H1N1 At Work: If You're Sick, Stay Home?

GUESTS:
Joanne Silberner, NPR's health policy correspondent
Dr. Russell Robbins, head of Mercer human resources consulting firm's H1N1 and pandemic preparedness

The threat of the H1N1 flu virus has many employers taking precautions to prevent its spread in the workplace. And while it may be an easy decision to allow one member of staff to stay home with the flu, decision-making gets tougher when half of the work force falls ill.

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REBECCA ROBERTS, host:

This is TALK OF THE NATION. I'm Rebecca Roberts in Washington. Neal Conan is away.

The threat of the H1N1 flu virus has many employers taking precautions to prevent its spread in the workplace. Measures range from signs warning employees to cover their coughs and strategically placed bottles of hand sanitizer, all the way to arranging for the most vulnerable employees to be vaccinated. In a moment, we'll hear from a human resources officer about what employers should be thinking about as they prepare for this pandemic at work.

But first, we go to NPR's health policy correspondent Joanna Silberner who joins us from Atlanta. Hi Joanne, welcome.

JOANNE SILBERNER: Hi, Rebecca.

ROBERTS: So, let's talk about the quick update. What's the latest on H1N1?

SILBERNER: The latest is there are a lot of people who have been infected, as many as 5.7 million people already, from the spring and then now again in the fall. The vaccine availability count is up to 32 million. There are about 32 million shots - shots and nasal spray - that's either already been given or is available to be given. It's still a young people's disease. It seems to be hitting younger people harder. Traditionally, flus hit older people harder. This one seems to be hitting younger people. It is staying constant in terms of the virus itself isn't mutating; that's good because it means the vaccine is still working.

ROBERTS: That 32 million number for the availability of the vaccine - how does that compare to targets?

SILBERNER: Well, everyone's the target.

(Soundbite of laughter)

SILBERNER: And there are risk groups, you know, and most of the vaccine is being distributed by the states. And the states, generally, are trying to get them to the people who, if they do get sick, are really at the highest risk of problems. That's pregnant women, that's young kids, it's health care workers -not only for their own sake, but because they could spread it. So, most of the states are trying to target to those groups.

ROBERTS: And other than it disproportionately affecting kids, at this point can we tell if it's spreading, if the epidemiology is spreading differently than the seasonal flu?

SILBERNER: Other than kids, you know, it seems - it spreads in the same way -it's droplets from, you know, from sneezes or coughs that you either touch or inhale. It's about - if you're about six feet or closer to somebody, if they sneeze or cough, you're in trouble. And that's the same as the seasonal flu. It's very much like a seasonal flu except for the weirdness of slightly younger people and the weirdness of having come in the warmer months. Flus traditionally don't come in warmer months and we did see this in April and May.

ROBERTS: How infectious is it?

SILBERNER: About the same. You know, I've heard people say, maybe a little bit more. I don't think that they really know that yet. It seems to be about the same as the regular flu. You know, within six feet that can be a problem. If you look at household contacts of people with the flu, you know, not everyone gets it. I have heard 25 percent of people get it if you're in, you know, in a close household contact. It's infectious enough that if you've got symptoms, you need to be using that elbow anytime you need to cough or sneeze. You need to be sanitizing your own hands and everybody else needs to be doing the same.

ROBERTS: We've been hearing news today that pregnant women seem to get immunity from just one shot, but not so much with the kids.

SILBERNER: Yeah, kids under 10, and that's actually true for regular flu as well. Kids under nine, actually, with seasonal flu, usually get two flu shots. You know, they're kids, they're young, their immune systems haven't been around as long as the immune systems of us older people. They're considered na�ve, biologically. So, they need a couple of flu shots and it's true with this flu as well. Kids under 10 need a couple of shots.

ROBERTS: We are talking with Joanne Silberner about the H1N1 flu virus. Coming up, we'll talk with an HR professional about H1N1 in the workplace. You can join us at 800-989-8255 or send us email. The address is talk@npr.org. I understand in terms of the workplace, Joanne, that there's a sick leave bill in the House and Senate right now - would it change sick leave laws?

SILBERNER: Yes, it would. It would require businesses of a certain size, you know, over, I think, about - well, I can't remember - maybe about a dozen or two dozen people. If you've got enough workers, you're going to have to give them sick leave if this legislation passes - seven days of sick leave. The idea being that, you know, it's no good for anybody if people go to work sick. If they're sick, they're not going to get better as quickly or as well, and they're going to spread it to other people. They're going to spread it to their co-workers, they're going to spread it to customers. So, this bill was introduced actually last spring. It somehow got in line behind the health reform bill. You know, it's odd. I kept expecting to see it stuck into the health reform bill because it does have so much to do with health care and with health, but it doesn't look like it's going to go that way. It looks like, if anything happens, it will be late this winter.

ROBERTS: Is there a consensus on when you are no longer contagious - when after you show symptoms, you should be safe to go back to work?

SILBERNER: Yes there is. It's a practical consensus, and that's 24 hours after your fever goes away without the use of Tylenol or any other fever controlling medication. So, in other words, if you've been off fever controlling medication, your fever is down for 24 hours, you can go back to work or to school or to whatever. Again, that's a practical consideration because you can actually find, if you look hard enough, you can find some virus in some people. There was just a study done on Air Force cadets. And something like 18 or 19 percent of them were still shedding some virus. Was it enough to make other people sick? Well, nobody wants to do that experiment. But 24 hour - you know, you can't keep everybody home forever. So, the idea is 24 hours after the fever drops.

ROBERTS: And what is your sense of availability of vaccine outside of the first couple of risk groups? Will we get to a point where healthy adults are able to get vaccinated?

SILBERNER: Yeah, they're coming online at about 10 million vaccines a week now. So, it will come eventually. You know, it's frustrating because it's not here now. It's frustrating�

(Soundbite of cough)

SILBERNER: Excuse me. I don't have swine flu, actually.

(Soundbite of laughter)

ROBERTS: Hope you're coughing into that elbow, Joanne.

SILBERNER: Well I'm alone here, so it's okay.

(Soundbite of laughter)

SILBERNER: The vaccine is coming online. It's slow. It's very frustrating to everyone. You know, the manufacturers were hoping that the viruses would grow a little quicker in the eggs in which they're produced. The head of the CDC had a great line a couple of weeks ago. He said, you know, you can't yell at the eggs and ask them to work harder. These viruses are reproducing at their own rate. It's slower than people were expecting. There's less vaccine around. It's very frustrating. I know the public health officials are worried. People are going to lose interest in the vaccine. They're going to feel, oh, well, I missed - you know, I didn't get at the beginning. I don't want it now.

That's bad thinking though, because certain flu seasons are marked by waves. We've already seen a wave with this particular flu back in May. There was a wave that came back at the end of the summer. The flu season generally lasts until May, you know. Even if it's been through your community, it can come back again.

ROBERTS: Well, balanced with that idea that people may lose interest is the fear among consumers that if it was rushed through production that it might not be effective or safe.

SILBERNER: That is a big fear. It's a consistent one, and we hear a lot from our listeners and the readers of our Web site about that issue. If you're worried about the regular seasonal flu vaccine, then you can worry about this one. If you're not worried about the regular seasonal flu, which changes - most people don't realize this - it changes every year. And it's - this one has been tested. This new flu has been tested more carefully in humans than the seasonal flu vaccines usually are. This one has been looked at more closely. It's made in the same manufacturing plants, by the same manufacturers, using the same procedures and it's been better tested. And the seasonal flu vaccines have been given, you know, in a typical year, it's maybe 80 or 90 million people get a seasonal flu vaccine.

And I understand the concern about this, it's new. People my age still remember a problem back in 1976 with an old vaccine - in fact it was a swine flu vaccine, and maybe that's another reason for the concern. So it's reasonable to be concerned, but it's also a good idea to get yourself educated. And if you're in one of the high-risk groups, you've got to weigh the risks and benefits.

You know, this vaccine's already been given to millions of people. They're not seeing anything yet. They're looking very carefully, and you know, especially if you're a pregnant woman, you know, this is something - you need to consider the risks versus the benefits.

ROBERTS: Let's hear from Amy(ph) in Shinglehouse, Pennsylvania. Amy, welcome to TALK OF THE NATION.

AMY (Caller): Hi. Last week, I was in a retail store, an office supply store, and the clerk, the person who I was talking to, was just clearly sick, I mean grotesquely sick; runny eyes, coughing, coughing into his sleeve, but still - I just beat it. I just got out of there.

(Soundbite of laughter)

SILBERNER: That's a good - you know, public-health-wise, that's a very good idea, and�

AMY: Well, and it was disgusting, and I realized on the way home that I should have just gone to the manager and said let that person go home now and make that person stay home, because it is disgusting. I have five little kids. You know, I don't need them to get sick, and we homeschool, so we aren't out...

SILBERNER: No, and, well, one of the issues for that - one of the issues for - some workers don't get paid if they go home, or they get job demerits if they go home. So they're worried. And the Centers for Disease Control and Prevention has been asking employers and telling them, you need to have a plan, you need to make sure that sick workers don't come in to work. You know, let them go home. And you know, with that legislation that's out there that, you know, would pay people - although, you know, small businesses are saying we don't want that legislation because, you know, we let them go home anyway. We don't need to be dictated to, and you know, there's a resistance to that legislation. But, you know, if you tell the manager, the manager's going to realize that there's an economic consequence to not giving sick leave or not getting that worker to go home.

ROBERTS: Well, let's turn it out to our callers. If you either have had to make the decision of whether or not to go to work or possibly forgo some pay or get demerits from a sick day, if you're an employer and you've been trying to figure out how to deal with H1N1 in your workplace, in what might not be the best economic climate - we want to hear from you.

What are your plans, and what has changed? We're taking your calls at 800-989-8255. You can also send us email. The address is talk@npr.org. And Joanne Silberner, is there any sense that the virus itself is playing out differently in the workplace than in other places? Are there special concerns there?

SILBERNER: No, the special concerns are the vulnerable populations. You know, in a traditional flu year, you're getting older people who are the hardest hit, and they're having the most problems. You know, now you're having pregnant women having problems. You're having younger people having problems. So in that they're sort of out and about more, that's a bit of an issue.

ROBERTS: That is Joanne Silberner. She is NPR's health policy correspondent. She is joining us from her home in Atlanta. She will stay with us after this break. We will also be joined by Dr. Russell Robbins. He's a principal and senior clinical consultant for a human resources consultancy firm, and we will be taking your calls.

If you're an employee or an employer and trying to figure out exactly how to handle H1N1 in the workplace, give us a call, 800-989-8255. You can also send us email. The address is talk@npr.org.

Take this break to go wash your hands, and we'll talk more about the H1N1 virus in the workplace after this break. I'm Rebecca Roberts. It's TALK OF THE NATION from NPR News.

(Soundbite of music)

ROBERTS: This is TALK OF THE NATION. I'm Rebecca Roberts in Washington. If you felt a little shiver of apprehension when the person in the next cubicle coughs or complains of flu-like symptoms, and there's not enough hand sanitizer in the world to assuage your anxieties, then H1N1 is here, and it's in the workplace.

It's causing all kinds of problems for employers and employees. We're talking with Joanne Silberner, NPR's health policy correspondent, and we want to hear from you - business owners and employees - how are you dealing with H1N1 in the workplace? Our number is 800-989-8255. Our email address is talk@npr.org. You can also join the conversation at our Web site. Go to npr.org, and click on TALK OF THE NATION. Tell us what's going on at your workplace. For instance, here at NPR, there's hand sanitizer everywhere. I can see a bottle from where I'm sitting in the studio, so that guests can scrub up before they come in and shake my hand. We haven't quite gone to the elbow-bump with studio guests yet, but I imagine that is not far away.

We are joined now by Dr. Russell Robbins. While the spread of swine flu is a public health issue, for businesses and employees, it also comes down to HR, human resources. Russell Robbins is the principal and senior clinical consultant for Mercer. It's a human resources consultancy firm. He's been fielding H1N1 questions from both employees and businesses, and today he joins us from his office in Norwalk, Connecticut. Welcome to the program.

Dr. RUSSELL ROBBINS (Senior Clinical Consultant, Mercer): Great, thank you so much, Rebecca.

ROBERTS: What are the majority of the questions you're getting from businesses?

Dr. ROBBINS: Really, you know, it's everything across the board, you know, in terms of we don't have an H1N1 or any type of pandemic preparedness plan, can you help us? To, you know, here's what we have in place, is this the right thing? And you know, really the key question right now is before the pandemic strikes, how do we know what are the right things to put into place? How do we make sure that our employees will be healthy, and more important, how do we make sure if the pandemic becomes worse, that we're going to be able to stay open for business.

ROBERTS: It seems like the availability of paid sick leave is a big issue here. How is it coming into play?

Dr. ROBBINS: Yeah, no - absolutely. You know, paid sick leave is a big issue. We're seeing, you know, many employers, you know, trying creative solutions right now, creating pools of unused sick days that employees can tap into, you know, making sure that vacation time is utilized if, you know, further time is needed. And the other thing that we're also seeing is, you know, employers are concerned if you have a healthy employee whose healthy child is out because their school is closed, how do you accommodate them, you know. So now you have people who otherwise could show up to work but can't because of other reasons. So how do you make sure that they're able to still be productive, whether remotely or, you know, come up with creative alternatives to allow for that as well.

ROBERTS: Well, we haven't even touched on that, that if an employee feels like she can't necessarily take sick time, she's also more likely to send her sick kid to school.

Dr. ROBBINS: No, absolutely right, you know, and that's one of the things that we're trying to - you know, education is the key to all of this, to make sure that employees, individuals understand, you know, if you're sick and really sick, stay home. You know, that's the best thing you can do, and you know, if you're sick at work, you know, leave work, and if you're sick, don't come to work. You know, that's one of the key things that we can't emphasize enough.

ROBERTS: And Joanne Silberner, do you have any sense of what employees without paid sick leave are doing instead?

SILBERNER: They're going to work.

ROBERTS: Yeah.

SILBERNER: You know, it's a problem. If - I did a story on this last week and talked to a number of people who actually didn't want to be on the air because they didn't want their co-workers hearing them. You know, they - a lot of them, the ones I talked to, felt bad about it, but they needed the money. And when you look at the percentages of people who do not have sick leave, who do not have paid sick leave - among them, you know, among the private work force, it's something like 40 percent. It's high. And you're stuck. You need to pay the rent, and you need to buy your groceries, and your boss is saying I'm not going to pay if you don't come in.

ROBERTS: Let's hear from Robin(ph) in San Francisco. Robin, welcome to TALK OF THE NATION. Hey, Robin, you're on the air. I think we've lost Robin. Let's hear from Evan(ph) in Tallahassee, Florida.

EVAN (Caller): Hi, how are you doing?

ROBERTS: Good.

EVAN: I am a server, and it is just - I mean, first of all, if you're sick, you're faced with, you know, losing a lot of money, and we have, like, a whole student-based economy down here. So if you're not working, you can't pay for books, etcetera, and so you're faced with that.

Anyway, even if you, you know, want to give up your shift, if you can't get it covered, the best thing you can do is maybe go in and food run. That's all they'll let you do. You cannot just be let off work if you can't get someone else to come in for you. They'll let you come in and handle the most food out of anybody, though, so that you're there for the least amount of time. And you can be in and out, is the idea, but it's kind of a horrid concept.

ROBERTS: And have you talked to your managers about maybe this is actually not saving them any money because you're just going to get more people sick?

EVAN: Yeah, well, I mean, it's an issue, but sometimes, the communication - the communication between - it's not, you know, horizontal. So it's not so easy to make happen.

ROBERTS: Evan, thanks for your call. Russell Robbins, Evan - he serves food at a restaurant. If he doesn't work, he doesn't get paid.

Dr. ROBBINS: No, and you know, and we hear this a lot. You know, restaurant employees, hotel employees, other, you know, hourly shift workers, you know, in particular are, you know, very strapped and, you know, put at risk, you know, and putting us at risk.

So you know, what we're trying to do is educate employers to see if there are alternatives, as Evan mentioned, you know, to possibly, you know, find ways to, you know, get coverage or to, you know, work in areas that you're not in the direct contact with food or other people, you know, as much as possible so you can still be at work but maybe do something a little bit different while you're sick.

You know, fortunately for the majority of people, you know, the H1N1 is over within about three to five days. So, you know, if possible, you know, just for that short time period is to see if your employer can provide some alternative for you to still be at work earning your salary but at the same time not contaminating people, you know, that you otherwise would be.

ROBERTS: Well, I think everybody is, you know, suitably disgusted with the idea of the person serving them food actually also shedding virus. It's just squirm-making, but do you think there should be different policies for different kinds of businesses?

Dr. ROBBINS: Well, you know, that's a difficult question. You know, we see this, you know, from many of our employers, you know, where, you know, they ask us, you know, where they may have a plan in place and, you know, if it's a manufacturing company, you know, they'd say, you know, well what do we do if our supplier can't deliver to us? We're ready, we're willing to be open for business, but we can't get the raw materials?

So, you know, so we're seeing, you know, that employers are having to, you know, across the board be more creative in terms of how they're looking at, you know, dealing with a pandemic. You know, fortunately, it's not something we have to deal with, you know, on a, you know, all the time. But now, you know, now we're facing the reality of you have to be able to sort of be a little bit more - a little bit more facile in terms of your ability to, you know, do things, you know, slightly differently and, you know, to be able to prepare for that is, you know, the key to successfully weathering this problem.

SILBERNER: And, you know, I would remind you, it's not just food because this virus spreads very well through the air, you know, by breathing, by coughing. So if you're sitting across from somebody at a desk, and they're talking to you, you know, if it's any kind of interaction like that. Food is, of course, you know, you've got the disgust measure in there, but it's breathing, sneezing, coughing, which can happen, you know, far outside of a food environment - in a retail situation, in any kind of business encounter.

Dr. ROBBINS: Oh absolutely. I mean, even, you know, just, you know, if you're commuting, you know, on the subway or bus, you know, or train, you know, there are, you know, other types of, you know, you know, people. You want to just be careful that, you know, if you are feeling sick yourself that you're trying to do some type of self-isolation and try to, you know, keep things at a minimum whenever possible.

ROBERTS: Let's hear from Patty(ph) in Syracuse, New York. Patty, welcome to TALK OF THE NATION.

PATTY (Caller): Thank you. I work in a supermarket, and a co-worker's daughter has been diagnosed with H1N1, and I was just wondering how safe is it, because the co-worker is continuing to work?

ROBERTS: And she's not symptomatic, it's just her daughter?

PATTY: Just the daughter, yes.

SILBERNER: Well, there you get into the practical aspects of it. It's very possible that she's not going to get sick. It's possible that she is going to get sick. She's more likely to get sick if she's in close contact with her daughter, and her daughter - you know, if you look at the Centers for Disease Control recommendations on having someone sick in your home, the idea is to keep them as isolated as possible. And you know, with a kid, that can be kind of tough. You know, your child is sick, you really don't want to stay six feet away from them.

You know, if you stay six feet away from this person, and you wash your hands, and you know, do all the other recommended activities, it's probably okay. You know, at some point - it's a hard thing to do. You know, if you want to be completely safe, if you're in a high risk group, for example, if you have asthma or you have underlying heart disease, you might want to be especially careful. If you're healthy and don't have these chronic things, you still want to be a little careful, you know, not to be around that co-worker if the co-worker's coughing, not to pick up things the co-worker's handled if the co-worker isn't keeping his or her hands clean. You want to be a little careful.

It's not as likely that you'll get it as if you were living in the same house with somebody. It's a little more likely than if the person didn't have someone in their house, but at some point you have to be practical.

ROBERTS: Let's hear from Julie in Grand Rapids, Michigan. Julie, welcome to TALK OF THE NATION.

JULIE (Caller): Thank you.

ROBERTS: Go ahead, Julie. You're on the air.

JULIE: I'm sorry?

ROBERTS: You're on the air. Go ahead.

JULIE: Oh, hi. Well, I just, you know, I just got both of my shots, that H1N1 and the seasonal flu. And I kind of feel like I just won the lottery or made the jackpot. It was very - they were even whispering in the waiting room at the doctor's office because they didn't want other people to know that they were - they already have the seasonal flu vaccine. They were giving it to selected people.

I'm pregnant and my daughter is five, and we both got vaccinated for both flus today. I hardly - I never get the flu vaccine. There's so many nasty things going around. And I've already missed work for my daughter. And that's, you know, that's been hard for me, is because, you know, I work in school, so I do have - you know, I'll have co-workers that are sick. But it's - to me that's not a big deal. I just assume I'm getting exposed to everything, because I've got two different schools, you know, there's plenty of people in the germ pool and I just assume I get exposed to everything.

But now I miss work when my daughter is sick, not just when I'm sick. And so that's the hard part, is that, you know, if she gets sick I have to miss work. And then if I get sick, I have to miss work. And plus, I'm pregnant, so it's a higher risk. So to get both of the vaccines today was, I felt very lucky.

And I know there's, you know, there's like 700 people on the waiting list at the office, but they bumped me forward because I was pregnant and then she kind of slid in there too, so it was, yeah...

SILBERNER: Julie, you make a really important point that I should have made to the previous caller, which is another way you can protect yourself if you think your co-worker is sick is to see what you can do about getting the vaccine.

Dr. ROBBINS: Absolutely right.

ROBERTS: Well, also, this is a question where all of the workplace preventative measures wouldn't necessarily help if you need to take sick leave because you've got a sick child. You know, you can have a workplace where there's vaccines available and hand sanitizer on every corner. But you still need to take sick leave if the school isn't as preventative.

SILBERNER: Right. And that's a real issue. What do you do? And actually, the legislation would include if there's - not only if you're sick but if you have to stay home to take care of somebody sick in your family.

ROBERTS: Let's hear from Tammy in Glidden, Wisconsin. Tammy, welcome to TALK OF THE NATION.

TAMMY (Caller): Yes. One minute, please.

ROBERTS: Hey, Tammy. You're on the air.

TAMMY: Yes. I'm sorry. Yeah. We just had another county that had shut down an entire school for a week, and none of the parents are getting paid for it. Now, our town is a very small town. A lot of the kids have already gotten it. And now I'm going to have to take off work. I can't even get a babysitter because nobody knows what child's got it. And it's like, is legislation is going to help these parents or even like myself that can't have a babysitter or the whole entire school is shut down?

SILBERNER: Yeah, the legislation as it's written would allow you to take sick leave for - to take care of a family member.

ROBERTS: You're listening to TALK OF THE NATION from NPR News.

We have email from Sidney Leung(ph) in Berkeley, California. He says: I run a nightclub and we provide sick leave as mandated by San Francisco law -Washington, D.C. also, by the way, mandates sick leave - by which employees accumulate paid sick leave. It works for my employees who don't depend on tips. But for those whose majority of incomes comes from tips, they just might not take it off. This is the same situation with the server. Russell Robbins?

Dr. ROBBINS: Mm-hmm. Yeah, no, absolutely. I mean, you know, that's always, you know, the challenge is, you know, trying to, you know - obviously, you know, someone's salary, someone's, you know, means of livelihood, you know, is going to be - you know, has to be taken into consideration. But, you know, whenever possible, you want to try to accommodate and, you know, figure out are there ways to, you know, get these - to get the person to still come to work if they're not, you know, sick and spreading the virus, you know, can they at least, you know, come up with a different job function or is there some other way for them to able to, you know, to still be productive without necessarily infecting everybody in the workplace?

And it is a real challenge, you know, and we see this, you know, for, you know, as I mentioned earlier, you know, particularly for salaried employees who are hourly wage earners, you know, where not showing up to work means you're not getting any pay. And that's, you know, that's a real - a real problem.

And you know, what we're trying to do, though, is educate the employers to see if there are other types of solutions to be more creative, to allow for this to - to still allow these people to get paid or at least come to work and do something not directly contacting other people.

ROBERTS: Well, there are also workplaces where the culture is such that everybody puts in crazy hours and nobody ever takes sick leave. And if you're going to make partner, you have to, you know, be at your desk at midnight even if you're, you know, missing a limb. Is - do you see that some of these policies that might be temporary for a pandemic situation might actually lead to a systemic policy change? Russell Robbins?

Dr. ROBBINS: Yeah. Well, you know, absolutely. I mean, we are seeing some employers, you know, thinking along those lines as well, you know, where, you know, what are the things that, you know, once this pandemic is over, you know, what are going to be, you know, ongoing type of practices, you know, from learning from this experience to then implement. And it may, you know, it may change the way some employers are viewing, you know, what kind of pressure they're putting on their employees.

The other thing that we're also seeing too is, you know, some employers are talking about, you know, being, allowing more employees than they have in the past to work from home, but of course there are costs associated with that because you may have to provide extra equipment, extra security to allow them to do this. But you know, at least now they're beginning to think, you know, beyond just, you know, having everybody always having to come to the workplace; you may be able to provide them the ability to work remotely.

ROBERTS: Dr. Russell Robbins is the principal and senior clinical consultant for Mercer, a human resources consultancy firm. He joined us from his office in Norwalk, Connecticut.

Thank you so much.

Dr. ROBBINS: Thank you very much.

ROBERTS: And, Joanne Silberner, you said people need to educate themselves about the risks and benefits of the vaccine. What are your favorite sources of education?

SILBERNER: CDC has a good Web site, flu.gov. That's a good place to go.

ROBERTS: Joanne Silberner, NPR's health policy correspondent. She joined us today from Atlanta.

Thank you so much.

SILBERNER: Thank you.

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