The Virus Danger

The influenza virus is an efficient little infection machine, constantly reinventing itself. Some of the new versions of the flu are familiar enough to our immune defenses that we recognize the infection and typically have only mild symptoms. Occasionally, the virus reassembles itself in a truly unique way and completely surprises our antibodies, generating waves of disease and causing a pandemic. The virus has an advantage, since each child is born without the immunologic knowledge of previous generations and has to learn once more how to fight off all the old infections, as well as all the new ones.

Pending a scientific breakthrough, this age-old dance between the mutating flu virus and human immunity will keep pandemics coming. We have had three in the past 100 years. The “Spanish Flu” of 1918 had a pandemic severity index (PSI) of five, the most severe, and killed 50 million to 100 million people worldwide. But even a mid-severity pandemic with a PSI of three can cause over 500,000 deaths in the United States. The current H1N1 (swine flu) is considered moderate; 1,500 people have died and more than 175,000 have been infected, giving it a PSI of 1. But it could mutate into something far more dangerous.

Proper preparation can reduce the cost to your company and its employees in lives and income. A well-designed pandemic preparedness plan should include the following:

1. Identify a “pandemic manager” to provide leadership in pandemic planning, and to run the pandemic response team.

2. Encourage the use of sick leave. During a pandemic, sick workers need to stay home, even if their symptoms are mild. The same virus that may cause few symptoms in one person could kill others. We often think a particular meeting or deal is too important to delay or delegate. But during a pandemic, this heroic work ethic can introduce illness into an office with unpredictable results. Create a culture of responsibility: if you are sick, don’t come to work.

3. Be prepared to restrict travel. Pandemics will infect different regions at different times and will cause disruption in travel, quarantine and closed borders. Keep employees from traveling to highly infected regions, where they won’t have access to their usual medical care.

4. Prepare employees to work from home. Secure remote networks can be built that allow staff to log in and remain productive while keeping a safe distance from potential infections. When the pandemic becomes serious, you will be in a better position to maintain your operations.

5. Some functions can’t be fulfilled from a home office. Employees who must come to work during a full-blown pandemic should be trained to use personal protective equipment, such as special respirators and gloves.

6. Everyone should assemble an “emergency box” at home, with extra food and water, important medications, batteries, pet food and cash.

7. Encourage wellness. Yearly influenza vaccines will help prevent this sometimes dangerous illness. And employees who take time to exercise and play will be more productive and creative, and more likely to bounce back quickly from an infectious illness.

Don’t delay. There will be another pandemic some day. Prepare for it.

Dr. Jorge Garcia is the associate director of the Swedish Family Medicine Residency in Seattle and a senior consultant with International SOS, where he functions as medical director for a number of foundations and institutions worldwide.