Preparing for H1N1

Brian Zawada, FBCI Brian Zawada, FBCI | Jun 19, 2009

pandemicAs Published in the May/June Issue of Continuity Insights

This spring introduced another threat with global business continuity implications.  The swine flu, or more appropriately 2009 H1N1, caused alarm among the population as this novel influenza A strain appeared for the first time, originating in rural Mexico.  At the time of this writing, the 2009 H1N1 virus continues to spread worldwide, affecting seventy countries with over twenty-one thousand confirmed and probable cases in the United States as logged by the CDC.  Thus far, 2009 H1N1 has a relatively low mortality rate, with symptoms resembling seasonal flu.  On June 11, 2009 The World Health Organization (WHO) raised its alert level to a Phase VI, indicating “increased and sustained transmission in general population”.  As a result, the 2009 H1N1 is now classified as a pandemic.

From an epidemiology perspective, pandemics have a number of characteristics worth remembering:

  • Scope and Geography
    A new global viral strain affecting the human population (with the majority being susceptible), easily spread human to human on two or more continents; pandemics affect everyone (including healthy adults), not just those normally with weaker immune systems (i.e. the young and elderly)
  • Duration
    18-24 months worldwide
  • Waves
    2-3, with a single wave affecting a specific geography for approximately six weeks
  • Absenteeism
    Higher than normal seasonal flu, with estimates ranging from ten to forty percent
  • Stability
    Viruses leading to pandemics are often biologically unstable (their structures change frequently), making it difficult to acquire immunity and manufacture effective vaccines

So, was this in fact the first wave of a multi-wave public health event?  If so, should organizations around the world view it as a wakeup call, thus affording everyone an opportunity to fine-tune their business continuity strategies and pandemic preparedness efforts?  Assuming this is the case, what should you focus on during these next few months, leading up to the traditional seasonal flu season (when the next wave might occur)?

Why Care About Wave 2?
Public health experts (through the media) offered perspectives comparing the 1918 pandemic and the 2009 H1N1 outbreak.  The similarities are somewhat remote, but they include the following:

  • A similar viral structure (H1N1), but as public health officials indicate, far different viral markers influencing transmission and mortality (the 1918 pandemic was strictly avian in nature)
  • A mild, initial wave in the spring
  • A proven capability to infect a relative high percentage of young and healthy adults that come in contact with the disease

Known as the Spanish Flu, the 1918 pandemic killed between twenty and fifty million people by the time it dissipated in 1919.  What scares people the most is that the 1918 outbreak had a mild spring outbreak (similar to the 2009 H1N1 influenza spring outbreak), then returned in the fall in a severe second wave that led to millions of deaths worldwide.  While experts believe that this version of the virus is not likely to cause severe illness in the fall, there is a possibility it may merge with another more virulent strain, resulting in a new virus that can be easily spread person-to-person.

Although these similarities may spur executive managers to action, it’s important to note that experts remain unsure how the 1918 virus formed.  It’s also important to note that the 2009 H1N1 virus has demonstrated an ability to easily swap out genetic material with other viruses (which is why it has four separate strains). This could possibly make it easier for it to mix further with other viruses, which may possibly be more virulent.  Overall, a significant number of unknowns remain.  Because the traditional seasonal flu season is imminent in the southern hemisphere, experts are poised to closely monitor its impact (if any) and how it might impact the northern hemisphere beginning as early as September.

Preparedness Recommendations
Let’s assume for a moment that the April/May outbreak of H1N1 will reappear later in the fall as a more virulent strain.  Or more generally, it surely can be assumed that a pandemic will occur at some point in the future, as it has throughout history.  Regardless, what should organizations do to best prepare right now?  Based on input from a number of leading organizations, the following eight issues require management attention prior to the next public health event.

  1. Human Resources Policy Implications
    Arguably the most discussed issue associated with 2009 H1N1 thus far is the adequacy of human resources policies.  Over the past few years, many organizations that proactively planned for a pandemic evaluated their then current-state policies to better understand the implications associated with prolonged absenteeism (and the effect on continued employment, benefits and payroll), caring for sick family members, travel restrictions, on-site quarantine and demanding employees stay home (if they are sick or exposed to someone who is sick).  Some of these organizations made amendments to their policies, whereas others made policy addendums but held them in reserve until an event triggered their need (one such trigger being a World Health Organization move to a Phase IV or Phase V).Human resources policy implications are a tough issue – but one that shouldn’t be ignored due to complexity.  Now that management isn’t under the gun to make a decision in the middle of crisis, engage your leadership team in thinking through the effects of a prolonged pandemic and the effect on the employee relationship.  The issues mentioned above should be viewed as key topics to engage your leadership team, which may result in value-added discussions and possibly policy amendments.  In addition, proactively addressing these concerns will give your organization time to consider any legal repercussions associated with any proposed strategies to ensure these strategies are implemented appropriately.
  2. Personnel Single Points of Failure Analysis
    This recommendation may seem obvious, but many organizations haven’t taken the time to identify critical roles and where single points of failure may exist (or maybe where only two or three people have the knowledge and experience to perform a critical role).  Taking this one step further, the 2009 H1N1 event taught many planners to assess the impact of school or day care closures on critical roles, and if a business continuity risk exists due to family priorities.For organizational activities that must continue, carefully identify these roles that must be staffed and the skill level / experience necessary to perform these activities.  Identify contingent staffing sources for roles with minimal day-to-day staffing (internally or externally within the organization) or initiate cross-training.
  3. Supply Chain Assessment
    A common topic of discussion over the past few weeks amongst crisis management teams was the adequacy of inventory levels during a pandemic, specifically if the organization’s supply chain would be able to meet changes in demand, and if key suppliers were adequately prepared for a pandemic.Consider engaging your key suppliers in a dialogue regarding preparedness, expectations and capabilities.  Try to avoid the mass questionnaire; instead, engage in verbal dialogue to enable two-way expectations management and business continuity capability improvement.
  4. Stockpiling Resources
    This issue may not apply to all organizations, but a good number of executive managers made the decision to acquire antibacterial solutions, enhanced cleaning products, masks, gloves and even antivirals, only to find they were unavailable or back-ordered.If these resources are important as a method of controlling fear or encouraging employees to remain at work, consider carefully and prudently investing in resources in advance of a Phase IV, V or VI declaration.
  5. Product / Service Demand Preparations
    In most organizations, the 2009 H1N1 incident may not have resulted in significant changes in demand for your products or services.  In the event of a pandemic with significant societal disruption and fear, many organizations can expect to experience shifts in demand – some less, some much more.As part of your pandemic preparedness initiative, consider engaging the operational elements of your organization, and assess the effect of a pandemic on demand.  This analysis will help focus staff scheduling on the most important elements of the organization, as well as ensure those same organizational activities have the right resources to meet realistic customer expectations.
  6. Work From Home Viability Analysis
    Some organizations made the assumption that many of their people could work from home in the event of a pandemic, beginning when the WHO moved the alert level to Phase V or VI.  These same organizations began working to implement such strategies, only to find these designated employees did not have the resources or access to perform essential tasks at home.If work from home is a part of your organization’s strategy, evaluate resource needs and capacity constraints, in particular remote access availability.  Exercise this capability to ensure this is a strategy that management can rely on.
  7. Prepare Leadership to Make Decisions
    A common issue discussed amongst business continuity professionals is how their crisis management teams were ill-prepared to address a public health event.  These teams were comfortable in dealing with a lost supplier or a facility issue, but they disagreed and failed to fully understand the implications associated with a pandemic.Consider delivering hands-on training to your crisis management team and other executive managers, and offer a table-top exercise session that enables participants to explore the tough issues associated with absenteeism, supply chain disruption, changes in product / service demand and communications.
  8. Prepare to Communicate
    Odds are, your organization experienced this – a customer called or emailed asking for a 24-hour turnaround response regarding your pandemic preparedness status.  Through no fault of their own, the sales, operations and marketing organizations each sent out various summaries of your organization’s capability.  Unfortunately, many were incomplete, inaccurate or introduced legal risk.Take this opportunity to preplan internal and external communications in order to create awareness amongst your employees, business partners and customers, providing them assurance regarding the time and resources invested to mitigate the threat of absenteeism.  In addition, provide guidance internally to ensure crisis communications messaging comes from one source, with statements authorized by the Crisis Management Team.


The future impact associated with 2009 H1N1 is purely speculative.  Waves, the total number of cases, mortality rates, the availability of an effective vaccine, antiviral stock and above all, population fear and government reaction are all unknown.  Yes, the most severe pandemic will cause significant societal breakdown, but public and private organizations can take action to blunt some of the effects.  Everyone has a responsibility to perform activities deemed prudent and realistic, with the goal of offering as safe a workplace as possible, thus continuing the delivery of essential products and services.  Overall, any business continuity practitioners offered an opportunity to improve business continuity and pandemic preparedness strategies in preparation for Wave Two (if it occurs) should consider the points raised here to improve their organization’s preparedness for any widespread public health event.