An increase in cases of H1N1 flu during the month of September have prompted many Triangle employers to rethink their policies on employee sick leave and staffing.

At WakeMed, H1N1 is on everyone's mind.

"We have been in what we call incident command since August," said Barb Bisset, director of WakeMed's Emergency Institute.

With more than 90 patients coming into the emergency department every day with flu like symptoms, employees are encouraged to take precautions to keep themselves well. Bisset said participation in seasonal flu shot clinics for employees has been good.  But the hospital system isn't taking any chances on spreading the pandemic among its staff or patients, and has revised its employee health policy to further encourage workers to stay home when they are the ones who are sick.

"Every day, we're asking each manager to put eyes on all their staff, every employee reporting to work," said Bisset. "If they have staff coming to work, and if they have fevers, we are asking that they not be at work. They need to be sent home."

Chantal Howard, manager of the Adult Emergency Department at WakeMed's main campus on New Bern Avenue, said there has been an increase in the sick call rate over the past two months.

"If they have a fever over 100 degrees, we've asked them not to come," she said. "If they do get sick, we've asked them not to come to work until 24 hours past the fever."

WakeMed has developed contingency plans to cover for absent staff members, including using outside contract nurses to ensure patient care is not affected. They're also encouraging administrative staff to work from home, if possible. But not every company has that luxury.

"You can't wait tables from home, you can't cook from home," said Dean Ogan, one of the owners of Rocky Top Hospitality, which manages six restaurants and a catering business in the Raleigh area and another restaurant in Fayetteville. "So we need our people to be healthy and their best."

Ogan said his company is doing all it can to keep its 300 employees well, even offering upcoming flu shot clinics. So far, most employees have avoided the flu.

"It's not only a danger to our guests that come into the restaurant," said Ogan. "But I can't imagine having a week go by where I lost 20 or 30 of my staff members."

Most of the employees depend on tip income for their livelihood, so missing out on work can be a real hardship. Ogan said the company will work with employees to offer extra shifts to make up for lost wages.