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An influenza pandemic presents a unique threat to businesses and a
unique challenge for continuity planners. The purpose of this article
will be to discuss approaches to the kinds of challenges presented
by an influenza pandemic and presenting ways to address those challenges.
Understanding the Risks
Let’s understand this fact at the very beginning: there will
be a pandemic. We have experienced three pandemics in the last 100
years, the last one occurring in 1968. Like 100-year floods, the closer
you are to the 100-year mark, the more likely the event becomes, and
right now, we are past the 33-year marker for pandemics. It is very
probable we will experience an influenza pandemic in the next five
to 10 years.
Like all natural disasters, a pandemic can be severe or “mild.” Conditions
in which a disaster occurs can change results significantly. For example,
if a storm surge coincides with high tide, the damage will be much
more significant than at low tide.
This is true with pandemics as well. There has been a significant change
in the population since the last pandemic in 1968. Many persons with
compromised immune systems are now in our midst. Immune-compromised
persons may have HIV. They may be under treatment for cancer with radiation
and chemotherapy. They may have received an organ transplant and are
receiving immune-suppression medications. Given this new population
among us, a “mild” pandemic could cause upwards of 200,000
deaths in the United States alone.
A severe pandemic, such as the one we experienced in 1918, would change
the world dramatically. If the current Avian influenza were to become
transmittable human to human, we could expect up to 1.7 million deaths
in the United States and 180 to 360 million deaths world-wide.
Finally, there is the mistaken belief that a vaccine will be developed
in time to inoculate everyone against the flu pandemic. Currently,
it takes approximately six months to create vaccine, and not enough
vaccine, to inoculate the population of the United States for seasonal
influenza. While the federal government is spending significant dollars
in an attempt to find a way to develop vaccine faster, it seems unlikely
that, once such a solution is found, private companies will be able
to build this entirely new capability in time to provide a vaccine
for a pandemic.
Furthermore, this solution is only a theoretical possibility and it
begs a number of questions. Who will man the factories to create the
vaccine, manufacture the syringes, drive the trucks to deliver the
vaccine and syringes, and set up the delivery of vaccine to people – when
it may be a danger to have contact with any other human being?
Unlike seasonal flu, we cannot predict what a pandemic flu will look
like. The amount of time from an outbreak to global transmission will
be measured in weeks or a few months due to the speed of global travel.
This is simply not enough time to find, manufacture, and distribute
a vaccine.
An influenza pandemic is a vast event. Unlike other natural disasters,
a pandemic has the power to affect billions of people. Planning for
one is categorically different than planning for a local or regional
disaster.
Many companies incur significant business risk with the threat of a
pandemic. In this article, I will not address such issues (such as
impact to life insurance reserves); I will only address business operations
issues.
Stages of the Crisis
Pandemic influenza has specific stages and we ought to plan our contingencies
accordingly. The World Health Organization has established the following
stages of a pandemic:

Our contingency planning will be determined in large part by what
stage we are experiencing because we need to execute differently in
each stage. Currently, we are at stage three for the Avian flu.
Planning for a Pandemic
Communications
If you work in a global organization as I do, employees are going to
want to know what the corporation is doing to meet the risk of the
Avian flu, and they are also going to want to know about it and what
to do. In the area of communications, there are several areas which
have to be addressed in terms of education. Families need to know how
to prepare. Employees need to know that the corporate is preparing.
Employees will need to know what procedures will be followed if an
outbreak occurs both at the local office level and at the corporate
level. The following is a minimal list of what corporate communications
must prepare in stage 3:
- Stage 3 Communications
- Communicate that corporation has a plan
- Educate employees on personal
risks
- Educate and disseminate information regarding how to care for
the sick
- Communicate personal protection guidelines
- Communicate CDC family
checklist
- Communicate special pandemic employee policies
- Create and communicate
guidelines for immune-suppressed employees
- Establish single point
of presentation for reliable influenza information and corporate
actions
- Communicate and train key employees in each location on how
to handle a person who becomes sick at work
- Create a crisis communications
plan
Some of these tasks may already be covered in your
emergency plans; however, dealing with medical emergencies for flu
is probably not covered. If someone shows up to work feeling well and
gets sick, it is not enough to call the nurse or dial 911. That individual
will need to be immediately isolated. Everyone who has been in contact
with that person will have been exposed and this will need to be communicated.
Persons who are immune-compromised may have to take special actions.
During stage 4, communications will be critical when
outbreaks occur, since the actions taken by individuals may be life-saving
of their own lives or families. At this point employees should be informed
of the actions they are required to take and that they need to take
them.
- Stage 4 Communications
- Status of
offices (open, closed)
- Status of the outbreak
- Border closings and other
government actions which affect the business
- Initiate crisis communications
- Ongoing communications
Stage 4 provides some time for final preparations
for stages 5 and 6. Everyone must recognize that there will be more
to come and to act accordingly. In stages 5 and 6 the role of communications
will be primarily one of providing status.
There has been much discussion of the role of fear in communications.
The great concern is not to cause people to panic. However, in depth
studies of communications in times of crisis indicate that honesty
is the best policy and that people can be trusted to make sound judgments.
The big mistake is to tell everyone that “everything is under
control.” Such pronouncements have the opposite intended effect,
they make people suspicious and, far worse, if believed, such statements
may put people in danger.
Human Resources Policies
It will be critical to encourage persons not to come to work during
an outbreak if there is significant lethality associated with the
influenza strain. Human resources must take a close look at existing
policies. Persons who will be required to come to work may incur
significant risk in doing so. Some companies may need to create incentive
pay policies for persons who must come to work. At minimum, HR must
address policies as follows:
- Stage 3 Human Resource Employee Policies
- Create
absenteeism policy for use during pandemic (some people may not be
sick but should stay home for safety)
- Create sick-leave policy for
influenza
- Establish employee compensation policies for use
during pandemic (some employees may be unable to work because they
are attending to sick family members)
- Establish employee policies
for families who experience losses
- Determine feasibility of internal
healthcare support services
In stage 4, HR will have to initiate their influenza
policies. They will have to begin a regular series of meetings to monitor
the crisis and determine if policies are effective. If polices are
not effective they will have to be adjusted.
HR will also have to create travel policies for employees
who travel a significant amount.
- Stage 3 Human Resource Travel Policies
- Communicate
to create awareness of the threat to travelers
- Create travel kits
(masks, gloves, and Tamiflu)
- Distribute travel kits
- Establish travel restriction
policies based upon stages, locations of outbreaks, and border closings.
- Create first-priority awareness (i.e. don’t
go to work but get home if exposed or in an area where an outbreak
occurs)
- Establish stay-at-home policies for travelers who
come from an infected area
- Establish airport personal protection
policy
External Agencies and Government Relations
For all global corporations, location offices will have to establish
communications channels with government agencies or health departments.
We can anticipate that governments and health departments will manage
any pandemic differently, and therefore, location offices will have
to be sensitive to these differences.
At minimum, local offices will have to consider the following preparation
tasks:
- Stage 3 Government Relations
- Establish relationships with government officials
- Collaborate with officials in planning
- Establish
relationships with healthcare providers where appropriate
- Establish
process for communicating with official during the outbreak
When an outbreak occurs, it will be difficult if not
impossible to establish relationships with the appropriate authorities.
Once stage 4 is under way, local offices will have to execute these
tasks and funnel up critical information to any corporate crisis management
team:
- Stage 4 Government Relations
- Obtain
status and any critical information from officials
- Communicate critical
information to communications team for dissemination
Physical Resources
We can expect that the wise employee will stay home during a severe
pandemic. Why risk serious illness or death for a job? This means
that corporations must have significant work from home capability.
You will not be able to obtain such a capability during a pandemic
as resources will be at a premium. Therefore it makes sense to have
the capability set up in advance. This has a number of implications.
A BIA should have been executed to indicate not simply which applications
are critical, but who runs and uses those applications. You must
identify critical users beforehand, they must have a work from home
capability, and you must document their procedures in the event that
they are incapacitated.
All offices will need the capability to clean their facilities to a
level achieved by hospitals. Infection control supplies, masks, and
gloves must be available for use in the workplace in the event that
a person comes to work and gets sick. It will be difficult if not impossible
to obtain masks and gloves in stage 4 of a severe pandemic since there
will be a run on such supplies.
Global corporations must also contract the capability to extract senior
officers and managers. Having a senior manager stuck in a country where
borders are about to close and unable to get an airline ticket is a
distinct possibility. If the individual contracts influenza, and is
visiting a third-world country, it is unlikely that they will be able
to obtain western-style medicine. You may want to consider contracting
one of the international air ambulance services that are available.
Planners should consider, at minimum, these steps:
- Stage 3 Physical Resources
- Stockpile
infection control supplies at all locations (masks, gloves, and receptacles
for disposal) in the event infected employees come to work
- Enhance
work-from-home infrastructure
- Determine feasibility of stockpiling
Tamiflu
- Determine feasibility of stockpiling food in certain
locations
- Contract evacuation from foreign countries capabilities
Medical Knowledge Resources
Most companies do not have a physician on payroll, let alone a physician
with expertise in infectious disease and epidemiology. Yet, to make
informed decisions and adapt to the changing circumstances of a pandemic,
corporate crisis management teams will need access to such expertise.
Such resources will have to be contracted prior to any outbreak.
Summary
We know a pandemic is going to happen, but, unlike Y2K we don’t
know when. The memory of the 1918 influenza pandemic is no longer alive
among us. We have, I believe, been spoiled by a supremely efficacious
medical technology. We have forgotten that significant logistics are
required to enable that technology, logistics that we take for granted,
and logistics which will, in all probability, be unavailable in a severe
pandemic.
The conditions under which pandemics have occurred in the past have
changed significantly, particularly with respect to the vulnerability
of the overall population and the prevalence of global travel. Given
these conditions, the only reasonable response is to plan.
"Appeared in DRJ's Summer 2006 Issue"
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