Medicare Agent News: Are you a comfort giver or a flu giver?

That’s the question the UK’s South West Yorkshire Partnership NHS Foundation Trust recently posed in a series of advertisements targeting its employees. In one advert, an elderly woman reaches out to a nurse, who shares a smile — and perhaps the flu virus. In another, a boy tightly hugs the neck of a caregiver who may well be infected even though she shows no symptoms.¹

Those adverts helped the trust win a Flu Fighter Award from the NHS Employers organisation in 2019.² More importantly, they helped the trust convince a high number of employees to get flu vaccines. In fact, thanks to several years of promotional campaigns, the trust has increased the share of frontline health care workers who have been immunised to 76.1 percent in 2018-2019, compared with just 33 percent a few years earlier. (The average uptake across the NHS was 73.1 percent.) ³ As Jude Tipper, Head of Marketing, Communications and Engagement for the trust said, “We knew that the creative concept for this campaign was hard hitting and would get people talking about their reasons for having — or not having — their flu jab.”⁴

Getting workers to talk — and to get a flu jab — is important as it can save organisations money while saving workers’ misery. “Flu vaccines represent a true win-win situation,” says Dr Lori Stetz, Senior Medical Director, Aetna International. “Smart organisations make every effort to get their workers vaccinated because they realise how expensive the alternative is financially - due to lost productivity, and emotionally – due to low workforce spirit.”

How expensive? In the midst of the 2017-2018 flu season, global outplacement and executive coaching firm Challenger, Gray and Christmas, predicted that the flu would cause $21.39 billion in lost productivity and that 25 million workers would fall ill.⁵ For high-risk individuals the flu can cause more than just a week or so of misery. According to the World Health Organization, “Worldwide, these annual epidemics are estimated to result in about 3 to 5 million cases of severe illness and about 290,000 to 650,000 respiratory deaths.”⁶ In light of these figures, organisations owe it to themselves and to their workers to become flu fighters.

About the flu

Influenza is a respiratory illness caused by influenza viruses, (which mutate frequently, causing past inoculations to be ineffective). Symptoms can include fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches and fatigue. While anyone can get the flu, the illness is more serious for children under age 5, adults 65 years and older, pregnant women and people with certain chronic medical conditions, including asthma, diabetes and heart disease. According to the U.S. Centers for Disease Control and Prevention (CDC), about 8 per cent of the U.S. population gets the flu each year.⁷

In temperate climates, outbreaks mostly occur during the winter months, but tropical regions can see irregular outbreaks throughout the year. Flu’s seasonality in temperate areas is due to the virus’s ease of transmission in close quarters. As the WHO notes, “When an infected person coughs or sneezes, droplets containing viruses (infectious droplets) are dispersed into the air and can spread up to one meter and infect persons in close proximity who breathe these droplets in. The virus can also be spread by hands contaminated with influenza viruses.”⁸

Hands may be the leading cause of transmission, according to research conducted at the University of Arizona a few years ago. Researchers there sprayed the hands of a single worker in an 80-person campus office with artificial viruses mimicking the flu and two other illnesses (and masked that person’s identity by spraying the hands of other workers with plain water). Even though just one employee carried the viruses, within four hours 50 percent of employees and office surfaces — telephones, coffeepot handles, photocopier buttons, etc. — had been infected. “We really felt that the hand was quicker than the sneeze in the spread of disease,” said Professor Charles Gerba, a co-principal investigator on the study. “Most people think it’s coughing and sneezing that spreads germs, but the number of objects you touch is incredible, especially in this push-button generation. We push more buttons than any other generation in history.”⁹

According to the CDC, “You may be able to pass on flu to someone else before you know you are sick, as well as while you are sick. Some otherwise healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick.”¹⁰

“Since you can be contagious even when you don’t feel sick, it probably makes sense to assume you’re contagious during flu season — and to assume that your co-workers are ill as well,” says Dr Lori Stetz, Senior Medical Director, Aetna International.

About the flu shot

For more than six decades the best way to prevent the flu has been to get an annual flu shot. Each year, authorities at the CDC and other partners in the WHO Global Influenza Surveillance and Response System determine the strains of flu most likely to be prevalent in the coming flu season and provide those strains to commercial vaccine manufacturers. The manufacturers then create either trivalent or quadrivalent vaccines, depending on whether three or four strains are included. Traditionally, all vaccines were created using an egg-based process, but in the last decade cell-based and recombinant vaccines have been approved.¹¹

The CDC recommends that virtually everyone over the age of 6 months receive a flu vaccine. In fact, it says the only people who definitely should not be vaccinated are infants and people with “severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine.” Those people must rely on herd immunity, whereby transmission risks are reduced because most people in the community have been immunised.^12,13

Vaccines work by introducing killed or weakened viruses into the body, a process that stimulates antibodies to fight the virus. Vaccines work best when there’s a good match between the viruses included and the viruses in circulation, but even a partial match is better than nothing. One study in New Zealand found a 59 percent reduction in intensive care unit (ICU) admissions for flu patients who had been vaccinated. As the researchers concluded, “Inactivated influenza vaccines prevented influenza-associated ICU admissions, may have higher effectiveness in ICU than GW [general ward] hospital settings and appeared to reduce the risk of severe disease among those who are infected despite vaccination.”¹⁴

It takes about two weeks for antibodies to develop, so authorities recommend getting vaccinated shortly before flu season starts. (Late September or early October seems to be about right in the Northern Hemisphere.) That said, many authorities believe it’s possible to get vaccinated too early. “We know that antibodies peak four to six weeks after getting a vaccine and then slowly go down over the next six months,” said Ann Falsey, MD, Professor of Medicine, University of Rochester Medical Center, told Health magazine. “There are some theoretical concerns toward spring that you might be less protected if you get vaccinated too early.”¹⁵

Flu shot misconceptions

Despite the overwhelming evidence in favour of getting an annual flu shot, many people — even some health care workers — harbour misconceptions. Some believe they can catch the flu from the flu shot, some believe they’re in groups that shouldn’t be vaccinated due to risk factors and some believe the shot is rarely effective.

That last misconception is exacerbated in years when the vaccine ends up being a poor match for the dominant flu viruses (such as in 2014-2015, when the vaccine was just 23 percent effective).¹⁶ As a recent paper in the journal Health Promotion International noted, “We see when the vaccine fails to protect us; but when the vaccine does work, we do not see anything different from our normal state of being. Thus, negative experiences with the flu shot … could cause us to overestimate the failure rate of flu shots.” Moreover, the news media are far more likely to report vaccine failures than vaccine successes.¹⁷

Preventing the spread of the flu

Even if this year’s vaccine is not a good match and even if most people in the office fail to get vaccinated, there are other steps you can take to keep workers healthy. After University of Arizona researchers discovered how quickly viruses spread in that 80-person campus office, they repeated their experiment. This time, however, they first implemented a “healthy workplace” initiative that include hygiene instructions and free tissues and hand sanitiser. This time, the rate of infection dropped below 10 per cent. “The take-home message here is that very simple interventions that we all kind of know about have great efficacy,” said Associate Professor Kelly Reynolds, a co-principal investigator on the study. “Using tissues to wipe your face, using hand sanitizer or having it available for use and washing your hands before lunch and after a big meeting resulted in an 80 per cent reduction across the board, for all three viruses, in their risk of infection.”¹⁸

Of course, those same measures also protect people against the common cold, stomach bugs and other communicable illnesses. For example, the average adult has two to four colds each year, while the average child has six to 10 colds each year — and those mostly occur during flu season.¹⁹ In the U.S., colds lead to approximately 150 million workdays missed when employees are sick and another 126 million workdays missed when employees must stay home to care for their children.²⁰

And that doesn’t count the number of days when people go to work even though they’re ill. According to one survey, a quarter of American workers acknowledge going to work sick — even though 57 percent say they would encourage an ill co-worker to go home.²¹

“Clearly, the best option when you’re sick is to stay home, but we recognise that that’s not always possible,” says Dr Lori Stetz. “The second-best option is to follow precautions to prevent the spread of germs — and to get the flu shot every year.”

Eight corporate flu prevention strategies to consider

The flu benefits no one except perhaps the makers of chicken soup and over-the-counter drugs. Here are eight ideas organisations can implement to prevent the flu from affecting their workers:

1. Provide employee benefits that cover seasonal vaccines. For example, Aetna International’s Summit 5000+ product offers routine health checks and vaccinations for all members.²² And be sure employees are aware of the wellness benefits that are available to them.

2. Develop a comprehensive plan. According to NHS Employers, there are seven key benchmarks to a successful flu campaign: a multidisciplinary team, support at all levels of the organisation, communication, myth-busting, easy access to vaccines, peer vaccinators and awards and incentives. Try to include all those elements in your campaign.²³

3. Host an onsite vaccination clinic. Get senior management buy-in, allow workers to receive vaccinations while on the clock and set goals that teams and the entire organisation can work toward. “Consider creating a ‘jab-o-meter’ where you track the organisation’s progress toward its goal (which should be at least 80 per cent),” says Dr Lori Stetz. “Then celebrate when you reach that goal.”²⁴The CDC offers tips on hosting a vaccination clinic at https://www.cdc.gov/flu/business/promoting-vaccines-workplace.htm.

4. Promote flu prevention through employee communications. As noted above, some people have misconceptions about the flu shot, while others inaccurately weigh costs and benefits.²⁵ Use employee newsletters, worksite screens and bulletin boards and other channels to highlight the importance of vaccinations.

5. Make staying healthy easier. During flu season, ensure that workers have ready access to hand sanitiser and tissues. And if you are considering an office remodel, install hands-free faucets, toilets, soap dispensers and trash bins. “You should also make it a priority to disinfect common areas,” says Lori Stetz. “Some of the dirtiest office surfaces are actual the faucets and appliances in breakrooms.”²⁶

6. Encourage sick employees to go home — and to stay home until at least 24 hours after their fever has broken.²⁷ Also be sure workers are aware of your organisation’s sick-leave policy. “You could encourage employees to work from home if they’re feeling well enough to do so but may still be contagious,” says Dr Lori Stetz. “This can help reduce the number of people who show up at the office sick because they have too much work to do.”

7. Set the right example. When an organisation’s leaders are the first to line up for flu shots and the last to come into the office while sick, rank-and-file employees are more likely to do the right thing as well.

8. Share tips and advice: Regularly sharing articles and information with employees can prompt them to make small adjustments to their behaviours, gradually helping to improve their well-being over time. As an example, read and share 10 tips to prevent and manage flu and other seasonal viruses.

How Aetna can help employers and employees

Healthy behaviours and lifestyle coaching: Aetna International’s care and response excellence (CARE) team clinicians can work with globally mobile employees and those seeking advice/support around developing healthy behaviours. Contact the CARE team for more information by calling the number on the back of your Member ID card or logging in to the Health Hub — your secure member website.

Wellness webinars: Aetna International also provides customers and their employees with access to wellness webinars to help employees live well and feel better. To find out how to tap into the webinars, email the Aetna CARE team here.

Corporate health and wellness programmes: From smoking cessation to mindful eating, we often work with customers to design and roll out in-office health and wellness programmes. These are designed to help employees adopt healthier behaviours, thereby improving their overall well-being.

Read 10 tips to prevent and manage flu and other seasonal viruses or share it with your employees to provide clear guidance on how people can keep germs from spreading.

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