Preparing For Influenza Pandemic: It's Not If, But When

If your company is not already preparing for influenza pandemic, you need to begin now. A good place to start is your local health department. Here's how to do it and why it's so important.

Influenza pandemics are like hurricanes: they happen. Although no one can predict with any certainty when the next one will strike, most experts believe we are overdo.

All agree that sooner or later an influenza pandemic is going to break out, with the potential for devastating consequences on the world economy and your company. The influenza pandemic of 1918 not only killed millions of people, it caused innumerable bankruptcies.

At a recent ORC Worldwide meeting, Julie Gerberding, M.D., director of the Centers for Disease Control and Prevention (CDC), told our members why business planning for a pandemic is so important.

We could be close to an outbreak of avian flu, and a pandemic is certain to happen at some point in the future, Gerberding noted. "We've never been as close to a pandemic in my lifetime," Gerberding said.

She predicted a pandemic would kill 2 million Americans and place three-quarters of a million people on intensive care respirators, overwhelming the nation's health care capacity while causing enormous disruptions to the world economy.

Companies and communities must plan to be "self-contained" and not expect much help from the federal government, according to Gerberding. "In this planning scenario, we are operating under the assumption that local planning has to be where the action is," she asserted.

Where to Begin

After Hurricane Katrina, the federal government was widely criticized for failing to prepare and respond to the devastation. But Gerberding explained it would be even harder for the federal government to respond to a pandemic, because a hurricane hits one region, while a pandemic strikes everywhere. (For more information on what an influenza pandemic could mean for business, see "How Would a Pandemic Affect Your Company?" on p. 34.)

ORC brought this issue to our members' attention at a quarterly meeting in February 2005, when we invited Tim Uyeki, M.D., MPH, medical epidemiologist at CDC, to speak to members about "The Growing Threat of an Avian Flu Pandemic."

Our members got the message. In April, ORC Worldwide conducted a survey of employers concerning the state of their preparedness for flu pandemic. We found that of the 129 companies who responded, 116 are engaged in pandemic preparedness planning: 29 percent have completed their planning, 52 percent are in the process and another 19 percent intend to start soon. Only 13 companies out of the 129 surveyed said they are going to rely solely on existing disaster plans or do not intend to do any planning for a pandemic. A summary of the survey is now available on our corporate Web site at http://www.orcworldwide.com.

We found the planning process raised a number of issues for our members, so to help them through this, our Washington, D.C., office established a Pandemic Preparedness Task Force and organized teleconferences on the issue. (See Sidebar: "Preparing for a Pandemic: What Companies Are Doing.")

Opening Conversations

In California, I discovered that the conversation between the business community and local health departments (LHDs) about pandemic preparedness had not yet begun.

This was due to a variety of reasons: LHDs often have no experience in reaching out to local businesses and no dedicated staff members to do it. The business community, on the other hand, may not realize how important LHDs are for pandemic preparedness, nor do companies always know whom to contact, even if they want to. Finally, in California, LHDs have very limited funding for pandemic preparedness.

While we may hope this will soon change, for now, LHDs have not reached out to companies. The business community cannot afford to wait for this situation to change; it is critical that we take the first step.

ORC's Western OSH Group, located in the Sacramento, Calif., area, realized it could help facilitate bringing businesses and LHDs together by identifying key individuals in both groups, establishing contacts and encouraging them to be partners in the planning process. Our role is to raise awareness, stress the urgency of the public and private sectors working together, develop agendas and assist with meeting arrangements.

We had our first meeting in Sacramento on Feb. 17, followed by another on March 31 and a third on June 1. They were regional meetings, attracting the participation of several county health department officials as well as a variety of representatives from the business community. Meetings also were held in San Francisco and San Diego. Because ORC members tend to be large companies, we found a regional, multi-county approach to these meetings to be a more efficient way to conduct business.

The goal of these early meetings was pretty basic: Local businesses want to know what the LHD is going to do when there's a pandemic, while the LHD wants to know what businesses are going to do and how they can help.

Getting to Know Your LHD

Once you have decided you want to meet your local health department, here are some tips I can offer to help get you started:

  • Network with other businesses in the county and approach the LHD as a group;
  • Seek a meeting between businesses and LHD personnel only (i.e., no additional stakeholders);
  • Offer to facilitate the meeting, including agenda development and contacting local businesses;
  • Provide information about the status of business planning efforts, concerns and the contents of plans;
  • Request information about the LHD's planning activities, response capabilities and issues;
  • Identify opportunities for cooperation, coordination and collaboration.

Becoming part of the communication network when a pandemic hits is critical for any business, so company leaders can give employees good information and know whom to contact with questions. An additional benefit of these meetings is finding out what other businesses in your community are doing to prepare for a pandemic.

Outcomes

In the course of my effort to bring companies together with LHDs, I am recommending that county health departments in California adopt a business engagement plan. ORC companies located in the King County/Seattle area told me that a plan being used there works well, and I am sharing it with health departments here in California. The King County plan recommends the following business engagement outcomes:

  • Establish regular communication with local businesses;
  • Obtain key contact lists and emergency contact lists;
  • Identify "Promising Practices" and resources that can be used as models for business continuity, human resources policies and preparedness planning; and
  • Inventory resources that could be available during an event and establish utilization agreements if needed.

The King County plan also provides guidance on what to expect from your LHD. The ultimate goal of your discussions with local officials is to ensure they will:

  • Brief businesses on pandemic flu and community containment measures that may be used, i.e., social distancing, restriction of large public gatherings, school closures, etc.;
  • Provide technical assistance; and
  • Establish ongoing communication with businesses before, during and after an event.

The Reaction

I have found local health departments in California very receptive to meeting with companies. In fact, because they often are lacking in resources, LHDs are grateful to the business community for taking a leadership role in this effort.

For example, Glennah Trochet is the top public health officer in Sacramento County and also is leading a regional effort to prepare for an influenza pandemic.

"I'm very appreciative of everything ORC has done," she said. "What they have been doing is extremely valuable. It's very helpful when you don't have staff to do this."

ORC members, for the most part, also have derived a good deal of business value from meeting with LHDs.

"Businesses can't wait for the phone to ring, but that's what they were doing," said Jon Frisch, Ph.D., MPH, senior program manager at Pacific Gas and Electric. "Putting companies together with the local health departments is a great service. Organizing these meetings in the major urban centers is saving me a lot of effort."

While there are many business and technical issues that need to be addressed in these meetings, in the end what is probably most valuable about them comes down to something as simple as getting to know people and establishing relationships. When a pandemic hits, you will need help and you may want your questions answered in a hurry. But finding out whom to contact and knowing where to reach them in the middle of a crisis is going to be difficult.

I think Jon Frisch said it best: "Developing communication, relationships, and trust are important to do now. Once there is an emergency, it will be too late."

Judi Freyman is vice president, Western Occupational Safety and Health Operations (WOSH), for ORC Worldwide. The WOSH Group is a network of large companies that focuses on best practices and works closely with agencies responsible for OSH issues in the western states. For more information, visit http://www.orc-sac.com and www.orc-sac.com and www.orc-dc.com.

Sidebar: How Would a Pandemic Affect Your Company?

(The following is adapted from a King County/Seattle pandemic preparedness plan.)

Pandemic flu refers to a worldwide epidemic involving the spread of a flu virus to which few human beings have previously been exposed. Because of this, a pandemic flu has the potential to cause increased levels of serious illness and death in a very short period of time. The current outbreak of avian flu in Southeast Asia is of concern to health officials because it could lead to an influenza pandemic.

Impact of Pandemic Flu on Business

  • From 25 to 35 percent of the work force could be affected at any given time.
  • The economic impact in the U.S could range from $71.3 billion to $166.5 billion.
  • The epidemic could persist for 2 months or longer.
  • Psychological impact on the work force will be extreme.
  • Community containment measures, such as closing schools and other establishments and canceling events, may be implemented to minimize disease spread.

Key Assumptions

  • Due to travel, a flu pandemic could spread rapidly.
  • A pandemic is widespread and King County will not be able to rely on other government entities for staff and resources.
  • There are limited supplies of antiviral drugs, and a vaccine is not likely to be available for 6 to 8 months from the onset of pandemic flu or other newly emerging infection.
  • Pandemic flu will overwhelm the medical system.
  • Ill individuals may be isolated and their contacts quarantined during the first stages of the pandemic to delay spread in the community.

Sidebar: Preparing for a Pandemic: What Companies Are Doing

In addition to establishing working relationships with local health departments, companies are taking other important steps to prepare for an influenza pandemic.

ORC Worldwide consultant Ann Brockhaus, MPH, has been helping members with this issue since February 2005, when ORC's corporate medical directors group expressed concern about a new type of avian flu.

Soon after this, ORC Worldwide conducted the first of several surveys to help companies share information on the "nuts and bolts" of pandemic preparedness.

Early in 2006, ORC arranged two well-attended teleconferences to address specific aspects of pandemic preparedness; a third conference will be held soon. So far, these are the topics member companies have placed on the agenda:

  • How to handle internal and external communications in the event of a pandemic;
  • Company expectations of suppliers;
  • Managing the expectations of customers; and
  • Preventing the spread of infection among employees.
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