RADM W. Craig Vanderwagen, M.D.
Assistant Secretary for Preparedness and Response
U.S. Department of Health and Human Services
HHS’ Efforts to Provide Science-based Pandemic Influenza Guidance for the U.S. Workforce
Committee on Homeland Security and Governmental Affairs
Subcom. on Oversight of Government Management, the Federal Workforce, and the District of Colombia
United States Senate
Tuesday June 16, 2009
Good morning Chairman Akaka, Member Voinovich and members of the Subcommittee. I am RADM W. Craig Vanderwagen, MD, the Assistant Secretary for Preparedness and Response (ASPR) at the Department of Health and Human Services. In this capacity, I have served as one of the HHS leads on pandemic influenza preparedness and response planning. I appreciate this opportunity to discuss the vital role of science-based guidance for the protection of workers, including Federal, during an influenza pandemic.
As the United States Governmental lead for public health and medical response, HHS is committed to providing current guidance based on the best available scientific evidence. During public health emergencies like the current 2009-H1N1 influenza outbreak, protecting workers, including federal workers, is a top priority. HHS, through the Centers for Disease Control and Prevention (CDC), and in coordination with the Department of Labor’s Occupational Safety and Health Administration (OSHA), provides guidance for workplace protection on the comprehensive Federal website, www.pandemicflu.gov as well as www.cdc.gov, and continues to update that guidance as new evidence emerges.
In 2007, HHS released Community Mitigation Guidance, whichincluded specific planning recommendations for aligning business practices with public health protection interventions. The document provides clear steps an employer can take to potentially slow the spread of pandemic influenza, help keep workplaces safe, and reduce the number of people who become sick. To that end, we identified important, specific activities large businesses can do to prepare-- things that will also apply to other emergencies. These include strategies for ensuring business continuity if there are high rates of absenteeism during a pandemic, steps to take to reduce the impact of a pandemic on employees and customers; policies to be implemented during a pandemic; allocation of resources to protect employees and customers during a pandemic; communicating and educating employees; and coordination with external organizations and the communities in which they operate.
HHS guidance for business continuity and workplace protection has been directed to the entire business and employer community. The fundamentals of achieving a safe workplace and operational continuity are the same for government and non-government employers. The private sector has an important role to play in preparing for, responding to, and recovering from a pandemic. The private sector owns and operates over 85 percent of the critical infrastructure in the United States, and therefore represents an integral part of our society because of the critical goods and services that it provides. As early as 2005, HHS issued a planning checklist for large businesses to guide their efforts to plan for an influenza pandemic. In this Checklist, we highlighted that, in the event of an influenza pandemic, businesses will play a key role in protecting employees' health and safety as well as limiting the negative impact to the economy and society.
HHS guidance related to 2009-H1N1 influenza is based in sound public health principles and adapted from existing guidance on pandemic influenza preparedness and response. More specifically, the response to a pandemic is tailored to pandemic severity. Therefore, earlier this spring, when uncorroborated reports of death and severe illness from 2009 H1N1 were emerging from outbreaks in Mexico, HHS/CDC took a precautionary approach to guidance, while sending teams of public health and medical investigators to work with Mexican health authorities to better understand the epidemiology of this novel virus including aspects such as severity and transmissibility/infectiousness. As our understanding of the characteristics of this novel virus evolved, we have refined our guidance – and expect that will continue to be the case as we monitor the situation in the United States and around the world of the H1N1 outbreak.
An increase in the scientific understanding of the 2009 H1N1 virus and the events this spring allowed us to develop, evaluate and alter guidance. For example, our guidance on testing of clinical samples was altered based on new information about the severity of illness and based on practical considerations, including the availability of diagnostic tests. CDC released guidance related to dismissal of students from school (school closure) and later updated this guidance based on new information about the level of severity of disease, disease transmission and secondary attack rates. This spring, a CDC Travel Health Warning for Novel H1N1 Influenza in Mexico was issued on April 27th recommending against non-essential travel to Mexico, and on May 15 that recommendation was downgraded to a Travel Health Precaution for Mexico as the risks to travelers to Mexico became clearer. By grounding our guidance in scientific evidence, as our mission requires, we provide the best possible information in order to effectively respond to, and minimize the impact of, community outbreaks of this novel influenza virus.
HHS, working closely with our Federal partners and other stakeholders, has developed guidelines, including the previously mentioned checklists, to assist businesses, industries, and other employers in planning for an influenza pandemic. As part of the HHS response to 2009 H1N1 influenza, HHS/CDC has contributed efforts specifically directed to federal workers, including the following:
- One of our best measures for reducing the spread of an outbreak of a novel influenza virus is to encourage sick people to stay home while they are contagious. HHS employees and contractors have been notified that if they are ill with symptoms of influenza (fever and cough or sore throat), they are to stay home and seek medical care if needed.
- HHS has addressed national health needs associated with preventing the spread of H1N1 flu virus by providing information to workers and employers. During this H1N1 outbreak HHS has provided technical guidance for health-care, transportation and postal workers, for whom questions about exposure or infection may be an occupational concern. HHS posted a guidance document entitled General Business and Workplace Guidance for the Prevention of Novel Influenza A (H1N1) Flu in Workers to assist Federal and non-Federal employers in protecting their workforce.
- HHS has provided consultation to Federal Agencies that have employees who have close contact with persons ill with pandemic influenza as part of their occupations. In alignment with the Department of Labor’s OSHA Pandemic Influenza Risk Pyramid, which arrays the risk of exposure to a pandemic virus by type of contact with ill persons, HHS has produced guidance for health care workers regarding use of strategies including personal protective equipment when caring for patients who have H1N1 (CDC Interim Guidance for Infection Control for Care of Patients with Confirmed or Suspected Novel Influenza A (H1N1) Virus Infection in a Healthcare Setting) and for workers and the general public in other community settings (CDC Interim Recommendations for Facemask and Respirator Use to Reduce Novel Influenza A (H1N1) Virus Transmission). This guidance continues to be reviewed as information about the risk of H1N1 is gathered.
- HHS has led by example and shared with other Federal agencies information about the practices we use in various worksites to protect our workforce. For example, HHS has provided guidance to the U.S. Navy on how to clean its ships to avoid spread of the 2009-H1N1 influenza virus, and has shared with the U.S. Northern Command guidance used by the CDC Emergency Operations Center to protect CDC′s own employees during this outbreak. HHS has provided guidance, using best available scientific information, to the U.S. General Services Administration that the odds of transmission of the 2009-H1N1 influenza over significant distances through heating, ventilation, and air conditioning (HVAC) systems was extremely remote and that special cleaning of air ducts is not required.
- In collaboration with DHS, HHS has hosted a number of outreach efforts to employers including large teleconferences, to provide key information that employers can use to protect their workforce and ensure business continuity during the H1N1 outbreak. Over 3,000 business representatives have participated in a series of five teleconferences held since April 30, 2009.
- We believe that this guidance is an important resource to employers in order to maintain a safe workplace for a healthy workforce. During the H1N1 outbreak it is critical that employers encourage sick workers to stay home and away from the workplace. HHS has encouraged employers to re-examine their human resources policies to allow sick workers to stay home. Simple measures, such as covering coughs and sneezes and frequent hand washing, remain effective means of reducing the spread of influenza in workplaces and in the community and can help ensure safe workplaces and a healthy workforce beyond this new influenza virus.
In our commitment to improve the health and safety of all Americans, we are dedicated to the principle that the best policies for health and safety are based on the best available science.
At this time I conclude my remarks. I welcome your comments or questions.
Last revised: April 19, 2011