Withstanding A Pandemic: How To Prepare Your Organization For A Global Threat

Robert Clark, an emergency preparedness expert, joins Danielle Ricci, Sr. Director of Marketing for AlertFind, to educate businesses about epidemics and pandemics. In our upcoming webinar, he shares the best ways for organizations to prepare for this global threat and ensure they can reduce the impact pandemics will have on their workforce, suppliers and customers.

Robert will address how businesses can prepare on both an organizational and personal level as well as outline what planning and training can be done now to ensure you’re ready if a global illness strikes.

Danielle Ricci: Let's talk about how you first got involved in pandemics in relation to business continuity.

Robert Clark: Well, it must have been about seven or eight years ago. I was facilitating some risk management workshops for the Department of Health in the country of Malta.

The sponsor of the workshop was the incumbent future chief medical officer and one of the things I very quickly realized was that pandemics were at the top of the risk register. You can almost see the look of fright on their faces when you talked about pandemics.

About three years ago, I was asked to put together a two-day training course about business continuity and the pandemic threat to present in Hong Kong and in Dubai. And the more research I did, the scarier the threat of pandemics became. I was beginning to understand why the look of fear was on the faces of everyone at the convention. So that's how I first got into it and as a consequence of that work, I ended up writing a book on the subject.

Danielle Ricci: You said they had a look of fear on their faces. Was it because they weren't prepared or was it because the task was so enormous, they didn't know where to start?

Robert Clark: I think you can tick both of those boxes. If you look at the history of pandemics, it is really scary stuff and in some cases, you are talking about many millions of people dying. In a worst case scenario, it's really going to be nasty for us as a species. I don't think I'm giving anything away when I said no, they're not ready.

Danielle Ricci: How did Harvard get in touch with you to talk about pandemics?

Robert Clark: Well, I got a phone call from Dr. Jonathan Quick, Senior Fellow Emeritus at Management Sciences for Health and a faculty member at Harvard Medical School. He and his team were doing research on epidemics and pandemics and he asked me to speak about pandemics’ affect on business continuity. (Dr. Quick’s book, “The End of Epidemics,” is now available.)

Danielle Ricci: Could you tell us a little bit more about the research that Dr. Quick was doing?

Robert Clark: Well, the ultimate objective for the research is to identify how to get rid of epidemics forever. An interesting objective so I think it will make quite fascinating reading. So that was the end game and they were interviewing a number of people, myself included.

Danielle Ricci: What did your interview focus on?

Robert Clark: Well, he'd read my book, “Business Continuity and the Pandemic Threat.” There is very little out there about that subject so it was his starting point from a business continuity point of view. We talked through the various implications that could affect a business, what a business could do from a precautionary perspective. You can't stop a pandemic but you can prepare for it.

Danielle Ricci: How do we define a pandemic and how does that differ from an epidemic?

Robert Clark: Simplistically, the World Health Organization's definition of a pandemic is a contagion that has gone global. Now if you narrow that down a bit, you could say it’s a contagion that's spread across more than one continent. The most recent scare we had is the Zika virus.

So we've been going through a learning process and the initial scare has died down but if you look at where Zika is now, it's across Africa, it's across much of Asia, across South America, parts of the United States and Mexico are infected, so and so on. Zika's still around but that's an example of a pandemic, as is HIV AIDS.

We've been living with that now for over 30 years. So far, I think 35 million have died and more than that are still infected with the virus. So we mustn't forget that, while we focus on influenza as a rule, there are other diseases that present a serious threat.

Now if we take the Ebola outbreak in West Africa, that was contained within the region and although more than 11,000 people succumbed to Ebola, it was always referred to as an epidemic because it was contained within the same region. Yes, we had cases of it in the U.K., there were cases of it in the United States but there was no case of someone being infected while they were outside that region. In every case, it had been someone that had traveled to the region and picked up the infection while they were there.

Danielle Ricci: Where does seasonal flu fit into the picture?

Robert Clark: What we’re looking at is the seasonal flu and there are a number of influenza viruses that are continually circulating around the world and, from our perspective in the northern hemisphere, it's our winter months when we're most susceptible to seasonal flu and of course when it's our summer, it's the southern hemisphere's turn.

Each year, there are new influenza vaccines which are offered to people who are considered vulnerable, the elderly, people with respiratory problems like asthma, etc. This is because these viruses go through what's called an antigenic drift, that is to say they undergo minor mutations.

Now if we then talk about what's called an antigenic shift, that means there's been a major mutation and when the virus is first identified there will not be any vaccines available and that situation may exist for several months after the initial identification of the virus.

If we go back to 1918 when the Spanish Flu first hit us, it had the same effect as it's having now. Yes, people were being affected, people were dying, and then it mutated. And it came back with renewed vigor. Some can feel perfectly fine at breakfast time, but they're dead by dinner time. It was that sudden. Are we facing that this time with the current flu? That's the big unknown.

But what I can tell you is that the WHO is keeping an eye on the H5N1 strain of avian flu. And that's currently flagged as being in the alert phase, which means we're seeing a new sub-type and it's been identified in humans. And they're monitoring that in terms of what's the risk at a local level, at a national level, at the global level, and identifying the characteristics of the virus.

Now it may turn out that it's a big non-event. On the other hand, this could be the nasty virus that we're expecting to hit us at some time in the not-too-distant future. So there's a big guessing game going on.

Another example that was given to me a long time ago was if you can imagine that a chicken virus meets say, a virus from a pig, and they fall in love and they start producing offspring, then that virus will be totally new. And there will be nothing in our immune system that will recognize it. And consequently, we as individuals will be vulnerable to that. So that's the worst case scenario.

Danielle Ricci: You’ve said that businesses have a duty of care to their employees. What does a responsible organization owe to the people who work for it?

Robert Clark: Pandemics are 90% about people and a duty of care could cover a number of things. So look at your workforce from the point of view of how are they exposed? Are they dealing directly with the public? Is Joe Public walking in off the street putting your employees at risk because they're working on the customer service desk?

You need to protect them from the point of view of what contingencies could you put in place to reduce the risk of them being infected by someone that they're having to deal with. You're going to introduce things like people coming in and having to sign in if they're a visitor.

Well, you don't give them the common pen that everyone's using that could be infected. You might give them a pen which they use and then they keep. You're going to discourage the exchanging of business cards. You're going to discourage things like shaking hands.

So duty of care is about making sure that you minimize the risk of your employees being infected. And other things that you can do: encourage people to bring their own coffee cups to work; if you have a communal drinking fountain, that's a bad move because with lots of people touching it, an infection can stay on a hard surface for a while, and the next person who uses it gets infected.

What are you going to do about people who are taken ill at work? Do you have first aid facilities that you can put them into while they wait to go to the hospital or whatever's necessary? How are you going to protect the people that are dealing with them? There's a whole raft of things that companies could put in place.

Danielle Ricci: So what is the probability of a serious pandemic occurring?

Robert Clark: To determine that, it varies by where you live. In the U.S., look at the National Risk Register, because that will tell them the way the thinking is going within your country. In the U.K., the National Risk Register was published in September 2017. It's available online so it can be downloaded.

It estimates the probability of a serious pandemic occurring within the next five years to be between 1 and 20, and 1 in 2. Okay? It can only get slightly worse, eg, look at the time, it's due any minute now. So it's pretty high. It also estimates that as many as half the UK population could be infected.

Up to 750,000 could die in the U.K. alone. If you transpose that to a global figure, we're talking in excess of 100 million. And there are some experts out there who think that's on the low side.

Danielle Ricci: How much warning are we likely to get that a pandemic is coming?

Robert Clark: That's a good question. It may be none at all. With SARS, it was proliferating across the world before the World Health Organization even knew it existed.

But in the case of influenza, they are monitoring on an ongoing basis. I think it's H5N1 that they're the most concerned about at the moment. And they are detecting transmission from human to human.

The alert phase is immediately before the pandemic phase, which means, increased vigilance on monitoring and risk management.

Danielle Ricci: Pandemics could be caused by either a virus or by bacteria. What is essentially the difference between them?

Robert Clark: A virus and bacteria are both microbes and we can't see them with a naked eye, but they can behave differently. I mean, for example, we've all got bacteria that live in our digestive tracts and we need them, so I would look upon them as good bacteria.

Then you've got bad bacteria, which are associated with nasty illnesses like plague, salmonella, norovirus, E. coli, and so on. So there are two sides of the coin as far as bacteria are concerned.

Now for viruses, I can't say I've actually come across any good viruses in my research, so I conclude that they're all nasty. The difference between them are their varying degrees of nastiness. We've already talked about influenza, HIV/AIDS, etc.

But in the last 50 years, we've seen Ebola, Legionnaires' disease, SARS, MERS (Middle Eastern Respiratory Syndrome), and Zika. These are all recent discoveries. Every time Ebola comes back it gets worse. And it started off with one or two people being the unfortunate victims of the virus, and every time there are a few more and a few more. And last time it killed from a few hundred to over 11,000 because it had mutated. That's essentially the difference between them. The common factor is that they're both microbes.

Danielle Ricci: In the event of a serious pandemic, apart from people becoming sick, what other things could have a detrimental effect on businesses?

Robert Clark: Well, it's actually more than just people that are infected, because you could have people who are quarantined, nothing appears to be wrong with them, but they have been exposed. So you've got the infected, you've got the exposed.

It's possible that schools are going to be closed, so someone may need to stay home from work to look after the children. Then you've got situations where transport could be disrupted, not just because they're trying to stop so many people traveling on public transportation, but transportation workers themselves could be affected. So these are the areas we need to consider in terms of what emergency legislation may be introduced in order to try and prevent the spread of the pandemic.

And we may also see things like bars are closed, meetings are banned, football matches are scrubbed, church services are cancelled, and so on, simply to stop people being in close proximity with each other. There could be some rather draconian measures that need to be taken in our best interest, although people may not necessarily see that at the time.

Danielle Ricci: We can’t stop a pandemic from happening so what should we being doing to prepare - both individually and as organizations?

Robert Clark: If you look at it from a civil perspective, a corporate perspective and an individual perspective, the lovely quote from JFK comes to mind. “Ask not what your country can do for you but what you can do for your country.”

Don't expect someone to look after you. There will be situations where the best person to look after you is you. You need to ask, "What can I do to protect me and my family?" Because it's not just a business responsibility. One friend of mine who is a retired throat specialist read my book and he said to me afterward, "I know that you have targeted these businesses, but everyone should read it because it could save lives.”

I certainly cover that part in the book in terms of what we and individuals could be doing to better look after ourselves and it's certainly worth mentioning along with the corporate and the civil side of it too.

For businesses, they need to think about how they’ll handle issues like people coming back to work while they’re still sick or infected because they can’t afford to stay home.

What about other absenteeism? What other risks are there and how are we going to look upon them? Start with being quarantined. If your employees are being quarantined, there's nothing they can do about it. There are those that may not be able to get to work because of a public transportation disruption. Parents who've got to stay home to look after sick families or children.

Think about your remote workers. What if because other people are sick, you say to him or her, "We need you to come into the office." And they say, "I'm not going to. My contract says I'm a remote worker," because they're not prepared to put themselves at extra risk, leave their home and travel and go to work. What are you going to do about situations like that?

There's a whole host of things that human resources can be looking at and saying, What's our policy going to be? Are we going to offer any compensation for individuals that take on roles that they're not contracted to do and put themselves at extra risk? What's our policy going to be if an employee dies? Are we going to go around to see their family and offer our condolences like most decent companies would?

But if we do that and there's other people there that are infected, are we going to get infected, are we going to infect our family? I ran a workshop, which was an exercise to validate a pandemic plan, and that one question really, really generated a lot of emotion to the extent there was almost a fight.

The human resources director said, "I am not prepared to risk myself or my staff to go around to visit the bereaved's family and put ourselves at risk of being infected." This individual was accused of being uncaring and it really got heated. These are the sort of things that the companies will have to think through.

Danielle Ricci: I’ve heard about antimicrobial (antibiotic) resistance (AMR). What exactly is that and how does that fit into the picture?

Robert Clark: It's where drugs are no longer effective in treating infections. We're not seeing replacement antibiotics being developed by pharmaceutical organizations. So we're entering what some people refer to as the post-antibiotic age. We haven't quite got there but we're not far off it. And the number of antibiotic-resistant infections is expected to increase markedly over the next 20 years.

At this point in time, the CDC have estimated that something in the range of 2 million illnesses and 23,000 deaths are caused every year by AMR. It's not exactly a pandemic, but it is also medically related in terms of if we do not find a way out of this, then we could see a resurgence of nasties like the bubonic plague. It still exists in the world, mainly in Africa, and there are some examples actually in the U.S.

If antibiotics cease to be of any use to us, then we're going to be at the mercy of these things again. So we could, worse case scenario, see medicine go back into the dark ages. And what should be routine operations today, minor surgeries and so and so forth, become high-risk procedures because the antibiotics that they would use to help with part of the treatment, would no longer be effective.

It's one of these situations that’s a little bit like global warming. It's on the radar. And although we're seeing early signs of it, it hasn't quite arrived yet.

Join Robert and Danielle to learn more about pandemics and their wide-ranging impact on business operations in our next webinar, “Pandemics: Preparing For Business's Next Big Threat,” at 11 a.m. EDT on Thursday, March 22.