Sandy Says: Bringing Home the Bacon

May 1, 2009
How many people can say that the most interesting experience they had on a trip to Europe involved a swine flu pandemic?

So I walk into the Strategic Health Operations Center at the World Health Organization's (WHO) headquarters in Geneva, Switzerland on Friday, April 24. It's the last working day of a long trip spent discussing emergency response and pandemic preparedness with organizations and companies in Switzerland because everyone knows the Swiss are organized and prepared.

(It's a tough job, visiting Zurich, Zug, Bern, Basel and Geneva — some of Europe's most charming cities — while riding around in the bus belonging to the country's Federal Council, complete with an espresso maker and conference table, but somebody has to do it.)

The cavernous operations room has microphones, giant video screens and translation services. Walking in, I thought, “Toto, we're not in Kansas anymore.”

A few hours earlier, at 4 a.m., WHO alerted key personnel to a swine/avian/human flu strain that reportedly had human to human to human transmission (important to note when talking about pandemics). On the day I visited, the people I met were beginning to coordinate the global response to the reports of swine influenza A (H1N1) and monitoring the corresponding threat of an influenza pandemic.

The following day, April 25, WHO Director-General Margaret Chan, upon the advice of the organization's Emergency Committee, declared the outbreak “a Public Health Emergency of International Concern.”

On April 26, the day I flew home, WHO and the Global Alert and Response Network (GOARN) sent experts to Mexico to work with health authorities.

Paul Cox, an operations manager for WHO in the Health Security and Environment division who was on the receiving end of that 4 a.m. call, suggests that companies not only have a written plan to follow should a pandemic strike, but that they drill for a pandemic outbreak. “Exercises are important, simply because things change. Staff changes, resources change, the virus changes,” said Cox.

For many us in the United States, pandemic illnesses are history projects or science fiction. We are told to prepare for them, but we secretly think we won't experience them. Although many employers — at the urging of agencies like OSHA ( — have plans in place to ensure they can continue operations should a pandemic occur, just how prepared are they?

For example, all of your employees are well, but as in New York, some local kids returning from a school trip become ill with a strain of influenza and city schools close for a week. As a result, you experience much higher than average absentee levels as parents, unable to find or afford daycare, stay home with their kids.

Or, you're really on the ball and not only have you provided all employees with a seasonal flu vaccine, but at the first news reports of a pandemic virus in your state, you offered employees Tamiflu, an oral antiviral treatment used to prevent influenza. But (as in the current case) what if the strain of flu is not the same as the seasonal influenza vaccination? And what if employees don't develop influenza because of the Tamiflu, but their family members become sick?

“Three trillion dollars could be the impact of a pandemic on the United States,” Dr. David Reddy, the global leader for Tamiflu at Roche, told me on April 22. “There could be an absentee rate as high as 40 percent, and the potential for temporary closures of businesses, schools and even public transportation systems.”

According to Reddy, there currently are enough stockpiles of Tamiflu to treat approximately 5 percent of the world's population. Should the demand require it, Roche's global manufacturing network can produce 400 million doses per year. Although offering employees and their families Tamiflu won't stop a pandemic in your city, it potentially can stop one from temporarily shutting the doors of your facility.

When it comes to planning for a pandemic, experts agree: Be prepared for the worst and hope for the best.

(OSHA and other organizations offer tips to limit the spread of pandemic viruses. You can visit our Web site at for more information.)

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