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Planning for 2009 H1N1 Influenza

A Preparedness Guide for Small Business
02 Foreword

03 Introduction

04 How to Write Your Plan

05 Keeping Healthy: 10 Tips for Businesses 

06 Keeping Healthy: 8 Tips for Individuals

07 Frequently Asked Questions

08 More Resources

Table of Contents
As a small business leader, you are a valuable partner in our nation’s defense 

against natural and man-made threats. Preparedness is the best method to 

defend against the impacts of all threats and all hazards, including public 

health threats.

As we face the possibility of a wider H1N1 influenza outbreak, it is difficult to 

predict how the virus may or may not change. However, we know the nation 

must be prepared to respond appropriately. The Department of Homeland 

Security is working to ensure you have the necessary tools and information 

to be prepared as well. The severity of illness that 2009 H1N1 influenza flu will 

cause (including hospitalizations and deaths) or the amount of illness that may 

occur as a result of seasonal influenza during the 2009–2010 influenza season 

cannot be predicted with a high degree of certainty. Therefore, small businesses 

should plan to be able to respond in a flexible way to varying levels of severity 

and be prepared to take additional steps if a potentially more serious outbreak 

of influenza evolves during the fall and winter.

Small businesses are often the backbone of private sector industries and their 

local communities. With this in mind, we must partner to ensure the wheels of 

the nation’s economy continue to turn, even if faced with absenteeism, restricted 

services, and supply chain disruptions. If prepared, small businesses can keep 

their doors open and our nation’s economic health and security resilient.

The most important thing you can do to prepare your business is to have a 

written plan.

This guide is intended to help you write your plan and help spread the message 

of preparedness. Also, encourage your employees to prepare their own homes 

and families, which includes having a plan to care for sick family members and 

storing a two-week supply of food and medical supplies. More information is 

available at www.flu.gov. With your help, we can help keep our economy and 

our communities healthy and safe.

Yours truly,

Janet Napolitano

Secretary of Homeland Security

September 2009

Foreword
Introduction

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Small businesses play a key role in protecting employees’ health and safety as well as limiting 

the impact to the economy and society during an influenza pandemic. Advance planning for 

pandemic influenza, a novel infectious disease that could occur in varying levels of severity, is 

critical. Companies that provide critical services, such as power and telecommunications, have 

a special responsibility to their community to plan for continued operations in a pandemic and 

should plan accordingly. 

A new influenza virus, now called 2009 H1N1 influenza, or 2009 H1N1 flu, first caused illness

in Mexico and the United States in March and April, 2009. On June 11, 2009, the World

Health Organization (WHO) signaled that a global pandemic of 2009 H1N1 flu was underway

by raising the worldwide pandemic alert level to Phase 6. This action was a reflection of the

spread of the new 2009 H1N1 flu virus across the globe, not the severity of illness caused by

the virus. At the time, more than 70 countries had reported cases of 2009 H1N1 flu infection

and there were ongoing community level outbreaks of 2009 H1N1 flu in multiple parts of

the world. Since June, this new H1N1 virus has continued to spread. The Centers for Disease

Control and Prevention (CDC) anticipates additional cases, hospitalizations and deaths 

associated with this pandemic in the United States during the U.S. 2009–2010

influenza season.

Community strategies that delay or reduce the impact of a pandemic (also called 

nonpharmaceutical interventions) may help reduce the spread of disease until a vaccine is 

available. Over the past several years, the Department of Health and Human Services (HHS), 

the CDC, and the Occupational Safety and Health Administration have developed guidelines, 

including checklists, to assist businesses, industries, and other employers in planning for a 

pandemic outbreak as well as for other potential disasters. 

The Department of Homeland Security, the CDC, and the Small Business Administration have

developed this booklet to help small businesses understand what impact a new influenza virus, 

like 2009 H1N1 flu, might have on their operations, and how important it is to have a written 

plan for guiding your business through a possible pandemic.

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Identify a workplace coordinator who will be responsible for dealing with 2009 H1N1 flu issues and their 

impact at the workplace, including contacting local health 

department and health care providers in advance and 

developing and implementing protocols for response to ill 

individuals. The coordinator should not wait for flu season 

to start in order to establish those contacts and relationships, and check online resources of local public health 

officials immediately to learn what you should be doing.

Examine policies for leave, telework, and employee 

compensation and review with all employees so they 

are up-to-date on sick leave policies and employee 

assistance services that are covered under any of your 

employee-sponsored health plans. Leave policies should 

be flexible, non-punitive, and well-communicated. They 

should allow workers who have the flu to stay home and 

away from co-workers. Also, plan to have workers stay 

home if they have to care for sick family members. Be prepared, in the event that there are school closures, to allow 

workers flexible schedules or other accommodations so 

they can mind their children and keep them safe at home. 

Explore the possibility of some of your workers working 

from home with appropriate infrastructure support.

Determine who will be responsible for assisting

ill individuals in the workplace, and make sure at 

least one person can serve as the “go to” person if a 

worker becomes sick at the workplace. 

Identify essential employees, essential business functions, and other critical inputs (e.g. raw 

materials, suppliers, subcontractor services/products, 

and logistics) required to maintain business operations 

should there be disruptions during the 2009 H1N1 flu 

outbreak – and make plans on how to communicate with 

people that perform essential tasks to provide them 

assignments and work direction. Explore other ways you 

can continue business operations if there are supply 

chain or other disruptions. 

Share your pandemic plans with employees and 

clearly communicate expectations. It is important 

to let your employees know your plans and expectations 

when 2009 H1N1 flu outbreaks occur in communities 

where you have a workplace. Consider ways to communicate with employees who do not speak English or those 

with disabilities.

Prepare business continuity plans so that if there 

is significant absenteeism or changes in the way you 

need to conduct business in the workplace during 

this outbreak you can maintain operations. School 

dismissals and childcare provider closures may 

increase absenteeism in the workplace. Health officials 

may also advise that workplaces take multiple steps 

to increase the space between people and decrease 

the frequency of contact among people, also known as 

“social distancing” to reduce the spread of illness during 

a more severe outbreak.

Establish an emergency communications plan. 

This plan includes identification of key contacts (with 

back-ups), chain of communications (including suppliers 

and customers), and processes for tracking and communicating business and employee status. 

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How to Write Your Plan

As a small business owner or employee, you do not want to be caught unprepared when the flu season hits. 

Regardless of the size or type of your business, a bit of planning now can put strategies into place that will 

help protect the business and its employees, when 2009 H1N1 flu hits. Plan now for the return of 2009 H1N1 

to your community and for the potential for a more severe outbreak. It is important that the following list of 

recommendations be reviewed carefully and applied in the most appropriate way to your small business.
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Develop policies that encourage ill workers to stay 

at home without fear of any reprisals. 

Develop other flexible policies to allow workers 

to telework (if feasible) and create other leave 

policies to allow workers to stay home to care for sick 

family members or care for children if schools close.

Provide resources and a work environment that 

promotes personal hygiene. For example, provide 

tissues, no-touch trash cans, hand soap, hand 

sanitizer, disinfectants and disposable towels for 

workers to clean their work surfaces. 

Provide education and training materials in an 

easy to understand format and in the appropriate 

language and literacy level for all employees. 

See www.cdc.gov/h1n1flu/business. 

Instruct employees who are well but who have 

an ill family member at home with the flu that 

they can go to work as usual. These employees 

should monitor their health every day, and notify their 

supervisor and stay home if they become ill. Employees 

who have a certain underlying medical condition or 

who are pregnant should promptly call their health care 

provider for advice if they become ill. 

Encourage workers to obtain a seasonal influenza 

vaccine, if it is appropriate for them according to 

CDC recommendations (http://www.cdc.gov/flu/

protect/keyfacts.htm). This helps to prevent illness from 

seasonal influenza strains that may circulate at the 

same time as the 2009 H1N1 flu. 

Encourage employees to get the 2009 H1N1 

vaccine when it becomes available if they are in 

a priority group according to CDC recommendations. 

For information on groups recommended for seasonal 

and H1N1 vaccines, please see www.flu.gov. Consider 

granting employees time off from work to get vaccinated 

when the vaccine is available in your community.

Provide workers with up-to-date information on 

influenza risk factors, protective behaviors, and 

instruction on proper behaviors (for example, cough 

etiquette; avoid touching eyes, nose and mouth; 

and hand hygiene). 

Plan to implement practices to minimize face-toface contact between workers if advised by the 

local health department. Consider the use of such 

strategies as extended use of e-mail, websites and 

teleconferences, encouraging flexible work arrangements 

(for example, telecommuting or flexible work hours) to 

reduce the number of workers who must be at the work 

site at the same time or in one specific location. 

If an employee does become sick while at work,

place the employee in a separate room or area until 

they can go home, away from other workers. If the 

employee needs to go into a common area prior to 

leaving, he or she should cover coughs/sneezes with a 

tissue or wear a facemask if available and tolerable. Ask 

the employee to go home as soon as possible.

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Employees are a crucial resource at any business, and especially small businesses. There are steps you 

can take now, and during the flu season, to help protect the health of your employees.

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Keeping Healthy: 10 Tips for Businesses
06

Keeping Healthy: 8 Tips for Individuals

Stay home if you are sick with influenza-like illness 

for example, fever or chills AND cough or sore throat. In 

addition, symptoms of flu can include runny nose, body 

aches, headache, tiredness, diarrhea, or vomiting. CDC 

recommends that sick workers stay home if they are ill 

with influenza-like illness until at least 24 hours after 

they are free of fever (100° F [37.8° C] or greater) 

or signs of a fever without the use of fever-reducing 

medications. This would require employees to stay 

home for 3 to 5 days in most cases. CDC recommends 

this time period away from work regardless of whether 

or not antiviral medications are used.

Wash your hands frequently with soap and water 

for 20 seconds or use an alcohol-based hand sanitizer 

if soap and water are not available. 

Avoid touching your nose, mouth and eyes. 

Cover your coughs and sneezes with a tissue, or 

cough and sneeze into your upper sleeve. Dispose of 

tissues in no-touch trash receptacles. 

Wash your hands or use an alcohol-based hand 

sanitizer after coughing, sneezing, or blowing 

your nose. 

Keep frequently touched common surfaces 

clean. For example, telephones, computer 

equipment, etc.

Try not to use other workers’ phones, desks, 

offices, or other work tools and equipment. 

If necessary, consider cleaning them first with a 

disinfectant. 

Maintain a healthy lifestyle; attention to rest, diet, 

exercise, and relaxation helps maintain physical and 

emotional health.

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In addition to the actions a small business employer can take to help protect the health of their 

employees, there are actions which employees may take to protect their own health, and that of those 

around them. Employers should review this list and encourage employees to read it and practice good 

health habits.
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What is 2009 H1N1 flu?

2009 H1N1 flu is a new influenza virus causing illness in 

people. Most people do not have immunity to this virus, so it 

spreads quickly. 

People with the flu spread the virus through coughing or sneezing near others. Sometimes people may become infected by 

touching something with flu viruses on it and then touching 

their eyes, mouth, or nose.

Those currently at higher risk of serious flu-related complications from 2009 H1N1 flu include children younger than five 

years old, pregnant women, people of any age with certain 

chronic medical conditions (such as asthma, diabetes, heart 

disease), adults and children who have a weak immune system, 

residents of nursing homes and other chronic-care facilities 

and persons aged 65 years or older. See http://www.cdc.gov/

h1n1flu/qa.htm for more information about high risk groups.

What are the signs and symptoms 

of 2009 H1N1 flu in people?

The symptoms of seasonal and 2009 H1N1 flu virus in people 

include fever or chills AND cough or sore throat. In addition, 

symptoms of flu can include runny nose, body aches, headache, 

tiredness, diarrhea, or vomiting. Like seasonal flu, 2009 H1N1 

flu may cause a worsening of underlying chronic medical 

conditions.

In adults, emergency warning signs that need urgent 

medical attention include:

! Difficulty breathing or shortness of breath 

! Pain or pressure in the chest or abdomen 

! Sudden dizziness 

! Confusion 

! Severe or persistent vomiting 

! Flu-like symptoms improve but then return 

with fever and worse cough

In children, emergency warning signs that need urgent 

medical attention include: 

! Fast breathing or trouble breathing 

! Bluish or gray skin color 

! Not drinking enough fluids 

! Severe or persistent vomiting 

! Not waking up or not interacting 

! Being so irritable that the child does not want to be held 

!!!Flu-like symptoms improve but then return with fever and 

worse cough 

Severe illness (pneumonia and respiratory failure) and deaths 

have been reported with 2009 H1N1 flu infection in some 

people. 

How long should a person stay out of work if 

they have an influenza-like illness?

Workers who have symptoms of influenza-like illness 

(see above) should stay home and not come to work until at 

least 24 hours after their fever has resolved. You should plan 

now to allow and encourage sick workers to stay home.

When will it hit my community and 

how serious will it be?

The 2009 H1N1 flu influenza virus may affect different communities at different times and in different ways. The flu may 

make many more people sick then usual, or it may not. We will 

likely see a re-emergence or continued outbreak in communities 

as the regular 2009–2010 flu season begins this fall.

Why should small business owners plan 

for 2009 H1N1 flu?

Small businesses are especially susceptible to the negative 

economic impacts of a flu pandemic. An estimated 25 percent of 

businesses do not reopen following a major disaster, according 

to the Institute for Business and Home Safety. Planning from the 

outset can help offset business losses, and protect your business 

and your employees when this flu hits. Benefits of planning are: 

! Minimize disruption to business activities

! Protect employees’ health and safety

!!!Limit the negative impact to the community, 

economy and society

What steps should you be prepared to take 

when the H1N1 flu hits your community?

CDC recommends that sick people stay home and away from 

the workplace. The best way to slow the spread of the disease is 

to keep sick people away from well people, given that the 2009 

H1N1 flu virus is a new virus and most people will not have 

prior immunity to protect them from acquiring infection. If 

sick people come to work, they may infect other workers, and 

this has the potential to lead to a high rate of absenteeism in 

the workplace. 

Your business’s actions should be tied to the extent and severity 

in your local area. Choose someone to be responsible for flu 

issues at the workplace. They should contact the local heath 

department for guidance and monitor the level and severity of 

2009 H1N1 flu illness in your business’ community and region, 

and sign up for e-mailed updates from www.cdc.gov/h1n1flu.

Where can I go for more resources?

Additional website links can be found on the last page of this 

guide. More resources can be found online at www.flu.gov, a 

one-stop access to U.S. Government 2009 H1N1 flu, avian and 

pandemic flu information. Also go to http://www.ready.gov/

business/ for help on preparing a business continuity plan.

Frequently Asked Questions
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2009 H1N1 Flu Resources for Businesses and Employers

http://www.cdc.gov/h1n1flu/business/

http://flu.gov/plan/workplaceplanning/index.html

CDC Guidance for Businesses and Employers To Plan and Respond to the 2009–2010 Influenza Season

http://www.cdc.gov/h1n1flu/business/guidance/

Preparing for the Flu: A Communication Toolkit for Businesses and Employers

http://www.cdc.gov/h1n1flu/business/toolkit/

Occupational Safety and Health Administration (OSHA) Hotline

1-800-321-OSHA

What Employers Can Do to Protect Workers from Pandemic Influenza (OSHA)

https://www.osha.gov/Publications/employers-protect-workers-flu-factsheet.html

CDC/NIOSH Occupational Health Issues Associated with 2009 H1N1 Influenza Virus 

http://www.cdc.gov/niosh/topics/h1n1flu/

Healthcare Workplaces Classified as Very High or High Exposure Risk for Pandemic Influenza

http://www.osha.gov/Publications/exposure-risk-classification-factsheet.html

Cover Your Cough

http://www.cdc.gov/flu/protect/covercough.htm

Stopping the Spread of Germs at Work

http://www.cdc.gov/germstopper/work.htm

Workplace Questions: 

http://www.pandemicflu.gov/faq/workplace_questions/index.html

Community Mitigation Measures

http://www.pandemicflu.gov/plan/community/commitigation.html)

OSHA Website for Businesses

https://www.osha.gov/dsg/topics/pandemicflu/index.html

DHS.gov: For General Updates on 2009 H1N1 Influenza Preparedness and Response

http://www.dhs.gov

Disaster Assistance and Recover Resources from the ASBDC

http://www.asbdc-us.org/Resources/Disaster.html

Central Repository of Federal Disaster Assistance from 13 Agencies

http://www.disasterassistance.gov/daip_en.portal

FEMA’s Guidance on Business Continuity

http://www.fema.gov/business.index.shtm

SBA’s Disaster Preparedness Page

http://www.sba.gov/services/disasterassistance/disasterpreparedness/index.html

Every Business Should Have an Emergency Plan

http://www.ready.gov/business/

More Resources
For more information visit: www.ready.gov and www.flu.gov