Dear Mayor:

In an effort to provide public and private healthcare workers with safety guidelines for caring for patients with pandemic influenza (of which avian influenza is one type), the Department of Labor’s Occupational Safety and Health Administration (OSHA) last week released “Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers.”

The publication provides the private and public healthcare system with a broad set of guidelines on how to treat patients suspected of having pandemic influenza, as well as strategies for insuring the health and well-being of healthcare workers. Among the recommendations is adherence to many of the standard precautions associated with communicable diseases as well as more specific recommendations designed to address the specific ways that pandemic influenza may be spread.

The guide, which was not released as a standard or regulation, and therefore does not have the force of law, was designed for both the lay person and professional.

The publication describes how a pandemic influenza virus presents itself in patients, appropriate testing and diagnostic procedures and the most likely circumstances under which transmission is possible.

It also provides information on the methods of transmission and the precautions that should be taken by healthcare workers and their employers to limit its transmission, from standard recommendations considered normal to prevent the transmission of any communicable disease, to facility design, administrative controls, vaccination, resource stockpiling and workplace practices.

Specific workplace practices recommendations include designating essential workers; granting managers and planners with worker protection authority; and cross-training staff in a variety of functions to ensure that the likely prevalence of absent workers will not undermine the overall delivery of healthcare services. The guide also provides surveillance protocols, describes the importance of psychological support for workers, and urges healthcare employers to develop facility security plans.

Noting that immunity from most pandemic versions of influenza will be very limited among the general population, the guide urges healthcare workers and their employers to be acutely aware of the various approaches to treating the disease and protecting workers who come in contact with patients. Potential methods of exposure, including direct contact with patients or transport of influenza specimens, are discussed, as are the precautions that should be taken.
In a rather detailed set of appendices, OSHA provides protocols to be followed to ensure appropriate outpatient and inpatient management control; recommended guidelines for healthcare and patient self-triage and home care; references for diagnosis and treatment of clinic or hospital staff during an influenza pandemic; a planning checklist and example plans including specialized staff training; risk and crisis communication resources; and a sample supply checklist.

Very truly yours,

                                                                        William G. Dressel, Jr.
                                                                        Executive Director