Preventing and Containing Outbreaks of Flu and Other Illnesses in the Workplace

This tookit provides a roadmap for managing outbreaks of flu and other diseases in the workplace by::

• Preparing for the threat of an epidemic through business continuity planning.
• Implementing measures to prevent the spread of flu.
• Taking steps to keep employees healthy throughout flu season.
• Executing management strategies to optimize business operations.

Planning for Business Continuity

A business continuity plan details how an organization will recover interrupted critical business functions after a disaster or disruption, such as a flu outbreak. If no business continuity plan exists, employers should start developing one for a worst-case scenario during an epidemic. Here’s how to get started:

A crisis such as a flu outbreak or COVID-19 pandemic can precipitate confusion, and even panic, among employees and managers. Armed with a business continuity plan, leaders can respond in an orderly, rational way; make decisions based on predetermined guidelines; and allocate resources ahead of time. By planning ahead, employers may be able to reduce the impact of an outbreak on their employees and their business, as well as costly public relations issues.

Health-Related Considerations

An employer’s business continuity plan should acknowledge the possibility that a large portion of their workforce will be unable to work during the flu season. The plan should answer the following questions:

• How many absences can we handle before business operations are interrupted?
• How do we keep operations running during an interruption?
• What changes can we make to keep the business operating effectively?

Employers may need to review, modify or even create policies and communicate any changes accordingly, whether they are temporary or permanent.

Member Resource: How to Handle Communicable Diseases In the Work Place

Labor Relations Considerations

Employers with unionized workforces should closely review their collective bargaining agreements to determine whether special provisions apply in the event of a disruption of business operations. For example, some agreements may have provisions that provide paid time off to union workers in the event of an emergency when employees are prohibited from reporting to work. 

Preventive Measures to Prevent the Spread of Flu

Employers can use various preventive measures to limit the effect of flu and other illnesses on the workplace.

Limiting the Spread

Many common preventive measures are fairly inexpensive and easy to implement. Employers can educate employees on proper handwashing and what to do if they develop flu-like symptoms. One way to do this is hang posters in bathrooms and eating areas that communicate the proper way to stop the spread of germs. Depending on the industry and employees' proximity to one another and the public, an employer can also provide respirators or masks to employees. The Centers for Disease Control and Prevention’s (CDC’s) Flu Resource Center and Respiratory Virus Guidance have additional resources.

Vaccinations

A vaccination program can be one of the best ways to control the spread of the flu and COVID-19 in the workplace. However, employers should not mandate that employees get vaccinated, due to the Americans with Disabilities Act (ADA) and other laws. Only in certain industries, such as health care, are mandatory vaccines essential for both employee and patient safety. 

Even in industries in which flu vaccinations are not mandatory, employers can strongly urge employees to get flu shots and provide incentives such as:

• Paid time off to get the flu shot.
• Providing the flu shot free to employees, families, partners and kids.
• Reimbursing employees for the cost of the flu shot.
• Hosting a flu shot clinic.

Member Resources: Infectious Disease Control Policy, Communicable Diseases Policy

Screenings

A screening program can include providing free testing to employees who are exhibiting symptoms of the flu and requiring employees returning from high-risk areas to stay home for a predetermined amount of time to ensure they don't develop flu-like symptoms.

As part of a screening program, employers should consider how to handle employees who have not contracted the flu but have been exposed, such as an employee staying home to care for a sick child or spouse. The employer's response may include requiring testing before employees return to work or requiring these employees to self isolate until the incubation period has passed. The CDC offers guidance on prevention strategies in healthcare settings.

Keeping People Healthy Throughout Flu Season

Your primary goal throughout flu season should be to ensure that employees remain healthy and that business operations are affected as little as possible. If operations are severely limited, focus on resuming them safely and quickly.

To keep the workforce healthy, organizations can do the following:

• Send symptomatic employees home.
• Implement quarantines for employees returning from high-risk areas.
• Limit face-to-face meetings.
• Allow for telework.
• Temporarily shut down operations.

Pregnant women, individuals 65 years of age and older, and individuals with certain chronic health conditions are at higher risk for developing flu-related complications, according to the CDC. Employers may wish to take additional steps to ensure the health and ongoing work of these employees by providing information and vaccination and screenings. 

Benefits Considerations: Review Leave Policies

With certain legal exceptions, employers are free to establish their own paid leave benefits and administer them accordingly. Employers should review their existing paid leave policies before an epidemic strikes to determine whether modifications should be made. Questions to ask include:

• How will we handle "excessive" absences related to employee illness?
• How does our current policy accommodate family illnesses?
• What is our paid leave policy in the event of a school or child care facility closing?
• During an epidemic, will we still require the same level of leave substantiation (e.g., doctor's notes) that we normally require?
• Is the implementation of flexible leave policies an option—even if temporary?
• How will we address employee absences related to obtaining vaccinations for themselves and their family members?

Eligible employees may need to use Family and Medical Leave Act (FMLA) leave. Employers should prepare for an increase in FMLA leave requests during flu season and coordinate compliance among FMLA, ADA, and paid leave laws.

Compensation Considerations

Employers must decide whether to pay employees during health-related absences. If pay is provided, the next question to address is, at what point does the employer stop paying the employee when the employee is not performing work. Sick leave policies, FMLA, disability insurance, and federal, state, and local laws all play a part in the sick-leave compensation equation.

The Fair Labor Standards Act (FLSA) is the cornerstone of wage and hour law in the U.S. Employers should consider applicable provisions of this law, as well as applicable state laws, before deciding not to pay an employee for an absence. Generally, under the FLSA, hourly, nonexempt employees need only be paid for actual hours worked, unless there is a policy or practice that promises pay to employees for these types of absences. Nonexempt employees paid a salary may fall under different rules.

Key rules under the FLSA say that:

• Exempt employees must generally receive a guaranteed weekly salary regardless of the number of hours they work during the week.
• However, employers may deduct from pay for full-day absences due to sickness or disability when there is a bona fide sick-leave plan and the employee is not yet eligible for it or has already exhausted the benefit.
• Employers may not deduct for sickness absences of exempt or salaried employees when there is no sick-leave plan.
• Employers may not reduce an exempt employee’s salary for absences directed by the employer.
• If an exempt employee is directed to stay home, the employer will likely need to pay them.
• However, no pay is required for any workweek in which an exempt employee performs no work, regardless of the reason.

Employers may want to consider implementing leave donation programs.

Independent contractors and consultants can also be affected by the flu. Review contracts with these individuals and consider how to handle excessive absences or missed deadlines in case of a flu outbreak or other epidemic. Since independent contractors and consultants are not employees, the FLSA rules mentioned above do not apply.

Employee Relations Considerations

Employers will need to consider how they manage employee absenteeism. Employers with no-fault attendance policies may decide to temporarily forgo counting absences during a flu outbreak. They will need to decide how stringently to apply their rules for sick leave and unscheduled absences.

Develop a Communications Strategy

Without proper communication, during a potential epidemic, employees can become worried about their exposure to the bacteria and viruses, which affects their productivity. Employer communications should provide relevant information and encourage employees to remain calm. Keep the following in mind when drafting employee communications:

• Inform employees that the company will take any reasonable and necessary steps to ensure a safe and healthy work environment.
• Identify the biological threat, including typical symptoms.
• Include information on how to protect against getting the illness.
• Advise employees of any changes to policies.
• Notify employees of any discontinued travel.
• Ask employees with concerns to contact HR.

Protect Employee Information

When there has been a reported case of a contagious disease in the workplace, employers should not reveal the identity of a particular employee or an employee's family member. Employers can notify employees and other relevant parties that a case has been reported, in the workplace, remind employees of the company policy, and list precautionary steps suggested by medical professionals, such as the CDC or the local health department. Depending on the particular facts involved, information regarding the illness of an employee or family member may be protected under the Health Insurance Portability and Accountability Act (HIPAA), the ADA, or both. HR confidentiality is essential for protecting employee and company information.

Address Employee Refusals to Return to Work

In some instances, healthy employees may refuse to come to work due to fear of contracting a disease. In these situations, employers should:

1. Attempt to address employees’ fears and answer questions.
2. Inform them that there isn’t much legal protection for them if they continue to refuse to come to work despite your attempts to address their fears and misconceptions.

Relevant Laws: The Occupational Safety and Health Act (OSHA) generally does give employees the right to refuse to come to work under certain circumstances when the employees reasonably believe that coming to work would put them in serious and immediate danger. The National Labor Relations Act protects both nonunionized and unionized workers, when two or more employees address the employer about improving their working conditions. However, both employees and employers should consult with legal counsel before relying on either of these statutes as a reason for work absences.

Member Resource: Can an Employer Fire Workers Who Are Scared to Return to the Office?

Keeping the Business Running

After organizations establish an approach for handling workplace absences during an epidemic, the next step is to determine how to keep the business running smoothly despite high rates of unplanned absences. It is important to think creatively and be flexible during such crises and to use temporary measures that may not have been appropriate before. The following key staff should be ready to perform certain responsibilities:

• HR professionals and top management: Prepare written guidance for managers instructing them how to handle such situations.
• Managers: Provide constant communication for employees and upper management on staffing considerations.
• Senior management: Educate and empower frontline managers to make quick decisions about business operations and staffing.

Staffing Strategies

Some staffing strategies that managers may want to consider during the flu season include:

• Increasing remote work arrangements or relaxing requirements to come into the office.
• Implementing staggered shifts or other alternative work schedules so that fewer employees are in the office together at the same time.

Employers should also look to their IT departments for technology strategies that could help businesses function despite employees' inability to work together in the same room. For employees scheduled to travel to high-risk areas, alternatives to face-to-face meetings include videoconferencing, teleconferencing and webinars. Businesses may wish to use less formal technologies such as social networking platforms (e.g., X, Facebook and LinkedIn) and free instant messaging services to enable employees to communicate with one another quickly while working miles apart. If these staffing strategies fail to keep operations at full capacity, the organization should start thinking about how to operate at a reduced capacity.

Business Recovery

Once an outbreak has ended and business begins to return to normal, employers  ensure a seamless transition from emergency operations back to normal ones. The first step is communicating. Organizations should notify employees that any policies or rules that were temporarily lifted, added, or changed to accommodate the  disease outbreak are no longer in effect. In addition, employees should be reminded about what the normal operating policies are and when they will return.