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Features - Epidemic management

By: Jacelyn Woo, Singapore
Published: May 01, 2005

At the height of the SARS outbreak in Asia two years ago, TNT Singapore had to quarantine a staff member because her family member was in contact with a SARS patient. Fortunately, says the logistic provider's managing director, Mark Shorney, the employee and her family were safe. Stories like these were not uncommon during the SARS period.

Although the SARS epidemic has come under control, outbreaks like avian influenza are a new threat to the region. However, that's not to say that SARS will not strike again. According to Dr Lim Poh Lian, Tan Tock Seng Hospital and the Communicable Disease Centre's consultant physician of the department of infectious diseases, "SARS and avian influenza viruses are still residing in their animal reservoirs".

"It is only a matter of time before they emerge again, says Lim. "As we live in a global village, any pathogen (an agent such as a bacterium or fungus that causes diseases) is potentially only a flight away." The measures used by companies in Singapore to prevent or control SARS include issuing medical kits, implementing temperature checks, telling staff to stay at home should they feel unwell, restricting travel, having work teams operate off-site and sending out updates on preventive steps.

According to Lim, the most effective ways of preventing or minimising the effects of an epidemic such as SARS or avian influenza at work include minimising travel to areas where the pathogens are most likely to resurface and getting staff vaccinated before they travel. Staff should also be told to minimise contact with live poultry. Companies should also advise staff who fall ill within two weeks after such travel to seek medical care and stay at home to limit transmission at work.

At ABN AMRO Bank, even though it has adapted its business continuity plan (BCP) from a global one to pre-empt a fire, cut in electricity supply or the collapse of the office building, revising the plan was necessary.

Prior to SARS, there was no similar plan for epidemics, says Molly Yeo, the bank's senior vice president of human resources. "We were one of the first in the banking industry to put in place the measures, such that the Singapore National Employers Federation invited the bank to share our experience with the other banks on how we did it," she adds.

Amongst the measures added to the bank's BCP in 2003 to prevent the spread of epidemics and minimise its impact include getting infected staff to stay at home and telling healthy staff to avoid the office until the premises are fumigated.

To minimise disruption to the business, the bank issues contingency laptops that contain key operations information if staff can't be at the office. "We have a set of contingency laptops where staff can key in the passwords and work from there," Yeo says. The laptops can be retrieved from the Cisco-protected BCP site at Kim Chuan Centre, which is a data centre. The site is rented year-round to cater to contingencies.

Getting staff to work in a split office environment is also part of the epidemic prevention plan. The BCP site can take up to 100 staff. "For HR, we need just one desk, while most staff can work from home," says Yeo.

Further, Yeo adds that managers have to identify and advise sick staff to go home. To prevent the spread of a virus, the unwell staff member is also escorted out of the office premises. A doctor will be called when needed. "If the managers weren't comfortable with it, HR was willing to help. But the managers were on the ball with the SARS situation."

SARS being an unfamiliar infectious disease then, Yeo and her colleagues had to find out as much as they could about it. Speaking to the relevant healthcare experts is key. She also found the Ministry of Health helpful in getting updates about the steps to take in keeping SARS at bay during the outbreak.

"We didn't know how fast SARS spread and how fatal it was. We can deal with fire, but with an epidemic, it's an unknown," she adds. "Companies have to be proactive and gather information about the unknown epidemic and see if the BCP can be applied to the situation, or whether the plans need tweaking."

According to Yeo, the combined efforts of the managers and staff, together with the BCP, put the bank in the clear during the SARS outbreak.

ABN AMRO Bank also carries out BCP tests yearly, Yeo reveals. During the simulation exercises, a "call tree" will be triggered to update the 1,000 staff in Singapore on the situation. The chief operating officer, Bruno Schricke, is expected to contact two other senior management members and this contacting pattern cascades downwards. Staff might be told not to come to the office and to wait for further instructions. SingTel will make available a hotline for bank staff and their family members to call in for updates as well.

TNT Singapore goes one step further by engaging experts to audit, improve and strengthen its health and safety (H&S) systems.

Last May, the company received a 5-star accreditation from the National Safety Council of Australia, a provider of occupational H&S management systems, training and support to businesses. The Council conducts audits of TNT Singapore's systems biennially.

TNT Singapore also undergoes half-yearly Occupational Health and Safety Assessment Series evaluations to reduce the H&S risks faced by employees. In addition, Spot Management Services annually assesses TNT's contingency procedures, equipment such as goggles, masks, gloves and boots and staff in managing hazardous and dangerous consignments such as viruses and specimens for testing and research. Spot Management Services is a local company specialising in health and safety audits.

Under the ‘Dangerous Goods Procedure', TNT staff must be certified by the International Air Transport Association (IATA) to handle dangerous goods such as infectious blood samples, flavour samples and gases. At least five IATA-certified staff are stationed at every depot to look into the requirements of such consignments. The staff are also required to take refresher courses every two years.

Since SARS, the logistics provider has fine-tuned its prevention and control measures including splitting the workforce to work shifts and segregating staff to roll out like clockwork should an incident similar to SARS occurs, says TNT's Shorney.

When the workforce is split in the event of an outbreak, drivers work either from 7am to 2pm or from 2.15pm to 11pm. "The shifts have a 15-minute break in between so that persons from both shifts do not meet," says Shorney.

When staff are segregated, employees will be advised to stay within their work areas. Staff will also be asked not to go to the pick-up and delivery area where the drivers would have been in contact with outside parties.

A health, safety and security manager develops, monitors and reviews the H&S management system based on the global one. TNT Singapore has also established a cross-functional H&S improvement committee to promote amongst employees the awareness of best practices together with the health, safety and security manager.

"Though the primary responsibility of the management of H&S activities lies with the managing director, all 380 employees at TNT Singapore have a role to play in ensuring a safe environment," Shorney says.

A main challenge of implementing epidemic prevention measures is getting people to understand the measures and practise them.

"It takes only one irresponsible person to put the entire organisation at risk, including those we come into contact with outside of the organisation. We are only as strong as the weakest link," says Shorney.

ABN AMRO's Yeo agrees, "Cooperation of staff is definitely key because the BCP, however good, can only do so much."

Instilling in staff an attitude of cooperation, notes Lim, depends on three factors: helping people understand the reasons behind the policies, disseminating the details in a user-friendly manner such as brochures and the intranet and embedding those policies within the organisational culture of teamwork and employee care. People are more likely to cooperate if they believe the policy makes sense, and the company cares about their well-being, Lim adds.

From the start, H&S is highlighted in every employee's job description, says Shorney. In addition, various events such as carnivals, fruits day, corporate jogs and health talks are held every month to encourage employees to share the same H&S values as the company. The National Kidney Foundation is also engaged to conduct annual health screening.

The lack of management involvement or support is another challenge. Senior management support is crucial in setting an epidemic management plan. Lim advises HR practitioners to get buy-in from senior management to do so. "If an epidemic affects the company, it will require executive and operational decisions. The last thing you want in a chaotic situation is for different signals to be given. Coordinated, effective leadership is required,"

ABN AMRO's BCP specialists drew up contingency plans with the input of senior managers every step of the way, Yeo reveals. In addition, constant communication from the team leaders and senior managers' setting an example helped with the SARS situation.

Shorney says the epidemic prevention and control policy should include these key points: objectives, management and employee responsibilities, training, H&S resources, consultation, control of risks, accident management, as well as policy control and review.

In a crisis, there should also appoint a person to disseminate information, so the message is clear and coherent, says Lim.

At ABN AMRO, the COO, head of property services and Yeo are expected to brainstorm on how to manage a crisis should it occur. The decisions are then relayed through the call tree.

Another challenge arises when companies incur costs when making contingency plans and setting aside emergency resources. The bills ABN AMRO has to foot is an indication - when maintaining the BCP site, the bank has to pay for electricity usage and rental of Kim Chuan Centre.

"But assessing and handling risk appropriately can be done based on good business principles and can be budgeted for, just like fire or indemnity insurance," says Dr Lim.

NTUC Income, for one, has been offering companies a SARS business continuity plan since January 2004. The plan covers the wages paid by insured companies to contingent workers who replace permanent employees served with a SARS home quarantine order by the Ministry of Health. The plan will reimburse the wages of contingent workers for up to 10 days. Companies need to pay an annual premium rate of 4% of 10 days' wages of permanent staff. This continuity plan is in addition to NTUC's insurance plan that covers death, hospitalisation and home quarantine arising from SARS, since May 2003.

The costs of implementing an epidemic prevention plan pale in comparison to a company losing revenue and contracts because it has no effective contingency plan in the event of an outbreak.

"If companies (or countries) handle crises and adverse events competently, it builds confidence and morale internally and earns respect from external parties. This can translate into improved business opportunities downstream from the event," says Lim.

TNT Singapore and ABN AMRO say employees matter as well. Shorney says: "At TNT, health and safety of our employees and customers are of paramount importance, and in such an event, our priority will be to ensure their well-being is far more important than looking at potential cost savings."

The SARS outbreak showed that the government and the private sector can manage a potential epidemic together. However, Yeo thinks multinational companies (MNCs) are more prepared than smaller counterparts in pre-empting the impact of epidemics on their businesses. The reason, says Yeo, is that the multinationals need to be compliant with global standards.

"SMEs are usually individually run or owned. MNCs are listed and are accountable to shareholders. We can invite SMEs to come to a talk to learn the cost implications and benefits of a contingency plan. Then SMEs will be more willing to come up with such plans. Regardless of company size, the implications and suffering are the same," she adds.

Yeo also suggests that the government offer funding to support SMEs' efforts to set their own BCPs.

As memories of SARS fade and fears recede, Lim says, everyone will relax in their vigilance, but they may be caught unprepared. On the other hand, she adds that it is appropriate to ratchet down the level of anxiety, since staff in organisations cannot live at a "hyper-adrenalin state" all the time. The solution is to be able to ramp up the preventive measures when necessary.

Ultimately, contingency plans should be flexible to respond to different scenarios. "To keep fighting yesterday's batters such as SARS is to risk being blind-sided by tomorrow's challenges," Lim says.


Friday, 10 February 2012, 10:20 AM


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