Back to Volume 12
	Pandemic Preparedness By Miranda Duncan and Christin Puschauver

You've seen it before: C-Suite executives huddled around the boardroom taking a war room-style approach to crisis planning. They're asking difficult questions, assessing vulnerabilities and developing scenario plans to respond to potential issues.

At first blush, a pandemic preparedness planning session resembles — in many ways — your ordinary executive-level brainstorm. But what's new is who is at the table. Business continuity managers — typically the gruff, pragmatic leaders working behind the scenes on emergency planning — sit side-byside with operations, communications and human resources leaders, largely in the same way that Y2K increased the strategic planning role of IT professionals. And they're the ones running the show.

Preparing for an Avian Flu pandemic has brought business continuity planners to the forefront of high-level strategic management. Why? Their risk assessment expertise is what ultimately will ensure supply chain continuity, employee welfare and financial stability for the company in the event of a pandemic outbreak.

In fact, their place at the table is a result of corporate needs similar to those that prompted the rise of technology executives during Y2K. However, they're not alone. Given what pandemic preparedness entails, business continuity planners are working hand-in-hand with corporate communications executives. This new cross-functional leadership is ultimately what sets pandemic preparedness planning apart.

As it turned out, Y2K was more hype than anything else. As University of London Computer Science Professor Anthony Finkelstein points out, in retrospect it is clear that "estimates of the nature and severity of the problem were wildly exaggerated."

Global corporations, international organizations and governments alike are banking on an eventual Avian Flu outbreak — with massive repercussions. The public and private sectors are pouring hundreds of millions of dollars into pandemic preparedness planning.

Some analyzing the situation on the surface may ask, "Is it really worth it? What happens then, if the pandemic doesn't occur — and turns into the next Y2K?"

Those on the inside of the executive boardroom see things differently and aren't even asking those particular questions. Instead, the high-level executives are not only evaluating risk the specific risk of an Avian Flu pandemic. Rather, they are also recognizing an emerging business trend: In today's society, there is no such thing as being overly prepared for an emergency situation. Regardless of whether an Avian Flu pandemic occurs, Business Continuity Planning is an important component of corporate strategy.

About the Avian Flu

WHAT IS IT?

It's not just for the birds. Although the Avian Flu is caused by the Influenza A virus hosted by birds, it has the potential to infect several species of mammals — including humans. A specific form of the Influenza A virus, subtype H5N1, has been generating global concern about a potential Avian Flu pandemic outbreak.

To date, no human-to-human cases of Avian Flu have been documented. The only human cases, which have occurred mainly in Asia, resulted from direct contact with infected birds. (Table 1)

The first documented cases of human contraction and deaths from the H5N1 strain of the virus were determined in 2003 at a pediatric hospital in Hanoi, Vietnam. According to the World Health Organization (WHO), more than 220 million birds died or were slaughtered in an attempt to control the outbreak. As of April 10, 2007, there have been 291 documented human cases of Avian Flu, of which 171 cases were fatal.

Why all the fuss about a virus that has not yet demonstrated an ability to spread from human to human?

Most health experts agree: A global Avian Flu pandemic is a real threat. According to the WHO, "With the H5N1 virus now firmly entrenched in large parts of Asia, the risk that more human cases will occur will persist. Each additional human case gives the virus an opportunity to improve its transmissibility in humans, and thus develop into a pandemic strain."

WHAT'S THE REAL RISK?

According to Dr. John Agwunobi of the U.S. Department of Health & Human Services, "Pandemics are as natural as earthquakes and hurricanes." Michael Osterholm, the head of the University of Minnesota's Center for Infectious Disease Research and Policy, believes "It is not if it [avian flu] is going to happen... It is when, and where, and how bad." Experts at the WHO concur: "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." (Table 2)

But not everyone agrees. "There are so many unknowables and a lot of hype," stated AG Edwards analyst Al Goldman. "The avian flu potential is something that you can't get your arms around because no one knows if — or when — a pandemic is going to happen."

The risks associated with a pandemic outbreak concern not only human life but also financial health. According to Dr. Margaret Chan, the director-general of the WHO, "Estimates of the costs of the next influenza pandemic vary greatly, depending on the presumed virulence of the virus, rang[ing] from 800 billion dollars within a year to well over 2 trillion dollars." All estimates indicate, however, that the highest costs will come from the uncoordinated efforts of the public to avoid infection.

Pandemic Preparedness: A Multi-pronged Approach

It is essential then for governments, the private sector and individuals to plan ahead. They must coordinate efforts to minimize infection, death and the drain of financial resources. (Table 3)

Government Preparedness

GLOBAL LEVEL: WHO

The WHO is coordinating the global response to human cases of the Avian Flu and monitoring the corresponding threat of an influenza pandemic. The WHO has developed a "Stage of Alert" system for identifying levels of pandemic. Each stage is associated with international and national public health actions. The organization is leveraging its Global Outbreak Alert and Response Network (GOARN), a technical collaboration of existing institutions and networks, which pool human and technical resources for the rapid identification, confirmation and response to outbreaks of international importance to monitor the Avian Flu.

Acknowledging the real risk of pandemic, government officials around the world have been developing preparedness plans. The WHO's website tracks the evolving situation and provides access to both technical guidelines for national governments and information useful for the general public, including fact sheets and regional information.

NATIONAL LEVEL: U.S. GOVERNMENT

National governments have also taken the threat of pandemic seriously. In the United States, President Bush issued the National Strategy for Pandemic Influenza in 2005 to guide the preparedness and response of the U.S. to an influenza pandemic. Bush also requested an additional $7.1 billion of emergency budget for pandemic preparedness funding. (Table 4)

In 2006, President Bush issued the Implementation Plan for the National Strategy, which translates the strategy into more than 300 actions for federal departments and agencies. It sets clear expectations for state and local governments and other non-federal entities. It also provides guidance for all federal departments and agencies on the development of their own plans.

Among other initiatives, the government is investing in the development of new cellculture technologies for influenza vaccine production and plans to adapt existing eggbased vaccine facilities for pandemic vaccine production. Also, concerning vaccines, the U.S. government tested adjuvants, or "dosestretching" materials that would minimize the amount of vaccine necessary for a vaccination, enabling more people to be vaccinated for Avian Flu with a set stockpile.

However, the U.S. government's most essential priority for maintaining the resilience of communities and of the nation is to "encourage all entities, from government agencies to schools to individuals and families, to develop their own pandemic plans."

The Private Sector's Role

Given the need for an integrated response, the private sector has taken a leading role in pandemic preparedness. From ensuring employee health to establishing mechanisms to provide for business continuity, leading corporations have implemented comprehensive pandemic preparedness programs.

PRIVATE SECTOR PREPAREDNESS
CASE STUDIES

Novartis: Business Continuity Planning Leadership

Ruder Finn has supported Novartis in their Avian Flu preparedness planning. Along with developing a comprehensive employee education program focused on preparedness planning and training, Novartis has established a comprehensive program for ensuring its lifesaving treatments continue to reach those who need them in the event of a global pandemic.

The Novartis business continuity plan was developed through a comprehensive analysis of scenarios, risk tracking and vulnerability mapping. From an operational standpoint, Novartis preparedness is best in class. This preparedness initiative has also carried over to ensuring Novartis communications are maintained. "While supply-chain management and operations infrastructure is paramount, also important is being able to communicate up-to-the-minute information to our employees, our customers and our shareholders," said Brandi Robinson, Executive Director of communications at Novartis, who has led the company's pandemic preparedness for the U.S.

Communications is playing a critical role in pandemic preparedness. The overlap between business continuity planning and the communications function has, to date, never been more profound.

As part of this effort, Ruder Finn has helped Novartis establish procedures and protocols to ensure communications are up and running in the event of a pandemic. This program includes a highly specific scenario plan that maps out back up offices, spokespersons and procedural processes should a pandemic — or any adverse event — arise.

Intel: Pandemic Preparedness in Business-to- Business Relationships

Intel recognizes the threat of Avian Flu and thus is developing a pandemic plan utilizing lessons learned from its experience with Severe Acute Respiratory Syndrome (SARS). The company's plan includes monitoring and tracking developments, educating employees and implementing programs to increase good hygiene practices and infectious disease control. Specifically, Intel's planning will result in establishing a cross-functional team, conducting drills and creating a detailed plan that covers areas such as communications, travel policies and infection control. Like many organizations planning for pandemic influenza, the company's plan includes phased-in responses prompted by the WHO pandemic phases.

Intel has taken its preparedness plan another step forward. Recognizing that its business operations rely on external parties in its business network, Intel has set expectations with its suppliers that they will prepare for a potential Avian Flu pandemic.

Suppliers in affected areas are expected to have plans for a pandemic influenza that are part of their business continuity planning. The suppliers review these plans with their Intel Commodity Manager. Currently, suppliers are expected to educate employees about personal hygiene practices and encourage them to stay away from live poultry and consumption of undercooked eggs and meat.

If the WHO alerts a higher risk level of pandemic, involving an increase in human-tohuman transmission, Intel will implement a self-screening process for sites, and suppliers' on-site employees will be expected to participate in the self-screening process provided by Intel. At such a time, Intel also expects that any employees that show flu symptoms will not enter an Intel facility and will be required to obtain appropriate healthcare.

In the unfortunate case that the WHO level alert reaches phase five, supplier employees will be required to participate and follow actions as directed by Intel. Policies regarding the use of respirators by employees must be determined and communicated. Employees will need to be trained and fit tested for N95 respirators by the supplier. For its part, Intel will provide a limited amount of N95 respirators for all employees/contractors working on Intel sites.

As no company exists in a vacuum, Intel has developed a calculated plan that addresses a potential pandemic by engaging two key business stakeholders - employees and suppliers.

Roche: Sharing Best Practices

The Roche pharmaceutical company tagline is, "We innovate healthcare." The company also is innovative in its approach to creating awareness around issues, including issues regarding regular influenza and a potential avian influenza outbreak.

Roche launched an unbranded advertising campaign in the United States called "Flu Facts" featuring characters from the Warner Brothers film Happy Feet, the campaign was released in November 2006 and played during peak flu season. The ads pointed to a website (www.fluFACTS.com) where visitors could reference information and practical advice consistent with healthexpert guidance.

Roche extended its Happy Feet partnership to include entertaining and memorable educational brochures and activity books for teachers to use in schools and parents at home to help educate children about the flu. Roche was targeting children since they are 1.5 to 3 times more likely than adults to get the flu, and children age 6 to 10 have the highest flu infection rates.

Just as Roche understood the need for seasonal flu awareness the company was also cognizant of the need for Avian Flu pandemic awareness. Thus, Roche has addressed a potential pandemic flu outbreak not only by planning for its own company but by also developing an educational website (www.pandemictoolkit.com) that provides resources to assist other organizations in preparing for pandemic influenza. Laid out in a simple question-and-answer format, information is readily available for businesses and individuals alike. Topics include an influenza overview, background information on pandemic flu and how to prepare one's organization. Roche is the maker of Tamiflu, which is part of the current treatment for Avian Flu. Thus the company provides details regarding the drug itself as well as the supply of Tamiflu and how organizations can order it for employees.

For additional educational and informative materials, one can register at the pandemic planning toolkit site. By registering, individuals and organizations can benefit from webcasts on pandemic flu and access a downloadable education module plus case studies and whitepapers. To stay up-to-date, registered individuals also receive periodic e-mails alerting them to upcoming events and new information.

Sharing of practices and information in the private sector as Roche is doing will help to align the responses of companies in various industries and may potentially cut down some of the costs associated with developing, planning and implementing a pandemic preparedness strategy.

Individual Preparedness: What you can do

Physicians recommend a series of simple measures to prevent the spread of the Avian Flu virus in the event it becomes transmissible from human to human. Prevention of exposure, good hygiene, and social distancing will present everyone the best opportunity to survive any and all possibilities of Avian Flu.

In addition to taking precautions specific to a potential pandemic, there are other simple steps you can take to prepare for adverse events generally. (Figure 1)

The U.S. Department of Homeland Security promotes individual emergency preparedness through the Ready Campaign. The website — created by Ruder Finn Interactive — for the campaign (www.Ready.gov) offers tips and planning suggestions so that individuals and families can have the tools and plans in place to survive on their own, at least for a period of time whenever a disaster strikes, be it a natural disaster, biological threat, terrorist attack or other emergency.

The Ready Campaign suggests three key planning actions for families, including having an emergency supply kit, making a family emergency plan and being informed about the different kinds of emergencies that occur and their appropriate responses.

An emergency supply kit should include a three-day supply of food and water, a flashlight, a battery-powered or hand crank radio, a NOAA Weather Radio with tone alert and extra batteries for all of the above. A first aid kit is essential. Also, the kit should include a whistle to signal for help, a dust mask and supplies for sanitation including moist towelettes, garbage bags and plastic ties. Tools needed consist of a wrench or pliers to turn off utilities and a can opener for canned food. Local maps are also a plus. There are other recommended items, but these are the most basic.

A family emergency plan is important since a family may not be together when disaster strikes. Being able to communicate among separated family members is crucial. A virtual calling tree will help information about affected family members reach others most efficiently. Furthermore, as it may be easier to call long-distance than cross-town, an out-oftown family member may be the best initial contact that will enable individuals to communicate among separated family members.

Finally, individuals can browse Ready.gov about all the potential disasters they may have to face. Knowledge is key in being prepared to respond to each specific disaster.

So, is pandemic preparedness worth it?

One thing is clear: Everyone — from the government to the private sector to the individual — must play a part in preparing for a pandemic. Through the alignment of plans, ideas and procedures, we can help mitigate the impact of an Avian Flu outbreak.

Perhaps more importantly though, pandemic preparedness is shedding light on an emerging business trend — the rise of the business continuity manager and his expanding role and influence on C-level executives.

For the first time, Business Continuity Planning and communications functions are overlapping. An aligned approach between these two key functions is essential to preparing for a pandemic. "Business continuity planning for multinationals is complex, but a flu pandemic will be particularly challenging. The threat of a pandemic demands that companies develop and implement proactive crisis leadership strategies," says Rosaline Chow Koo of Mercer Consulting. According to Koo, "Since a pandemic could incapacitate any member of the management team, there must be a plan to identify a group of managers who can back up one another and who will be available to exercise leadership in different locations and at different times during a pandemic."

And while the pandemic may or may not be another Y2K, programs to prepare for an adverse event are necessary and real. While no one — not even the WHO — knows for sure if and when a pandemic will occur, events like 9/11, the Indonesian tsunami, SARS and Hurricane Katrina show us that adverse event preparedness is essential.

CASE STUDIES IN BUSINESS CONTINUITY BEST PRACTICES
Responding to Hurricane Katrina

It was the costliest and one of the most deadly hurricanes that the United States has faced, and many saw how ill-prepared the country was for such a disaster when Hurricane Katrina hit the Gulf Coast in 2005. However, some companies had the foresight to plan for business continuity in the face of potential adverse events. Both Pricewaterhouse Coopers (PwC) and National Gypsum, a fully integrated manufacturer and supplier of products and services used worldwide in building and construction, are recognized for their best practices in preparing for and responding to Hurricane Katrina by Business Roundtable's Partnership for Disaster Response (http://www.respondtodisaster.com).

PwC is a successful example of business continuity because prior to the coming of Hurricane Katrina, the company already had in place had a system of logs, databases, and employee preparedness to account for all of its New Orleans employees, which it successfully did within 48 hours of the storm. The company even tracked and located retired employees through up-to-date records and helped employees who were not in the affected regions locate their relatives who were.

After all employees were accounted for, PwC was ready to provide short-term housing assistance for staff who needed it and longerterm financial relief to those most devastated by the disaster.

According to Stephen Malloy, PwC's Crisis Assessment Team leader, "By planning ahead and establishing a proactive method of contacting our people in an emergency, we were able to quickly account for all of our staff even under the worst of conditions. It was a very stressful, emotional time for our people and their families, and we were glad we could be a source of information and support for them."

National Gypsum's best practices involved keeping constant communication with its employees. With the onset of Katrina, a pre-prepared crisis management plan was immediately implemented to evacuate its plant, and a 24-hour toll-free number was activated through which employees could hear facility updates and service information and speak to a live staffer to provide their location. The hotline assured employees that the company would continue to pay their salaries despite plant closures. Continuous communication with plant employees during Hurricane Katrina enabled National Gypsum to reassemble its workforce and bring the plant back to operation in only three weeks.

In short, preparing for a pandemic is not similar to falling prey to Y2K hype. It is something to take seriously, as it will help governments, corporations and individuals design and implement mechanisms for coping with adverse events generally. The best practices developed for a pandemic will ensure we are better prepared the next time any adverse event arises. C-level executives are recognizing the importance of preparedness and business continuity. National Gypsum CEO Thomas C. Nelson pointed out that "The Katrina disaster defined our company in many respects... We were able to locate all our associates... and tell them they would have a place to stay and a job when we could open the plant."

As business continuity gains the power to define companies, one thing becomes clear: Business Continuity Planners are here to stay. And more than ever, communications is playing a critical role in the preparedness planning process. Executive strategies will continue to leverage these key areas of expertise. Pandemic preparedness — at the very least — is a positive step in developing effective response infrastructures and mechanisms to respond to adverse events globally.