Influenza Update H1N1-(swine)

MedPrep Consulting Group LLC Dr. Stuart B. Weiss   INFLUENZA UPDATE WHO PANDEMIC ALERT LEVEL 6 June 26, 2009   SUBSCRIBE: Click button at bottom or send email to alert@MedPrepGroup.com So what's going on in the Southern Hemisphere? The H1N1 (swine) flu season continues in the Southern Hemisphere where case numbers continue to rise however, flu continues to spread in the Northern Hemisphere as well.    Current Situation: The WHO reports 55,867 confirmed cases in 109 countries. Remember, in countries with large outbreaks, the absolute number of cases is less important than the disease outbreak pattern. In many parts of the world, there is insufficient public health infrastructure to accurately test or count new cases. Leaders in case counts in the Southern Hemisphere are: Australia, Chile and Argentina with 421 new cases in Australia and 203 new cases in Argentina in the past two days. On Thursday, the CDC posted new interim guidance for businesses. It outlines guidance for preventing flu in "low risk" employees (i.e. office employees) You can find this guidance at: http://www.cdc.gov/h1n1flu/guidance/workplace.htm Spread within U.S. summer camps has caused several to close already and has raised concerns of outbreaks this summer at camps. Egyptian health authorities warn pilgrims to Mecca (Saudi Arabia) of the dangers posed by H1N1 (swine) and suggest that pilgrims will be quarantined upon return. There are issues in China with travelers showing even a minor elevation in temperature being quarantined in less than hospitable locations.   HOUSEKEEPING ITEM:  If you get this Alert through a mailing list and not directly from us, subscribe by clicking the button at the bottom or send an email to alert@MedPrepGroup.com       ANALYSIS:    With Influenza falling out of the media throughout most of the U.S.. its easy to forget that it is spreading and causing concern through much of the world. As expected, the number of cases in the Southern Hemisphere has continued to rise however the number of cases in other parts of the world also continues to rise. Its an interesting pattern. We continue to have cases in the U.S. and the CDC reported recently that 99% of the cases of influenza-like illness are now caused by the new flu virus. As expected, seasonal flu has died way down, but the H1N1 (Swine) continues.   As discussed earlier there are a couple of possible scenarios for the fall. I'd like to go over them again since I was asked about them on a recent conference call. The first scenario is that the H1N1 (swine) doesn't change much but returns with increased circulation next fall, at the same time that seasonal flu begins to circulate again. Since the two viruses seem to affect different populations and having one doesn't seem to protect you from the other, we may see the two become additive. H1N1 (seasonal) affecting infants and older people and H1N1 (swine) affecting young adults. That could lead to a really bad flu season with twice as many deaths and hospitalizations. This would completely overwhelm our healthcare system and lead to significant increase in employee absenteeism. The second scenario is that the H1N1 (swine) acquires Tamiflu resistance from the H1N1 (seasonal) virus and comes back but now we can't treat it as easily. That would lead to more deaths and a still worse flu season. The last scenario is the really bad one where the H1N1 (swine) mixes with Avian H5N1 and gains its lethality. This is least likely due to several missing factors in the H1N1 (swine) virus but if it happened, it would lead to a highly lethal rapidly spreading virus.   Regardless of which scenario occurs, we will have disruptions this coming fall. It would be wise to plan over the summer for worker absenteeism. You can be certain that if H1N1 (swine) affects children and causes deaths, parents will be quick to keep their children home from school. In the early days of the H1N1 (swine) outbreak, back in May, one bank on Texas reported to us that they had up to a 70% absenteeism rate due to schools being closed.   So don't take your eye off this dark cloud on the horizon. We will continue to help you follow this evolution over the summer.       ADVICE: Ensure that someone follows the developments of H1N1 (swine) over the summer. This is still an evolving outbreak. No one knows how this virus and the other circulating flu viruses will react.  Communicate with your southern offices. If you have offices or employees in the Southern Hemisphere it is very important to communicate with them. They are going through the worry and stress over H1N1 (swine) that we went through in May. Share with them strategies to prevent the spread of illness (hand hygiene, cough/sneeze etiquette, social distancing, etc.). Let them know that you are concerned about their wellbeing and are following the situation. Communicate with Employees traveling to China and parts of the Middle East. We have seen reports that China is screening travelers and quarantining people with even minor elevations of temperature in location lacking clean food and water. There are also reports of other countries that are also screening travelers and mandating quarantine. Continue your planning efforts. Over the summer, you should be planning for continuity of operations during a significant employee shortage and with interruptions in supply chain. Even if flu just comes back in its current form with two strain circulating simultaneously, it will be a bad flu season and we will have interruptions. Take time to look at HR policies on sick time and return to work. Look at how you will handle employees that come to work sick or are exposed to sick workers. There is some CDC guidance on this or you can contact us for assistance. Take time to figure out how you will implement social distancing and hand hygiene. Think about your cleaning needs. Revise your triggers for your trigger based action plan. If you have linked your plan activation to WHO phases, it is time to uncouple those plans and design new triggers. Be certain that your triggers take into account information not only on the disease but also on community resilience, corporate resilience and corporate impact. We have developed a formula for htis which I will write more about in the next Influenza Update. Develop a trusted source for important medical information and analysis. If you have a corporate medical director, include them in the planning process. If you do not have this resource in-house, find someone now that you can call on. We can serve as your Virtual Medical Director if you wish. See below for information.   Virtual Medical Director If you don't have a corporate medical director, we'll be your medical director. Our Virtual Medical Director service provides you with 24 hour access to physicians and experts trained in emergency medicine, disaster medicine, business continuity, occupational health and mental health crisis management to give you situation updates, analysis and advice. Contact us for further information.     Not preparing now would be a serious mistake should things worsen quickly.       If you have any questions or concerns that we can help you with, please feel free to reach out to me. My email is: sweiss@MedPrepGroup.com       MedPrep Consulting Group is internationally recognized as a leader in pandemic, disaster and business continuity planning, training and exercising. We have resources and expertise that you can count on. Ask us about our Virtual Medical Director Program.   Dr. Stuart Weiss is the CEO of MedPrep Consulting Group. For more information, visit www.MedPrepGroup.com   Stuart Weiss, MD, CBCP MedPrep Consulting Group LLC