Our meetings provide a national forum for leaders in the field to explore and discuss priorities, challenges, and policy implications in health security.
Bulls, Bears, and Birds:
Preparing the Financial Industry for a Pandemic
Sponsored by the Center for Biosecurity of UPMC, Deutsche Bank, The Contingency Planning Exchange
Synopses of Speakers' Key Recommendations
Tara O'Toole, MD, MPH
- There is a deep, growing concern among scientific and political leaders around the world that the avian flu strain H5N1 could develop the capacity to spread efficiently from person to person and initiate a pandemic that could kill tens, even hundreds of millions of people.
- The U.S. bears special responsibility for leading efforts to prepare for such an event given its scientific leadership, talent, resources and health systems.
- Such a crisis would certainly have a grave impact on global businesses, which should be making their own plans to cope as best they can, and examining ways to use their considerable resources (e.g., IT, logistical systems, distribution processes) to helping communities or even governments prepare to cope with a pandemic.
Rajeev Venkayya, MD
- The U.S. Government judges the avian flu threat to be very serious and has engaged all federal agencies in the governmental response. From a historical standpoint, the world is overdue for a major pandemic, and even if it does not happen this year, it will surely happen in the years ahead.
- The U.S. Government recommends that business leaders prepare their own organizations and business communities for the possibility of an avian flu pandemic that is prolonged and pervasive. Business should integrate its activities into existing federal and local planning efforts.
- The financial sector should model the impact of infectious diseases on the industry to help guide and prioritize preparedness activities within the industry.
James L. Pavitt
- Current outbreaks of H5N1 around the world have provided strategic warning about the avian flu threat, and the U.S. should act accordingly, expecting no further advanced warning. The Katrina response has shown that near perfect intelligence about an impending crisis is not sufficient -- planning and execution will matter the most.
- The U.S. government has not yet dedicated resources commensurate with the scale of the avian flu threat; it would be irresponsible if the U.S. did not fully use the extraordinary scientific talent and economic power of the nation to prepare the cope with this problem.
- Businesses leaders should not only have pandemic plans; they must exercise them. Recent history has shown that many plans that are not tested or transparent are worth little in the midst of crisis.
Robert Webster, PhD
- The H5N1 virus has killed more than 50% of those infected, including many healthy adults. It is highly lethal in animals (the most lethal flu virus Dr. Webster ever worked upon), constantly mutating, and will eventually develop the capacity for easy transmission from person to person.
- Scientists have made tremendous strides in understanding the science of the H5N1 virus, for instance, it is now clear how to formulate a new vaccine from a new viral strain in 15 days, but developing the capacity to manufacture massive amounts of vaccine is now the responsibility of policy -makers , not science. Scientists have performed their work, and now it is time for political leaders to do their part.
- The public, the private sector, and national governments must realize the seriousness of this threat and immediately bring to bear the resources necessary to develop effective surveillance, produce adequate amounts of vaccine and antivirals, and expand distribution capacity substantially.
Robert Shapiro, PhD, MSc
- The impact of natural catastrophes and terrorist attacks on the macroecomony of nations has depended on (and will continue to depend on) key factors, such as the size of a nation's economy, the structure of its markets, and the geographic extent of the crisis. The U.S. has not suffered major macro-economic damage following the 9-11 attacks, nor is it likely to after Hurricane Katrina.
- The impact of avian flu pandemic on the economies of smaller countries could be devastating; whereas, the impact of an avian flu pandemic on the U.S. economy would be likely to be more localized and less severe, assuming the U.S. is taking all logical steps to prepare now, and assuming that steps could be taken to prevent the pandemic from being pervasive and protracted in the U.S..
- It is deeply concerning that the U.S. government appears to still be in the process of developing its pandemic preparedness plans, nationally and internationally. The U.S. should clearly be making the necessary modest public investments and planning steps now necessary to shorten the duration of an epidemic and minimize its impact.
Isaac Weisfuse, MD, MPH
- The NYC Department of Health has made substantial investments in avian flu preparedness -- working with its hospitals, laboratories, and the city's large clinical community. Business leaders should be educating their own organizations about avian influenza now in preparation for a pandemic.
- Businesses should engage with their local health departments to understand and coordinate with local preparedness planning.
- Businesses should consider specific steps they could take in the event of a pandemic to minimize major disruption, such as increasing the portion of their workforce that telecommutes for a time, expanding online transaction and self-service options to keep essential services running, giving employees good information before and during a crisis, encouraging clinicians and employee health offices to register with the Health Alert Network, and reinforcing prevention messages such as hand-washing and staying home when sick.
Klaus Stöhr, DVM
- H5N1 is a major pandemic concern, and it will continue to spread widely in animals, making animal and human surveillance a top priority. Improvements in animal surveillance may necessitate profound changes in national agricultural and poultry production systems.
- Adequate stockpiles of antivirals cannot be produced in the near term due to limited production capacity, nor will generic antiviral medications be available in the short-term; therefore, the global community needs to invest in long-term solutions that will improve global supplies of influenza vaccines and antivirals and improve and streamline vaccine and drug development processes.
- Hospital and community preparedness plans around the world need to take into consideration the scarcity of drugs and vaccines, since vaccines and antivirals will only be available to a small number of countries and only a portion of their populations. Plans for preventive interventions such as masks, social distancing, voluntary home stay, etc., will be key. Incentives for collaboration among affected countries would be necessary in a crisis and strong international collaboration is needed now.
David S. Fedson, MD
- The World Health Organization (WHO) (with just 12 people working full-time on global pandemic preparedness) has not received appropriate political or financial support from donor nations including the US; member countries must provide more resources and support to the WHO for it to develop a strong response to avian flu.
- For there to be any chance that the U.S. will have enough vaccine for its whole population during an avian flu pandemic the U.S . (and other vaccine producing nations) must immediately pursue the development of an antigen sparing vaccine so that we are able to protect more people per volume of vaccine produced . This will require a change in the U.S. F.D.A policy and public funding for clinical trials of low dose antigen sparing vaccines on urgent time frame.
- To maximize global vaccine production, the U.S. should lead the effort t 1. Coordinate the efforts of the 9 global vaccine manufacturers to make low dose antigen/adjuvant vaccine; 2. Reach agreements on the requirements for emergency licensing; 3. Resolve intellectual property issues that now impair development of vaccine; and, 4. Make serious plans regarding how to allocate vaccines internationally in a crisis.
- Research into other substances for treating influenza, such as cholesterol-lowering statins, which have been shown to be of possible benefit in preliminary studies, should be pursued immediately.
Gene Matthews, JD
- The SARS outbreak in 2003 revealed how bad the impact of an epidemic can be for businesses and illustrated the interdependence of governments, businesses, and the public health sector in such crises.
- In future epidemics, in the U.S. or elsewhere in the world, the private sector will certainly be called upon to help provide resources and assistance in efforts to cope. Because their role in responding to and recovering from a public health emergency will be at least as important as that of the government, businesses should build external preparedness networks geographically and industry-wide.
- It is essential that businesses engage in local, state and federal preparedness efforts with public health; those working relationships and bridges between the sectors must be established in advance of a crisis. Businesses should verify that local, state and national governments have the necessary institutional and legal frameworks in place to respond to a large public health emergency.
Peter Sandman, Ph.D.
- Effective communication, with employees and others, about avian influenza is essential and includes
- Frightening people may be necessary and appropriate in order to assure that they are adequately concerned about the risk and taking the threat of pandemic influenza seriously. Fear is rational and useful in response to frightening events, and it may help motivate necessary action.
- Acknowledging the uncertainty of the situation publicly and providing candid and transparent information as early as feasible.
- Giving people useful actions to take.
- Once an event has occurred, focusing communication on helping people to cope and "bear their fears." It is the responsibility of leaders to accept that responsibility and to help people to cope appropriately.
Building on lessons learned from SARS, he suggested that businesses should:
- Build a knowledge base by reaching out to individuals, organizations, and disciplines that may be beyond the usual practices. These should include disease, legal, and regulatory experts.
- Define the "trigger points" for when contingency measures should be executed.
- Be aware that while plans will be made for global operations, execution will, ultimately, be local; therefore, all plans should assimilate health and legal guidelines from local governments.
- Maintain open and honest communications. It is essential that senior managers and employees be educated on plans and policies, which should also be communicated to employees and stakeholders.
- Even with well-crafted plans, flexibility and adaptability are essential, because there has to be capacity for addressing the new and unknown that will always arise.