By now, almost everyone has heard of SARS (severe acute respiratory syndrome)–the mysterious illness which has now infected thousands and killed hundreds worldwide. With no known cure and little known about its transmission methods, the emergence of SARS has caused a great deal of alarm, which is no longer confined to those who live or have contact with the Asian countries where the syndrome first appeared and has had its greatest impact. SARS is finally beginning to impact the American workplace, and raises a number of critical issues for employers and workers alike.
• Travel The first impact of SARS in the workplace was felt by those who travel as part of their jobs. When news of the disease first surfaced, companies began voluntarily limiting travel to Asian countries where the disease was first spotted. The Centers for Disease Control has now issued a travel advisory, recommending that travelers limit all nonessential travel to China, Hong Kong, Singapore, and Hanoi, Vietnam. The CDC has also issued a travel alert for Toronto, Canada. This alert does not recommend that travel to Toronto be limited, however; it recommends only that travelers to Toronto “observe precautions to safeguard their health,” which includes avoidance of settings where SARS is most likely to be transmitted, such as health care facilities caring for SARS patients, and practicing careful hand hygiene. The difficulties lies in determining what travel is nonessential, however. In our global economy, many companies do an extensive amount of business in Asia, some of which cannot be conducted without travel to the region. Will firms sacrifice (even temporarily, until more is known about the illness and its transmission) their business interests to protect the health of their employees, or will workers be forced to choose between traveling (and possibly jeopardizing their health) and doing their jobs effectively? This remains to be seen.
• Workplace Transmission Given that so little is known about transmission methods at this time, what is the risk that a worker with SARS will infect an entire workplace? At this time, that risk appears to be quite significant. While most of the cases of SARS in the United States among those who have not themselves traveled to Asia have involved health care workers who have treated SARS patients and family members of the health care workers, a Florida case in mid-April caused a great deal of concern, because it appeared to be the first workplace transmission case. (See USA Today article.) A Gainesville, Florida woman was hospitalized with a suspicious respiratory infection and is believed to have contracted SARS from a coworker who recently visited Asia. (See Voice of America article.) While there has been some difficulty confirming whether the Florida case was actually an instance of workplace transmission. Due in part to the lack of a definitive test for the disease, SARS can currently be identified only as a set of symptoms and circumstances. (See Tallahassee Democrat article.) After the emergence of the Florida case, the CDC issued Interim Guidelines applicable to the workplace, which include the following:
Workers, who in the last 10 days have traveled to a known SARS area, or have had close contact with a co-worker or family member with suspected or probable SARS could be at increased risk of developing SARS and should be vigilant for the development of fever (greater than 100.4° F) or respiratory symptoms (e.g., cough or difficulty breathing). If these symptoms develop you should not go to work, school, or other public areas but should seek evaluation by a health-care provider and practice infection control precautions recommended for the home or residential setting; be sure to contact your health-care provider beforehand to let them know you may have been exposed to SARS. As with other infectious illnesses, one of the most important and appropriate preventive practices is careful and frequent hand hygiene. Cleaning your hands often using either soap and water or waterless alcohol-based hand sanitizers removes potentially infectious materials from your skin and helps prevent disease transmission. The routine use of personal protective equipment (PPE) such as respirators, gloves, or, using surgical masks for protection against SARS exposure is currently not recommended in the general workplace (outside the health-care setting).
The CDC guidelines identify one precautionary measure which is likely to present problems in the workplace, which is staying away from work. While most workers will voluntarily comply with these guidelines, some may not do so willingly, either because they are disinclined to believe they present a risk or out of financial necessity. Even if the Florida case is determined not to be a case of workplace-transmitted SARS, businesses who employ individuals at risk of contracting SARS will likely be confronting this issue very soon, if not already.
• Quarantining Workers Some major US corporations who do business in Asia have already started to address the issue, in some cases out of necessity. Both Wal-Mart and Intel have already had one of their Asian employees contract SARS, requiring that coworkers be tested, and in Intel’s case, the brief closing of its Hong Kong office. (See Washington Post article. The emerging consensus is that companies should ask their employees traveling from affected countries to stay home for 10 days, with pay. Companies that ask their employees to take time off without pay run the risk that workers will not report their travel plans or exposure to disease. However, there will undoubtedly be companies that try to require their workers to take unpaid leave, raising potential wage disputes. What if workers refuse to take time off after travel to Asia or other affected regions, either because a company refuses to offer paid leave or because they believe they no longer pose a risk? At this time, a company does not have the legal right to quarantine that employee; that type of action could only be taken by public health officials. Both Wal-Mart and Intel are asking their workers to “self-quarantine” and paying them for the time they are unable to work–will other firms follow their lead and act accordingly to simultaneously guard against the risk of workplace exposue and recognize the financial needs of employees who must be quarantined?
If the future progression of SARS indicates that it will continue to pose a workplace threat, we can expect to see battles between employees who may have been exposed to SARS and employers trying to protect their business interests and the health and safety of the rest of their employees. While at this time, many companies are taking a “wait-and-see” approach, smart employers should act quickly to put in place reasonable guidelines which both respond to this sometimes-deadly disease and accommodate the needs of workers at risk.