ShareThisBelieve It or Not
Pandemic Flu – Te Prepare or Not Prepare?
By Jon Gorman
For a period of 232 days in 2002 and 2003, the world would experience the birth of a symbol. A surgical white mask became the most recognizable image of a global pandemic. Exposed to images on TV, in newspapers, in magazines, or on the Internet, the world saw citizens of Toronto and Taiwan – and places in between – donning white masks in their everyday lives to protect themselves from severe acute respiratory syndrome, or SARS.
While the first known case of atypical pneumonia wasn’t identified until much later, Foshan City, Guangdong Province, China, would become the birthplace, and Nov. 16, 2002, would become the starting date of the worldwide outbreak that eventually led to 8,098 known cases of the disease with 774 deaths in 26 countries deaths according to the World Health Organization. On July 5, 2003, Taiwan, the last area with local transmission of the disease on WHO’s list of such locations was removed from the list, and WHO declared that SARS outbreaks had been contained worldwide.
Some specific items to consider outlined in the Homeland Security guidance are:How will businesses:
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Today, terms such as SARS, pandemic flu, and avian flu are more recognizable than they were in 2003. Reports, studies, headlines, and HR policy meeting discussions have aroused our awareness of pandemic concerns.
According to the U.S. Department of Health and Human Services, influenza pandemics occur when a new influenza strain emerges to which people have little or no immunity. Most experts believe another pandemic will occur, but it is impossible to predict which strain will emerge as the next pandemic strain, when it will occur, or how severe it will be.
“Interest in pandemic flu has increased significantly due to the spread and lethality of the active H5N1 avian flu virus, and many fear that a reassortment may occur, resulting in a human-to-human transmissible virus and global pandemic,” said Derek Blum, vice president of emerging risk models for RMS.
Researchers at the Harvard Initiative for Global Health, in a report published online in the December 23/30, 2006, issue of The Lancet, stated that the number of dead in a modern pandemic could range from 50 million to 80 million people. Information and estimates were based on the most severe previous case, a 1918-1920 influenza outbreak that claimed at least 20 million lives.
WHO’s current phase of pandemic alert is 3 – meaning there is a new influenza virus subtype causing disease in humans with no or very limited human-to-human transmission. However, WHO experts believe that the world is now closer to another influenza pandemic than at any time since 1968, when the last of the previous century’s three pandemics occurred. A pandemic – alert level 6 – would mean that there is efficient and sustained human-to-human transmission.
Obviously, people in the travel industry and those who travel worldwide as required or necessary for the development and maintenance of their careers, care a great deal about how outbreaks of influenza in Asia, for example, would affect their ability to do their jobs, let alone, sustain their lives.
However, the issue has spread far beyond those who live in or travel to countries with low per capita income; countries which may not have the resources in place to provide vaccinations if available, antiviral drugs, and antibiotics; or areas already afflicted with other prevalent diseases like malaria or HIV/AIDS.
But loss of life isn’t the only concern – an altered workforce and business interruption are of significant worry as well.
The United States Department of Labor’s Occupational Safety & Health Administration and the DHSS unveiled guidance on Feb. 6, 2007, on preparing workplaces for influenza pandemic. In the guidance, Guidance on Preparing Workplaces for an Influenza Pandemic, OSHA identifies other specific concerns, including absenteeism with as much as 40 percent of the workforce unable to work due to illness or the need to care for someone who is ill, change in patterns of commerce, and interrupted supply and delivery of shipments of items from areas severely affected by a pandemic.
The guidance offers general information for all types of workplaces, including descriptions of the differences between seasonal, avian, and pandemic influenza; and information on the nature of a potential pandemic, how the virus is likely to spread, and how exposure is likely to occur.
“In anticipation of a flu pandemic, our top priority is protecting the safety and health of America’s working men and women,” said Assistant Secretary of Labor for Occupational Safety and Health Edwin G. Foulke, Jr. “Employers and employees should use this guidance to help identify risk levels and implement appropriate control measures to prevent illness in the workplace.”
To help employers determine appropriate workplace practices and precautions, the guidance presents recommendations for employee protection, including engineering controls, work practices, and use of personal protective equipment such as respirators and surgical masks, and their relative value in protecting employees.
However, more important than procedural office or employee practices developed and implemented as responses to pandemic flu is the speed at which the company responds to an outbreak.
Rapid response was determined to be crucial to containing the 1918 flu pandemic, according to history analyses by the National Institutes of Health. According to the NIH, cities where public health imposed multiple social containment measures within a few days after the first local cases were recorded cut peak weekly death rates by up to half compared with cities that waited just a few weeks to respond. Overall mortality was also lower in cities that implemented early interventions, but the effect was smaller.
These important papers suggest that a primary lesson of the 1918 influenza pandemic is that it is critical to intervene early,” says Anthony S. Fauci, M.D., director of NIH’s National Institute of Allergy and Infectious Diseases, which funded one of the studies published in the journal Proceedings of the National Academy of Sciences. “While researchers are working very hard to develop pandemic influenza vaccines and increase the speed with which they can be made, nonpharmaceutical interventions may buy valuable time at the beginning of a pandemic while a targeted vaccine is being produced.”
For example, nonpharmaceutical interventions may limit the spread of the virus by imposing restrictions on social gatherings where person-to-person transmission can occur. The first of the two historical studies, conducted by a team of researchers from NIAID, the Department of Veterans Affairs, and the Harvard School of Public Health, looked at 19 different public health measures that were implemented in 17 U.S. cities in the autumn of 1918. The second study, undertaken at Imperial College London, looked at 16 U.S. cities for which both the start and stop dates of interventions were available.
Schools, theaters, churches, and dance halls in cities across the country were closed. Kansas City banned weddings and funerals if more than 20 people were to be in attendance. New York mandated staggered shifts at factories to reduce rush hour commuter traffic. Seattle’s mayor ordered his constituents to wear face masks.
The first study found a clear correlation between the number of interventions applied and the resulting peak death rate seen. Perhaps more importantly, both studies showed that while interventions effectively mitigated the transmission of influenza virus in 1918, a critical factor in how much death rates were reduced was how soon the measures were put in place.
The fact that the early, nonpharmaceutical interventions were effective at the height of the pandemic can inform pandemic planners today, the authors of the studies say. OSHA suggests that all businesses and organizations begin planning for a pandemic now – whether as part of enterprise risk management plan, a business continuity plan, or as a plan specific to pandemic flu outbreak.
The insurance industry isn’t immune from this threat. Not only will insurance companies need to develop their own plans to address pandemic flu and their business operations, but the industry also has an enormous societal responsibility to maintain and sustain its operations as identified and recommended by the United States Department of Homeland Security.
In Pandemic Influenza Preparedness, Response, and Recovery Guide for Critical Infrastructure and Key Resources, Homeland Security identifies the banking and finance industries as one of 13 physical critical infrastructure sectors providing essential goods and services; interconnectedness; and operability, public safety, and security. Obviously, the insurance industry has been identified by Homeland Security as needing to sustain its “essential” services that “contribute to a strong national defense and thriving economy.”
With regard to internal operations maintenance and functionality, Homeland Security recommends the following disease containment strategies: isolation, quarantine, social distancing, closing places of assembly, snow days/weeks and/or furloughing non-essential workers, and changes in movement patterns.
Clearly, individual companies have a great responsibility to develop plans for their employees and business operations – not just in the event of pandemic flu – but also are accountable for protecting and safeguarding their policyholders.
Many people, including insurance industry professionals, researchers, and scientists, are skeptical and believe that pandemic flu can’t and won’t happen. However, a pandemic flu disaster plan can also apply to other areas of workplace concerns that may not be directly evident as part of a pandemic response. Imagine a small company that might lose half of its employees for extended periods of time due to inclement weather conditions or an ordinary run-of-the-mill strain of flu or stomach virus.
Now imagine the unimaginable – 40 percent of the U.S. workforce unable to work, 80 million dead worldwide during the span of a year or more – wouldn’t it be best to be prepared for the most dire circumstances rather than reacting to events as they unfold. Threat of pandemic flu – believe in its possibility or not – is in the realm of reality, whether that reality is in employee or boardroom conversations or with regard to potential catastrophic worldwide outbreaks.
Posted: Thursday, May 31, 2007 12:00:00 AM. Modified: Thursday, May 31, 2007 3:10:41 PM.
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