Severe Acute Respiratory Syndrome
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SEVERE ACUTE RESPIRATORY SYNDROME |
It is inconceivable that there is anyone who is not familiar with the SARS (Severe Acute Respiratory Syndrome) outbreak. It is a new form of pneumonia that does not conform to any previously known type (i.e. atypical).
The Nature of the Problem
The incubation period, before symptoms appear, is in the range 2 to 7 days, though there have been reports of exceptional cases where incubation has taken 10 days. The initial indication of infection is a fever, accompanied by chills, headache, aching muscles and general feeling of malaise. After 3 to 7 days, a dry unproductive cough develops and, in some cases, the condition results in hypoxemia - reduced concentration of oxygen in the blood - and as a consequence, patients need some form of assistance with their breathing. Some cases are fatal, though at present it is still uncertain how many - perhaps somewhere between 4% and 10% of those who are infected.
The problem is that scientists and the medical community are still in the dark as regards its cause or even the source of the disease. Consequently, there is currently no known cure. At present, the best advice is to apply the same treatment as for any other serious type of pneumonia. Since there is no specific antiviral treatment, the most effective approach is to implement controls to eliminate, or at least minimise, the likelihood of infection in the first place.
SARS spreads in much the same way as many other respiratory diseases, by close contact with someone who is already infected. For example, if an infected person coughs or sneezes, they may contaminate their surroundings. Someone in close proximity can become infected by breathing in the droplets or by picking them up on their hands from a contaminated surface and then transferring the infection to their mouths. There may be other possibilities, but this appears to be the primary mechanism.
The Health & Safety Risks
So how should companies respond to this threat in terms of Health and Safety?
The first step is to assess the health risks to employees, which will vary dramatically according to the nature of the organisation's business and even for different activities within the same organisation. For example, people in the travel industry who visit those countries where the infection is most rife (currently Canada and Asian Pacific countries such as China, Singapore and Vietnam), or who frequently meet other travellers to such countries, are clearly at considerably higher risk than employees working in an office where they rarely meet other people.
The obvious first risk to consider, therefore, is the possibility of close contact with infected persons, either through travelling to other countries or by mixing with people who have. Even though it may not initially result in infection, being in the wrong place at the wrong time could result in being quarantined, along with others who are suspected of being infected. Apart from the inconvenience and cost this might cause, the conditions of such quarantine may themselves be conducive to contracting the virus.
Of course companies are not only responsible for the health and safety of their own employees. Their responsibility extends to others who might be affected by their activities. If, for example, infection was spread to members of the public as a result of negligence or recklessness on the part of a company, that company could be held responsible for such infections.
Reducing the Risks
When establishing controls, the preferred approach is to eliminate the risk as far as possible, which means avoiding travel to places where the virus is known to be rife and close contact with other people who are suspected of being infected. This might involve changing business plans or finding an alternative means of achieving the same objective that doesn't involve travel. In terms of taking all reasonable precautions, a company would be wise to heed advice of the recognised health authorities when deciding whether or not to travel on business. These might include, for example, our own governmental health bodies, those of the country to which the trip is to be made and such international bodies as the World Health Authority. Another important consideration is to ensure that trips made to such countries are entirely on a voluntary basis.
If travel, or other reasons for potential close contact with infected persons, cannot be avoided, the next option is to minimise the risks. Ensure employees are aware of the level of risk to which they are being exposed and that they are also aware of the symptoms of SARS. As far as possible, they should avoid any places or situations where close contact with other people is unavoidable.
Masks can offer some protection but for maximum effectiveness they must comply with international standards for microbial respiratory protection (i.e. N-95). The Public Health Laboratory Service (UK) recommends the 3M 1873 V respirator/mask or the Technol PFR 95 respirator/mask. Although not as effective, even simple surgical masks can provide some level of protection. Masks should be purchased before travelling since the most effective models have sold out in the countries most affected.
Good personal hygiene is important; particularly washing and disinfecting the hands. The virus has been shown to be killed by exposure to antiseptics. As far as possible, avoid touching the face, particularly around the areas of the mouth, nose and eyes. Avoid sharing personal items such as cutlery, towels, etc. and regularly disinfect household surfaces such as work surfaces, washbasins and toilets.
Avoiding hospitals and crowds in general is also a good idea. However, if symptoms develop, this may be unavoidable. The risk then is that local medical services may not meet western standards, and further complications may arise if the traveller is unfamiliar with the local language. A wise precaution, therefore, is to pre-arrange ready access to a western medical advisor if at all possible.
Organisations who have employees travelling to the most affected countries would also be wise to consider the impact on business continuity should one of their employees develop the symptoms after returning home. Regardless of whether or not there is a requirement to formally notify the authorities about the suspected infection, it is essential that the individual should seek urgent medical help. There is then the possibility that parts of the workforce might be quarantined or that other employees may simply refuse to attend for work. Unfortunately there are still many unknowns and any company faced with this scenario would be well advised to contact their Health & Safety consultant and Occupational Health advisor for professional advice on the best course of action.
There is unprecedented international co-operation to try and find an effective cure for the SARS virus. In mid March an international research network was created to bring together the resources of the top laboratories from 10 countries. This has already resulted in the development of two diagnostic tests. Although the work is still in its early stages, it is a step in the right direction and with such cooperation we can look forward with some confidence to a cure being found in the not too distant future. In the meantime, however, everyone needs to adopt the usual health and safety common sense approach to risk reduction.
Further Information
For further information and up to date progress on the infection and possible cure, the following Internet links may prove useful:
See Concepts for a broader perspective on Managing Health & Safety
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David Skews, (CEO)
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EDP Health Safety & Environment Consultants Ltd
Lakeside, Alexandra Park, Prescot Road, St. Helens, Merseyside, UK
Telephone: +44(0)1744 766000
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