WCDM Pandemic 2009 Gws

Pandemic Unpreparedness
Pandemic: The Second Wave
How unprepared are we
Copyright 2009, Geary W. Sikich, All rights reserved. Nonexclusive license granted for use at the 18th World Conference on Disaster Management (WCDM)
Pandemic Unpreparedness Confronting the Edge
of Chaos: Continuity
Strategy Implications
The take-away:
 Businesses and industries are complex adaptive
systems.
 Businesses and industries are governed by deep
laws of complexity
 Plans that lack flexibility will constrain the users
 Energy drives everything
 Clearly defined rules for the world do not exist,
therefore computing future risks can only be
accomplished if one knows future uncertainty
There are hundreds of strains of avian

influenza virus but only five – H1N1, H5N1,
H7N3, H7N7, and H9N2 - are known to have
caused human infections, according to the
World Health Organization.
Say, you wouldn't be that
scwewy swine fwoo, would
you?
What We Know
(Facts)
What We Think We Know
(Assumptions)
What We Do Not Know
(Speculation)
What We Do Not Know that We Do Not Know
(Unknown Unknownables)
Seasonal Flu Stats
Annual flu affects between 5% and 20% of the U.S. population
Approximately 200,000 people end up hospitalized
Approximately 36,000 deaths result
Deaths from annual flu are mainly elderly and very young
Current Swine Flu is attacking young adults (approximate ages 20 – 40)
Spanish Flu mortality – 2.5%
1957 Flu and 1968 Flu mortality – 0.5%
Current Swine Flu – not enough data to determine mortality
Pandemic Unpreparedness World Population:
6,525,170,264
(approximately)
Assumption # 1: Influenza attack rate = 25%

1,631,292,566 will succumb to illness from influenza
Assumption # 2: Influenza mortality rate = 3%

48,938,777 will die from influenza
ssumption # 3: Influenza survivors could suffer long term health effects

1,582,353,789 will require long term care as a result of influenza
Assumption # 4: Government social services programs will be

created to address long term effects of Influenza
pandemic
Economic effect of influenza pandemic could
create a new world order and shift geo-political
power
Pandemic – The Second W
While the cause [influenza] will remain the same, the

problems that we will face in the second wave of a
pandemic will not be the same problems that we faced
in the first wave.
Seat of the Pants? Forward Thinking?

Process Oriented Rigidity Situational Awareness
Old Planning Paradigms Adaptive Behavior
Ineffective Response Modes “Active Analysis”
Inflexibility “Futureproofing”
Time – How Much – How Lo
Antivirals and Vaccine Supply:

It will take 10 years to provide enough antivirals to treat
20% of the world’s population if bird flu becomes seriously
endemic worldwide. H1N1 Vaccine may be available
sooner – but will the supply be there?
Fact: H5N1 is already endemic in much of Asia.
H1N1 is the first declared pandemic in
41 years
Question: How will we know which 20% to provide
antivirals for?
How much of the H1N1 Vaccine will
need to be produced?
Question: Where will the antiviral supplies be stored?
Question: How will we know if current vaccine will be
effective against the emergent strain of
influenza (mutated virus)?
Black Swans, Randomness, Preparedness

A black swan is a highly improbable event with three
principal characteristics: it is unpredictable; it carries a
massive impact; and, after the fact, we concoct an
explanation that makes it appear less random, and
more predictable, than it was.
Nassim Nicholas Taleb
The Black Swan: The Impact of the Highly Improbable
The biggest single threat to

business during a pandemic will be
staying with a previously successful
business model too long and not being
able to adapt to the fluidity of situation
Failure to recognize:
 Weak cause-an-effect linkages
 Small and isolated changes can have huge effects
 Complexity making the strategic challenge more

urgent
 How the complexity of the event can facilitate the

ability of the organization to adapt if it can
broaden its continuity approach
Pandemic Unpreparedness Leadership Decision
Making and Situational
Awareness
Uncontrollable
Inputs
Influencers (positive or negative)
Interacti
Underst
Recogni Take Reali
and
ons
Go Optio Choic
ze Actio ze
al ns es
Interact n Goal
ions s
Alternati
ves
Redefine Goals and

Objectives
Observe Orient Decide Act
Pandemic Unpreparedness Leadership Decision
Making and Situational
Awareness
Uncontrollable inputs result in compressed logic stream leading to
higher potentialInfluencers
for failure (positive or negative)
Compression
Interacti
Underst
Recogni Take Reali
and
ons
Go Optio Choic
ze Actio ze
al ns es
Interact n Goal
ions s
Alternati
ves
Redefine Goals and

Objectives
Observe Orient Decide Act
A few important factors will drive your

organization’s
Focus on aligning success Directly contributes to
pandemic plans with business need and
business goals and competitive
objectives advantage
Can provide Deliver immediate
quick-hit value and ROI
solutions
Understand business
Proven,
drivers and focus
experienced
efforts to support
teams
them
A few important factors will drive your

organization’s
Ongoing, successPinpoints skill sets when
strategic
staff allocation and where needed
Enables decision
“Active Analysis” making based on best
available intelligence
Drives solutions that

Long-term enable realignment to
strategic strengthen your position
alignment in the marketplace
Second Wave – A
Speculative Look
How Flexible is Your

Organization’s Plan?
Have You Built a Sandcastle,

Pyramid or Cathedral?
We know very little about how

different highly disruptive,
nonlinear changes might
interact with and amplify one
another
Second Wave – A
Speculative Look
How Flexible is Your

Organization’s Plan?
Mange the unavoidable and avoid the
unmanageable
(planning framework)
We need flexibility precisely because

change is constant and flexibility provides
the raw material we need to adapt to
changing situations (situational
awareness)
All kinds of things are going to be moving

and shifting much faster than in the past,
Will your workload increase in respect to the severity of a pandemic or will

it decline due to lack of demand for your product/service?
Workload Factors
Demand – Will your product or
service be in demand?
Workload D
at 100% E
M
Product/Service Relation to Pandemic Cycle
A
Staff at N
100% D
Product or service demand down
Workforce degradation less
Staff Degradation Factors

Pandemic
Declared 60 – 180 days 180 – 320 days 320 – 600 days 600 – 800 days
Confronting the Edge
America used to lead the world in education, now
it depends on the world for larger and larger
percentages of key skill sets to keep operating:
 In 3 or 4 years, there's expected to be a 30 to 40% shortage of
technical and professional oil workers in the U.S.
 As much as 80% of the oil industry workforce will be eligible for
retirement in the next decade.
 In the next 5 years, just as the nuclear industry hopes to launch a
renaissance, up to 19,600 nuclear workers – 35% of the workforce –
will reach retirement age.
 The top 25 oil companies in the industry have shed more than one
million employees since 1982.
 According to the US Bureau of Labor Statistics, more than 25% of
the working population will reach retirement age by 2010, resulting in
a potential worker shortage of nearly 10 million.
Premise for Collapse:
Relationships among resources, capital, waste and

production form the basis for an ecological model of
collapse in which production fails to meet maintenance
requirements for existing capital.
Tainter – complex societies break down when

increasing complexity results in negative marginal
returns. Unsustainably high level of complexity.
Extended process of progressive disintegration rather

than a rapid shift from an unsustainable state to a
sustainable state.
Pandemic Unpreparedness 903 Million Tourists
Traveled in 2007
(Top 17 Countries)
Rank Country International tourist arrivals Monthly
1 France 81.9 million 6.825 million

2 Spain 59.2 million 4.93 million
3 United States 56.0 million 4.66 million
4 China 54.7 million 4.56 million
5 Italy 43.7 million 3.64 million
6 United Kingdom 30.7 million 2.56 million
9 Germany 24.4 million 2.03 million
10 Ukraine 23.1 million 1.925 million
11 Turkey 22.2 million 1.85 million
10 Mexico 21.4 million 1.78 million
11 Malaysia 21.0 million 1.75 million
12 Austria 20.3 million 1.69 million
13 Russia 20.2 million 1.68 million
14 Canada 18.2 million 1.52 million
15 Hong Kong 15.8 million 1.32 million
16 Poland 15.7 million 1.31 million
17 Greece 14.3 million 1.19 million
Pandemic Unpreparedness World's busiest
passenger airports
orld's busiest passenger airports Annual Monthly
Hartsfield-Jackson Atlanta International Airport 84,846,639 7,0

O'Hare International Airport (Chicago) 77,028,134 6,4
Heathrow Airport (London) 67,530,197 5,627,516
Haneda Airport (Tokyo) 65,810,672 5,484,227
Los Angeles International Airport 61,041,066 5,086,756
Dallas/Fort Worth International Airport 60,226,138 5,0
Paris-Charles de Gaulle Airport 56,849,567 4,737,464
Frankfurt Airport 52,810,683 4,400,890
Beijing Capital International Airport 48,654,770 4,054,564
. Denver International Airport 47,325,016 3,9
. McCarran International Airport (Las Vegas) 46,193,329 3,849,444
. Amsterdam Airport Schiphol 46,065,719 3,8
. Madrid Barajas Airport 45,501,168 3,791,764
. Hong Kong International Airport 43,857,908 3,654,826
. John F. Kennedy International Airport (New York City) 43,762,282 3,6
U.S. = 46%
Pandemic Unpreparedness World's busiest po
Busiest Ports By Volume
1. Singapore
2. Rotterdam, Netherlands
3. South Louisiana, U.S.A.
4. Shanghai, China
5. Hong Kong, China
6. Houston, U.S.A
7. Chiba, Japan
8. Nagoya, Japan
9. Ulsan, South Korea
10. Kwangyang, South Korea
Two areas for concern
Pandemic Unpreparedness World's busiest po
Busiest Ports By Containers
1. Hong Kong, China

2. Singapore
3. Pusan, South Korea
4. Kaohsiung, Taiwan
5. Rotterdam, Netherlands
6. Shanghai, China
7. Los Angeles, U.S.A.
8. Long Beach, U.S.A.
9. Hamburg, Germany
10. Antwerp, Belgium
Pandemic Unpreparedness Busiest U.S. Ports of Entry
U.S. PORT OF ENTRY (ALL MODES) OF NON-U.S. RESIDENT ARRIVALS

December 2008 Year-to-Date TOTAL % change
PORTS OVERSEAS 2008/2007 Rank
GRAND TOTAL 25,341,451 6%
NEW YORK, NY 4,255,262 12% 1

MIAMI, FL 3,097,120 9% 2
LOS ANGELES, CA 2,345,741 2% 3
NEWARK, NJ 1,834,483 15% 4
SAN FRANCISCO, CA 1,422,728 8% 5
CHICAGO, IL 1,347,963 4% 6
HONOLULU, HI 1,314,662 -10% 7
ATLANTA, GA 1,064,096 13% 8
AGANA, GU 976,620 -8% 9
WASHINGTON, DC 836,176 8% 10
ORLANDO, FL 708,337 20% 11
HOUSTON, TX 549,496 11% 12
BOSTON, MA 532,013 2% 13
DETROIT, MI 529,948 3% 14
PHILADELPHIA, PA 427,212 26% 15
*Overseas includes all countries except Canada and Mexico

Note: This is one column froma report containing 29 tables of international arrivals data.
Forty ports of entryare tracked each month by world region and select countries.
Release date: March 2009
Profitability of
Selected U.S.
Industries (Average ROIC,
Child
1992 –Day Care Services
2006) 17.6
Security Brokers, Dealers 40.9%
Household Furniture 17.0%
Soft Drinks 37.6% Drug Stores 16.5%
Packaged Software 37.6% Stores
Grocery 16.0
Pharmaceuticals 31.7%
Iron, Steel Foundries 15.6%
Perfume, Cosmetics, Toiletries 28.6% Crackers
Cookies, 15.4
Advertising Agencies 27.3% Wine, Brandy 13.9%
Distilled Spirits 26.4% Products
Bakery 13.8
Semiconductors 21.3% Turbines
Engines, 13.7
Medical Instruments 21.0% Laboratory Equipment 13.4
Men’s, Boys’ Clothing 19.5%
Oil, Gas machinery 12.6
Tires 19.5% Soft Drink Bottling 11.7
Household Appliances 19.2% Mills
Knitting 10.5%
Malt Beverages 19.0%
Hotels 10.4%
Catalog, Mail-Order Houses 5.9
Airlines 5.9
Return On Invested Capital (ROIC) = Measure of profitability
for strategy development. Earnings before interest and taxes
divided by average invested capital less excess cash
Copyright 2009, Geary W. Sikich, All rights reserved. Nonexclusive license granted for use at the 18 World Conference on Disaster Management (WCDM)
th
How Flexible is Your Organization’s Plan?
Plans are not failure proof – what will your

organization do if your plan does not work
exactly as it is conceived?
Pandemic Unpreparedness Antivirals
One course of Tamiflu and/or Relenza is approximately

$80. The dose of Tamiflu (for grownups) is one 75mg
capsule twice a day for five days.
The dosage for kids varies from 30mg twice daily to 75mg
twice daily depending on their weight. (Children that
weigh more than 88lbs take the adult dose of 75mg per
day).
Every Tamiflu prescription must contain 10 doses.

Sometimes people don't take all 10 pills - this is not good.
If you do this, the medicine may not work well. Your
illness could come back.
You must not skip any doses if you expect it to work.

Even if you feel better, you must take all 10 doses
regardless.
“no guarantee as yet that Tamiflu will prove effective against a pandemic strain
[of Bird Flu]...”
Scripps Reports Press Release; 11/2006
Pandemic Unpreparedness Antivirals – Planning
Pandemic of 500 days duration:

Tamiflu $80.00 per course (1 course 10 pills, 5 days of treatment)
100 courses per employee to cover each - $8,000 per employee.


Pandemic Unpreparedness Other Planning Considerati
Personal:
Masks
Gloves
Hand Sanitizers (individual) What’s the cost?
Kleenex Tissues
Antibacterial Wipes What’s the liability?
Antivirals Individual Issue
Personal Thermometer When do you make
the commitment?
Enterprise:
How long are you
Cleaning Supplies committed to
Decontamination maintaining the
Equipment/Supplies inventory?
Hand Sanitizers
(Restrooms, etc.)
Signage in Various
Languages
Antivirals Bulk Supplies
Pandemic Unpreparedness Antivirals/PPE – Plann
Antivirals/PPE are subject to:

• Confiscation by government – eminent domain
for social greater good
• Loss after distribution – misplaced, stolen and/or
used otherwise
• Black-market – price after declaration, bartered for
goods/services
• Undersupply – stockpiles insufficient for demand
• Family member needs – distributed to family
instead of taking
• Out of date (Inventory expiration) – disposal of old
inventory
• Theft – cargo, distribution, warehouse, etc.
Sector Analysis – (98 days)
The financial sector is faced with solvency issues as savings

and checking accounts are drawn down. Banks experience
a demand for money (physical currency) that exceeds their
ability to supply currency. Institutions such as the World
Bank, International Monetary Fund and Asian Development
Bank saw donor nations suspend their commitments of
funds. Many recipient nations petition for restructuring of
their loans. Consumer credit evaporates as merchants
demand cash as payment for goods and services. Central
banks in some countries cannot keep up with the demand
for currency. Interests rates, exchange rates, stock, bond
and commodity markets experienced wide swings as the
worldwide economy is disrupted.
The manufacturing sector feels the impact of the

pandemic, factories are forced to close due to workforce
issues, in some areas quarantine, lack of raw materials
availability and curtailment of imports and exports due to
border closures. Firms dependent on outsourcing and parts
made externally are forced to alter their operations (either
reducing operations or suspending operations) creating
spot shortages and displacing workers.
The service sector, comprised of volume driven firms, sees

demand for services dwindle. A significant portion of the
workforce is laid off as a result. Severe strains on the
financial health of the service sector begin to appear as
credit and debit card firms see defaults on payments due.
Fraud becomes an increasingly significant issue for this
sector.
The telecommunications sector continues to be under

intense pressure as worldwide, people attempt to
telecommute. In many countries governments exercise
authority and commandeer the bulk of telecommunication
services in attempts to maintain order and keep
government operations functioning. Telephone exchanges
in many parts of the world have degraded to sporadic
service as demand far exceeds capacity.
The utility sector is under intense

pressure. Brownouts in most areas of the
world are normal, in part due aging
infrastructure, lack of and/or disruption of
fuel supplies. Distribution issues and
demand shifts continue to create
reliability issues. Blackouts of extended
duration are beginning to affect many
countries. In many areas fuel supplies are
being rationed due to curtailment of
deliveries. System maintenance becomes
more difficult due to a lack of experienced
workers and rampant illegal tapping of
supply lines (electrical, gas, water, etc.).
In many instances government has had to
intercede to assist the utilities maintain
operation, through guarantees of payment
The insurance sector sees an upsurge in claims for

medical benefits during the initial 60 days of the
pandemic, causing a slowdown in payments due to
volume impact. As the system is overwhelmed, the
volume of claims drops dramatically as healthcare
providers are unable to process claims and health
insurance companies experience depletion of their
workforce due to illness and other factors.
The healthcare sector continues to be overwhelmed by

patient volume. Healthcare operations in some areas
cease to function due to surge, lack of supplies, panic and
inability to staff facilities. This continues to be a factor as
people who think they have exhibited the symptoms of
the influenza seek medical aid. Limited availability of
critical supplies due to trade disruption and border
closures continues. Hospitals are unable to contain other
illnesses, such as, adenovirus, MRSA (Methicillin resistant
Staphylococcus aureus) due to lack of staff and supplies.
The energy sector sees a decline in demand, but a spike in

prices for raw materials due to worker shortages; continues
to see chaotic swings in prices. International and national
travel is less than 30% of pre-pandemic levels. The shift
from occupied offices in cities to stay at home workers has
reduced the demand for transportation fuel. However, due
to the disruption in international trade there continues to
be erratic spikes in commodity prices.

The agriculture sector continues to experience “commodity
shock” as demand for agricultural products cannot be met
as transportation sector disruption continues. As a major
importer of foodstuffs the U.S. continues to suffer regional
spot outages as grocery stores are forced to close due to
lack of inventory. Government food warehouses are unable
to alleviate the shortages due to the impact of fuel
distribution problems affecting the transportation sector,
shortages of personnel and transportation system closures
due to quarantine and border closures. Spoilage becomes
Food-constrained nations
a factor in planning continue
for this sector. Political tensions
to have difficulty
continue to build getting
as food prices increase faster than the
agricultural products (WFP)
World Food Program due toand other Non-Governmental
transportation, borderbudgets.
Organizations’ (NGO) and port
closures. The U.S., the world’s
biggest agricultural supplier, is
hampered in its ability to ship
agricultural products due to a lack
The education sector continues to remain closed as students

and teachers furloughed when schools close due to health
concerns, quarantine and transportation system impacts are
not returning. Additionally, many schools converted to
provide healthcare services during the surge are still
occupied and in general decontamination is required for all
facilities.
E D
O Y
P L
E M
U N
The high-technology sector continues to see surges in

demand for access and support related to the Internet.
Hampered by workforce degradation, many call center
operations are being reconfigured resulting in significant
disruption of services.
Anticipating Surpr
Whether a natural or human induced

disaster, surprise is the key element
in an organization’s failure to
anticipate effectively.
What we missed because weGeary did not
W. Sikich - 2003
plan for it, will be extremely obvious

in retrospect:
Have you developed a plan, policy or
protocol for dealing with deaths
occurring in the workplace during the
pandemic?
Geary W. Sikich
Principal
Logical Management Systems, Corp.
www.logicalmanagement.com
g.sikich@att.net
or
gsikich@logicalmanagement.com

WCDM Pandemic 2009 Gws

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Pandemic Unpreparedness

Pandemic: The Second Wave

How unprepared are we

There are hundreds of strains of avian

Annual flu affects between 5% and 20% of the U.S. population

Approximately 200,000 people end up hospitalized

Approximately 36,000 deaths result

Current Swine Flu is attacking young adults (approximate ages 20 – 40)

Spanish Flu mortality – 2.5%

1957 Flu and 1968 Flu mortality – 0.5%

Current Swine Flu – not enough data to determine mortality

Assumption # 1: Influenza attack rate = 25%

Assumption # 2: Influenza mortality rate = 3%

ssumption # 3: Influenza survivors could suffer long term health effects

Assumption # 4: Government social services programs will be

While the cause [influenza] will remain the same, the

Seat of the Pants? Forward Thinking?

Old Planning Paradigms Adaptive Behavior

Ineffective Response Modes “Active Analysis”

Antivirals and Vaccine Supply:

Black Swans, Randomness, Preparedness

The biggest single threat to

 Weak cause-an-effect linkages

 Small and isolated changes can have huge effects

 Complexity making the strategic challenge more

 How the complexity of the event can facilitate the

Redefine Goals and

Observe Orient Decide Act

Redefine Goals and

A few important factors will drive your

A few important factors will drive your

Drives solutions that

How Flexible is Your

Have You Built a Sandcastle,

We know very little about how

How Flexible is Your

We need flexibility precisely because

All kinds of things are going to be moving

Will your workload increase in respect to the severity of a pandemic or will

Staff Degradation Factors

Relationships among resources, capital, waste and

Tainter – complex societies break down when

Extended process of progressive disintegration rather

1 France 81.9 million 6.825 million

orld's busiest passenger airports Annual Monthly

Hartsfield-Jackson Atlanta International Airport 84,846,639 7,0

Busiest Ports By Volume

Busiest Ports By Containers

1. Hong Kong, China

U.S. PORT OF ENTRY (ALL MODES) OF NON-U.S. RESIDENT ARRIVALS

NEW YORK, NY 4,255,262 12% 1

*Overseas includes all countries except Canada and Mexico

How Flexible is Your Organization’s Plan?

Plans are not failure proof – what will your

One course of Tamiflu and/or Relenza is approximately

Every Tamiflu prescription must contain 10 doses.

You must not skip any doses if you expect it to work.

Pandemic of 500 days duration:

Pandemic of 800 days duration:

Pandemic of 90 days duration:

Antivirals/PPE are subject to:

Sector Analysis – (98 days)

The financial sector is faced with solvency issues as savings