Friday, January 27, 2017

Probably Not The Worst Idea In The World . . .

Credit CDC


The reality of life in this 21st century is that disease threats that once were local, can now spread globally in a matter of hours or days.  Vast oceans and prolonged travel times no longer protect us, as millions of travelers cross hundreds of borders each and every day.

And despite the media hype over airport screening, we have no technology that can realistically, or reliably detect infected individuals and prevent them from entering a country (see  Head ‘Em Off At The Passenger Gate?).

As our ability to transport diseases rapidly to or from any corner of the globe has increased, so have the number and variety of emerging infectious diseases.  A trend foretold two decades ago by the late anthropologist and researcher George Armelagos of Emory University, which I described in considerable detail in The Third Epidemiological Transition.

According to Dr. Armelagos, the Third Epidemiological Transition began in the late 1970s or early 1980s, and is hallmarked by newly emerging infectious diseases, re-emerging diseases carried over from the 2nd transition, and a rise in antimicrobial resistant pathogens

In recent years we've seen a global outbreak of SARS in 2003, the H1N1 influenza pandemic of 2009, exported cases of MERS to places like South Korea, Europe, and the United States,  Ebola cases turning in the United States and Europe, and the global spread of Zika, Dengue, Yellow Fever, and Chikungunya.

In other words, the emergence of MERS-CoV, H5N1, Nipah, Hendra, Lyme Disease, H7N9, H5N6, H10N8, NDM-1, CRE, etc. are not temporary aberrations. They are the new norm, and we should get used to seeing more pathogens like these appear in the coming years.

These emerging infectious diseases are considered such an important threat that the CDC maintains as special division – NCEZID (National Center for Emerging and Zoonotic Infectious Diseases) – to deal with them. According to the NCEZID:
Emerging means infections that have increased recently or are threatening to increase in the near future. These infections could be
  • completely new (like Bourbon virus, which was recently discovered in Kansas or MERS, Middle East Respiratory Syndrome).
  • completely new to an area (like chikungunya in Florida).
  • reappearing in an area (like dengue in south Florida and Texas).
  • caused by bacteria  that have become resistant to antibiotics, like MRSA (methicillin-resistant Staphylococcus aureus), C. difficile, or drug-resistant TB.
Now, with three avian flu subtypes (H5N1, H7N9, H5N6) circulating around the world which have demonstrated the ability to infect, and even kill, humans  - and a growing list of related viruses (H5N8, H5N5, H5N2, etc.) that could conceivably someday evolve into public health threats - concerns are growing that we could face another pandemic in the not-too-distant future. 

We've been here before, of course.   In 2006, the world watched with alarm as H5N1 spread out of China and Southeast Asia into Europe and the Middle East.  The United States, along with most of the rest of the world, began to prepare for a possible pandemic.  Businesses, agencies, and even individuals were also encouraged to develop pandemic plans.

Millions of dollars were spent stockpiling antivirals, and developing an H5N1 vaccine. But when the pandemic finally arrived, it turned out to due to a less severe strain of Swine flu; H1N1.   
We got `lucky’ in that we ended up with a `Cat 1’ pandemic, not the feared Category 5 event that most plans had envisioned. Since the end of 2009 - between the prolonged economic downturn and the belief that we’d seen `our pandemic’  –  pandemic preparedness has pretty much been put on the back burner. 

Many of the carefully prepared pandemic plans drafted a decade ago are now gathering dust in some desk drawer, and have not been reviewed or updated for years.

No one can predict when, how severe, or what virus will spark the next pandemic.  But the risks of seeing a severe pandemic have not diminished.  One could argue with the recent proliferation of bird flu viruses,  they are greater now than ever before.

Making this an opportune time to drag out, dust off, and take a hard look at your old pandemic plans (or create a new one if need be).  While many of the pandemic preparedness resources on the web have vanished in the past 8 years, there are still plenty of good sources to draw from. 

One of the nation’s leaders in pandemic and disaster planning is Public Health - Seattle & King County.  In 2008 they produced a 20 minute film called Business Not As Usual, designed to help introduce businesses to the core concepts of pandemic planning.

Frankly, this video should be required viewing for every businesses owner, manager, and employee.

You’ll also find a long list of preparedness resources available on this page as well:
 General resources:
Business and government preparedness:
Community Based Organization (CBO) preparedness:
Personal preparedness:

 Another excellent resources comes from TFAH (Trust for America’s Health)


Credit TFAH It's Not Flu As Usual Brochure

Pandemics, while rare, are just one of scores of possible disaster scenarios that one can find themselves suddenly thrust into. When you add in the risks from earthquakes, hurricanes, tornadoes, floods, blizzards, and other – even more common – emergencies, it makes sense to maintain a general level of preparedness against `all threats’.

Every family needs an appropriate disaster plan, just as everyone should have a good first aid kit, a `bug-out bag’, and sufficient emergency supplies to last a bare minimum of 72 hours.

Most preparedness experts would recommend that people should consider maintaining a 2-week supply of supplies in their home.  A topic I address in When 72 Hours Isn’t Enough.

And businesses, if they hope to survive a pandemic (or any other disaster), need a comprehensive business continuity plan.

Although there are many good resources on the web to get you started, a couple of good places to start with are The Business Continuity Daily and The Emergency Management Daily, both of which provide daily reviews of current threats and advice on preparedness.

Because, no matter what the crisis, the advantage always goes to those who are best prepared.

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