A radioactive bomb explodes in a mall in Brooklyn. Thousands of people flock to emergency rooms in New York City, Long Island, and Westchester County.
Faced with this scenario and six other catastrophic disasters on paper, 20 percent to 50 percent of New York City area health care workers surveyed by Mailman disaster preparedness researchers say they would be unwilling to report to work.
"Those numbers of absentees would have serious effects," says the study's lead author, Kristine Qureshi, DNSc., a faculty member in the Department of Epidemiology. "If you have an additional influx of patients created by the disaster you need even more staff than you have already. The facility would not be able to address its surge capacity needs and it would not deliver effective care."
Employers have traditionally focused on an employee's ability to get to work during a disaster, not on an employee's willingness to go to work, Dr. Qureshi says. Many facilities offer on-site childcare during severe snowstorms or other emergencies to increase their employees' ability to come to work.
"But during a SARS outbreak, who is going to bring their child to the hospital?" Dr. Qureshi asks. "Our results show that willingness is a different concept from ability, and employers need to start evaluating barriers to willingness as well as barriers to ability."
Fear and concern for the safety of themselves and their families was the most frequently cited reason for unwillingness to work, Dr. Qureshi adds, and can be allayed with education, provision of personal protection equipment and a safe working environment that will prevent the spread of illness.
Full results of the study, which surveyed more than 6,000 healthcare workers in 47 different facilities, was published in the September 2005 issue of the Journal of Urban Health.
The study was funded by the Common-wealth Fund and the Columbia University Center for Public Health Preparedness.