The fog of pandemic planning

(CIDRAP Business Source Weekly Briefing) – Next week the Center for Infectious Disease Research and Policy hosts the second national summit on business preparedness and pandemic influenza. I have the opportunity to address 300 or more business, government, and community leaders who will convene for the common purpose of better preparing the business world for the next pandemic. As we were planning the summit several months ago, I chose to title my talk, "The Fog of Pandemic Planning," a takeoff on the concept of the fog of war. Let me explain why the title is even more appropriate now.

The "fog of war" describes the level of ambiguity in situational awareness experienced by participants in military operations. The term captures the uncertainty regarding one's own capability and the capability and intent of the adversary during battle. The conceptual similarities between the fog of war and the fog of pandemic preparedness are unmistakable:

  • We really don't understand our capability as a nation or international community to respond.
  • We have only a very general sense of what the pandemic influenza virus is capable of doing in terms of human illness or the social, political, and economic collateral damage.
  • We can't predict with any certainty how the next pandemic virus will behave in humans and animals.

Based on many discussions with business continuity planners and risk management officials around the country (and a few from outside the United States), I believe that the private sector is walking deeper and deeper into that fog of pandemic preparedness. While the private sector has been involved in pandemic preparedness planning (to varying degrees), sustaining the effort grows harder as more time passes from when those first urgent and sometimes dramatic warnings were issued to commence planning. The more time that passes, the more the fog thickens. I'm convinced that there are more doubters about the inevitability of the next pandemic than before. What they don't realize is that, like earthquakes, hurricanes, and tsunamis, pandemics happen.

Some organizations have tried to account for all eventualities with regard to their employees, supply chains, and even customers. Typically, the single biggest challenge relates to the ability to estimate the response of government, suppliers, providers of infrastructure support such as water and electricity, workers, and respective markets. With so many unknowns, one leading business continuity planner recently noted, "Planning for a pandemic is so different from anything we've done in business before that we're writing the book as we go—and it won't be finished until the virus is finished."

One way that companies are attempting to shore up preparedness is to require their suppliers to sign affidavits indicating they have a workable pandemic plan in place. In short, most of these affidavits are not worth the paper they are printed on, because their suppliers are in no better position to account and prepare for all aspects of the pandemic than are the companies demanding the affidavits. Furthermore, determining which preparedness activities need to be undertaken by any single company quickly becomes a Rubik's cube of possibilities, given the interdependency of each company on outside suppliers, transportation, communications, utilities, and even government leadership and direction during a crisis.

Another challenge for private sector preparedness was summarized in a September 2006 report by the Department of Homeland Security. This report stated, "Eighty-five percent of critical infrastructure resources reside in the private sector, which generally lacks individual and system-wide business continuity plans specifically for catastrophic health emergencies such as pandemic influenza. Many businesses have extensive contingency plans in response to threats from diverse natural and manmade disasters. While useful for their intended purpose, these plans may prove ineffective given they do not account for the extreme health impact assumptions and containment strategies projected for a severe pandemic influenza."

Despite the complexity, every organization must consider in its plan the combination of:

  • The direct impact of influenza on the population
  • The collateral damage from a potentially collapsing global just-in-time economy
  • The lack of comprehensive business continuity planning
  • The inability of governments around the world to provide exhaustive and immediate relief

Even if we can't solve these issues, at least we can be honest about them and develop strategies that manage expectations in line with the potential realities. This is a tough message to deliver to those who want to enhance their organizations' preparedness. But I believe it's a fair and accurate assessment of our current state of pandemic preparedness—and particularly in the private sector.

The key is that rigid pandemic planning is self-defeating, because we can't predict every pandemic possibility. So we have to plan for resilience. We have to plan to cope with eventualities we never thought of and therefore couldn't plan for.

Our job now is to begin burning off that fog and keep pushing forward. I can only hope our summit provides some of the sunshine needed to do that.

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