Pandemic Flu Threat and Business Continuity

By Willie Collins,2014-04-18 19:07
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Similarly, many public companies view responses to a pandemic or severe epidemic Consolidation of like corporate entities or transfer of corporate

    Pandemic Flu Threat and Business Continuity

James “Jim” D. Blair, DPA, MHA, FACHE, DABCHS, MCAS, CHS-V, President

    and CEO

    Pauline A. Scanlon, PhD, Chief Operating Officer

Today's challenge for survival in an ever increasing hostile world calls for a

    transformational shift to a "culture of readiness." The triple threats of:

    - emerging infectious disease, both naturally occurring and novel man made


    - more robust natural disasters; and,

    - terrorist events, alone or in tandem with the other two,

    require a collaborative national effort unlike any we have experienced before.

    The overarching national strategic theme for All-Hazards Homeland Security

    (HLS) embraces the concept of a unified, comprehensive structure built on the

    good faith partnership between and among all the nation's economic sectors;

    Federal, State, Tribal, Public, Private, and Non-governmental organizations.

There are a number of explanations which account for the current "Hot Topic"

    focus on Pandemic Avian Flu and conditions which present flu-like symptoms. First, is the intense interest from the White House for a timely implementation of

    the November, 2005 guidance on the nation's strategy for Pandemic Flu

    Protection. Second, it is Flu season and each Flu season we are reminded by

    the media that we are not properly prepared to deal with current "wimpy strain" of

    the virus, let alone a worldwide pandemic. Third, the research and exhaustive

    documentation of the recent SARS experience and the graphic tales of its impact

    on our Canadian neighbors hovers in the background. Fourth, public trust in the

    nation's capacity, and for some, its will, to protect it from all-hazards threats is

    waning. Fifth, the Institute of Medicine's (IOM) reports on healthcare acquired

    infections raise the specter that the Nation's Healthcare System may not be able

    to deal with emerging infections or virulent man made agents since it is unable to

    control unintended infections.

    And Sixth, it will happen. By April 27, 2006, the World Health Organization had tracked 205 non-US cases of bird flu that led to 113 deaths. On April 28, 2006, a

    mild form of bird flu was found at a live-bird market in New Jersey. According to

    the Department of Health and Human Services, a severe bird flu pandemic would

    make 30 percent of the US population, or 90 million people, ill and result in 2

    million deaths. Companies would have absentee rates of about 40 percent.

Assessing the level of preparedness has a surprising number of dependent and

    independent variables, some obvious and some not so obvious. While

    preparations are fluid, there is one bright side: We have some time. An avian flu

    pandemic most probably will not occur tomorrow, but this nation’s annual flu

    epidemic is in its first wave and now is the time to plan. Insuring continuity of


operations under either scenario depends on the successful execution of a set of

    complex tasks requiring proactive steps over which you may have full control and

    others over which you have marginal to no control. Even though various federal

    agencies, such as the CDC, state health agencies, and the majority of business

    Trade Associations have published guidance materials and “check-lists” for

    pandemic flu preparation, many companies are not paying any attention at all or

    are extremely reticent to discuss their preparation processes, although many

    have noted the risks. As of the fiscal year ending April 2006, avian flu was

    mentioned 388 times in the quarterly and annual regulatory filings with the

    Security and Exchange Commission. Similarly, many public companies view

    responses to a pandemic or severe epidemic scenario as extensions of their

    current Business Continuity Plans rather than as a risk management strategy to

    avoid a Sarbanes-Oxley disclosure of an operational failure or vulnerability

    (safety, environmental, or property) that may “significantly impact” the

    organization’s financial soundness.

The Center for HealthCare Emergency Readiness (CHCER) has evolved from

    assessing healthcare facilities for Homeland Security Chemical, Biological,

    Radiological, Nuclear, Explosive (CBRNE, with or without radioactive elements)

    readiness to assessing All-Hazards readiness. Our findings over the years are

    not unlike the "lessons learned" from recent all-hazards events, e.g., Hurricanes

    Katrina and Rita. Hospitals have been required to respond to threats from

    natural disasters, endemic/pandemic agents and all manner of casualties from

    associated accidental events. Even with their long history of attention to

    preparedness and good faith efforts to protect their stakeholders, many "best

    practice" actions have eluded them. We would like to share with you what we

    have observed over time to be Continuity of Entity Readiness Imperatives that

    can be generalized to all businesses in their pandemic or epidemic flu planning

    efforts. These observations represent a limited set of actions which are far from

    comprehensive but are those we find most important.

What will it take for your organization to be ready?

? Perform a Hazard Vulnerability Analysis (HVA) to include:

    - Self-identified Internal and External Hazards

    - External hazards identified by the your community and geographic

    region - do not accept community and regional HVA’s at face value as

    hazards often are overlooked

    ? Provide strong leadership from Board and Executive levels to include:

    - High profile advocacy and oversight

    - Identified and documented resources for short and long range planning

    - Selection of a competent and respected planning task coordinator

    - Selection of a planning committee and meeting protocol enforcement


- Appropriate input from labor representatives

    - Dissemination of the emergency response and business continuity

    plans throughout the organization

    - Establishment of an “operations” center to direct and coordinate the

    organization’s response.

    ? Implement and maintain ongoing Planning Processes which include and


    - Preparedness-Identification of resources needed to sustain operations

    and to ensure the continuation of essential services

    - Establishment of a policy on workforce safety and survival to determine

    the appropriate numbers of essential personnel that would be a priority

    for receiving antiviral prophylaxis, vaccination and personal protective

    equipment (PPE), e.g., masks, to protect those staff most at risk - Actions designed to maximize worker availability

    ? Annual Immunization programs for workers and family members

    ? Stockpiling of items needed for treatment (e.g., antivirals)

    ? Disinfection requirements for equipment and facility and proper

    disposal of infectious waste, including disposable


    ? Identification of safe havens for workers, families and their pets

    and other family/dependent care issues to maximize employee

    numbers at work.

    ? Cross- and multi-competency training of staff

    ? Identification of retirees and volunteers as potential back-up - Actions designed to increase flexibility of approaches for continuity

    ? Alternative work sites, selected in advance - the fewer people who

    are physically together, the better

    ? Consolidation of like corporate entities or transfer of corporate

    functions to other organizational locations currently unaffected

    ? Establish Mutual Support Agreements (MSAs) based on:

    - Assessments of projected personnel supplementation needs to include

    exclusive agreements with personnel agencies in unaffected areas for

    temporary staff

    - Assessments of demand for raw materials and supplies in advance - if

    a supplier is also affected and transportation networks are down, just-

    in-time inventory arrangements will be disabled.

    - Assurances that the provider/contractor has not oversubscribed its

    capacity to respond to:

    ? Insure that the provider/contractor has adequate stockpiles of fuel

    and parts

    ? Insure that the provider/contactor has established its own “plan”

    and provides for availability of its workforce



    - Adequate numbers of security personnel to maintain facility security and

    security of stockpiles of vaccines and antiviral medications

    - Procedures to limit access, e.g., lockdown, to a small number of

    designated and monitored entrances so that staff and visitors entering

    the facility can be screened for illness (e.g., temperature checks)

    ? Conduct Exercises and Drills to evaluate organizational proficiency and

    provide instruction and/or training for personnel on particular roles,

    responsibilities, plans, and/or equipment using a “crawl-walk-run” approach

    through the following:

    - Tabletop Exercises (crawl) which allow participants to move through a

    scenario based on discussions regarding the coordination of plans and

    procedures with other departments or agencies.

    - Functional Exercises (walk) which allow participants to work through

    plans and procedures in a real-time scenario, typically based in an

    operations center environment. The exercise pace can be increased or

    decreased depending on participants ability to work through their plans

    and procedures.

    - Full-scale Exercises (run) which require participants to move people

    and apparatus while working through plans and procedures in real-time.

    Personnel conducting drills or helping to plan exercises should have the

    experience and documented training to facilitate these events. Additionally,

    a system to provide a critical evaluation process for use in every exercise,

    drill and actual event is strongly encouraged. Such evaluations should

    provide both quantitative and qualitative data/information upon which to

    define a process for improvement in future drills, exercises or actual events.

    The ability to identify both strengths and areas for improvement is critical to

    effective drill and exercise management over time and helps to strengthen

    the organization’s Corrective Actions developed in response to evaluation


Realization of a successful Pandemic and or “Severe” Flu readiness status

    requires strong leadership and executive management buy in for the need to be

    prepared and a belief that the effort will produce the desired

    protection. Paradoxically, the organization’s corporate vision must include a

    sense of partnership with local county, State, and Federal authorities, including

    National Preparedness Goals (outlined by the Department of Homeland Security)

    and the discrete uniqueness of the organization’s "Part," adapted to the nature of

    its operation and local conditions. Fundamental to this partnership is the adoption

    of HLS missions to Prevent, Protect, Respond, and Recover from all-hazards

    events. A Nation prepared to deal with the anticipated Avian Pandemic or a

    “Severe” Flu Epidemic must be able to deliver the appropriate combinations of all

    sector capabilities in a seamless, protracted manner. Your company’s role

    needs to focus on the immediate environment and the scope of your


    organization’s operation. In order for your organization to be a viable part of the solution and not of the problem, it must have a plan for business survival.

James “Jim” D. Blair, DPA, MHA, FACHE, DABCHS, MCAS, CHS-V is a

    domestic and international healthcare consultant and career retired Army Colonel. His assignments include service as Chief of Staff of the 7th Medical Command in Heidelberg, Germany and as Chief Executive Officer for medical facilities (i.e. combat field, evacuation hospitals, medical centers) and healthcare systems. He also served as USAREUR Deputy Chief Surgeon for Medical Support Services, Safety and Security Readiness during the “Red Brigade Euro-Terrorism” period.

    As a consultant to the Army Surgeon General for Health Care Administration, he guided the JCAHO re-accreditation of the 7th MEDCOM medical treatment facilities. His Pentagon assignments include: Chief of Education and Training, Office of the Army Surgeon General, and the Surgeon General’s principle

    representative to the Comptroller of the U.S. Army’s study of reorganization of the Army Medical Department’s CONUS healthcare system. In the private sector, Jim served as Vice President for the Hospital Corporation of America, MIDEAST limited; Project Manager for the Saudi Arabia National Guard Medical Services Project in Riyadh, Saudi Arabia; and Senior Consultant to the Pacific Healthcare Management Corporation.

    Pauline Scanlon is a nationally recognized healthcare consultant who has over 36 years of experience in both the public and private health care sectors. Her experience includes federal and state employment as a regulator and compliance officer with oversight responsibility for research, development and policy planning for state and regionalized healthcare delivery systems. For the last 16 years she has served as President and CEO of American Healthcare Resources, a consulting company specializing in risk management, compliance monitoring and auditing, medico-legal consultation, grant development and implementation of targeted healthcare intervention initiatives.

About the Center for Healthcare Emergency Readiness

    The Center for Healthcare Emergency Readiness, LLC (CHCER) assists health care facilities in their efforts to comply with the National Incident Management System (NIMS) and the National Response Plan (NRP) and with the disaster preparedness requirements of the Medicare Conditions of Participation and national accrediting bodies. CHCER provides assessments to determine a facility’s current state of readiness and with recommendations related to its preparation for, response to and recovery from future natural disasters, pandemics, and acts of terrorism. CHCER combines the expertise of a diverse group of subject matter experts in the areas of hospital management and security, risk management, government regulation and oversight, vigilance skills and


CBRNE training, law enforcement and counter-terrorism. For additional

information see (


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