Pandemics: Ready...Or Not

H1N1, or swine flu, was a wake-up call for building service contractors. How well BSCs and the cleaning industry as a whole answered, and whether they’ve stayed awake on the job, will be put to the test this fall. Not only will the annual flu season be upon us, but additionally, those viral strains will include the novel pandemic H1N1 flu.

Predictions from federal health and government entities are that up to half of the U.S. population could be affected by the flu strain. Deaths could be double the typical 40,000 who succumb each year to flu complications — but would reach into the children and young adult populations as well as the over-65 set.

Seasonal influenza is a real health concern for the clientele of building service contractors, who know to step up communication each fall about what they are doing to minimize the risk of transmission of flu in facilities.

But pandemic flu is not the same as seasonal flu — which the world discovered in April with the emergence of H1N1, which swept through Mexico, the United States and the rest of the world. Pandemics are defined as epidemics of infectious diseases that spread throughout a large region, continent or the world.

A working H1N1 vaccine won’t be ready until mid-October, and even then supplies will be limited, so the prevention spotlight will focus on cleaning and hygiene. That means making sure vendors are well-stocked with cleaners, disinfectants and hand sanitizers, and that BSCS are organizationally prepared to handle cleaning during a pandemic.

“If you’re not prepared right now, it might already be too late,” says Todd Haddock, vice president of sales and marketing for AHI Facility Services in Dallas. “I’ve already got guarantees from vendors of the products that I’ll be using and selling. So I think if BSCs aren’t doing that, they’re going to miss an opportunity and they’re not going to have the products, which is going to upset their customers.”

Planning for pandemic illnesses — which include not just new flu strains but other modern threats such as HIV and SARS — should be approached similarly to planning for any emergency situation that threatens the health of building occupants.

Many BSCs have some sort of formalized plan or directive regarding pandemic flu; some have very detailed plans that include instructions on employee protection, product use, frequency changes, areas of priority and customer communication and education. Ideally, pandemic plans should be revisited annually and tweaked if necessary.

Keeping current

The Avian Flu scare in 2006 prompted many BSCs to update — or create — their pandemic flu plans, so those companies haven’t needed to change much to deal with H1N1.

For Newton, Mass.-based UGL Unicco, which has an overall business continuity plan that includes a comprehensive pandemic flu/avian flu plan, it was no problem to further adapt the plan to include swine flu.

“We’ve had, for a couple of years now, a site-specific and a corporate version of a pandemic response plan, and it includes everything from communication between corporate and our sites down to what type of cleaning, type of products and personal safety equipment our onsite personnel should use as the pandemic progresses through the stages,” says George Lohnes, vice president of marketing for UGL Unicco.

Each of UGL Unicco’s sizeable accounts, from commercial office buildings to universities, has an emergency preparedness plan of its own. While those may be part of overall safety plans, pandemic plans tend to be broader and less specific in some ways since they occur much more rarely than other emergencies, Lohnes says.

The company’s corporate version focuses on management, delegation of authority and internal communication mechanisms, which would be handled through an intranet site for employees.

Pandemic planning for cleaning professionals has its roots in bloodborne pathogen prevention, says Paul Condie, president of KBM Building Services in San Diego. Facilities such as stadiums, arenas, hospitals and schools regularly deal with having to clean up pathogen-carrying bodily fluids such as blood and vomit. Large facilities like that need back-up plans for any type of emergency, including a pandemic situation, he says.

Many larger customers will also have plans to deal with pandemic flu outbreaks, and those can be aligned with BSCs’ plans for a fluid response strategy.

“It’s been really interesting — the swine flu brought a lot to the forefront,” says Condie. “A lot of them had [a pandemic plan] and they never really mentioned anything about it to us, so it was very interesting when they came forward and we showed them where we were. We were more advanced in our plans than they were.”

In a few instances, customers took KBM’s plan and modeled a revised plan from that example, he adds. Likewise, in viewing other pandemic plans, Condie saw a few things in KBM’s plan that could be improved.

Plans don’t necessarily have to evolve much from pandemic to pandemic, Condie says, but they do have to be in practice in order for them to work the way they’re intended.

“A lot of people were pulling the book off the shelf and blowing the dust off it and no one was really familiar with it,” Condie says.

Dry run

The H1N1 flu outbreak has been a useful exercise for all BSCs, as it became an immediate and urgent priority for customers over the course of the few weeks when it was first spreading throughout the country in late April and early May. That tested the ability of contractors to be proactive about getting information out to customers in a timely manner, as well as their ability to react to a public health threat and panicking public.

One of the worst things a BSC can do in a situation like that is to create a panic, says Joe Schulman, president of Gold Bond Building Services Inc. in Jackson, N.J.

“Don’t overblow the situation,” he says. “Tread lightly on the situation that comes out of the public, read everything with a grain of salt, do research, don’t start a panic. All it takes is someone to yell fire in a crowded room, to use that analogy, and you can have a big problem.”

Communication is key to keeping customers calm and informed — in fact, it’s so important in pandemic planning and response that it’s right up there with the cleaning itself. Many BSCs contacted customers through e-mail, alerts on their Web sites, or letters in the mail, informing them about the virus and the role cleaning plays in preventing illness.

“One of the things we found out is that our customers were looking for suggestions because this was the first time they’d been through it, so what we did was send out an e-mail communication to all of our customers, recommending things they could do,” Lohnes says.

There are customers who will be concerned enough to request extra services, such as sanitation and disinfection of entire facilities, so BSCs should be prepared to offer the right products for the job.

During the initial stages of the swine flu outbreak, BSCs reported being low on disinfectant foggers, disinfectants and hand sanitizers and wipes, so it’s good to make sure distributors will be able to handle the demand a pandemic may bring. Some BSCs also rotate through extra stores of those products in their warehouses so they will have the initial resources to deal with a crisis.

Though some BSCs did change frequencies or focus more on frequently touched surfaces with the H1N1 pandemic, others did not change a thing — instead, they reminded customers that occupants play the biggest role in preventing the spread of disease, encouraging hand hygiene.

“That’s how the germs really spread: touching and coughing. There’s no other way,” says Haddock. “As a cleaning company, if you’re disinfecting high traffic areas as much as you can and you’re educating people to wash their hands with hot water on a consistent basis, and/or use hand sanitizers on a consistent basis, it will help prevent it.”

Along with having a plan to communicate with customers and employees, BSCs need to understand the basics of infection control in order to implement a pandemic plan, says Trixi Babcock, healthcare consultant and partner with HCI Consulting Group in Aurora, Colo.

“When they put their plan together, a lot of it needs to include training and education of the staff,” Babcock says.

Often, janitorial workers don’t understand the basics of infection control, so for any pandemic plan to be successful, workers need to understand the proper uses of disinfectant and protective equipment, and proper hand washing techniques.

BSCs should consider the ramifications of pandemic illness on their own staffs as well as occupants in customer buildings. Not only should customers understand the basics of hand hygiene and staying home when sick, but so should janitorial workers, as they have high exposure to microorganisms and have the potential to sicken many people just by doing their jobs.

Prepping for flu season

Most BSCs target the end of summer as a time to approach customers about seasonal flu precautions. This year, H1N1 is sure to influence the flu season, and rather than scrambling to react to the augmented flu predictions, contractors are heading into autumn prepared.

“This fall season, it might come back with a vengeance so we’re not resting on our laurels, but we do feel that we’re as prepared as we can be for something that’s difficult to prepare for,” Lohnes says.

Haddock says September is the best month to address pandemic and seasonal flu concerns — any earlier in the summer won’t be as effective.

“I believe it’s just going to pick up again,” Haddock says. “People aren’t thinking about it as much now because it’s not in the news, in the media, but come this fall, when it hits, if you’re not prepared, you’re not going to be able to help your customers.”

Customers of particular concern are those with vulnerable populations, such as healthcare facilities and schools. In August, the U.S. Centers For Disease Control and Prevention (CDC) released updated response guidelines for schools this flu season. Since the highest number of probable and confirmed cases of H1N1 are among children and adults under 25, it is extremely important to keep schools sanitized and educated about proper hygienic practices. The guidelines are flexible to account for differences in severity in situations.

BSCs should pay attention to guidelines and recommendations, for seasonal cold and flu as well as pandemic illness, as issued by the CDC and the World Health Organization. Contractors can then use that accurate and updated information, combined with business savvy and common sense, to claim their roles as experts, advisers and educators

When H1N1 hit, it provided as close to a dry run of a pandemic plan as BSCs are likely to get, aiding preparations for the next pandemic by serving as a reminder that things can get serious and deadly, quickly. With a potentially bad flu season on its way, thanks to the emergence of H1N1, now is the time to make sure plans are ready for implementation before they are ever needed.

Editor’s Note: Trixi Babcock will be speaking at ISSA/INTERCLEAN^® on Tuesday, Oct. 6. Her seminar, titled “Controlling Cross-Contamination in Schools and Hospitals,” is sponsored by Housekeeping Solutions, a sister publication of Contracting Profits.