HEALTH INCIDENT PLANNING

Infectious Disease and the Workplace

Presenter: Dr Andrew Ebringer, International SOS

AAMIG Member Seminar

Minespace, 2nd July 2015

2 2 2 2 2

Africa Health Risk Map 2015

Medical Care

Vaccinations

Food & Water Quality

Disease Risk

Risk of Malaria

Risk of Rabies

3 3 3 3 3

Risk of medical evacuation for international assignees and

travellers is 20 times greater in High Risk countries1

1Source: JOEM _ Volume 54, Number 9, September 2012. Myles Druckman, MD, Philip Harber, MD, MPH,

Yihang Liu, MD, MS, MA, and Robert L. Quigley, MD, DPhil, Results from International SOS medical

evacuation activity from 50 companies based on 94,561 International Assignees located in 181 countries and

8,727,361 International Trips to 214 countries in 2009

Medical evacuation likelihood by country risk rating

4 4 4 4 4

Australasia AC Data : Evacuation Causes

0

5

10

15

20

25

30

35%

Combined PNG Africa

Top 5 causes account for

80% of all causes for

evacuation

5

Infective causes of air evacuation by International

SOS

0

10

20

30

40

50

60

70

Malaria PUO Meningitis Dengue TB Hepatitis Cellulitis

% Combined

PNG

Africa

54% of evacuations relate to

malaria, a largely preventable

disease in these populations

Key Diseases

7 7

Key Diseases - Workplace

Person-to Person

Flu

Measles

Chickenpox

Mumps

Meningitis

Ebola

TB

Bed Bugs

Water/ food -borne

Cholera

Typhoid

Hep A

Norovirus

Mosquitoes

Malaria

Dengue

Yellow Fever

Chikungunya

• Some are vaccine preventable

• Many occur in Australia

• Some are new ‘emerging’ threats

• Mosquito-borne diseases cannot be

transmitted person to person, however

vector-control programmes can reduce

prevalence in the workplace

Can all be

transmitted

person-to-

person

8 8

Emerging Threats

Common requests for assistance with

workplace incidents for which there is no

vaccine

• Tuberculosis

• Bed bugs

• Gastroenteritis – Norovirus

Emerging threats which increase client

concern, even if no incident has occurred

• Ebola

• Bird flu

• MERS-CoV

Question: How many of you created or

amended procedures due to Ebola?

Infectious disease in the

workplace

10

Infectious Disease – Workplace Impact

Poor management of an outbreak can lead to:

• Poor clinical outcomes

• Employee anxiety / lack of corporate confidence

• Reduced business productivity

• Business disruption and financial losses

• Liability & reputational losses

Best practice

• Crisis plans for earthquakes, floods etc

• Influenza pandemic planning now a standard

• Need an infectious disease plan as part of crisis

management plans

Case Study : Mine Site

Norovirus Outbreak

Gastroenteritis / Norovirus

• Very common outbreaks

• Highly contagious

• Person-to-person

• Contaminated food or water

• From surfaces

• Hardy

• Symptoms: sudden onset of nausea, violent

vomiting, diarrhoea, aches and fever

• Usually clears when well hydrated and rested

• Prevention = good personal hygiene

Project site with 2,000 employees

• Dec 5 - Employee arrives on site from Dubai

• Dec 6 - He develops sudden vomiting and

diarrhoea

• Dec 7 – 2 people develop same illness

• Dec 8 – 1 more case

• Dec 9 – 9 new cases

• Dec 17 – Final case #42.

Took 12 days to eliminate

• Isolation

• Room review

• Deep cleaning - toilet blocks/accommodation

• Laundry segregation

• Dining facilities

• Enhanced personal hygiene

Site management of outbreak

Washing hands

Use soap: Using water alone

does not remove soil and

grease which can trap unseen

germs and viruses.

Wash your hands for at least

15-20 seconds using the

following steps. Total duration

of the entire procedure is

40-60 seconds.

Site management of outbreak

• Awareness – emails and toolbox talks

• Daily briefings - senior managers

• Daily team meetings - facility managers

• Reporting to all stakeholders on site and

externally

17 17

Outbreak Plan : Procedures

2

3

4 5

6

1 1. Screening and PPE

2. Isolation / Quarantine

3. Cleaning

4. Food handling

5. Health authorities are notified

6. Prevention

1

2

3

4

How to prepare for an

health incident

19 19

Compliance Environment : Legislative Framework

• Obligations on employers to take

reasonably practicable steps to minimise

the threats identified and reduce the risk of

injury or other harm to those who work for

them

• WH&S Laws are criminal in nature. Penalties

may apply to any PCBU: Company Director,

white van tradesman, workers in a practice

– Not tested in law yet

– Consideration - justification vs. cost (unjustifiable

hardship)

– Cannot ‘contract off’ legal obligations

– Requirement for threat assessments to be

conducted prior to work commencing

– Judged against peers

20 20

Components of Effective Disease Management

1. Disease dependent procedures in place

2. Health Incident Plan

• In advance

• Allows business leaders to systematically manage a health

incident

• Simultaneously support affected personnel and protect the

organisation

• Living document : review, update, reflect

• Sits within greater framework of business continuity plans

3. Communications should be pre-prepared

• To address expected questions

• To educate on best practice

21 21 21 21 21

Key Organisation Takeaways

Develop an adaptable Corporate Plan to

protect employees and business assets,

include:

1. Corporate Policies for guidance to

business units

2. Practical Action Tables to guide Crisis

Management Team/s – scalable to the

severity and impact

3. Reference Documents, Procedures,

Communication, Posters and Tools

for handling the disease

4. Health promotion and screening to

maintain optimal health

5. Provide vaccinations for preventable

diseases

22 22 22 22 22

Key Traveller Takeaways

Wash your hands often Wash

regularly and properly with

soap. Carry hand sanitiser

and use it when you can’t

wash your hands

Cover your cough or sneeze

If you are sick, cover your

cough or sneeze to avoid

transferring the virus to others

Avoid touching your face

Viruses can transfer from

surfaces to your hands, then

to your mouth and nose

Keep your distance from people

who are sick If you have to

attend to someone who is ill,

wash your hands afterwards

Ensure food is

thoroughly cooked, milk

is pasteurised

Avoid unnecessary

exposure to

mosquitoes /

animals

Key Contacts

International SOS 24/7 Assistance Centre Sydney

Ph: +61 2 9372 2468

www.internationalsos.com

For more information, please contact:

Beth King

Business Development Manager (Perth Based)

Ph: +61 8 6465 5104

M: +61 447 628 155

E: beth.king@internationalsos.com