Economic Consequences of a Pandemic
Category Business Continuity Management - Avian Flu Pandemic
Introduction
At the time of this writing H5N1, known as Avian Flu, is spreading throughout Asia with one of the highest mortality rates of any flu virus of the previous century. Even the Influenza (Spanish Flu) of 1918 did not have as high a morbidity and mortality rate as H5N1 (Avian Flu). We are seeing almost daily some revelation from the World Health Organization (WHO) or Centers for Disease Control (CDC) or the popular media.
I recently wrote an article on the parallels that can be drawn between the impact of Hurricane Katrina and the aftermath of a manmade ‘dirty bomb’ attack (http://www.continuitycentral.com/feature0247.htm). Viruses mutate in order to adapt. It is the nature of a virus to survive and mutating is a virus’ defense mechanism against manmade antibiotics. When H5N1 mutates to allow human to human transmission the stage will be set for a global pandemic.
In the aftermath of Hurricanes Katrina and Rita, New Orleans has been reeling from the devastation. In spite of significant warnings ahead of time, the city, the State of Louisiana and the Federal Government were overwhelmed by the impact of the direct hit by Katrina and the cascade effect of the rains from Hurricane Rita. Katrina, a category 4 hurricane, rendered effective allocation of resources and rapid response totally ineffective. Hurricane Rita’s rains re-flooded an already devastated city.
The consequences of a rapid spread of H5N1 from a continuity planning perspective cannot be overlooked. If hurricanes Katrina and Rita put the people of New Orleans and the Gulf Coast in a fight for their very survival, what would a pandemic do?
Why is so much attention being paid to H5N1?
At present the transmission of H5N1 has been limited to animal/human transmission. This has limited the number of people who have become infected by the virus. Mortimer B. Zuckerman writes in the New York Daily News on 20 June, 2005, in his article entitled, “A Nightmare Scenario – H5N1 Pandemic” the following excerpt:
Should we sound the alarm for a worldwide epidemic that might not occur? There is no choice with the avian flu emerging from Asia. Should it adapt to be able to be transmitted from human to human, international health experts warn, bird flu could spark a global pandemic, infecting as much of a quarter of the world's population and killing as many as 180 million to 360 million people - at least seven times the number of AIDS deaths, all within a matter of weeks.
This is utterly different from ordinary flu, which kills between 1 million and 2 million people worldwide in a typical year. In the worst previous catastrophic pandemic, in 1918, more than 20 million died from the Spanish Flu. That's more than the number of people who died from the Black Death in the Middle Ages, and more people killed in 24 weeks than AIDS killed in 24 years.
There are three elements to a pandemic. First, a virus emerges from the pool of animal life that has never infected human beings, meaning no person has antibodies to fight it. Second, the virus has to make us seriously ill. Third, the virus must be capable of moving swiftly from human to human through coughing, sneezing or just a handshake.
For avian flu, the first two elements are already with us. Well over half the people who have contracted it have died. The question now is whether the virus will meet the third condition: mutating so that it can spread rapidly from human to human.
Table 1 reflects the latest statistics on H5N1 as of April 2005. The forecast, issued by the World Health Organization that accompanies the statistics reads:
The outbreak in Asia is not expected to diminish significantly in the short term. It is likely that H5N1 infection among birds has become endemic to the region and that human infections will continue to occur. So far, no sustained human-to-human transmission of the H5N1 virus has been identified, and no evidence for genetic re-assortment between human and avian influenza virus genes has been found.
It should be noted that the types of antiviral drugs that may be effective against H5N1 (bird flu) may have been diminished since April as the result of giving Tamifu, one of the antiviral drugs, to infected birds in Asia. This should be of concern, as Tamiflu is being stockpiled by many countries as their first line of defense against H5N1.
It should also be noted, that of those who have become ill with H5N1, approximately half (50%) have died. The eventual mutation of H5N1 virus into a form that can be transmitted easily from human to human has experts around the world worried due to the high mortality rate. When this mutation occurs, the current worst case forecast is for a worldwide pandemic even worse than the Spanish Flu. Note that Table 1 provides an estimate of the global deaths that resulted from the Spanish Flu at 40 – 50 million. Recent worst case scenario figures for a H5N1 are in the range of 180 – 360 million. Table 1 give a “best case” scenario figure of 2 – 7 million deaths worldwide. Please take note, the figures are for deaths, not those who get infected and are able to survive. An H5N1 pandemic could affect between 20 – 50% of the total world population.
If H5N1 has a mortality rate even half of its current rate, estimates of the deaths worldwide will range from 40,000,000 to 100,000,000. Even more important experts are predicting that the morbidity rate will be around 33% of the population. In the United States, current medical facilities would be overwhelmed having to support over 80 million sick individuals.
But the World Health Organization issues these warnings all the time
Why should we as business continuity planners be concerned? The World Health Organization (WHO) issues many warnings, for example a recent WHO advisory stated:
The World Health Organization has warned of the rapid spread of an atypical strain of pneumonia which appears to be resistant to conventional treatments. Reports of the illness have been received from Canada, China, Hong Kong Special Administrative Region of China, Indonesia, Philippines, Singapore, Thailand, and Viet Nam. Businesses should be aware of the risk to staff, especially those that have recently traveled to any of the affected countries. The new disease could be the cause of a global pandemic.
A recent Reuters story entitled, “Bird flu 'resistant to main drug'”, reveals that H5N1 is showing resistance to Tamiflu.
The Lancet carried an article entitled, “H5N1 influenza pandemic: contingency plans” (The Lancet 2005; 366:533-534 DOI: 10.1016/S0140-6736(05)67080-8) written by Dr.’s Kenneth WT Tsang, University Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong SAR, China, Philip Eng, Department of Respiratory and Critical Care Medicine, Singapore General Hospital, Republic of Singapore, CK Liam, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia, Young-soo Shim and Wah K Lam, Department of Internal Medicine, Seoul National University College of Medicine, Korea, is highlighted on the next page:
