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USA: Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic [Excerpts]
Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic
Summary
Optimal planning and preparation for an influenza pandemic requires coordinated efforts by every part of society including individuals and families, communities, employers in public and private sectors, and all levels of government.
Federal, State, and local governments will implement strategies to protect the public in an influenza pandemic. Employers also will play a key role in protecting employees' health and safety, thereby limiting pandemic impacts on health, the economy, and society.
As part of their comprehensive pandemic planning, some employers (from public and private sectors) have asked for guidance about whether they should stockpile or otherwise arrange for influenza antiviral drugs to be available for their employees during a pandemic.
Private stockpiles, in coordination with public health stockpiles, would extend protection more broadly than could be achieved through the public sector alone and improve the ability to achieve the national pandemic response goals of mitigating disease, suffering, and death, and minimizing impacts on the economy and functioning of society.[1]
The Federal Government strongly encourages all public and private sector employers, regardless of size, to plan for a pandemic, to protect the health of employees and assure continuity of operations.[2]
Influenza antiviral drugs (antivirals) are one of several approaches to protecting people during a pandemic and can serve as an important part of a layered approach to pandemic mitigation.
In some cases, employees whose jobs would normally involve very high or high exposure risk to known/suspected pandemic patients may reduce or eliminate exposure through engineering, administrative and work practice strategies.
Nonpharmaceutical measures and personal protective equipment should also be used as a critical component of an employer's plan to protect employees during a pandemic.
Employers that provide frontline healthcare and emergency services should plan to protect their employees who will be exposed to ill persons during a pandemic.
This guidance recommends providing antiviral prophylaxis to these very high exposure risk and high exposure risk employees[3] for the duration of community pandemic outbreaks to prevent illness.
Businesses that provide goods or services essential to community health, safety, or well-being have an obligation to plan and prepare for continued operations in the event of a pandemic.
As a part of comprehensive pandemic planning, these critical infrastructure[4] employers should strongly consider providing antiviral prophylaxis for the small number of employees who are critical to essential operations.
In addition, other employers may consider antiviral prophylaxis for workers in order to maintain business continuity.
If an employer is considering stockpiling antiviral drugs, it should do so with a clear understanding of the legal, regulatory, ethical, logistical, and economic issues that will be encountered in ordering, storing, securing and dispensing prescription medications.
Employers should work with their company or contracted occupational health providers/services to plan for stockpiling antivirals.
This guidance does not establish the requirement or expectation that all employers stockpile antiviral drugs; rather, it defines a prudent strategy for employer antiviral drug stockpiling and use that can contribute to a more effective pandemic response.
Any employer that chooses to stockpile antivirals should do so as part of comprehensive pandemic preparedness and response activities in coordination with State and local pandemic preparedness plans and in conjunction with other measures to protect workers and maintain continuity of operations.
Antiviral drug stockpiles have been established at the Federal level and many States have also established stockpiles.
Current recommendations focus on using up to 6 million courses of the Federally stockpiled antiviral drugs as part of a comprehensive public health response to contain the initial pandemic outbreak, wherever in the world it occurs, to reduce transmission when cases first appear in the United States, and to use the majority of stockpiled antiviral drugs to treat persons who have pandemic illness and may benefit from therapy.
Newly developed Federal guidance[5] recommends expanding antiviral drug use to include prophylaxis (i.e., antiviral use to prevent infection in persons either before or after they are exposed to pandemic influenza) in healthcare and emergency services occupations, for people whose immunity is compromised by an underlying medical condition or treatment, and for people living in group settings (e.g., nursing homes) if an outbreak of pandemic disease occurs at the facility.
The Federal guidance on antiviral use also suggests a potential benefit of prophylaxis for workers who are critical to providing essential community services but leaves decisions on how to identify approaches to purchase and stockpile antiviral drugs to support its implementation to employers.
Household contacts of ill persons also may benefit from prophylaxis.[6]
However, further work is needed to assess the feasibility of stockpiling and providing antivirals for household contacts and to identify approaches to purchase and stockpiling the antiviral drugs to support its implementation.
Despite expanding recommendations for antiviral drug use, there are no current plans for a commensurate expansion of public sector stockpiles and employers will have to take the lead role for protection of their workforce if these recommendations are to be implemented.
Employers may choose to purchase antiviral drugs for stockpiling for several reasons:
(1) to provide prophylaxis for front-line healthcare and emergency services workers (fire, law enforcement, and emergency medical services [EMS]) whose occupations put them at very high or high risk of exposure and infection;
(2) to provide prophylaxis for workers who are critical to essential operations in critical infrastructure businesses to sustain provision of essential community services;
(3) to assure early treatment to employees who become ill[7];
(4) to maintain business continuity; and
(5) to protect overseas employees and operations where U.S. government pandemic response activities will not reach.
In addition to defining an employer's antiviral drug strategy and which workers may be targeted, employers may also consider protecting workers who must travel during the pandemic and non-employees such as contractors or volunteers.
Decisions on stockpiling should be made in the context of pandemic planning and preparedness, broadly, in which a range of protective measures are used to minimize employee infections during a pandemic, particularly for those employees at high risk for exposure to or severe diseases from complications of pandemic influenza.[8]
Nonpharmaceutical interventions such as isolation of ill persons, quarantine of household members, and social distancing will be the first line of defense for employers during a pandemic.
Antiviral drugs are only one tool that should be counted on to help mitigate a pandemic influenza, as their ultimate effectiveness in treating pandemic illnesses cannot be predicted in advance.
In addition, it is important that employers be aware of the potential impacts and potential side effects of antiviral medications, the legal requirements and strategies for stockpiling and dispensing, ethical considerations in providing antiviral medications to some portion or all of the workforce, as well as the current public sector stockpile strategies.
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<cite cite="http://pandemicflu.gov/vaccine/antiviral_employers.html">Considerations for Antiviral Drug Stockpiling by Employers in Preparation for an Influenza Pandemic</cite>
Summary
Optimal planning and preparation for an influenza pandemic requires coordinated efforts by every part of society including individuals and families, communities, employers in public and private sectors, and all levels of government.
Federal, State, and local governments will implement strategies to protect the public in an influenza pandemic. Employers also will play a key role in protecting employees' health and safety, thereby limiting pandemic impacts on health, the economy, and society.
As part of their comprehensive pandemic planning, some employers (from public and private sectors) have asked for guidance about whether they should stockpile or otherwise arrange for influenza antiviral drugs to be available for their employees during a pandemic.
Private stockpiles, in coordination with public health stockpiles, would extend protection more broadly than could be achieved through the public sector alone and improve the ability to achieve the national pandemic response goals of mitigating disease, suffering, and death, and minimizing impacts on the economy and functioning of society.[1]
The Federal Government strongly encourages all public and private sector employers, regardless of size, to plan for a pandemic, to protect the health of employees and assure continuity of operations.[2]
Influenza antiviral drugs (antivirals) are one of several approaches to protecting people during a pandemic and can serve as an important part of a layered approach to pandemic mitigation.
In some cases, employees whose jobs would normally involve very high or high exposure risk to known/suspected pandemic patients may reduce or eliminate exposure through engineering, administrative and work practice strategies.
Nonpharmaceutical measures and personal protective equipment should also be used as a critical component of an employer's plan to protect employees during a pandemic.
Employers that provide frontline healthcare and emergency services should plan to protect their employees who will be exposed to ill persons during a pandemic.
This guidance recommends providing antiviral prophylaxis to these very high exposure risk and high exposure risk employees[3] for the duration of community pandemic outbreaks to prevent illness.
Businesses that provide goods or services essential to community health, safety, or well-being have an obligation to plan and prepare for continued operations in the event of a pandemic.
As a part of comprehensive pandemic planning, these critical infrastructure[4] employers should strongly consider providing antiviral prophylaxis for the small number of employees who are critical to essential operations.
In addition, other employers may consider antiviral prophylaxis for workers in order to maintain business continuity.
If an employer is considering stockpiling antiviral drugs, it should do so with a clear understanding of the legal, regulatory, ethical, logistical, and economic issues that will be encountered in ordering, storing, securing and dispensing prescription medications.
Employers should work with their company or contracted occupational health providers/services to plan for stockpiling antivirals.
This guidance does not establish the requirement or expectation that all employers stockpile antiviral drugs; rather, it defines a prudent strategy for employer antiviral drug stockpiling and use that can contribute to a more effective pandemic response.
Any employer that chooses to stockpile antivirals should do so as part of comprehensive pandemic preparedness and response activities in coordination with State and local pandemic preparedness plans and in conjunction with other measures to protect workers and maintain continuity of operations.
Antiviral drug stockpiles have been established at the Federal level and many States have also established stockpiles.
Current recommendations focus on using up to 6 million courses of the Federally stockpiled antiviral drugs as part of a comprehensive public health response to contain the initial pandemic outbreak, wherever in the world it occurs, to reduce transmission when cases first appear in the United States, and to use the majority of stockpiled antiviral drugs to treat persons who have pandemic illness and may benefit from therapy.
Newly developed Federal guidance[5] recommends expanding antiviral drug use to include prophylaxis (i.e., antiviral use to prevent infection in persons either before or after they are exposed to pandemic influenza) in healthcare and emergency services occupations, for people whose immunity is compromised by an underlying medical condition or treatment, and for people living in group settings (e.g., nursing homes) if an outbreak of pandemic disease occurs at the facility.
The Federal guidance on antiviral use also suggests a potential benefit of prophylaxis for workers who are critical to providing essential community services but leaves decisions on how to identify approaches to purchase and stockpile antiviral drugs to support its implementation to employers.
Household contacts of ill persons also may benefit from prophylaxis.[6]
However, further work is needed to assess the feasibility of stockpiling and providing antivirals for household contacts and to identify approaches to purchase and stockpiling the antiviral drugs to support its implementation.
Despite expanding recommendations for antiviral drug use, there are no current plans for a commensurate expansion of public sector stockpiles and employers will have to take the lead role for protection of their workforce if these recommendations are to be implemented.
Employers may choose to purchase antiviral drugs for stockpiling for several reasons:
(1) to provide prophylaxis for front-line healthcare and emergency services workers (fire, law enforcement, and emergency medical services [EMS]) whose occupations put them at very high or high risk of exposure and infection;
(2) to provide prophylaxis for workers who are critical to essential operations in critical infrastructure businesses to sustain provision of essential community services;
(3) to assure early treatment to employees who become ill[7];
(4) to maintain business continuity; and
(5) to protect overseas employees and operations where U.S. government pandemic response activities will not reach.
In addition to defining an employer's antiviral drug strategy and which workers may be targeted, employers may also consider protecting workers who must travel during the pandemic and non-employees such as contractors or volunteers.
Decisions on stockpiling should be made in the context of pandemic planning and preparedness, broadly, in which a range of protective measures are used to minimize employee infections during a pandemic, particularly for those employees at high risk for exposure to or severe diseases from complications of pandemic influenza.[8]
Nonpharmaceutical interventions such as isolation of ill persons, quarantine of household members, and social distancing will be the first line of defense for employers during a pandemic.
Antiviral drugs are only one tool that should be counted on to help mitigate a pandemic influenza, as their ultimate effectiveness in treating pandemic illnesses cannot be predicted in advance.
In addition, it is important that employers be aware of the potential impacts and potential side effects of antiviral medications, the legal requirements and strategies for stockpiling and dispensing, ethical considerations in providing antiviral medications to some portion or all of the workforce, as well as the current public sector stockpile strategies.
(...)
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