In a national survey of businesses that looks at their preparations for a possible widespread H1N1 outbreak, Harvard School of Public Health (HSPH) researchers found that only one-third believe they could sustain their business without severe operational problems if half their workforce were absent for two weeks due to H1N1 (also known as "swine flu"). Just one-fifth believe they could avoid such problems for one month with half their employees out.
The survey also found that while 74% of businesses offer paid sick leave for employees, only 35% of businesses offer paid leave that would allow employees to take care of sick family members, and even fewer would allow paid time off to care for children if schools/daycares were closed (21%).
The survey is part of an ongoing series about the country's response to the H1N1 flu outbreak undertaken by the Harvard Opinion Research Program at HSPH. The polling was done July 16-August 12, 2009.
"Businesses need to start planning how to adjust their operations to account for greater absenteeism and to slow the spread of H1N1 in the workplace," said Robert J. Blendon, Professor of Health Policy and Political Analysis at HSPH.
Likelihood and Impact of Serious Outbreak
Just over half of businesses in the U.S. (52%) believe there will be a more widespread and more severe outbreak of novel influenza A (H1N1) in the fall. If such an outbreak does occur, 84% of firms are concerned that it will negatively affect their business.
One key reason that businesses may be concerned is that they have a limited ability to maintain operations successfully if a significant portion of their workforce is absent due to an outbreak of H1N1. Only a third of businesses believe they could avoid having severe operational problems for 2 weeks if 50% of their workforce were absent due to H1N1; less than a quarter (22%) of firms believe they could do so for a month. In general, more small businesses believe they would be able to avoid having severe operational problems with a reduced workforce as compared to large businesses. For example, small business are more likely than large businesses to say they could avoid having severe operational problems for 2 weeks if half their workforce were absent (40% vs. 27%), or to avoid having severe operational problems for a month if half their workforce were absent (27% vs. 18%).
Policies Affecting Employees in the Event of an H1N1 Outbreak
Leave Policies. Currently, three-quarters (74%) of businesses offer paid sick leave for at least some employees. Fewer offer paid leave that would allow employees to take care of sick family members (35%) or to take time off to care for children if schools/daycares closed (21%). Small businesses are less likely than medium or large businesses to offer paid leave for taking care of sick family members (27% vs. 40% and 43% respectively).
"Looking ahead, a critical issue will be that employees who must take care of children if they are sick or if schools and daycares close this fall may face financial troubles. Flexibility from employers can help," said Blendon.
About one in 10 businesses (12%) made changes to their employee policies after the spring outbreak of H1N1. However, few businesses that do not currently offer leave anticipate adding new leave policies in the wake of a more severe outbreak this fall. For example, only 6% of those who do not offer sick leave expect they will begin offering it if there is a serious outbreak. A minority of businesses currently offering leave to their employees believe they will enhance their existing leave policies by extending them to more employees or increasing the amount of time available if there were a serious outbreak. For example, 18% of firms offering sick leave expect they would increase the number of employees who have sick leave, and 29% expect they would extend the amount of sick time employees can take if there were a serious outbreak.
A Note from the Doctor. In a widespread outbreak, many people may have problems getting to see a physician due to the number of sick individuals. This may pose a challenge for workers whose employers have policies requiring a note for absences or for returning to work after an illness. Nearly half of businesses that offer sick leave (43%) currently require a doctor's note to take that leave. More than two-thirds of businesses that offer sick leave (69%) require a doctor's note to return to work after contagious illnesses. Small businesses that offer sick leave are less likely than large businesses that offer sick leave to require a doctor's note to stay home (33% vs. 50%) or return to work (60% vs. 75%). Few businesses report that they are likely to change their policies in the event of a serious outbreak. Only 10% of those that currently require a doctor's note to stay home and 10% of those that require a note to return to work after a contagious illness predict they will no longer do so in the event of a serious outbreak.
Strategies to Slow the Spread of the Illness if the Outbreak Becomes More Severe
One of the approaches to slowing the spread of the H1N1 virus if it becomes more severe is to encourage businesses to adopt strategies to limit contact between employees and between employees and customers. If these policies were recommended, many businesses would face serious problems in implementing them for long periods of time. Roughly half of businesses could make changes for at least 1-2 weeks before they ran into significant problems. For example, almost six in ten (59%) could stagger shifts in order to increase distances between people at the business site and on mass transit for at least 1-2 weeks; 42% could stagger shifts for more than 4 weeks. Fewer businesses could physically rearrange their workspace to reduce contact between employees (44%) or between employees and customers (42%) for at least 1-2 weeks. Only a quarter (26%) of businesses could keep up such a strategy for more than 4 weeks.
Getting Information for Planning
Businesses report being interested in learning more about how to support their business and employees in a serious outbreak. Interest is highest for information about keeping employees safe (77%), coping with a reduced workforce (59%) and planning for supply interruptions (59%).
Information for businesses about H1N1 flu planning is available at the following websites supported by the Department of Health and Human Services:
This poll is the fourth in a series of polls about the way that Americans and their institutions are responding to the H1N1 flu outbreak. Previous polls focused on the American public.
This study is part on an ongoing series on the public and biological security by the Harvard Opinion Research Program (HORP) at Harvard School of Public Health. The study was designed and analyzed by researchers at the Harvard School of Public Health (HSPH). The project director is Robert J. Blendon of the Harvard School of Public Health. The research team also includes Gillian K. SteelFisher, John M. Benson, and Kathleen J. Weldon of the Harvard School of Public Health, and Melissa J. Herrmann of SSRS/ICR. Fieldwork was conducted via telephone (including both landline and cell phone) for HORP by SSRS/ICR of Media (PA) July 16-August 12, 2009.
The survey was conducted with a representative sample of Human Resources personnel at 1,057 businesses across the United States selected using randomization. It included samples of small (20-99 employees); medium (100-500 employees); and large (>500 employees) businesses. In addition, it included samples of businesses designated as Critical Infrastructure and Key Resource (CIKR) institutions according to the Department of Homeland Security's general categories. The total sample included 180 small CI/KR and 173 small non-CI/KR businesses; 179 medium CI/KR and 177 medium non-CI/KR businesses; and 171 large CI/KR and 177 large non-CI/KR businesses. In the overall results, these groups were weighted to their actual proportion of businesses in the United States.
The margin of error for the total sample is plus or minus 4.2 percentage points. Possible sources of non-sampling error include non-response bias, as well as question wording and ordering effects. Non-response in telephone surveys of businesses may produce biases in survey-derived estimates if participation varies for different types of businesses. To compensate for this potential, sample data are weighted to the most recent data available from the Dunn and Bradstreet national databases of business listings for size, CI/KR status, and industry. Other techniques, including randomized sample selection, replicate subsamples, and varied call times are used to ensure that the sample is representative.
This Harvard School of Public Health series is funded under a cooperative agreement with the Centers for Disease Control and Prevention. The award enables HORP to provide technical assistance to the Centers for Disease Control and Prevention (CDC) as well as to other national and state government health officials in order to support two critical goals: (1) to better understand the country's response to public health emergencies, including biological threats and natural disasters; and (2) to improve related public health communications.
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