Friday, March 28, 2008

Fifty Percent Staffing Level

The following is the experience of an accounting person, SZ, who had to operate with only half the staff due to resignations and retirement - and how difficult she found it, with musings on how well organizations might cope during a pandemic

Fifty Percent Staffing Level

Tomorrow we will be half way through the month of March, and tomorrow I hope to "put February to bed" at work. For those that do not know, or may have forgotten, I work in the accounting department of a Vacation Rental Company that is wholly owned by a publicly traded Holding Company. The department started the year with a staffing level of four, a controller, his "second" (me), and two others.

At the beginning of January one of my coworkers announced his unexpected and immediate retirement and I absorbed his duties in their entirety. Then in February the controller left us. My department has been running with a staff of two. But since we are a subsidiary of a publicly traded company the reporting that we have to generate and submit to our corporate office is federally mandated... and rigidly scheduled to meet those federal mandates.

It is widely suggested, as well as supported, that businesses and organizations will find themselves operating at somewhere around a fifty percent staffing level during a moderate to severe influenza pandemic, something I can relate to personally.

Although I do not work in a business or industry that will find itself operating during a time of pandemic, and accounting is not exactly an "essential service", although, to be sure, money will still have to flow, I thought I would share with you a few of the things that I learned and equally enlightening, what had to happen to support my efforts and success.

I had an existing broad base of knowledge of all aspects of the department, database, and accounting software, however, since I am not the controller there were reporting functions, data collations, and spreadsheets that I only had a basic superficial knowledge of. I found myself hour-by-hour struggling to comprehend how "this or that" fed into "this or that", often getting it wrong any number of times until I finally managed the logic of the data flow and plopped the right number(s) in.

I had adequate basic knowledge of the myriad functions. I had a well established and proven matrix to follow. I had an entire company at my beck and call to support my stupid ill-informed questions. I had our software programmer made available to me at a moment's notice to assist with database malfunctions and miscellaneous support questions. I had a General Manager that "baby sat" me for two weeks, checking on me every other hour offering encouragement, cheerleading, offers of providing anything else that I might find myself requiring (within a business framework of course). At one point in the process the entire company was "booted off" the server for several hours so that I could have its resources all to myself, and lastly, I was determined to succeed.

And even with all of that, with every resource and advantage I could be given, I was only able to just manage. Perhaps a better way to state my point: The only was I could have been in a better position to succeed was to have my former boss standing over my shoulder walking me through the processes.

During a moderate to severe pandemic those who find themselves struggling to perform the duties of two or three missing colleagues will probably not (read surely not) have all of the wonderful support that I had. Many will not have a clear "play book" to refer to as they find themselves struggling with unfamiliar processes and procedures. And, unlike my situation where it was "just numbers" those struggling people may hold someone else's health, or even more frightening, life in their hands with their actions.

After my experiences these past three weeks I have a brand new appreciation about how impossible those tasks will be - and my concern about our critical infrastructure has deepened considerably.

S.Z. Exhausted, but pleased with accomplishing the impossible with a great deal of wonderful support.

Thursday, March 20, 2008

Inaccurate Media Reporting

You may have heard reports from Ontario about flu cases being hospitalized there.

There are two very important elements to this information. First is to realize the speed with which rumours will spread. The fact is that there is NO medical evidence that the people in hospital suffering from Influenza A have bird flu. However, rumour spread that one patient had recently arrived from Bangladesh - and since that country has been experiencing H5N1 in their poultry, a false conclusion fueled the rumour rocket.

The second consideration is to realize how easy it is for media outlets to get information and to attempt to quickly to be the first to broadcast, film, or print information - sometimes without checking the accuracy of the reports.

This suggests to us that everyone should rely on at least two sources they trust to be assured of accurate and timely information about the progress of H5N1, and its possible mutation to a form that can easily be passed between humans (H2H).

We at Pitsel & Associates, Ltd. will endeavor to keep you abreast of the news on H5N1 and possible pandemic implications. We do believe that a pandemic is inevitable as we know historically that a pandemic occurs every 40 years or so, the last one being the Hong Kong flu in 1967. It is important to have facts and not hysteria guiding our reactions.

The official news release regarding the Ontario cases of flu is as follows:

"Media Statement - Bird Flu Speculation: Inaccurate Media Reporting

"Toronto, March 19/CNW - Toronto East General Hospital (TEGH) is concerned about inaccurate media speculation and reporting regarding human cases of avian flu. TEGH has no reason to speculate that any patients in the hospital have avian flu.

"Toronto is experiencing steadily increasing cases of seasonal flu in the community. For example, during the week of March 2 to 8th, 2008, there were 47 new cases of seasonal flu (not avian flu) in Toronto. Although TEGH has effectively responded to an increased number of patients with seasonal flu-like symptoms, including those from other facilities experiencing seasonal flu outbreaks, the hospital has no reason to believe that any patients at TEGH have H5N1 avian flu.

"Furthermore, media reports are indicating that the individuals suspected to have avian flu had recently traveled to Bangladesh. It is important to clarify that, according to the World Health Network, there have been no reported human cases of H5N1 avian flu in Bangladesh.

"TEGH has a comprehensive screening program to identify patients who present with potential respiratory illness. The hospital is proud of our record in identifying such individuals. Effective identification enables TEGH to provide appropriate treatment, to utilize respiratory precautions, and to protect staff and others. We are confident that no staff, patients or visitors have been inadvertently exposed to seasonal influenza at TEGH.

"We wish to reassure the public that the hospital is safe and that there is no reason for anybody who has visited the hospital to be concerned. All services, including scheduled procedures, continue to be fully available. We do not anticipate a need for any reduction in service or visitation restrictions."

Friday, March 14, 2008

Pandemic Influenza Update

The good news is that Indonesia has at last agreed to submit influenza samples for testing to the World Health Organization (see previous blog posting, Feb 21, 2008)

The recent news from Hong Kong is also encouraging in their responsiveness to recent events. Hong Kong is closing its schools for two weeks due to an influenza outbreak that unfortunately took the life of one young boy. This step indicates how seriously governments and institutions are viewing the influenza threat. Hong Kong is assuring us that the infection is not due to the H5N1 virus called bird flu, but is taking precautions as though it were.

A recent article in the Proceedings of the National Academy of Sciences in the United States suggests we can reduce the likelihood of a pandemic influenza outbreak by quickly implementing social-distancing measures alongside antiviral treatment and preventive measures (frequent hand washing, cough and sneeze etiquette, prompt and careful disposal of used tissues) until a vaccine becomes available. This is what they are doing in Hong Kong.

What follows is the most recent summary of pandemic flu matters. It indicates the 15 most populated countries and their percentage of the world's population.

A) shows the country has reported bird flu in poultry, and

B) shows the country has reported human cases of bird flu.

The summary shows that 4.3 billion people live in these 15 most populated countries, and represent roughly two-thirds of the entire world's population. The percent figure following each country's population total represents the percentage of the world's population that lives in that country.

1. China: 1.32 B. 20% of the world's population (both A and B)

2. India: 1.12 B. 17% (A only)

3. United States: 300 M. 4.6% (neither A or B)

4. Indonesia: 225 M. 3.5% (both A and B)

5. Brazil: 186 M. 2.8% (neither A or B)

6. Pakistan: 165 M. 2.5% (both A and B)

7. Bangladesh: 147 M. 2.3% (A only)

8. Russia: 143 M. 2.2% (A only)

9. Nigeria: 135 M. 2.1% (both A and B)

10. Japan: 138 M. 2.0% (A only)

11. Mexico: 108 M. 1.7% (neither A or B)

12. Vietnam: 87 M. 1.3% (both A and B)

13. Phillipines: 86 M. 1.3% (neither A or B)

14. Germany: 82 M. 1.3% (A only)

15. Egypt: 75 M. 1.2% (both A and B)

Bird flu in poultry (infestation) has been reported in eleven of these countries, and human infections have only been reported in six countries. Note that India and Bangladesh have reported and continue to report extensive and repeated poultry outbreaks, massive culling operations, but not one human infection.

Friday, March 7, 2008

Insights From the Conference Board of Canada Pandemic Planning Conference, March 2008

These are some of the helpful insights from the 2 day Pandemic Planning Conference sponsored by the Conference Board of Canada, in Toronto:

1. SARS - Toronto has had a "dry run" so to speak, in preparing for a pandemic because of their experience with SARS. Health Care workers were among those most heavily impacted by this disease, and the session on Mental Health during Response and Recovery states that of those who had recovered from SARS (the vast majority), more than 50% had long lasting psychological impact.

This suggests that as part of your pandemic planning you will want to have conversations with your Employee Assistance Providers to see if they will be abil to provide support services during and after a pandemic.

2. "Presenteeism" - is the practice of coming to work when you are ill. A Decima study showed that 79% of Canadians go to work sick. You can begin to plan for a pandemic now by starting to change employee health habits. Frequent hand washing and clearning surfaces are the two most effective areas to focus on, but having people stay at home and NOT come to work when they are infectious will be a major part of your plan to manage the pandemic.

3. Retirees - people who have recently retired from your organization, are a good source of people you can ask to return and fill in for people who are ill during a pandemic. Include them in your pandemic planning BEFORE the pandemic hits. Make information and supplies available to them that are being dispensed to staff. In this way you are much more likely to have them willing to return and assist in a time of staff shortage that might reach 40%.

4. Most presenters at the conference stressed communication, communication, communication. Companies who had successfully weathered the SARS event laid their success to the amount of communicating with staff that they did during the event. Ontario Hydro (who runs nuclear plants among other things), would send out messages two or three times a day on some days, to keep the staff informed. Studies have shown that staff look to and trust information that they get from their employer (if there is a trusting relationship between employer and staff) more than they trust media. This means that you will have to have dependable communication channels for everyone working for you.

5. Privacy Issues - Personal privacy issues will probably come up during a pandemic, and one has to consider individual rights vs. the rights of the whole. Ordinarily, organizations may not disclose health problems of employees to anyone - but what do you tell people in your organization if the person working next to them is ill with the flu? This issue should probably be checked with your corporate lawyer prior to a time of pandemic when it will probably be impossible to reach a lawyer in a timely fashion.

6. Incident Control Room - Most organizations that have to plan for emergencies and business continuity planning that deal with things like fire, floods, etc., will want to re-think the value of having a central incident control room. People will want to maintain social distancing during a pandemic, and a central room with phones, faxes, computers, etc. that are used by everyone has a high likelihood of spreading viruses. How will you ensure that people in a critical incident room are not going to infect one another, thus taking out the very people you need most?

7. Force Majeure - Speakers from law firms stressed that a pandemic would not fall under Force Majeure clause in contracts that you have (this type of clause excludes liability from non-performance) unless it is specifically mentioned. This means that ALL contracts should be checked. As well, a pandemic event is probably non-insurable (again, check with your Insurance people to see what advice their company is giving).

8. Ethics - Ethics is a huge issue for the medical profession but will also play a part in businesses as well. Companies may have to make difficult decisions in choosing who to ask to perform certain duties that may be hazardous - and what action they will take if staff refuse this request.