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Influenza Pandemic
     Workshopp
       Ken Simpson
  The VR Group Pty Ltd
      September 2006
http://www.blog.vrg.net.au
http://www blog vrg net au
         © 2005, The VR Group Pty Ltd, All Rights reserved
Agenda




© 2005, The VR Group Pty Ltd, All Rights reserved
Briefing on Pandemic Influenza
•   What is it?
•                p
    How does it spread?
•   Likely impacts
•   Challenges




                     © 2005, The VR Group Pty Ltd, All Rights reserved
Some definitions
•   Influenza
     – Influenza (the flu) is a very infectious illness caused by a virus. It is much more
       serious than a common cold and can leave you ill for up to 10 days.
     – Symptoms of the flu include: a high fever, headache, muscle aches and pains,
       fatigue, cough
       fatigue cough, sore throat or a runny nose. It may take up to three days to feel
                              throat,             nose
       symptoms after you catch the flu (the incubation period).
     – Anyone can get the flu – being fit, active and healthy does not protect you from
       getting this virus.

•   Avian Influenza
     – Avian influenza refers to a large group of different influenza viruses that primarily
       affect birds.
     – On rare occasions, these bird viruses can infect other species, including pigs and
       humans. The vast majority of avian influenza viruses do not infect humans.
     – We are not planning for Avian Influenza

•   H5N1
     – Is a specific influenza subtype
     – Avian H5N1 is a strain with pandemic potential, since it might ultimately adapt
       into
       i t a strain that is contagious among h
               t i th t i      t i           humans

                                     © 2005, The VR Group Pty Ltd, All Rights reserved
Pandemic Influenza
• … i what we are planning f
    is h t           l  i for
• Pandemic is an Epidemic
  occurring simultaneously in
          g              y
  multiple countries
• Pandemic requires 3
  conditions
   – A new virus emerges which has
     not previously infected humans
     therefore nobody has antibodies
     to fight it (Avian H5N1 strain)
   – The virus makes humans
     seriously ill
               y
   – The virus is capable of efficient
     human to human transmission


                            © 2005, The VR Group Pty Ltd, All Rights reserved
Pandemics are not new
• They are (rare but) recurring events
• There were 3 in the 20th Century
  – 1918, Spanish Flu
     • E ti t d 40 50 million d d
       Estimated 40-50 illi dead
  – 1957, Asian Influenza
     • Estimated 2 million deaths
  – 1968, Hong Kong Flu
     • Estimated 1 million deaths


                      © 2005, The VR Group Pty Ltd, All Rights reserved
Pandemic and Business Continuity
• B i
  Business C ti it i concerned with IMPACT
           Continuity is     d ith
  not LIKELIHOOD

• Pandemic influenza will leverage existing BC
  capabilities
  – Incident Management
  – Mission Critical Activities
  – Minimum operating requirements
• Specific threat, may not match previous planning
  – Gl b l i
    Global impact
                t
  – Longer-term


                    © 2005, The VR Group Pty Ltd, All Rights reserved
More definitions
• WHO Phases
   – Adapted by Dept of Health for Australia
• Vaccine
• Anti-virals
  Anti virals




                       © 2005, The VR Group Pty Ltd, All Rights reserved
More definitions
• WHO Phases
• Vaccine
  – Not currently available
  – Not expected until approx 6
          p              pp
    months after the outbreak
• Anti-Virals
   – Medication that may reduce the impact of the
     symptoms
   – Seen in some quarters as having potential for use to
     prevent illness (prophylaxis)
   – Are in very short supply
                      © 2005, The VR Group Pty Ltd, All Rights reserved
Spreading the virus
•   Droplet
    D l
    –   occurs when large (greater than or equal to five micrometre diameter)
        droplets are generated, propelled a distance of up to one metre and
        deposited on the mouth, nose or eyes of another person.
    –   requires close contact as th d l t d not remain suspended i th
             i    l        t t     the droplets do t        i         d d in the
        air and generally only travel short distances (usually a metre or less).
•   Contact
    –   occu s
        occurs when s
                    e skin to s
                              skin co tact results in the physical t a s e o micro-
                                   contact esu ts t e p ys ca transfer of c o
        organisms.
    –   can also occur when a virus contaminates a person’s hand and then that
        person touches his or her mouth, nose or eyes.
    –   Indirect transmission occurs when the virus is transferred to a person’s
        eyes,
        eyes mouth or nose after coming into contact with a contaminated
        object or surface.
    –   Influenza A and B viruses have been shown to survive on hard, non-
        porous surfaces for 24–48 hours, on cloth, paper and tissue for less than
        8–12 hours and on hands for 5 minutes.
•   Airborne
    –   When smaller (less than five micrometres diameter) droplets or dust
        particles containing the infectious agent are produced (e.g. from the
        evaporation of water from larger droplets) which remain suspended in
        the air, are dispersed by air currents, and may be inhaled by a person
        who is some distance from the source patient.
                                         © 2005, The VR Group Pty Ltd, All Rights reserved
Basic mitigation strategies
• P
  Personal P t ti
         l Protective
  Equipment (PPE)
  –M k
    Masks
  – Gloves
  – Protective eyewear
• Hand Hygiene
  – Washing
                                • Social Distancing
  – Alcohol-gel
                                      – Isolation
• Cough/Sneeze                        – Quarantine
  etiquette
                                      – Avoiding crowds

                     © 2005, The VR Group Pty Ltd, All Rights reserved
Comparison to SARS
• 1918 Spanish Flu                  • SARS
  – 6 months to spread                    – Within weeks had
    around the world                        spread to 8 countries
  – Travelled around the
    world th
       ld three ti
                times i
                      in                  – Possible that modern
    two years                               influenza pandemic
     • In an era when a plane
                                            could spread around
                                                 ld     d      d
       couldn’t fly across the
       Atlantic                             the world in 30-60
                                            days



                         © 2005, The VR Group Pty Ltd, All Rights reserved
Spreading the virus – 747 style




            © 2005, The VR Group Pty Ltd, All Rights reserved
Likely impacts
• Primarily a people impact
• Not a single incident
   – Pandemic “waves” (approx 8-
     12 weeks in duration)
   – Can expect 3 waves, pe aps
     Ca e pect       a es, perhaps
     over 2 year period
• Disrupt global supply chains
• Can be expected to have a
  significant economic impact




                          © 2005, The VR Group Pty Ltd, All Rights reserved
Random thoughts
• WHO Phases do not always translate well
  to Corporate p
         p       planning
                        g
• Need to monitor for Trigger events
• Th most valuable asset t th b i
  The       t l bl        t to the business
  will be a staff member who has had
  influenza and recovered
• De-escalation from WHO 6 is as important
  to manage as the escalation

                 © 2005, The VR Group Pty Ltd, All Rights reserved
Standard Business Continuity
              Phases
• P
  Prevention
        ti
  – Things we do to reduce the likelihood or impact
• P
  Preparedness
         d
  – Being prepared to execute the Response/Recovery
    phases
• Response
  – To various trigger points
  – Also includes business resumption activities
• Recovery
  – Will include the de-escalation between “waves”


                      © 2005, The VR Group Pty Ltd, All Rights reserved
Challenges for us
• Support essential business
  processes/service delivery
• Support for remote working
• Increased focus on Service Desk
  process
  – Increase in number of staff working
    in unfamiliar jobs with unfamiliar
    systems




                      © 2005, The VR Group Pty Ltd, All Rights reserved
Action Plan
• Model impact on business
• Determine Trigger Points
               gg
• Action Plans
  – People issues
  – Operational issues
  – Consider reactions by
    government
     • Borders
     • Schools



                     © 2005, The VR Group Pty Ltd, All Rights reserved
Impact Modelling
600




500




400




300




200




100




 0
      5%   12%   15%   25%   40%         50%     55%     50%     40%   30%   25%   10%

                                   Absenteeism   Remote Access


                               © 2005, The VR Group Pty Ltd, All Rights reserved
Impact Modelling
1000


900


800


700


600


500


400


300


200


100


  0
       1   2   3   4   5          6          7          8   9   10   11    12

                           Min Staffing   Absenteeism

                       © 2005, The VR Group Pty Ltd, All Rights reserved
Trigger Points
• WHO upgrade to Phase 4
               d t Ph
• WHO upgrade to Phase 5 in any country
          pg                    y      y
• Australian DOHA declaration of Phase 6
  AUS
• First case in our company
• S
  Schools closed
• Borders closed
• De-escalation from AUS 6c

                 © 2005, The VR Group Pty Ltd, All Rights reserved
Identification of critical Process/
                Services
• Wh t are they?
  What     th ?
• What are the essential
  components of the
            t f th
  service?
   –PPeople
         l
   – Process
   – Technology
• Are there any critical
  suppliers that this
  service relies on?

                     © 2005, The VR Group Pty Ltd, All Rights reserved
Any Questions?




    © 2005, The VR Group Pty Ltd, All Rights reserved

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Pandemic Workshop

  • 1. Influenza Pandemic Workshopp Ken Simpson The VR Group Pty Ltd September 2006 http://www.blog.vrg.net.au http://www blog vrg net au © 2005, The VR Group Pty Ltd, All Rights reserved
  • 2. Agenda © 2005, The VR Group Pty Ltd, All Rights reserved
  • 3. Briefing on Pandemic Influenza • What is it? • p How does it spread? • Likely impacts • Challenges © 2005, The VR Group Pty Ltd, All Rights reserved
  • 4. Some definitions • Influenza – Influenza (the flu) is a very infectious illness caused by a virus. It is much more serious than a common cold and can leave you ill for up to 10 days. – Symptoms of the flu include: a high fever, headache, muscle aches and pains, fatigue, cough fatigue cough, sore throat or a runny nose. It may take up to three days to feel throat, nose symptoms after you catch the flu (the incubation period). – Anyone can get the flu – being fit, active and healthy does not protect you from getting this virus. • Avian Influenza – Avian influenza refers to a large group of different influenza viruses that primarily affect birds. – On rare occasions, these bird viruses can infect other species, including pigs and humans. The vast majority of avian influenza viruses do not infect humans. – We are not planning for Avian Influenza • H5N1 – Is a specific influenza subtype – Avian H5N1 is a strain with pandemic potential, since it might ultimately adapt into i t a strain that is contagious among h t i th t i t i humans © 2005, The VR Group Pty Ltd, All Rights reserved
  • 5. Pandemic Influenza • … i what we are planning f is h t l i for • Pandemic is an Epidemic occurring simultaneously in g y multiple countries • Pandemic requires 3 conditions – A new virus emerges which has not previously infected humans therefore nobody has antibodies to fight it (Avian H5N1 strain) – The virus makes humans seriously ill y – The virus is capable of efficient human to human transmission © 2005, The VR Group Pty Ltd, All Rights reserved
  • 6. Pandemics are not new • They are (rare but) recurring events • There were 3 in the 20th Century – 1918, Spanish Flu • E ti t d 40 50 million d d Estimated 40-50 illi dead – 1957, Asian Influenza • Estimated 2 million deaths – 1968, Hong Kong Flu • Estimated 1 million deaths © 2005, The VR Group Pty Ltd, All Rights reserved
  • 7. Pandemic and Business Continuity • B i Business C ti it i concerned with IMPACT Continuity is d ith not LIKELIHOOD • Pandemic influenza will leverage existing BC capabilities – Incident Management – Mission Critical Activities – Minimum operating requirements • Specific threat, may not match previous planning – Gl b l i Global impact t – Longer-term © 2005, The VR Group Pty Ltd, All Rights reserved
  • 8. More definitions • WHO Phases – Adapted by Dept of Health for Australia • Vaccine • Anti-virals Anti virals © 2005, The VR Group Pty Ltd, All Rights reserved
  • 9. More definitions • WHO Phases • Vaccine – Not currently available – Not expected until approx 6 p pp months after the outbreak • Anti-Virals – Medication that may reduce the impact of the symptoms – Seen in some quarters as having potential for use to prevent illness (prophylaxis) – Are in very short supply © 2005, The VR Group Pty Ltd, All Rights reserved
  • 10. Spreading the virus • Droplet D l – occurs when large (greater than or equal to five micrometre diameter) droplets are generated, propelled a distance of up to one metre and deposited on the mouth, nose or eyes of another person. – requires close contact as th d l t d not remain suspended i th i l t t the droplets do t i d d in the air and generally only travel short distances (usually a metre or less). • Contact – occu s occurs when s e skin to s skin co tact results in the physical t a s e o micro- contact esu ts t e p ys ca transfer of c o organisms. – can also occur when a virus contaminates a person’s hand and then that person touches his or her mouth, nose or eyes. – Indirect transmission occurs when the virus is transferred to a person’s eyes, eyes mouth or nose after coming into contact with a contaminated object or surface. – Influenza A and B viruses have been shown to survive on hard, non- porous surfaces for 24–48 hours, on cloth, paper and tissue for less than 8–12 hours and on hands for 5 minutes. • Airborne – When smaller (less than five micrometres diameter) droplets or dust particles containing the infectious agent are produced (e.g. from the evaporation of water from larger droplets) which remain suspended in the air, are dispersed by air currents, and may be inhaled by a person who is some distance from the source patient. © 2005, The VR Group Pty Ltd, All Rights reserved
  • 11. Basic mitigation strategies • P Personal P t ti l Protective Equipment (PPE) –M k Masks – Gloves – Protective eyewear • Hand Hygiene – Washing • Social Distancing – Alcohol-gel – Isolation • Cough/Sneeze – Quarantine etiquette – Avoiding crowds © 2005, The VR Group Pty Ltd, All Rights reserved
  • 12. Comparison to SARS • 1918 Spanish Flu • SARS – 6 months to spread – Within weeks had around the world spread to 8 countries – Travelled around the world th ld three ti times i in – Possible that modern two years influenza pandemic • In an era when a plane could spread around ld d d couldn’t fly across the Atlantic the world in 30-60 days © 2005, The VR Group Pty Ltd, All Rights reserved
  • 13. Spreading the virus – 747 style © 2005, The VR Group Pty Ltd, All Rights reserved
  • 14. Likely impacts • Primarily a people impact • Not a single incident – Pandemic “waves” (approx 8- 12 weeks in duration) – Can expect 3 waves, pe aps Ca e pect a es, perhaps over 2 year period • Disrupt global supply chains • Can be expected to have a significant economic impact © 2005, The VR Group Pty Ltd, All Rights reserved
  • 15. Random thoughts • WHO Phases do not always translate well to Corporate p p planning g • Need to monitor for Trigger events • Th most valuable asset t th b i The t l bl t to the business will be a staff member who has had influenza and recovered • De-escalation from WHO 6 is as important to manage as the escalation © 2005, The VR Group Pty Ltd, All Rights reserved
  • 16. Standard Business Continuity Phases • P Prevention ti – Things we do to reduce the likelihood or impact • P Preparedness d – Being prepared to execute the Response/Recovery phases • Response – To various trigger points – Also includes business resumption activities • Recovery – Will include the de-escalation between “waves” © 2005, The VR Group Pty Ltd, All Rights reserved
  • 17. Challenges for us • Support essential business processes/service delivery • Support for remote working • Increased focus on Service Desk process – Increase in number of staff working in unfamiliar jobs with unfamiliar systems © 2005, The VR Group Pty Ltd, All Rights reserved
  • 18. Action Plan • Model impact on business • Determine Trigger Points gg • Action Plans – People issues – Operational issues – Consider reactions by government • Borders • Schools © 2005, The VR Group Pty Ltd, All Rights reserved
  • 19. Impact Modelling 600 500 400 300 200 100 0 5% 12% 15% 25% 40% 50% 55% 50% 40% 30% 25% 10% Absenteeism Remote Access © 2005, The VR Group Pty Ltd, All Rights reserved
  • 20. Impact Modelling 1000 900 800 700 600 500 400 300 200 100 0 1 2 3 4 5 6 7 8 9 10 11 12 Min Staffing Absenteeism © 2005, The VR Group Pty Ltd, All Rights reserved
  • 21. Trigger Points • WHO upgrade to Phase 4 d t Ph • WHO upgrade to Phase 5 in any country pg y y • Australian DOHA declaration of Phase 6 AUS • First case in our company • S Schools closed • Borders closed • De-escalation from AUS 6c © 2005, The VR Group Pty Ltd, All Rights reserved
  • 22. Identification of critical Process/ Services • Wh t are they? What th ? • What are the essential components of the t f th service? –PPeople l – Process – Technology • Are there any critical suppliers that this service relies on? © 2005, The VR Group Pty Ltd, All Rights reserved
  • 23. Any Questions? © 2005, The VR Group Pty Ltd, All Rights reserved