It’s hard to believe, but flu season is almost upon us once again. To discuss the issues surrounding the flu and what you can do to help protect the health of your workers, we have a Q&A with Jocelyn Sivalingam, M.D., F.A.C.P., Medical Director at West’s Health Advocate Solutions.
Last year we heard a lot about the flu. There were imperfect vaccinations, some shortages, and rampant flu cases. Did that influence how people vaccinated?
Sivalingam: Last year was a very bad flu season for everyone, in retrospect with a lower than usual estimated vaccine effectiveness because of the strain H3N2. Low vaccination rates did not help.
Determining whether there was a direct impact of this specific flu season on the rate of vaccinations would be complicated, but anecdotally I can tell you that people often put off getting their flu shot when issues with efficacy are reported.
What is the most common reason you hear that people don’t vaccinate? What would you say to them?
Sivalingam: In my opinion, there are two main reasons people don’t get vaccinated. First, they do not believe they are at risk or that getting sick would only be a minor inconvenience. While older people, young children and those with chronic diseases are at a higher risk of flu-related complications, it is important to remember that even healthy people can get very sick or even die. Plus, catching the flu often results in multiple days out of work, the cost of doctor’s visits and treatment, as well as the risk of making family and co-workers sick. The flu is not a minor inconvenience.
The second is that they may think the vaccine does not work or can cause the flu.
Currently, the flu vaccine’s effectiveness may vary from 10-60 percent from season to season, however, it is still the best single preventive measure that we have against this disease. (Researchers are working to develop a “universal” flu shot, but it is still in the early stages of development.) It is important to remember that the flu vaccine is manufactured from components of the virus and does not contain actual viral particles, so it cannot cause the flu.
Some companies might not see the value in paying for vaccinations onsite, how do the costs of paying for employees’ vaccines compare against productivity loss due to sick employees?
Sivalingam: Consider that the cost of lost productivity due to a bout with the flu is approximately $1,000 per employee on average. This does not include the direct medical costs associated with being sick, including doctor’s visits, medication and more. Alternatively, the flu shot costs an average of $32 per person. While the flu shot may not prevent everyone from getting sick (the flu shot reduces the risk of getting sick by up to 60 percent), it can significantly reduce individuals’ risk and the overall number of people affected, making the potential cost savings easy to see.
A lot of people that I talk to say “I don’t get the flu, so why bother.” How would you convince them?
Sivalingam: The past does not predict the future, and there is no way to guarantee that you will not get sick in a given flu season. Just because someone has not contracted the flu virus previously is not an indicator of future immunity because the virus changes year to year. It only takes walking by a sick person as they cough or sneeze in your general direction to get the flu. It remains important for everyone to take steps to prevent the flu and its spread.
What are some strategies workplaces can use to reduce flu outbreaks for their employees?
Sivalingam: While the flu shot is the most effective strategy to reducing the risk of getting sick, employers should encourage their workforce to practice basic healthy habits to prevent the spread of bacteria and viruses. These include covering the mouth and nose when coughing or sneezing, regular hand washing (after coughs and sneezes, before meals and after the restroom). Having hand sanitizer available when washing facilities are not easily available is recommended. It is also helpful to spread out workstations and reduce overcrowding where germs can more easily spread. Inform workers about flu and other contagious respiratory disease symptoms. Facilitating appropriate use of sick time and making policies known helps keep those who are contagious from coming to work sick.
Prevention seems important, but what happens when that doesn’t work?
Sivalingam: There are a number of policies and programs employers can put in place to help those impacted by the flu and help reduce the spread. First, having a sick leave policy in place that ensures people are able to stay home when sick and prevents them from bringing their germs into the workplace. Equally important is providing access to appropriate care; timely antiviral treatment can reduce the length and severity of the illness, ensuring employees get healthy and back to work sooner. As part of this, ensure health benefits cover flu treatment – if employees are required to pay out of pocket for their care, they may not get the help they need in time.
What is something most people don’t know about the flu?
Sivalingam: We often hear that the flu vaccine needs to be reformulated each year. This is because several strains circulate around the world 365 days a year, and these strains also change over time. Influenza viruses circulate in other animals as well, recombining and evolving as they pass within and between species. Because of this, the influenza viruses constantly morph, creating the need to develop an updated version of the vaccine each year.
What is something you wish everyone knew about the flu?
Sivalingam: Prevention is critical because you can pass along the flu virus before you show signs or symptoms. Once you develop the chills or a sore throat, you’ve likely been contagious for 24 hours, and you will be contagious until 5-7 days afterward. So, it is important to always practice good hygiene, because you never know when you might be spreading germs to others (and vice versa!).
|Dr. Sivalingam is a board certified Infectious Disease specialist with more than 20 years of clinical and administrative experience. Prior to joining Health Advocate in 2009, Dr. Sivalingam operated an infectious disease consultative practice and served as an instructor in the Division of Infectious Disease at Thomas Jefferson University Hospital, where she also completed her internal medicine residency and infectious diseases fellowship.|