Like everyone else, North American employers and managers wonder about the recent Ebola outbreak and worry about the risks it may pose. At present, those risks are primarily rooted in anxiety and misinformation. It is important that organizations get – and share – solid information.

In the United States, with a population exceeding 300 million, there are to-date four confirmed cases of Ebola, including one fatality. One patient has already recovered. These are serious cases, but the fact that we know the victims’ names tell us how rare it is.

To put this in perspective, the U.S. Center for Disease Control (“CDC”) reports that in 2011 around 31,000 Americans died from the deliberate or accidental discharge of a gun – about 3.5 people per hour.  In short, firearms pose an exponentially larger public health risk to Americans than does Ebola.   

Despite that, the terrible nature of the disease and its ravaging effects in West Africa have galvanized public interest and spread fear. Information is the only cure for that.

Persons at Risk

Who is really at risk of contracting Ebola? So far, it would seem to be these categories of people:

  1. Persons recently travelling to the known high-risk areas of the world (specific countries in West Africa);
  2. Airport security workers tasked with intercepting persons who may have the disease;
  3. Health care workers treating people with the disease;
  4. Mortuary staff and/or persons in physical contact with the dead, sometimes through funeral rituals;
  5. Persons in intimate contact with any of the above;

If an organization is engaged in business in the high-risk zones of Africa, that demands a very specific and rigid response to the hazard posed to employees. Clearly that is also true of workers who must observe strict safety protocols dealing with known or suspected cases of Ebola. 

Causes and Symptoms of Ebola

Health Canada says this about the “causes” of Ebola Virus Disease (EVD):

Once a person is infected, the virus can spread through person-to-person contact.

Ebola can be spread through:

  • contact with infected animals (bats, monkeys, gorillas, pigs, etc.)
  • contact with blood, body fluids or tissues of infected persons
  • contact with medical equipment, such as needles, contaminated with infected body fluids

Exposure can occur in health care settings when staff do not wear appropriate protective equipment, such as masks, gowns and gloves.

It is useful to understand the characteristics of Ebola.   Health Canada says this:

Symptoms can begin 2 to 21 days after exposure.

Initial symptoms include:

  • sore throat
  • fever
  • chills
  • headache
  • muscle pain and weakness

Additional symptoms include:

  • rash
  • nausea, vomiting and diarrhea
  • haemorrhaging (bleeding from inside and outside the body)

The World Health Organization says that during the 2-21 day incubation period, the person is not contagious.  Once symptomatic, a person is contagious. 

Managing the Real and Imagined Risks

Clearly, workers in genuine risk environments must be given every possible form of personal protective equipment (PPE) and follow strictly any controls advised. 

Most other forms of work will simply not be conducive to spreading the virus. Even in occupations with significant public interaction (cashiers, servers) the chance of blood, bodily fluid or tissue exchange are minimal – unless the population being served is itself potentially higher risk, such as persons travelling from Africa.

Beyond the exceptionally narrow circumstances of real risk, it is unlikely that a Canadian safety regulator would treat any work or workplace as a “danger” to an employee, warranting that person’s refusal to perform duty or to travel.

One precaution that would be prudent for employers to take, is to ask employees to be aware of whether they personally – during or outside of work – are coming into contact with people in the higher risk categories. Those persons might require special attention (see below). The real danger is to family members of infected persons: in the small number of U.S. cases discovered, the public health focus has turned on to family and friends of infected persons – imposing quarantine and daily medical checks.  

Public health authorities are asking individuals who exhibit the symptoms of Ebola to contact help and to book, in advance, an examination which can be conducted with appropriate protective protocols by medical personnel. As we know so far in North America, almost every instance of an individual being examined for potential Ebola exposure has proven not to have the condition.

A five step protocol for employers in non-high risk activities

Employers can do the following:

  1. Ensure employees know the actual risk factors and symptoms,
  2. Ask employees to identify when they have encountered a real risk or are exhibiting the symptoms.
  3. Employees who fit both categories (real risk and symptoms) can be directed to obtain immediate proper attention from medical professionals.
  4. To remove dis-incentives to seek help, employers which can continue pay and benefits to employees during the short period of absence while being quarantined, would be wise to do so. 
  5. If there is a legitimate suspected case among employees, co-operate fully with public health investigations into the possible exposure of co-workers.

So far, the fear of Ebola greatly outstrips the real risk to public health. It is important to have a realistic perspective on the situation, without ignoring or minimizing those unique situations where an actual infection risk exists.

Heather C. Devine