This colorized negative stained transmission electron micrograph (TEM) depicts some of the ultrastructural morphology of the A/CA/4/09 swine flu virus. Photo courtesy of CDC Library.

WASHINGTON—Federal agencies must take appropriate measures to protect employees on the job from the H1N1 virus, Senate members told federal officials last month. “The activities of agencies critical to Americans’safety, health, and well-being cannot be allowed to stop during a pandemic…neither can we endanger the dedicated men and women who carry out those duties,” said Sen Daniel Akaka, D-Hawaii, who chaired a Senate subcommittee hearing on the efforts of federal agencies to prepare for a pandemic.

The World Health Organization declared the spread of H1N1 a pandemic. Senator Akaka said that he was concerned that agencies have not adequately communicated their pandemic planning and policies with their employees. This will be especially critical if H1N1 returns in a more potent form in the fall, he said. “There must be clear guidance to federal employees regarding employees’rights to protect themselves in the workplace,” he said.

A General Accountability Office report released June 16 surveyed 24 agencies in early 2009, prior to the H1N1 outbreak. It estimated that during a pandemic, about 40% of the workforce would be unable to work because of illness, the need to care for ill family workers, or fear of an infection.

While worker protection strategies are crucial to sustain an adequate workforce during a pandemic, the report stated that agency progress in pandemic planning is “uneven.” Several agencies reported that they were still developing their pandemic plans and measures to protect the workforce. “Some agencies are not close to having an operational pandemic plan, particularly at the facility level,” Bernice Steinhardt, GAO’s director of strategic issues, told the subcommittee.

Protecting Against Influenza in the Work Place

Rear Admiral W. Craig Vanderwagen, MD, assistant secretary for preparedness and response at HHS, told the subcommittee that it is critical that employers encourage sick workers to stay home and away from the workplace. He also said federal workers should take precautions like covering coughs and sneezes and frequent hand washing to reduce the spread of influenza in the workplace. HHS has provided workplace guidance for federal employees during a pandemic at www.pandemicflu.gov and www.cdc.gov. The US Office of Personnel Management is working to expand the use of telework strategies in the federal government to protect employees from H1N1, according to Nancy Kichak, who testified on behalf of the US Office of Personnel Management. Telework can help mitigate the spread of influenza by promoting social distancing, she explained. “The H1N1 flu outbreak has demonstrated the importance of being able to quickly expand the use of telework to cope with pandemic health crises and other emergencies,” she said.

Telework arrangements will not work for all jobs during a pandemic, however. According to the GAO report, 19 of 24 agencies said they had essential functions that cannot be continued through telework in the event of a pandemic. Five agencies were still working on a telework analysis at the time of the GAO report.

Senator Akaka wanted to know how federal jobs will be handled that cannot be done by people who use telework arrangements, like those of federal air traffic controllers.

Doctor Vanderwagen conceded that this is “challenging” and is an issue also facing Indian Health Service medical facilities and the NIH clinical center where health care must continue to be provided. “Business managers have to look at what is absolutely required in order to maintain a level of care. If they need to back away from elective surgeries for instance…it is an analysis of what is needed for a period of time in order to continue functioning,” he said.

Jobs like air traffic controllers, and those in prisons where prisoners will continue to need to be supervised during a pandemic, will be difficult because “there is no way to back off the service you provide,” he added. “Those are going to be extremely dicey situations,” he said.

Protective Gear

T. J. Bonner, president of the National Border Patrol Council of theAmerican Federation of Government Employees, expressed concern about the ability of federal employees who are in close contact with the public to wear N95 respirators to protect themselves from H1N1.

DHS guidance, for example, requires employees to wear a N95 respirator if they are within 6 feet of someone known or suspected to be infected with the H1N1 virus. However, custom and border patrol employees, among others federal workers, are in daily contact with travelers who they may not know or suspect have H1N1. These workers may not realize a traveler is infected, Bonner said. “When someone sneezes in your face when you are inspecting them as they come into the country or going through an airport, it is simply too late because you have been exposed,” Bonner said. “In the United States, we seem to have this phobia about people with masks—a protective measure that people should be glad to see.”

It is not certain that N95 respirators are effective in protecting people from H1N1, according to federal officials. “There is no particular scientific evidence that says that putting on a surgical mask is effective in preventing various contaminants,” Dr Vanderwagen said. “We are funding additional research with OSHA through the National Institutes of Occupational Safety and Health to see if we can find a much better scientific answer.”