Flu-Related Deaths on the Rise

Frigid weather across the United States and low effectiveness of this year’s flu vaccine have been blamed for a jump in the number of flu cases being reported across the country. Epidemiologists in 36 states so far have reported widespread influenza activity to the federal Centers for Disease Control and Prevention (CDC). Of those states, 21 reported a high number of cases.

Worldwide, the estimated number of fatalities caused by seasonal influenza-related respiratory illnesses is also higher than expected, according to the CDC. The agency released a new study in December 2017 with statistics indicating that between 291,000 and 646,000 people die from influenza every year, an increase from the previous estimate of 250,000 to 500,000. The estimates were drawn from a collaborative multinational survey conducted by the CDC and its global health partners.

“These findings remind us of the seriousness of flu and that flu prevention should really be a global priority,” said Joe Bresee, M.D., associate director for global health in CDC’s Influenza Division and a study co-author.

The study, which appeared in The Lancet, excluded data related to pandemics, indicated that poorer nations and older adults are especially at risk. It explained:

People age 75 years and older and people living in sub-Saharan African countries experienced the highest rates of flu-associated respiratory deaths. Eastern Mediterranean and Southeast Asian countries had slightly lower but still high rates of flu-associated respiratory deaths.

One cause for the rise could be that few developing countries have seasonal flu vaccination programs or the capacity to produce and distribute seasonal or pandemic vaccines.

The information was released following the CDC’s National Influenza Vaccination Week, which was held in early December 2017. That also marked what is typically considered the start of the season which continues through February in the U.S., although activity can last as late as May. Flu activity is expected to increase this month, the CDC warned back in December, and the freezing conditions from last week’s “bomb cyclone” may contribute to fully realizing that prediction.

People at high risk include:

  • Pregnant women.
  • Children younger than 5 years old, but especially children younger than 2 years old.
  • People 65 years of age and older.
  • People of any age who have certain medical conditions, such as asthma, diabetes, and heart disease.

The Society for Human Resources Management (SHRM) suggests that employers use this critical time to promote policies and procedures to protect their employees from communicable diseases like influenza, and reinforce that the risks may be greater for certain workers. According to SHRM:

Employers must be open to discuss employee concerns and listen to their ideas and suggestions for ways to help them stay healthy. Employers can encourage employees who are at high risk to talk with their health care provider to determine what, if any, additional measures they should consider to keep themselves healthy and safe at work. Employers should strongly consider doctor’s accommodation requests for high-risk workers.

The Occupational Safety and Health Act (OSHA) web site has a fact sheet and guidelines for companies to follow with regard to the flu and pandemics. Additionally, the National Institute for Occupational Safety and Health (NIOSH) has a page with tips for employers hoping to curb seasonal flu outbreaks in their workplaces and among employees. NIOSH’s suggestions include:

Zika and the Olympics: Business Travel Risks

The Zika virus, and its presumed association with serious birth defects and a paralytic neurological disorder, poses an unusual problem for business leaders and risk managers. While the virus is not currently being spread by mosquitoes in the U.S., Brazil is an important destination for many U.S. business travelers, which will only increase in the build-up to this summer’s Olympic Games. For many companies, health and safety concerns are top priorities, but travel to Brazil may be a business necessity. Before making decisions around these two opposing drives, it is vital that risk managers and business leaders weigh the facts around Zika.

The Risk to Employees

Brazil ranks in the top 10 in the business travel global rankings, making it one of the world’s largest corporate travel markets. With the Olympics, business travel to Brazil is expected to increase considerably this year, yet many Americans are worried about the threats of the virus. Consider the results of a recent survey conducted by my company, On Call International: 64% of Americans and 69% of all women surveyed, said they would cancel their travel plans because of Zika. There is, however, a disparity between these widespread concerns and the ways businesses have actually responded to the virus. A survey by the Overseas Security Advisory Council found that of the 321 businesses that responded, less than 40% are allowing female employees to defer travel to affected countries, and only a fifth are allowing men to opt out. The majority of respondents are only taking steps to inform their employees about the virus.

Should more employers allow their employees to defer travel? In considering this question, business leaders need to turn to authoritative travel health sources such as the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) to help make informed choices around employee health and safety concerns.

Furthermore, women currently account for nearly half of all business travelers. The virus’s risks around pregnancy-related issues like miscarriages and birth defects will be top of mind for many businesswomen with travel plans to Brazil. Are employee concerns enough reason for businesses to stop travel to Brazil? Turning to authorities such as the CDC—and its recent travel advisory urging women who are pregnant or thinking of becoming pregnant to avoid travel to places like Brazil—provides a compelling reason for business leaders to consider more flexibility.

While women’s apprehensions around Zika seem obvious, the rising concern of the virus being transmitted sexually means that men with pregnant partners, or partners who may become pregnant, also have reason for concern. Notably, the CDC has issued warnings specifically for men traveling to locations like Brazil, which is another reason for businesses to give deferral of travel by men further consideration.

Duty of Care

As part of a company’s Duty of Care—the legal obligation to protect your employees from any reasonably foreseeable harm—your employees’ concerns around the Zika virus should be taken seriously. The virus is a new obstacle for businesses, and its risks require new approaches before any business travel to Zika-affected areas. Through proactive education, there are appropriate and responsible ways organizations can consider responding to the virus that are aligned with their legal and ethical responsibilities to their employees and their business. Organizations should consider meetings with all employees to discuss the virus and the health risks the virus imposes for travel.

If Travel is Necessary

While the symptoms of the virus – which are generally mild – are not immediately life-endangering, it is a good precaution to ensure employees are aware of resources such as doctors or hospitals in the areas where they are traveling. With special events like the Olympics, business leaders can also look into potential resources that are developed to help provide backup services for Rio during the Games. In preparation, Brazil is expected to invest $3.7 million in projects that include improving the medical infrastructure. These are investments that can benefit business travelers, if they have are made aware of them.

As there is no vaccine for the virus, organizations should share protection methods, including:

  • Avoid mosquitos and limit outdoor activities, especially from dawn until dusk when the Aedes aegypti mosquito is most active
  • Stay in accommodations with properly air-conditioned rooms. Netting for beds can also go a long way in protecting against the virus
  • Avoid unnecessary skin exposure by wearing long sleeves and pants
  • Purchase the correct insect spray—specifically those that contain DEET, picaridin, oil of lemon eucalyptus or IR3535

Embracing Flexibility

A sound approach includes weighing the risks and rewards of travel to Brazil and other Zika-affected areas. Where possible, be flexibile. For example, if your organization has employees based permanently in Brazil, or local partners, leverage them for any work that needs to be done in person to reduce the risks of sending additional employees to Zika-affected areas. There are also easy, technology-driven solutions, such as video chats or teleconferences. Be creative in your travel risk management solutions and identify which methods work best for your organization. Building your risk management program from a solid base of proactive education helps empower employees to make informed decisions regarding their travel plans to locations affected by Zika.

For more on this topic, check out our May feature in Risk Management Magazine.

Lessons From Ebola: Boosting National Preparedness for Pandemics

NEW ORLEANS—At the first day of the International Disaster Conference and Expo (IDCE), one of the primary topics of areas of concern for attendees and speakers alike was the risk of pandemics and infectious diseases. In a plenary session titled “Contagious Epidemic Responses: Lessons Learned,” Dr. Clinton Lacy, director of the Institute for Emergency Preparedness and Homeland Security at Rutgers, focused on the recent and ongoing Ebola outbreak.

While only four people in the United States were diagnosed with Ebola, three of whom survived what was previously considered a death sentence, government and health officials cannot afford to ignore the crisis, Lacy warned.

“This outbreak is not just a cautionary tale, it is a warning,” Lacy said. “Ebola is our public health wakeup call.”

A slow start by the Centers for Disease Control, inadequate protective gear in healthcare facilities, and inadequate planning for screening quarantine and waste management were some of the key failings in national preparedness for Ebola. And all were clearly preventable. A significant amount has been done to improve preparedness, Lacy said, but there is still a significant amount yet to do as well.

Among the issues to be addressed, Lacy pointed to:

Lacy Pandemic Preparedness

Some of that improvement must come from the top. Funding has been cut for healthcare facilities nationwide, as has money for the Hospital Preparedness Program, operated by the CDC. Other solutions can be carried out at both a national level and among individual healthcare facilities, including:

Lacy Solutions

Ultimately, Lacy said, the concern is not about Ebola—it’s about the new and emerging diseases that could prove even more catastrophic. Dozens of diseases have been discovered emerging in nature, and we have no previous contact with them, meaning we have no immunity. Further, the risks of reemerging illnesses and synthetic bio threats that any graduate student or doctor of biology could make in a lab pose a significant danger that must be prepared for now.

“Public health infrastructure is like fire departments—you can’t just fund them when there are fires,” Lacy said.

Lloyd’s Underwrites Ebola Indemnity Coverage

A new class of insurance is now being offered to address the occupational hazards faced by healthcare workers and first responders who are in jeopardy of contracting blood-borne pathogens such as Ebola, HIV, Hepatitis B and Hepatitis C.

Underwritten by Lloyd’s of London and distributed by Specialty Insurance Advisors, Essential Professional Insurance Coverage (EPIC) is the first such indemnity coverage available to individuals, including administrators who check in patients, doctors and nurses treating patients and patrolmen and women responding to 911 calls. The coverage goes beyond workers compensation and disability insurance to protect these individuals, EPIC said.

According to the Occupational Safety and Hazards Association (OSHA), up to 800,000 needle sticks occur each year, of which 16,000 are likely to be contaminated with HIV. The risk of acquiring Hepatitis B or C from a needle stick is even higher than HIV.

EPIC President Richard Kosinski said in an online interview with Fox Business, “We provide the ability for a health care worker or law enforcement professional to buy very inexpensive coverage in the event they get infected with Ebola, HIV or Hepatitis B or C. For a nominal amount of $269 per year they can get $200,000 of coverage if the worst case happens and they get infected with Ebola or some other type of blood pathogen.”

While the coverage has been available for more than a year, primarily through unions, to large health care hospitals and other institutions, “We have just announced the ability for an individual to buy a policy,” Kosinski said. Centinela Hospital Medical Center in Inglewood, California was one of the first hospitals in the United States to offer EPIC to its healthcare workers, and the first to add Ebola infection coverage, according to EPIC.

The plan provides a safety net that can help defray some of the costs, Kosinski explained, adding that otherwise, “No one is going to pay the cost for the average health care worker to be flown by a private jet to a specific CDC facility to get Ebola care.”

How is it possible to write this coverage? “Because this is Lloyd’s of London, which has a 500 year history of writing specialty risks,” Kosinski said. “We understand the risk, how to price it correctly and how the claims will be paid out.”