industry / Key Resources (CI / KR) http://osha.gov/Publications/OSHA3327pandemic.pdf Helpful resource from OSHA on pandemics (especially the respirator section) http://wpsac.org/ Check the safety blog and newsletter for updates 33

130. In Conclusion This material was produced by the Workplace Safety Awareness Council, a 501(c)(3) not-for-profit organization dedicated to safety in the workplace. For further information about the council or upcoming safety related training, please visit our website at www.wpsac.org David A. Casavant, CFM (863) 537-4053 david@wpsac.org Larry D. Riley Compliance Consultant (561) 350-8913 Larry@wpsac.org 34