Download High Pathogenicity Avian Influenza

PLANNING FOR A CRISIS
PANDEMIC INFLUENZA
A
REAL LIFE EXAMPLE
Presented By
Gary Ades, Ph.D.
Senior Vice President
EHA Consulting Group, Inc.
To
Risk & Safety Managers
Executive Study Group
National Restaurant Association
Providence, RI
July 17, 2006
WHAT IS A CRISIS?
An unplanned event which triggers a real
or perceived threat to the safety, health or
environment of our customers and/or
employees
TYPES OF CRISES
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Food Safety- Product is recalled or a customer becomes
ill
Bioterrorism
Biosecurity
Workplace Violence
Robbery
Act of God – Hurricanes, earthquakes, etc
Worker Illness
Hepatitis, tuberculosis, Salmonella, Norovirus, etc.
► PLANNING FOR A PANDEMIC INFLUENZA
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SOME DEFINITIONS
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PRODUCT RECALL- a firm’s voluntary removal or correction of a
marketed product that violates the laws enforced by the FDA and
USDA.
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BIOSECURITY- is the series of management steps taken to prevent
the introduction of infectious agents into a herd or flock, e.g., Avian
Influenza, Foot and Mouth Disease
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BIOTERRORISM- is the intentional contamination of plants,
animals, or humans with infectious agents (viruses, bacteria,
protozoa, insects, or fungi) or toxins (nuclear, chemical, bacterial or
fungal) with the express intent to cause disease or economic
hardship in animals, agricultural systems, or humans.
CYCLES OF CRISIS MANAGEMENT
Crisis Management is a cyclical process involving:
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Initial action and fact gathering
Containment
Assessment and Analysis
Response
Control
Communication to all affected/interested publics
Evaluation
PRINCIPLES OF CRISIS MANAGEMENT
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Make as many preparations as possible in advance
Minimize the number of people involved
Communications will be accurate, efficient, secure and
appropriate
Decision-making will be allocated to appropriate levels
Threats and/or crises will be carefully analyzed and risks
and/or threats to the Company , its interests and employees
evaluated
Assume a worst-case scenario and prepare accordingly
Actions should be consistent with the Company’s values and
legal requirements
The Company's actions will be properly documented
The cause of any crisis will be thoroughly investigated
The Company will assess its effectiveness in responding to
any crisis
KEYS TO SUCCESSFULLY ADDRESSING
A CRISIS
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Plan ahead. Develop the plan before your need it.
Identify appropriate team members
Develop and use a checklist to guide and monitor
your preparedness planning activities
Prepare a written document of the plan
Keep the Plan current- especially regarding contact
information (at several levels) and training
Test the program. A written document whose
activities have not been tested is just a feel good
dust collector.
PANDEMIC INFLUENZA PLANNING
- IS YOUR COMPANY READY?According to a recently release study by the
Thompson Publishing Group:
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76% of the 468 business respondents have no contingency plan for
an avian flu (pandemic influenza) outbreak
47% of senior managers consider this to be an important issue
Of the 63% of the respondents who reported having a business
continuity plan only 25% had contingencies for pandemic influenza
What are employers worried about?
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Human resource-related issues (72%)
Remote work agreements (48%)
IT/data processing (41%)
Coordination with state and local governments (35%)
BACKGROUND
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Avian Influenza (AI) is a virus that causes disease in
various types of birds, thus the common name “bird flu”.
AI viruses can infect chickens, turkeys, pheasants, quail,
duck, geese and guinea fowl as well as a wide variety of
other birds, including migratory waterfowl.
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AI viruses are classified by a combination of two groups
of proteins found on the surface of the virus:
hemagglutinin proteins (H), of which there are 16 (H1H16), and neuraminidase proteins (N), of which there are
9 (N1-N9). AI strains also are divided into two groups
based on the pathogenicity of the virus--the ability of the
virus to produce disease.
BACKGROUND
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Low Pathogenicity Avian Influenza (LPAI)
Most AI strains are classified as low pathogenicity and
cause few clinical signs in infected birds. LPAI generally
does not pose a significant health threat to humans.
However, LPAI is monitored because two strains of
LPAI—the H5 and H7 strains–can mutate into highly
pathogenic forms.
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High Pathogenicity Avian Influenza (HPAI)
This is a more pathogenic type of avian influenza that is
frequently fatal to birds and easily transmissible between
susceptible species. The strain that is currently of
concern in East Asia & the Pacific, Africa, Europe &
Eurasia, Near East and South Asia is the H5N1 HPAI
virus.
BACKGROUND
TRANSMISSIBILITY
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AI is primarily spread by direct contact between
healthy and infected birds through respiratory
secretions and feces. The disease also can be
spread through indirect contact if healthy birds are
exposed to contaminated equipment or materials.
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The HPAI H5N1 virus can be spread from birds to
people as a result of extensive direct contact with
infected birds. Broad concerns about public health
relate to the potential for the virus to mutate, or
change into a form that could spread from person to
person.
World Health Organization’s
Current AI Pandemic Status
BACKGROUND
TRANSMISSABILITY
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According to the World Health Organization (WHO) domestic
ducks and some migratory waterfowl have acquired the ability
to resist the disease caused by these strains and are now
capable of excreting large quantities of highly pathogenic
virus without showing the warning signs of the illness. In
endemic countries, this altered role of domestic ducks and
migratory waterfowl is now thought to contribute to the
perpetuation of the transmission cycle.
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The H5N1 virus can survive in feces for at least 35 days at low
temperature (4°C); while at 37°C, viruses could survive for 6
days in stability tests on fecal samples. AI viruses can also
survive on surfaces, such as within the poultry house
environment, for several weeks
BACKGROUND
GIVENS
Based on the results of a Think Tank Session held at the
2006 International Livestock Congress and subsequent
white paper:
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It is speculated that H5N1 will arrive in North America
water fowl in near future.
If it invades commercial poultry systems, it will be quickly
identified and contained and controlled locally with
effective bio-security in production systems and through
testing of commercial flocks.
Consumer paranoia will occur and industry will suffer.
CONCERNS
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Impact from recreational fowl and back yard
[free-range, live/wet markets] flocks will be the
primary factor in failure of containment-control
strategies.
Much information is available, but planning
strategies of constituencies [industry,
government, research] are not unified,
consistent or effectively communicated and
focused.
Industry lacks credibility as viewed by consumer.
Media spins may be biased.
Pandemics Do Happen!
H9*
1998 1999
H5*
1997 2003-2006
H7*
1980
H2
H1
1915
1918
Spanish
Influenza
H1N1
H3
2003
1996 2002
2003 2004
H1
1977
1925
1935
1945
1955
1957
Asian
Influenza
H2N2
1965
1968
Hong Kong
Influenza
H3N2
1975
1985
1995
2005
*Avian
Flu
Pandemic Strain Emergence:
Reassortment
of Influenza A Viruses
Avian
virus
Human
virus
Avian
Reservoir
other mammals?
New
reassorted
virus
Planning Assumptions: Health Care
• 50% or more of those who become ill will seek medical care
• Number of hospitalizations and deaths will depend on the
virulence of the pandemic virus
Moderate (1957-like)
Severe (1918-like)
Illness
90 million (30%)
90 million (30%)
Outpatient medical care
45 million (50%)
45 million (50%)
Hospitalization
865,000
9, 900,000
ICU care
128,750
1,485,000
Mechanical ventilation
64,875
745,500
Deaths
209,000
1,903,000
Our Health Protection Preparedness
System
A NETWORK of Shared Responsibility!
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Local - state - federal
Domestic – international
Public – private
Multi-sector
Non-partisan
Animal – human
Health protection – homeland
security – economic protection
Healthcare
Delivery
System
Federal
Partners
Local /State /
Federal Public
Health
System
Business
& Workers
Education
System
Pandemic Influenza Checklists
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State and Local
BUSINESS
Preschool
Schools (K-12)
Colleges & Universities
Faith-based & Community
Organizations
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Physician Offices and
Ambulatory Care
Home Health
Emergency Medical
Services
Travel Industry
Correctional Facilities
Protecting Your Business
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Plan for impact on
business
Protect employees and
customers
Establish policies
Allocate resources
Engage employees
Coordinate with external
organizations
www.cdc.gov/business/
www.pandemicflu.gov
1.1 PLAN FOR THE IMPACT OF A PANDEMIC ON YOUR
BUSINESS
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Identify a pandemic coordinator and/or team with defined roles and
responsibilities for preparedness and response planning. The planning process
should include input from labor representatives.
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Identify essential employees and other critical inputs (e.g. raw materials,
suppliers, sub-contractor services/ products, and logistics) required to
maintain business operations by location and function during a pandemic.
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Train and prepare ancillary workforce (e.g. contractors, employees in other job
titles/descriptions, retirees).
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Develop and plan for scenarios likely to result in an increase or decrease in
demand for your products and/or services during a pandemic (e.g. effect of
restriction on mass gatherings, need for hygiene supplies).
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Determine potential impact of a pandemic on company business financials
using multiple possible scenarios that affect different product lines and/or
production sites.
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Determine potential impact of a pandemic on business-related domestic and
international travel (e.g. quarantines, border closures).
1.1 PLAN FOR THE IMPACT OF A PANDEMIC ON YOUR
BUSINESS (Con’t)
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Find up-to-date, reliable pandemic information from
community public health, emergency management,
and other sources and make sustainable links.
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Establish an emergency communications plan and
revise periodically. This plan includes identification
of key contacts (with back-ups), chain of
communications (including suppliers and
customers), and processes for tracking and
communicating business and employee status.
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Implement an exercise/drill to test your plan, and
revise periodically.
1.2 PLAN FOR THE IMPACT OF A PANDEMIC ON YOUR
EMPLOYEES AND CUSTOMERS
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Forecast and allow for employee absences during a pandemic due to factors
such as personal illness, family member illness, community containment
measures and quarantines, school and/or business closures, and public
transportation closures.
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Implement guidelines to modify the frequency and type of face-to-face contact
(e.g. hand-shaking, seating in meetings, office layout, shared workstations)
among employees and between employees and customers (refer to CDC
recommendations).
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Encourage and track annual influenza vaccination for employees.
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Evaluate employee access to and availability of healthcare services during a
pandemic, and improve services as needed.
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Evaluate employee access to and availability of mental health and social
services during a pandemic, including corporate, community, and faith-based
resources, and improve services as needed.
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Identify employees and key customers with special needs, and incorporate the
requirements of such persons into your preparedness plan.
1.3 ESTABLISH POLICIES TO BE IMPLEMENTED
DURING A PANDEMIC
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Establish policies for employee compensation and sick-leave absences unique
to a pandemic (e.g. non-punitive, liberal leave), including policies on when a
previously ill person is no longer infectious and can return to work after illness.
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Establish policies for flexible worksite (e.g. telecommuting) and flexible work
hours (e.g. staggered shifts).
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Establish policies for preventing influenza spread at the worksite (e.g.
promoting respiratory hygiene/ cough etiquette, and prompt exclusion of
people with influenza symptoms).
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Establish policies for employees who have been exposed to pandemic
influenza, are suspected to be ill, or become ill at the worksite (e.g. infection
control response, immediate mandatory sick leave).
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Establish policies for restricting travel to affected geographic areas (consider
both domestic and international sites), evacuating employees working in or
near an affected area when an outbreak begins, and guidance for employees
returning from affected areas (refer to CDC travel recommendations).
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Set up authorities, triggers, and procedures for activating and terminating the
company’s response plan, altering business operations (e.g. shutting down
operations in affected areas), and transferring business knowledge to key
employees.
1.4 ALLOCATE RESOURCES TO PROTECT YOUR
EMPLOYEES AND CUSTOMERS DURING A PANDEMIC
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Provide sufficient and accessible infection control
supplies (e.g. hand-hygiene products, tissues and
receptacles for their disposal) in all business
locations.
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Enhance communications and information
technology infrastructures as needed to support
employee telecommuting and remote customer
access.
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Ensure availability of medical consultation and
advice for emergency response.
1.5 COMMUNICATE TO AND EDUCATE YOUR
EMPLOYEES
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Develop and disseminate programs and materials covering pandemic
fundamentals (e.g. signs and symptoms of influenza, modes of transmission),
personal and family protection and response strategies (e.g. hand hygiene,
coughing/sneezing etiquette, contingency plans).
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Anticipate employee fear and anxiety, rumors and misinformation and plan
communications accordingly.
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Ensure that communications are culturally and linguistically appropriate.
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Disseminate information to employees about your pandemic preparedness and
response plan.
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Provide information for the at-home care of ill employees and family members.
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Develop platforms (e.g. hotlines, dedicated websites) for communicating
pandemic status and actions to employees, vendors, suppliers, and customers
inside and outside the worksite in a consistent and timely way, including
redundancies in the emergency contact system.
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Identify community sources for timely and accurate pandemic information
(domestic and international) and resources for obtaining counter-measures
(e.g. vaccines and antivirals).
1.6 COORDINATE WITH EXTERNAL ORGANIZATIONS
AND HELP YOUR COMMUNITY
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Collaborate with insurers, health plans, and major local healthcare
facilities to share your pandemic plans and understand their
capabilities and plans.
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Collaborate with federal, state, and local public health agencies
and/or emergency responders to participate in their planning
processes, share your pandemic plans, and understand their
capabilities and plans.
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Communicate with local and/or state public health agencies and/or
emergency responders about the assets and/or services your
business could contribute to the community.
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Share best practices with other businesses in your communities,
chambers of commerce, and associations to improve community
response efforts.
SOME QUESTIONS TO ASK YOURSELF
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What would happen to your business if 40% of
your work force didn’t show up for two weeks
straight?
If an outbreak hits one location, can you switch
to another location?
Can you operate if a majority of your workforce
works from home?
Can you modify your sick leave policy to
discourage sick workers from coming in?
What will you do if the local or state government
quarantines your area?
PLANNING SUGGESTIONS
From government officials, corporate contingency planners and
executives at a recent summit of New England-based businesses on
pandemic preparedness. The Summit was sponsored by the U.S.
Chamber of Commerce and the New England Council.
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Establish a pandemic planning team early
Analyze your supply chain
Draft a communicable diseases policy
Look into expanding your leave policy
Put up a pandemic flu section on your intranet
Establish a phone network to keep employees informed
Start enhancing your workplace hygiene now
TABLE TOP DRILLS
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As with any crisis management program, the program
should be tested before its used or needed.
A Tabletop Drill is the method of choice for this testing. It
allows key players, from participating groups within a
company or organization to gather in face-to-face, roundtable settings and talk through expected actions for an
pandemic influenza emergency scenario.
This allows for evaluation of the plans and procedures
and resolves questions of coordination and
responsibility.
Tabletop Drills are typically informal, and the moderator
will facilitate discussion among participants.
WILL IT HAPPEN?
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No one knows
Will this crisis or something similar happen
in the future? YES
Preparing for this situation NOW will not
only be needed if the pandemic influenza
occurs but provides an excellent template
for crisis management planning
FOR MORE INFORMATION OR TO
CONTACT US
Gary Ades
[email protected]
479.254.9026
Visit our web site at
www.ehagroup.com