Employers' preparedness for an H1N1 flu pandemic this year varies widely.

There are well-prepared firms with detailed plans in place, some of which are updated versions of plans developed in response to the avian flu scare in 2005; others, however, are just starting to think about it, observers say.

Complicating the scenario is a shortage of H1N1 flu vaccine which, at this point, generally is available only to those at highest risk, such as pregnant women. There is some fear that a sufficient supply may not be available until it is too late to effectively protect the U.S. population. Furthermore, no one knows for sure how hard H1N1 flu will strike.

H1N1 flu symptoms include high fever, cough, sore throat, congestion, body aches, headaches and fatigue, according to the Centers for Disease Control and Prevention in Atlanta. While most victims recover on their own, 20,000 people have been hospitalized and more than 1,000 have died in the United States, according to the CDC. As of Friday, H1N1 flu activity was widespread in 46 states and doctor visits for flulike illnesses were higher than the peak of many regular flu seasons, the CDC said.

Experts say employers should encourage workers to get vaccinated, observe germ-fighting tactics, and stay home if they feel ill, although worker absences may be a challenge (see story, page 25).

“The awareness levels of the disease and the risks it represents vary dramatically” among employers, said Tom Lerche, health care practice leader with Aon Consulting in Chicago.

“It depends on the employer,” said Dr. Russell Robbins, Norwalk, Conn.-based principal and senior clinical consultant with Mercer Inc. “We have seen everything all over the spectrum, from employers still contemplating how to make pandemic plans” to those that are “pretty much in good shape,” he said.

“I think many people are well-prepared from a communications and information perspective because there's so much (information) out there,” said Ophelia Galindo, Orange, Calif.-based principal and national leader, absence and productivity solutions, at Buck Consultants L.L.C.

“I think the weakness is on the operational side,” she said. “We want to make sure that supervisors are communicating” that employees should not come into work sick, but “sometimes supervisors have a tendency to just want people there, regardless of whether they're sick or not.”

Dr. Jeffrey Dobro, principal in Towers Perrin's health care consulting practice in Parsippany, N.J., said many medium- and large-size employers have been thinking about a pandemic since the avian flu and “are as well-prepared as they can be.”

Many employers are focusing on disease prevention through communications efforts that include e-mails and posters. They are teaching workers about proper hand washing, how to sneeze and cough without endangering others, and making hand sanitizers available. They also warn them to stay home if they are ill.

At Caterpillar Inc., the Peoria, Ill.-based heavy equipment maker, for several months has been “proactively communicating” with employees about steps to take to help minimize their exposure, a spokeswoman said.

Some employers are encouraging—and some health care operations are requiring—that employees be vaccinated for H1N1 and seasonal flu.

Patricia Friedman, senior health care consultant with Watson Wyatt Worldwide in New York, said most employers she works with have been giving flu shots onsite because they “want to make it easy” for employees.

For instance, Atlanta-based Home Depot Inc. has health care units that travel to stores to dispense free seasonal flu shots. Employees also can go to walk-in clinics for their seasonal flu shots, although the H1N1 vaccine has been unavailable, a spokesman said.

Home Depot pulled its crisis management team together in the spring, when H1N1 first became an issue, “just to make sure we had all the right people in the loop, and we were covering all the right bases,” said the spokesman, who said its contingency plan was developed to respond to avian flu.

“Prepare before the pandemic hits,” said Dr. Robbins. “The time to assess critically what you have” is when things still are calm.

Buck's Ms. Galindo said contingency plans generally consider staffing. “Some organizations have had layoffs and maybe they're very lean to begin with,” so they are “worried about what happens if 12%, 15% of their people aren't at work in any given day,” she said.

Some employers are preparing by cross-training employees in other jobs. In some cases, employers are going as much as four people deep “with the recognition that going only one person deep may not be sufficient,” said Jayne Lux, vp at the National Business Group on Health in Washington. “Only large employers can do that, and even they certainly struggle with it.”

As far as allowing employees to work from home, Dr. Robbins said employers must consider whether they have the necessary equipment. He said one client was interested in having employees work from home in the event of a pandemic until it realized that buying 1,000 computers “was a big cost they didn't necessarily want to take on.”

Employers are considering holding fewer meetings or social events, or closing common areas such as lunch rooms if a pandemic were severe, said Megan L. Anderson, a principal with law firm Gray Plant Mooty in Minneapolis.

“They are also preparing for what happens if their suppliers, or their own folks who serve them, are disrupted” by the flu, said Ms. Galindo. This could be an issue for instance, for hospitals that use temporary staffing agencies.

Although early demand for seasonal flu shots is higher than normal, the level of demand for the entire flu season remains unclear. That still “remains to be seen,” a spokeswoman for vaccine manufacturer Sanofi Pasteur Inc., which is based in Swiftwater, Pa., said in an e-mail.

Taking precautions

Steps employers should take to avoid the spread of influenza