Learning from Ebola
In light of the recent Ebola scare, employers might be well-served to revisit their policies and procedures-and prepare in advance for the next potential epidemic.
By Carol Harnett
Writing this column has inspired me to consider most news-related events from an HR executive's point of view. I've covered the impact of severe snowstorms, Superstorm Sandy and the Sandy Hook Elementary School shootings on employees and their companies.
Not surprisingly, the availability of employee-assistance programs was one strategy employers activated in all three situations, and the use of telework arrangements aided business-continuity plans for some employers in the first two crises.
Now, HR leaders are dealing with Ebola - or at least were a few weeks ago -- and its unique question set, including what businesses would do in the event of an epidemic and potential required quarantines:
· Should employees who traveled to and/or volunteered in West Africa be required to stay home for 21 days upon their return? And, if not required to do so by the government, should the employer compel those employees to stay away from the workplace?
· If employees are quarantined, or are kept away from work without symptoms, should they be paid by the employer? Or, should the employer only compensate employees who were in West Africa due to work commitments -- not volunteer-related activities?
· If an employee is diagnosed with Ebola, should the employer go outside its health-insurance-plan provisions and pay for experimental treatments that could potentially save the employee's (or family members') lives?
· What if the United States was hit with a true Ebola epidemic? How would business continue? Should companies that don't have telework policies revisit them? Or should remote work arrangements be expanded?
As the media noise and gratuitous headlines died away, so did the questions. And, as might be expected, many HR executives returned to issues that needed their immediate attention.
Over the years, I've witnessed similar fire drills around other viruses: mad cow disease, avian influenza A / H5N1 / SARS and swine flu / H1N1 just to name a few. In each instance, we debated comparable issues around quarantine, paying employees who were placed in quarantine (or whose children were placed in quarantine, or who were sent home because the school closed), paying for experimental treatments and business-continuity issues, including remote work policies. Rarely, have I witnessed employers create standing policies and procedures around epidemic/pandemic and quarantine following this type of crisis.
Since the most thoughtful decisions are made when people are calm, now is the best time to address the topic. And a great place to fuel a HR leader's thought process may come from employers that currently have workers in West Africa.
Education. An education policy should be the first step in any epidemic policy. Both the Centers for Disease Control and Prevention and the World Health Organization are reliable sources and willing partners for employers.
As I watched Americans' reactions to the Ebola cases on home soil, I was reminded of the risk-communications consultant, Peter Sandman's, formula: Risk = Hazard + Outrage.
Risk -- and people's understanding of risk -- falls into two components: (1) hazard represents the technical component of risk, or how dangerous something is (or is not); and (2) outrage is the social component of risk or how upsetting a situation is to the individual or population. While we need to manage the actual hazard, we also have to manage employees' outrage. As Sandman counsels, managing outrage may mean getting people more upset if the hazard is high, or getting people less upset if the hazard is low.
In the case of Ebola, we missed the opportunity to reset people's misplaced outrage. The tag line "Ebola is highly infectious, but not highly contagious" didn't seem to resonate with people.
NPR created a great graphic based upon an interview with the CDC Director Dr. Tom Frieden. The picture correctly portrayed the real hazard of Ebola in the context of other diseases, but most companies didn't take advantage of this clarifying visual. Nor did they share the YouTube video created by rapper/physician ZDoggMD, which presented the facts around Ebola to a parody of The Kinks' song, Lola.
Travel. A non-essential business travel ban to areas affected by a virus is also a key initial step. Most employers with operations in West Africa, however, didn't limit personal travel. Some companies requested employees report personal travel or mission work to the endemic area.
Quarantine. In my experience, quarantine and the ensuing questions about salary are the most angst-filled debates around an epidemic. On the one hand, employers often want to err on the side of caution when it comes to worker safety -- leading to a desire for employees to remain home while self-monitoring. But many stories were reported about the misguided shunning of people perceived to be at risk for contracting the Ebola virus - reminiscent of the HIV/AIDS crisis.
As an HR executive, you need to help your company decide how the business is going to compensate employees who are quarantined. Standing policies for the use of sick time, vacation or paid-time-off provide adequate financial coverage for people who are ill when quarantined. They can also transition to your short- or long-term disability policy once they've satisfied the waiting period (if your company has a disability policy in place).
The bigger question is how to handle employees who are quarantined -- or asked to self-quarantine -- when they have no symptoms of the virus or disease. Companies with a West African presence decided to pay the workers they requested to self-monitor for 21 days. And Governor Cuomo indicated New York state would pay people whose companies did not compensate them while in quarantine.
Employees who are not sick -- yet are asked to remain home -- are not eligible for sick time or short-term disability. So it is important to decide, before the issues of potential epidemic and quarantine come up again, how your company will address compensation. Some employers claimed no financial responsibility for employees who chose to volunteer in West Africa as part of a medical mission. If a company believes this is the correct course of action, its quarantine policy should state this.
Medical Treatment. On Monday, Ebola took the life of Dr. Martin Salina, a U.S. legal permanent resident. Other Americans who contracted the virus have thankfully recovered. In each case, the treatment they received could be qualified as experimental and would not be covered by many health insurance plans. Before the next medical crisis arises, companies should establish whether the health plan will cover experimental treatments related to epidemics.
Remote work/Telework. My column on Superstorm Sandy gave specific advice on how to develop or expand a telework program. In addition, the CDC developed guidance for businesses and employers on how to address the 2009 - 2010 influenza season.
If a company decides to increase its reliance on telework during an epidemic, it should lay out the policies and procedures in advance, and also test the feasibility of this approach through crisis management simulations. This approach allows businesses to test the gaps between the strategy development and execution in advance of the next epidemic.
Health organizations are cautiously monitoring whether the Ebola virus will be contained in West Africa, and dealt with quickly when it "sparks" in other countries. In the interim, companies that value business resilience will prepare in advance for the best ways to respond when an epidemic threatens their employees and their organizations.
Carol Harnett is a widely respected consultant, speaker, writer and trendspotter in the fields of employee benefits, health and productivity management, health and performance innovation, and value-based health. Follow her on Twitter via @carolharnett and on her video blog, The Work.Love.Play.Daily.