A11

Charles W. Moore

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A bigger challenge managing the second wave of pandemic H1N1 influenza could prove not so much production and administration of vaccines, but persistent cultural denial that flu should be taken seriously, particularly the phenomenon of workplace "presenteeism."

Too many people evidently imagine they not only have a "right," but even an obligation, to show up for work so long as they're able to stagger to the office. Once there, they touch doorknobs, elevator buttons, office machines, telephones, computers, coffeemakers, and so forth, as well as distributing aerosols of virus-laden mucoid culture by sneezing and coughing. A Cornell University Study published in the Journal of Occupational and Environmental Medicine determined that even in "normal" flu years, presenteeism costs employers an average of $255 per employee because people "working sick" slow down, have to repeat tasks, have difficulty concentrating, and generally lower productivity, not counting the many magnitudes greater financial impact of their infecting co-workers, costs of which were not analyzed by the study.

An Occupational Hazards article reported that 80 per cent of employees surveyed by OfficeTeam copped to frequently showing up to work sick, just 8 per cent saying they never come to work when ill. Another study by CCH Inc. found 48 per cent of employers surveyed citing presenteeism as a problem within their company, not only because of lowered productivity, but contagion in the workforce. Once exposed to an upper respiratory virus, the average person has a 75 per cent likelihood of becoming infected.

A survey by Caravan Opinion Research found four in 10 employees affirming they've caught flu from a co-worker.

Nevertheless, there remains a deeply-ingrained cultural attitude pervading many workplaces that tacitly praises work-at-all-costs doggedness, insinuating that it's wimpish to book off from work when you're sick and implicitly discouraging employees from taking sick time. A new poll commissioned by Quebec's Ordre des conseillers en resources humaines finds more than a quarter of Quebec workers surveyed saying they would go to the office with the H1N1 virus.

One-third of male respondents said they would probably go to work if sick, indicating a "macho" dynamic at play here as well. In a typical flu season, that sort of irresponsibility is guaranteed to spread the misery. In this H1N1 pandemic year, it could prove lethal.

A quarter-century ago, Linus Pauling - two-time Nobel Prize winner and advocate of Vitamin C mega-dosing - wrote: "A person with a cold or the flu should feel that he or she should go into isolation in order not to spread the virus to other people, and social pressure should operate to help him or her to act in such a way as to not harm others... a ... change in feeling about the 'right' of people to spread their viruses and infect others, so long as they themselves can stagger about, would benefit the world."

Few heeded Pauling then, but one example of positive proactive address is the unanimous decision last week of the Board of Supervisors of Pima County, Arizona, which includes the city of Tucson, enacting a policy that county employees manifesting fevers of 100.4 degrees (38 C) or higher combined with one or more of cough, sore throat, runny and stuffy nose, muscle aches, headache, chills, unusual fatigue, nausea, or vomiting or diarrhea, must stay home and minimize human contact until at least 24 hours after they're free of fever without use of fever reducing medicines, at risk of being disciplined or fired for non-compliance.

Health care workers need to stay out seven days after symptoms' onset or 24 hours after the last symptom is gone, whichever is longer. Managers and supervisors, responsible for ensuring the workplace is safe, have the authority to send home employees who display flu symptoms. This sensible approach merits widespread adoption.

Even in "normal" years, more than 100,000 North Americans are hospitalized with flu and its complications. About 23,000 of them die. Complications include bronchitis, sinus infections, ear infections, mastoiditis, meningitis, pneumonia and exacerbation of chronic illnesses. Economic losses related to colds and flu amount to tens of billions of dollars each year.

It appears many have been lulled into the delusory notion that H1N1 is a relatively mild affliction that needn't be worried about more than "regular" flu. In many instances H1N1 is "mild" (so to speak), but in some victims it's proving uncommonly deadly and damaging for those who become gravely ill. Two studies published last week in the American Journal of Roentgenology suggest pandemic H1N1 flu may cause blood clots and other unusual damage in the lungs, and that severely ill patients are also at risk for developing pulmonary emboli, which are not normally seen in flu.

Attitudinal adjustment is needed, fast - a new social ethic making it as unacceptable to circulate in public when sick with the flu as to drive drunk.

Charles W. Moore is a Nova Scotia based freelance writer and editor. He can be reached by e-mail at cwmoore@gmx.net. His column appears each Thursday.