DHHS Secretary from 1989 to 1993, Louis W. Sullivan, M.D., is chairman of the board of the National Health Museum in Atlanta, chairman of the Washington, D.C.-based Sullivan Alliance to Transform Americas Health Professions, and president emeritus of the Morehouse School of Medicine.

Disaster Planning in a Down Economy

Why Pandemic Planning Still Makes Sense

Whether in the public or private sector, risk managers with limited resources are constantly faced with the challenge of prioritizing competing concerns, managing the desire to take all possible steps to protect the organization and its employees. In today’s economic climate, shrinking budgets are the norm, and securing funding for things like emergency preparedness can be difficult.

As Mike Osterholm, director of the Center for Infectious Disease Research and Policy (CIDRAP) at the University of Minnesota, recently told Reuters, "People are just trying to survive and asking, 'Is this the time to be preparing for a catastrophe?'"

In this time of economic uncertainty, it can be tempting to ignore seemingly faraway threats. Such may be the case with an influenza pandemic -- while there was urgency behind pandemic planning several years ago, the perceived threat seems less imminent with every passing year, potentially slowing preparedness efforts.

Risk managers and emergency planners know that natural disasters and other threats don't wait for the opportune time to strike. They occur at random -- whether we're ready for them or not.

While some organizations' leadership may be looking at ways to reduce spending, risk managers understand the danger that cutbacks can pose when it comes to emergency preparedness. The threats remain, even if the budgets don't.

This lack of resources can leave risk managers feeling frustrated and discouraged. In such times, it's important to remember the bigger picture -- that there are opportunities for collaboration in such efforts. The U.S. Department of Health and Human Services (DHHS), in partnership with other government agencies, has identified roles for state and local governments, the private sector, community leaders, religious entities, and individuals and continues to provide comprehensive guidance and an impressive array of tools for each of these groups, available at www.pandemicflu.gov. Initiatives such as DHHS's "Take the Lead" program reinforce that preparing our nation for a pandemic involves everyone.

Making a strong case to management for the allotment of scarce resources is critical to ensuring that an organization stays one step ahead of looming threats. Indeed, there is a strong case to be made for the continued investment of time and resources in pandemic preparedness.

Pandemic Planning: An Insurance Policy
Experts contend we are closer to the next pandemic than at any time since 1968, when the last of the previous century’s three pandemics struck. The H5N1 strain of avian influenza continues to spread among bird populations throughout Asia, Europe, the Middle East, and Africa and has infected more than 400 people to date with a fatality rate of 61 percent. Since January, seven human infections were reported in China, where the SARS epidemic began. Even if the next pandemic were to start in a distant location such as China, it would likely reach American shores quickly, bringing with it worldwide economic and health consequences.

Pandemic planning should be viewed as an insurance policy against the economic damage that would result from widespread sickness, absenteeism, and death. Dr. Shigeru Omi, former regional director for the World Health Organization in the Western Pacific, stated in a recent newspaper editorial, "The economic cost of a pandemic would be many times any savings made by not preparing." DHHS has also acknowledged the economic risks associated with not increasing our nation’s readiness, writing on the "Take the Lead" Web site, "If America is not adequately prepared, pandemic flu could seriously affect everyone economically."

Build on Progress
Fortunately, indications are that the Obama administration is maintaining focus on pandemic preparedness. The spending bill signed in mid-March by President Obama contained more than $700 million in pandemic preparedness spending. This funding is a step in the right direction. But when you consider the potential implications of a severe flu pandemic -- according to a World Bank report released in late 2008, a severe pandemic could cause $3 trillion of damage to the global economy – the investment seems conservative.

The public and private sectors have already invested significantly in pandemic preparedness. It would be unfortunate to abandon pandemic planning efforts in an attempt to save money in the short-term because continued investment could lead to substantial long-term savings, were there to be a pandemic. The recession will undoubtedly impact corporate and government pandemic planning activities, but if risk managers hone their strategies, they can keep their plans going despite a smaller budget and fewer resources.

Planners should focus on what can realistically be accomplished while the country awaits economic recovery. For example, a full-scale mock pandemic exercise may be out of reach at this time, but a tabletop exercise may be more feasible. Engaging a broad, cross-company team in an effort to update existing plans may be a challenge given leaner corporate structures and competing concerns. Perhaps a smaller group can keep the plan refreshed until a full-scale review is possible.

Ongoing Organizational Planning: A Part of Something Bigger
The government's National Plan has successfully directed and facilitated collaboration among multiple stakeholders, and DHHS has led by example. Joining forces with the private sector in new ways, DHHS has provided grants to vaccine manufacturers to complement the research and development of the Centers for Disease Control and Prevention and has stockpiled new H5N1 pre-pandemic vaccines.

The government also has stockpiled quantities of the antiviral medications Tamiflu and Relenza, while encouraging businesses to consider doing the same. Antiviral drug manufacturers are working directly with companies through special programs that help to facilitate the stockpiling process. These medications remain an important part of the arsenal; in a recent article by CIDRAP News, experts characterized antivirals as reliable tools that can help preserve business continuity in an influenza pandemic.

Collaboration is also happening at the local, grassroots level. For example, in the St. Louis area, executives from companies including AT&T, Centene. and Edward Jones joined forces with representatives from several universities, school districts, hospitals, non-profit organizations, and city and county health departments to establish PandemicPrep.org. This coalition is helping educate others in the region about the importance of pandemic preparedness by hosting free conferences and maintaining a comprehensive Web site.

Risk managers should look to their own communities for opportunities to build similar organizations. Even if their own organization is unable to invest further funding into pandemic preparedness at this time, they can connect with their peers in other organizations to share their experiences and best practices.

These examples demonstrate that when there is a need for leadership and action, government and businesses can work together. In light of the financial burdens currently facing the government and the private sector, it is critical that we continue to work together to meet society’s needs.

We must sharpen our focus on the threat that a pandemic poses to our country, our citizens, and our businesses, as well as the continued planning that it demands.

Preparing for potential disasters requires commitment, foresight, discipline, and innovation. The leadership demonstrated by the federal government with its pandemic preparedness plan is an example of a great American tradition. When we put the best minds toward a significant challenge and give all stakeholders a seat at the table, we can achieve great things. It is critical to continue these collaborative efforts.

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