The H1N1 flu has arrived in Maryland. According to the Maryland Department of Health and Mental Hygiene, as of October 15, there have been 257 hospitalized cases of “swine flu” and 10 reported deaths (http://dhmh.maryland.gov/swineflu/). The H1N1 flu virus is characterized by symptoms that are very similar to those of seasonal flu: high fever, cough, sneezing, aches and pains, and feeling very tired. The American Bar Association quoted the Centers for Disease Control (CDC) as predicting that between the normally expected flu cases and the much-publicized H1N1 outbreak, this will be the most severe flu season in over 50 years. On October 24, 2009, President Barack Obama issued an emergency swine flu declaration in order to make federal resources more readily available to the states in order to treat and combat the spread of H1N1.
What can you do to protect yourself and others from H1N1?
- The prevailing advice is to isolate those who have flu-like symptoms to avoid contact with others and hopefully minimize affecting others. The CDC also recommends that anyone exhibiting flu-like symptoms wait 24 hours after a fever (100 degrees Fahrenheit or above) or signs of a fever have subsided without using fever-reducing medications. If your case is not overly severe, you should remain at home, take proper precautions and allow the disease to run its course. Hospitals and doctors’ offices are experiencing high volumes of patients and encourage only those with severe symptoms or underlying medical issues to seek professional care. However, if you experience difficulty breathing, shortness of breath, dizziness, chest or abdomen pressure or pain, or severe or persistent vomiting, seek medical attention immediately.
- Proper hand-washing is key to fighting the flu, especially after coughing, sneezing or blowing one’s nose. Any kind of soap will work against the flu viruses if warm water and 15-20 seconds of rubbing is employed. Alcohol-based hand sanitizers are also good (and portable) alternatives.
- Cough or sneeze into your elbow to prevent the spread of germs onto hands.
- Get vaccinated for both the seasonal flu and the 2009 H1N1 flu when vaccines are available. Call your healthcare provider for more information.
Members of the Maryland State Bar Association (MSBA) should be prepared to address the challenges they will face if confronted with the H1N1 virus. The two major communities (other than family members) that lawyers need to concentrate on in dealing with H1N1 are employees and clients. It is essential to develop policies regarding your relationship to them. It is particularly crucial that the policies be addressed and disseminated in advance to limit the reactive responses that do not allow time for careful consideration during the midst of the outbreak.
NO PLAN IS PERFECT, BUT IT WILL AVOID CONFUSION AND DISRUPTION.
For employees, emphasize proper hand-washing technique, cough and sneeze etiquette and the use of hand-sanitizers. Consider the availability of leave, telework and telecommunication policies and their use during a flu outbreak. Human Resources issues, such as use of sick leave for the care of children or other loved ones, or the ability of management to require that employees exhibiting flu-like symptoms be sent home, may also need to be addressed and discussed with employees.
For clients, consider: What is your policy for dealing with clients that arrive at your office with flu symptoms? Will you ask them to leave? Give them a surgical mask to wear? Forego traditional greetings/formalities, such as handshakes, in order to limit transmission of the flu? Are there other alternatives?
These are all serious issues and this is no one answer to all of them. However, the MSBA encourages all of its members to plan for a potential emergency such as an H1N1 pandemic so that you are prepared. No plan is perfect, but it will avoid confusion and disruption.
There are many resources available that will help you in your planning:
New York, Illinois and Ohio have all recently issued formal states of emergency or public health emergency in response to the H1N1 outbreak. These states join a number of initial states that made declarations early in the H1N1 outbreak.
For more information on global and domestic legal responses to the H1N1 outbreak, including prior and existing declared emergencies at the federal and state levels, please see the Program’s Global Legal Triage webpage at www.law.asu.edu/?id=2036.
Michael Vesely, Jessica Pitts and John Eidleman are members of the MSBA Special Committee on Disaster Preparedness.