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Risk management for public entities: Addressing the rise in measles cases and implications for public health

Recent increase in measles cases globally presents significant risks to public health and workplace safety. Discover best practices to mitigate exposure.

The recent increase in measles cases globally, including an uptick in cases in Canada, presents significant risks to public health and workplace safety. The resurgence in cases not only threatens vulnerable populations, such as young children and those with compromised immune systems, but also places strain on healthcare resources and emergency response systems.

At the same time, public health events can leave municipalities, school boards, healthcare providers, and others exposed to a wide range of liability risks. They may face heightened scrutiny or legal repercussions for various reasons, including outbreaks on their premises or because of their immunization policies.

The following guidance highlights key areas of consideration for public entities to help mitigate public health risks, protect individuals and communities, and minimize liability exposures. It should not be seen as an exhaustive list and should be used in conjunction with internal policies and procedures, as well as in compliance with local laws and regulations.

Understanding the impact of health risks on public entities

Public health events can uncover significant vulnerabilities within public institutions, including schools, healthcare facilities, and municipal programs. The main risks to public entities include:

Workplace safety and employee health

The health and safety of public employees and individuals is of critical importance. A public health crisis could present the following risks to public entities:

Workers’ compensation claims: Employees in high-risk settings (For example, hospitals, schools, and transit services) could file claims if exposed at work.
Employment practices liability (EPL): Employers may face challenges regarding vaccination policies, accommodations for at-risk workers, and leave management for exposed employees.
Business continuity risks: Widespread absenteeism due to illness or quarantines could disrupt municipal services, public transit, and emergency response.

Liability exposure

Public entities could face potential liability if measles transmission occurs within their facilities. Possible liability risks include:

Negligence claims: Failure to enforce immunization policies or implement proper infection control could lead to legal claims from employees, students, or the public.
Directors & Officers (D&O) liability: Decisionmakers responsible for public health policies may face scrutiny over preparedness and response measures.
Occupiers’ liability: Facilities have a duty to maintain a safe environment, including reasonable precautions against disease outbreaks. Note that this can vary by jurisdiction.

Business interruption

A public health event could significantly disrupt operations or services provided by a public entity, and have potential financial, legal, and insurance implications. These include:

School and facility closures: If outbreaks lead to temporary closures of schools, daycare centers, or municipal programs, there could be financial implications related to contractual obligations such as third-party vendors or service providers, as well as revenue loss and liability.
Emergency response costs: Municipalities may incur increased costs for outbreak containment, public health communication, and vaccination clinics.
Insurance considerations: Existing policies may not offer adequate coverage for business interruption, so public entities should check their existing coverage, communicable disease exclusions, and crisis management provisions.

Mitigating public health risks

In today's rapidly changing health landscape, implementing effective risk mitigation strategies is essential for safeguarding the wellbeing of employees, students, and the public while ensuring organizational resilience. Strategies should include:

A. Immunization policy and compliance

Ensure employees, students, and the public comply with local health authority protocols such as the Immunization of School Pupils Act and workplace immunization policies.
Verify vaccination status of frontline workers and implement booster campaigns where needed.
Communicate immunization requirements clearly to the public and staff.

B. Infection control and workplace safety

Implement airborne precautions, like N95 masks, and isolation procedures in public facilities.
Provide personal protective equipment (PPE) for employees in high-risk roles.
Encourage remote work and staggered scheduling where feasible.

C. Insurance review and policy updates

Review liability coverage for communicable diseases in general liability and professional liability policies. Discuss with your Marsh broker about possible exclusions.
Ensure D&O insurance includes public health-related liability protections.
Evaluate workers’ compensation strategies to manage workplace exposure claims.

D. Business continuity and emergency planning

Update pandemic and outbreak response plans.
Develop alternative service delivery models in case of staff shortages or facility closures.
Coordinate with public health agencies, insurers, and legal teams to align policies with evolving regulations.

Resources for risk managers and public entities

Measles symptoms and treatment, prevention and risks, travel health advice, guidance for health professionals, and more
Measles and rubella weekly monitoring reports
Regional-specific immunization requirements for schools and workplaces, like Ontario's guide

By understanding the implications of public health crises, organizations can better prepare and safeguard the health of their communities. Implementing robust immunization policies, enhancing infection control measures, and conducting thorough insurance reviews are critical steps in mitigating risks associated with outbreaks.

As public entities continue to navigate these challenges, it is essential to remain vigilant and adaptable, continuously updating strategies to address the evolving landscape of public health threats. By prioritizing the health and safety of employees and the community, public institutions can effectively manage risks and contribute to a safer environment for all.

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Risk management for public entities: Addressing the rise in measles cases and implications for public health