It’s probably safe to say that so far, 2020 has been a wild ride for the entire world. Every month seems to present a new surprise to wrap our heads around—and by the time we adjust to one crisis or disaster, the next one is here, giving us little time for preparation or prevention.

Luckily, we are already aware of one of the next big “surprises” of 2020: flu season. While it’s not really a surprise since it happens every year, it’s pretty certain that most of us are so distracted by everything else that we barely registered the looming influenza season.

One of the things to remember is that every fall/winter brings us a new version of the flu virus, bringing a fresh “plague” possibly running through the staff at your practice. While many people acknowledge the season by getting a flu shot, that’s usually the extent of preparation and prevention.

Despite Center for Disease Control (CDC) recommendations that you stay home if you have flu-like symptoms, most of us muster up the energy to still come in to work so we don’t leave our co-workers high and dry. Now thanks to the novel coronavirus pandemic, if you even cough or sneeze a few times in the workplace, you’ll likely be asked to go home by management. So, what does this mean for the impending flu season and your practice?

Influenza vs. COVID-19: Similarities and Differences

Both COVID-19 and influenza viruses most commonly impact the upper respiratory system, so many of the symptoms are the same—but there are some differences. Check out these charts created based on information from the CDC:

Signs and Symptoms

Signs/ Symptoms	COVID-19	Flu
Fever or feeling feverish/chills	✓	✓
Cough	✓	✓
Shortness of breath or difficulty breathing	✓	✓
Fatigue (tiredness)	✓	✓
Sore throat	✓	✓
Runny or stuffy nose	✓	✓
Muscle pain or body aches	✓	✓
Headache	✓	✓
Some people may have vomiting and diarrhea, though this is more common in children than adults	✓	✓
Change in or loss of taste or smell	✓

How Soon Symptoms Appear After Exposure and Infection

	COVID-19	Flu
Time window for onset of symptoms	2 to 14 days, on average symptoms develop after 5 days post infection	1 to 4 days post infection

How Long Someone Can Spread the Virus

	COVID-19	Flu
How Long Someone Can Spread the Virus	How long someone can spread the virus that causes COVID-19 is still under investigation.   It’s possible for people to spread the virus for about 2 days before experiencing signs or symptoms and remain contagious for at least 10 days after signs or symptoms first appeared.   If someone is asymptomatic or their symptoms go away, it’s possible to remain contagious for at least 10 days after testing positive for COVID-19.	Most people with flu are contagious for about 1 day before they show symptoms.   Older children and adults with flu appear to be most contagious during the initial 3-4 days of their illness but many remain contagious for about 7 days.   Infants and people with weakened immune systems can be contagious for even longer.

So What Should I Do As An Employer?

Since the pandemic arrived in the United States, workplaces nationwide have had to adjust their philosophies when it concerns sick employees coming to work. Most practices have put policies in place that require employees to stay home if they have any symptoms that could be related to COVID-19.

But based on the charts above, you’re probably wondering how you’re going to know if it’s the flu or COVID-19. Indeed, how do you handle anyone who is symptomatic during flu season?

Assume It’s COVID-19 And Hope It’s the Flu

The bottom line is that there’s really no need to have a separate policy for how to handle illness in the practice during flu season. We suggest you treat all symptoms that could possibly be either illness exactly the same—just ensure your policy addresses:

• How the practice will handle employees with symptoms
• How the practice will handle employees with sick family members at home
• How the practice will handle employees that have been exposed to someone who is COVID-19 positive
• Specifically how and when an employee can return back to work

It is also important to note that per the CDC, people can have both influenza and COVID-19 at the same time. Since this double whammy is possible, you might want to consider sticking to the CDC’s recommendations for ending home isolation based on COVID-related symptoms.

Those guidelines currently are:

• Fever-free for 24 hours without the aid of medication
• 10 days since the onset of symptoms
• All other symptoms have improved

You should also remind employees of what paid and unpaid leave they have available to them if they are ill and/or suffering from COVID-related symptoms. Keep in mind that the Families First Coronavirus Response Act and the Emergency Paid Sick Leave Act are still in effect until December 31, 2020. 

Double Down on Sanitation Protocols

We’ve heard from a lot of clients that one upside of this pandemic is that their hospitals have never been cleaner. We recommend continuing that focus during flu season!

Ensure that all high touch surfaces are being properly cleaned and disinfected multiple times a day in accordance with CDC recommendations. Ensure all employees have access to resources to allow them to regularly wash their hands for a minimum of 20 seconds with soap and water or use alcohol-base hand sanitizer.

Testing and Vaccinations: You’ve Got Options

Luckily, there is a test for both COVID-19 and the flu, so an employee can seek medical attention to determine which virus is causing their symptoms. If an employee gets tested for both the flu and COVID-19 and discloses those results to their manager, management could consider allowing the employee to come back sooner than the CDC’s 10-day recommendation for COVID-19 isolation.

According to research, individuals impacted by the flu are most contagious within three to four days of the onset of symptoms. However, they can still transmit the virus for up to seven days, so it could be argued that a sick employee should stay out of the practice for at least seven days after they become symptomatic.

Please note: we do not recommend that you require an employee to get tested for the flu or for COVID-19. In most states, if an employer makes a task a requirement of employment, that business could be financially responsible for any fees incurred for the test, any time spent to get the test, and in some cases, even the travel expenses to and from the testing facility. By making testing optional, employers should not be held financially responsible. We recognize that this is a fine line you will be dancing, so it’s imperative that you choose your words carefully when discussing testing.

Speaking of optional tasks that are probably a good idea: We suggest you ask your team to consider getting a flu shot this year. Have an all-staff meeting and discuss with your staff how the practice plans to continue to handle illness in the practice, as well as how they can do their part to prevent the spread of influenza by getting vaccinated before November. Again, it’s important to note that we do not recommend making the vaccination a requirement.

Give Your Team A Boost

There are many scientific studies that link stress to a compromised immune system. Right now, everyone is stressed—most veterinary hospitals are busier than ever, and teams are often shorthanded because they have someone out sick. We suggest looking for ways to help your team “reset their batteries” and hopefully give their immune system a boost prior to the start of flu season. Some ideas include:

• Consider giving each employee a “Me Holiday”. This entails coordinating an additional paid day off for each employee during a certain time frame. Essentially, it’s one extra PTO day you’re adding on to this benefits year, but you choose when they get to take this paid day off. We suggest having only one or two people out at a time so the rest of the team doesn’t feel team doesn’t feel understaffed, defeating the purpose of lowering stress levels. This option definitely takes some planning but will ultimately pay off with employees who feel rested and appreciated.

• If coordinating a day off for each person isn’t possible, consider closing down the practice for one day to give the whole team a break. We know, we know—losing a full day of revenue sounds like crazy talk, but hear us out. Clients will understand and appreciate that you are going the extra mile to take care of your staff so they can get reenergized. The staff will also appreciate the day, boosting morale. Consider writing the question “What are you going to do with your extra day off?” on one of your white boards and letting the team share fun ideas. It’s a great distraction from everything else going on in the world! You’ll hopefully be compensated for lost revenue by a boost in productivity and a mentally and physically healthier staff. 

• If the business cannot afford to give everyone a day off or shut down the practice for a day, consider finding alternate ways during the day to help the team pause. Consider blocking off an hour just before lunch for everyone to do an online yoga class or a mindfulness meditation. You and the team could take the time to pause the day and have a socially distant cup of coffee together and talk about life. Laughter and connecting on a deeper level are always a great way to give your battery a quick little charge.  

We know this added complication of flu season is probably one of the last things you want to think about right now, but our hope is that these suggestions can help you feel better prepared for this next 2020 hurdle. Control what you can control within your hospital. While you may not be able to stop the spread of these viruses, you can help your team focus on their well-being, which ultimately makes for a much healthier practice.