Novel H1N1 influenza: Lessons learned and yet to be learned

(CIDRAP Business Source Osterholm Briefing) – The irony is hard to miss. Much is being discussed and published about the "lessons learned" from the 2009 pandemic of the novel H1N1 influenza. And I expect the World Health Organization (WHO) will (as I did in my last column) finally call it a pandemic any moment now, based on extensive and growing transmission of the novel influenza virus in Australia and Europe.

So the declaration of phase 6 is upon us—a moment we've much anticipated—and we're already talking about lessons learned? Does that make sense?

Yes—to a point.

But stay tuned

I'm all in favor of reviewing what's worked well so far in our response to H1N1—and what needs fixing when examining any response to a public health threat. But I also think it's critical to emphasize that we are not out of the woods yet with this pandemic.

In other words, because we haven't had all the lessons, we can't know all the lessons. I wish I could know this virus won't do a repeat of 1918. That year a wave of a novel H1N1 virus infection circulated around the world—also causing mild illness in humans. But obvious changes occurred in the virus during the summer months. And, in late August of 1918, what was a mild pandemic turned into a killer.

 There is still much to be learned about the current pandemic, and we must not lower our vigilance or spend much time patting ourselves on the back for what we did right when it began. Too much is still at stake.

Given that caveat, yes, look at your organization's response to the early stages of this pandemic. And with whatever information you glean, adjust your plan accordingly.

At the top of the list

If you ask me, the biggest takeaway thus far is this: We have to stay nimble—and alert. And I'm talking about everyone from the WHO to national governments, C-suite executives, planners, media, and, ultimately, each individual.

You need look no further than the flap over the WHO's pandemic alert levels not accounting for severity to see why flexibility is a must.

OK, so the WHO alert phases don't include severity. What now? Are you going to wait for word from "on high" before you make your next move? Or are you going to take what you know at this point and ensure your organization is ready for any number of possibilities?

I urge you to use common sense and reliable information.

If your organization's plans were tied to alert levels and assumed the scenario of a severe pandemic, great. You've thought through one of the possibilities. But now it's time to adjust. The pandemic at this point isn't severe, which is also great—and not the end of the story as far as we know.

Shedding light on the questions

 Based on calls I've received in the past month from a variety of companies, I know you had to tackle some tricky challenges on the fly. For example, did you:

  • Try to act on an agreement to reserve antivirals and run into any glitches?
  • Enact a travel restriction order among your employees going to Mexico only to have to explain 2 weeks later why you weren't enforcing a similar order for travel to New York City even though the city had documented as many confirmed cases as Mexico had in the early days?
  • Try to order respirators or masks only to encounter a shortage or discover many were manufactured in the very country where the outbreak started and was most severe?
  • Put in place stay-at-home policies for employees who had flu-like illness only to find you couldn't count on anyone "certifying" they were clear to come back to work?
  • Find that media coverage declined even as the WHO raised its pandemic alert level, thus making it hard to maintain credibility?
  • Realize a need to be able to call on local public health officials and peers outside your organization to run a reality check or compare policies or practices?
  • Have all reliable sources of information you needed so you could respond to questions from management, employees, and customers quickly?

So now, go back to your plan, if you have one, and see how you can build greater flexibility into it. If you're starting from scratch, know that being nimble is going to be a key to keeping your business alive.

Remember: The plan is never final

Fortunately, the disease the virus is causing is mostly mild and the number of deaths associated with the infection is well within the range of what we'd expect with a mild seasonal influenza season.

But as sure as the sun rises in the east, I guarantee you there will many more lessons to learn and very likely more challenges to your organization's plan.

So while we all hope that we've dodged the bullet with this new H1N1 virus, we have a stark reminder of why we should not let down our guard: the events of 1918.

We don't have a clue if the same pattern will unfold with the new H1N1. But at CIDRAP Business Source, we're not taking our eyes off this pandemic for a second.

Bottom line for business

Consider the events of the past 6 weeks a wake-up call. In no way can we say yet that we've dodged the bullet. Learn what you can, especially about how to keep your plan flexible, and, to be sure, count on learning more.

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