When does your own health stop being a personal, private matter, and become a legitimate consideration in a company’s business continuity planning? In Asia, where many emerging (and re-emerging) diseases originate, that’s a relevant question.

3,700 people died of H1N1 influenza in North America in 2009. In response, many organizations offered masks, liquid disinfectant and nitrile gloves to their employees to inhibit the spread of influenza. In the same year, 3 times as many people – about 14,000 Americans – died of AIDS resulting from the human immunodeficiency virus (HIV).

Since companies distribute masks and gloves, shouldn’t they also distribute condoms? Why are rubber gloves acceptable, but ‘rubbers’ are not?

Disease Risk
In the years ahead, diseases you never heard of, affecting people in places you never heard of, will have in impact on your life, your company and your career as a resilience professional.  Infectious diseases can now have immediate global consequences as they spread around the world quickly through international air travel. The first case of H1N1 in the United States was on April 22, 2009. The first case in New Zealand, about as far away on the planet as you can get, occurred 6 days later on April 28. The first case in Asia was in Hong Kong on 1 May. So, it took just nine days to spread to the other side of the world.

In addition to spreading quickly, viruses mutate, too – most not as quickly as influenza. “Pathogens constantly change their genetic make-up,” wrote public health consultant Peter N. Fonkwo in “Pricing Infectious Disease“, a 2008 report from the European Molecular Biology Organization.  Even common bacteria like Eschirichia coli – e. coli –  mutate, too, and more quickly than epidemiologists had believed. Malaria and tuberculosis are re-emerging now because they have mutated to become resistant to the drugs with which doctors have fought them.

What does mutation mean for contingency planners? It means that disease is a moving target, that even bacteria and viruses we thought we could control come back in new forms.

You will agree that headache, high fever, back pain, joint pain, stomach pain, and vomiting are symptoms of something, but what? Except for the vomiting, those are the symptoms of influenza, which is rarely fatal. But they are also symptoms of Crimean-Congo Haemorhhaegic Fever, an emerging infectious disease that has a thirty (30%) percent mortality rate within two weeks. Not knowing that could, in theory, be fatal to an unfortunate employee who worked or traveled to a place where it occurs. Most business continuity and emergency managers don’t know much about disease, epidemiology or viruses – with the possible exception now of influenza.

Climate change exacerbates the spread of infectious diseases, enabling viruses and bacteria to survive in parts of the world that had not previously been warm enough to incubate and sustain them. Half the 126 member states of the World Organization for Animal Health report that at least one new disease has reached or returned to their territories, and that the cause was associated with climate change. Mosquito-borne West Nile virus in the United States is an example.

The more people in a given area, the more opportunity for viruses to spread and to change. The global population was three billion people in 1960. It’s 6.8 billion in 2010, a 125% increase in 50 years. It’s predicted to be 8.9 billion in 2050, forty years from now. The size of the planet is finite, so it’s getting more crowded, particularly in Asia’s biggest cities.  Higher population densities also contribute to higher rates of mutation, morbidity and mortality.

People aren’t just bumping up against each other, but against critters, too. In North America, the closest most people get to an animal is petting the family dog or cat, but in many parts of of Asia, people live in very close proximity to rodents (SARS), chickens and ducks (bird flu) and pigs (swine flu). Nearly all the diseases that make headlines are zoonoses: they incubate in animals and are transmitted to humans.

Here’s a short history of zoonotic diseases in Asia in the last decade: Severe Acute Respiratory Syndrome (SARS) incubated in China and has now been found in 37 countries. Between November 2002 and July 2003, there were 8,096 known cases of SARS and 774 deaths worldwide. The overall mortality rate was 9.6%, but mortality was 15% in working age adults 45-64 years old, and over 50% in people over 65 years old. That made SARS a business continuity issue.

Two years later in 2005, H5N1 ‘bird flu’ exhibited very limited human-to-human transmissibility, but frighteningly high mortality. To date, there have been 486 human cases of H5N1 and 287 deaths, a case-fatality rate of 59%. That is, if you catch ‘bird flu’, you have a 59% chance of dying from it. There have been five deaths in 2010 already, in Indonesia, Vietnam and Egypt.

The 2009 H1N1 ‘swine flu’ influenza was readily transmissible but had a lower mortality rate than originally feared. The case-fatality rate was less than 1%. There were 14,300 deaths worldwide, 2,700 of them in Asia. There were 14,300 deaths worldwide, 2,700 of them in Asia.

Let’s see: zoonotic pandemics in 2003, 2005 and 2009. How many epidemics does it take to create a trend? And as a planner I wonder, what will happen when an infectious disease comes along that is both easily-transmitted and deadly?

Emerging infectious diseases
In a bird flu exercise in 2006, we submitted the following employee symptoms to the exercise participants:

“J– tells the doctor he aches all over, has pain in his elbows and knees, and that he developed a painful headache over night. He has a high fever. He feels pain behind his eyes. He has vomited a couple of times, hasn’t eaten since yesterday and is not hungry. This morning, he started itching in several places, and when he removed his shirt, the doctor saw two red, angry rashes on his chest.”

What disease did J– have?

If you’d guessed any kind of influenza, your diagnosis would have been wrong, and that was the point. We were doing some misdirection, on purpose. J– turned out to have dengue fever, a mosquito-borne infection that, like malaria, has proven impossible to wipe out in Asia.

Have you ever seen someone who has dengue fever? The severity of the joint pain it causes has earned it the colloquial name “breakbone fever.” An employee at my company had it in 1998. At first she was afraid she was going to die, then she was afraid she was not going to die.  It can last up to 10 days, and complete recovery can take as long as a month. Our employee was out of work for three weeks. Adults are usually sicker than young children. That’s a business impact to a company’s workforce.

Dengue is transmitted to humans by the Aedes aegypti mosquito, which feeds only during daylight (business) hours.  Dengue is just as prevalent in cities as in the countryside and is now endemic in 100 countries.  The WHO thinks 2.5 billion people - 40% of the world’s population – are now at risk from dengue, and that there may be 50 million cases of dengue infection worldwide every year. Epidemics of different types of dengue occur because no immunity is incurred by having had one type. A severe form, dengue hemhorraegic fever, is almost always fatal.

Is dengue contagious? If you learned that five people at your assembly plant in Singapore or Malaysia had dengue, what would be an appropriate business response?  That’s a genuine business continuity concern even in spick-and-span Singapore, which had an average of 108 dengue cases every week in June in a population of 4.8 million people. Should an emergency manager or business continuity manager know if it’s infectious or fatal? If not, then who should know? (Unlike influenza, dengue is not contagious.)

New infections of tuberculosis still occur globally at the rate of one per second . One-third of the world’s population carries the TB virus. In 2008, there were an estimated 9.4 million new cases worldwide, resulting in 1.8 million deaths, a 19% mortality rate. Three million of those cases were in Southeast Asia, where 1.3 million people died of it.

If tuberculosis is treated, the mortality rate can be less than 5%.  But TB has mutated to become resistant to some of the four standard drugs - isoniazid, rifampicin, pyrazinamide and ehambutol – used to treat it. The WHO estimates 440,000 people worldwide were diagnosed with Multi-Drug Resistant TB in 2008 and that 150,000 of them died, a 34% mortality rate, but WHO also thinks only 7% of all MDR-TB patients were diagnosed, so the numbers could be 14 times higher.  About half of MDR-TB cases worldwide occur in China and India. MDR-TB costs 25 times as much to treat as non-resistant TB, and has a cure rate of just 60 percent. Ultimately, 25% of MDR-TB victims die.

TB has even mutated to be resistant to all four drugs, and that’s called eXtremely Drug-Resistant TB. There are no official estimates of XDR-TB frequency, but WHO guesses there may be as many as 25,000 cases a year; most are fatal.  Since XDR-TB was first defined in 2006, 58 countries have reported at least one case of it. That’s a moving target: a disease we have been treating for 50 years is re-emerging in a new form.

And not only in Asia. Do you (in North America) remember growing up with Christmas Seals, the annual fundraising drive for tuberculosis in the 1950′s and 60′s? Or do you remember the May 2007 case of American Andrew Speaker? Mr. Speaker is the Atlanta (USA) personal-injury lawyer who flew from Paris to Prague to Montreal then drove across the border into the U.S. so that he could assure himself of adequate treatment for his Multi-Drug Resistant-TB. Then he sued the U.S. Centers for Disease Control (CDC) for revealing his medical condition to the public. (His law suit was thrown out of court, thank goodness.)

There are 300 million cases of malaria each year in the world, and 1 million deaths – about 40,000 of them in Southeast Asia. Malaria is endemic in 10 of the 11 countries in Southeast Asia; there are four cases a day in the United States. It can be treated simply and it is easily prevented with mosquito netting and insecticide.  The United Nations believes that malaria is generally considered a symptom of poverty, but Douglas Gollin and Christian Zimmerman of the German Institute for the Study of Labor concluded in a 2007 paper that malaria is also a cause of poverty (page 2) and, therefore, a major drag on economic development. There is no vaccine yet, but that is specifically the goal of Bill & Melinda Gates Foundation grants.

What would the business consequences be of a disease that were physically disfiguring? A disease that left the faces of its victims scarred, so that they would stand out in the workplace? Like leishmaniasis, the second-largest parasitic killer in the world after malaria, responsible for an estimated 500,000 cases each year worldwide. Leishmaniasis threatens 300 million people in 88 countries. It is spread by sand flies. It is usually not fatal but it is terribly disfiguring, causing misery to women who are unable to marry and men who are unable to find work. Ninety percent of the world’s cases of are in India, Bangladesh, Nepal, Sudan, and Brazil. It commonly occurs in Kabul, Afghanistan;150 foreign soldiers were infected with leishmaniasis in Afghanistan in 2005. The traditional treatment is to inject antimony around the skin lesions, but resistance to antimony is now common in India, with rates of resistance as high as 60%.

Is disfigurement of employees by disease a business continuity issue? It is if those employees work in or go to a place where such a disease occurs.

In 2003, researchers at Indiana University in the United States discovered that adaptive mutation is common in the bacteria Eschirichia coli (O157:H7). A common cause of ‘food poisoning’, e. coli can be transmitted from person-to-person (if you have to ask how, you don’t want to know). Last year, for example, Nestlé toll house cookie dough contaminated with e. coli sickened 66 people in 28 states.  There are 73,000 cases and 40 deaths a year in the U.S. A particularly nasty, new version, Shiga toxin-producing escherichia coli (STEC) is an emerging pathogen that causes bloody diarrhea and something called hemolytic uraemic syndrome (HUS).

Plague wiped out 6 million people in the Black Death of the 14th century (25% of humanity at the time), and it’s still around in Asia. It is spread to humans by fleas carrying Yersinia pestis bacteria from rats. It survives in high temperatures above 30 degrees Centigrade (much of equatorial Asia). It can be treated with the common antibiotic, tetracycline, discovered in 1945.  Untreated, the mortality rate is 50%, about like SARS.

There are two kinds of plague: bubonic plague transmitted by blood, and the more-contagious and less-curable pneumonic plague transmitted by respiratory droplets.  Most human cases of plague are reported from developing countries in Asia and Africa. Between 1990 and 1995, 13,000 cases of plague were reported to the World Health Organization, with 1,009 deaths (8% mortality). Vietnam, India, Myanmar, and China each reported more than 100 cases. There are about 10 cases a year in the United States, mostly in the southwest where prairie dogs and ground squirrels carry the fleas.

“Yersinia pestis has evolved rapidly from being a pathogen widely found in the environment, able to infect mammalian intestines, to a blood-borne pathogen of mammals that can parasitize insects and has a limited capacity for survival outside a host,” according to its entry on MicrobeWiki. That is, it has mutated. CDC considers plague a Category A Agent, a likely choice as a bioterrorism weapon, because it has high transmissibility and results in high mortality .

What if I reminded you that five people die every two hours in the United States of one specific virus? That in the 20 minutes you’ll spend reading this, someone in the U.S. will die of that virus? Would you call that an epidemic?

That’s the U.S. death rate from AIDS, caused by the human immunodeficiency virus (HIV). AIDS is the second leading cause of death among working-age American males 25 to 44 years old. Most of us don’t call AIDS an “epidemic” any more, and I don’t know anyone who thinks it’s a business continuity issue. We think of AIDS as background noise.

In Asia, AIDS is the leading cause of death and lost work days among working-age 15 to 44 year olds. Five million people in Asia are infected with HIV, and 440,000 Asians die of AIDS each year. 33 million people around the world were infected with HIV at the end of 2008. The independent Commission on AIDS in Asia estimated in March 2008 that there will be 8 million more HIV-infected individuals by 2020.

And that’s not a business continuity concern? Or a risk management issue? A crisis? A disaster?

Business impact of disease
A 1994 epidemic of pneumonic plague in Surat, India killed 57 people. It lasted about two months. Here are some consequences and impact from that epidemic, described in this essay by Godshen Robert Pallipparambil of Montana State University (U.S.A.) Entomology Group (entomology is the study of insects, in this case fleas):

• Health officials in Surat declared a plague epidemic before it was known if the plague was pneumonic or bubonic, so some agencies began responding to the wrong disease.
• Rumor of a pending quarantine of Surat caused 300,000 inhabitants to flee the city in four days in a mass, uncontrolled evacuation, “taking the hysteria with them”, according to The Hindu Universe newspaper. Government and paramilitary intervention was required to stop the exodus.
• The Chief Minister of a neighboring state announced that the plague in Surat was pneumonic and not bubonic, perhaps not realizing that pneumonic plague is far more infectious and less curable than bubonic plague. As evidence that the plague was pneumonic, he noted that “rat fall” (deaths of rats) in Surat was not very high. Mortality of rodents is not an indicator of plague of either type.
• As a result of his comments, however, Surat residents started a concerted effort to kill rats. Killing rats simply caused their fleas to seek new hosts and had no effect on the spread of pneumonic plague, which is spread by human respiration.
• Lack of information on how to combat plague led to panic purchases of surgical masks. Many Surat residents used handkerchiefs to cover their noses and mouths, a useless precaution against bacteria three micrometers in diameter. N95 mask (95% effectives for particles of .1 to .3 micrometers) will trap respiratory droplets if worn properly, but it is clear, after the experiences in Asia in the H5N1 and H1N1 epidemics, that most people don’t or won’t wear them properly.
• All schools, colleges, cinemas and public gardens in Surat were closed on Sept 23. Banks, offices, industrial sites and diamond cutters were asked to shut down. Schools re-opened 5 days later because the government was unsure whether school closures would be effective.
• Tetracycline, the antibiotic effective against plague, disappeared from pharmacies in Mumbai and Delhi, many miles from Surat. Doctors and pharmacists in Surat took antibiotics with them for families and friends when they fled.
• Russia, Italy, the U.S. and the UAE imposed plague-related travel restrictions on Indian travelers coming to their countries. More than 45,000 people cancelled trips to India. India offered foreign journalists and tour operators free travel and hospitality to assess the situation in Surat, but few responded.
• The United Arab Emirates (UAE) suspended all cargo transshipment through India. The price of Indian Global Depository Receipts crashed after BBC and CNN reports.
• There were at the same time, by chance, three cases of bubonic plague in a hospital in Mumbai, India’s major financial center, “so panic gripped that city as well”.
• The local media greatly exaggerated the numbers of deaths from plague, adding to the hysteria. From late August to mid October 1994, India reported 693 suspected plague cases to the WHO. 6,000 reported plague cases were actually other diseases.  There were just 56 deaths in Surat from pneumonic plague over the two-month period.
• The outbreak occurred just before Deepavali (Hindu ‘Christmas’). Despite beginning and ending in less than two months, and despite a very small number of deaths, the plague outbreak cost the Indian economy over U.S. $600 million, and $260 million in Surat alone.

Other examples of the business impact of infectious disease: in a 2001 outbreak of Hand Foot & Mouth Disease (HFMD) in the UK, camping and outdoor products companies saw their profits fall thirty percent because people didn’t buy gear to go tramping around in the English countryside.

In that same HFMD epidemic, 270,000 cows were killed in the Netherlands, 200,000 of them after dairy farmers had already spent the money to vaccinate them. A study afterward found that almost half the farmers whose cows were culled exhibited symptoms of post-traumatic stress disorder (PTSD). The disease infected only animals, but the effects were felt by human beings.

Cash crops in Africa such as coffee are under-harvested because of AIDS, and the diamond- and coal mining industries are short of workers because of it.  25% of miners and 20% of construction workers may be HIV-positive. “Infection rates of even 25% could have serious effects on productivity, labor costs and skills base in the mining sector,” wrote Reuters journalist Steven Swindells in the Johannesburg Mail & Guardian. Fifteen million Africans have died of AIDS. The population of Africa may actually shrink by 2015 because of AIDS, reducing demand for products and services and  increasing the cost of health benefits and company payment to families of employees who die. As most medical costs are paid by company insurance plans, that’s a business impact.

In the “Pricing Infectious Disease” essay cited above, health consultant Peter N. Fonkwo wrote, “demographic changes caused by disease will affect economic growth and output.”  That is a clear, simple statement of the connection between disease and business continuity.

If you have a call center in the Philippines, infectious disease is a risk to its employees, and therefore to your company, even if they are not employed directly by your company. If your company’s products depend on electronic components made in China, or on information technology developed or managed in India, infectious disease is a risk to  employees in those countries, and therefore to your company.  If your executives or sales people travel to Asia, or your company plans to expand in Asia in the next 10 years, infectious disease is a risk your company must accept, explicitly or implicitly.

Even if your only connection to Asia is to shop at Walmart, infectious disease could have an impact on you.   80% of Walmart’s suppliers are in China and 70% of its merchandise comes from China. Walmart imports more Chinese goods than the entire countries of India or Russia do. It’s only a minor exaggeration to say, if employees at a factory in Guangdong (China) start coughing, shoppers in Nebraska catch a cold.

If you lived through the SARS and H5N1 epidemics in Asia, you understand this in a way that non-survivors do not. North America hasn’t really felt the business impact of infectious disease yet, because it hasn’t suffered a high-mortality epidemic since 1918. I’ve never seen a thermal scanner in a U.S. airport, but they are ubiquitous in Asian airports. I’ve never had my temperature taken in a public place in U.S., but I’ve had it taken dozens of times in public places in Asia.  I never see anyone wearing a mask in the U.S., but I see people in Asia wearing masks all the time. I don’t see restaurants and buildings in North America dispensing hand disinfectant to customers and visitors, but it’s quite common in Singapore, the world’s best-prepared country, in my opinion. Living through a high-mortality epidemic focuses the mind on disease in a way that no awareness campaign ever will.

If you live in Europe or North America, you may decide that your risk of contracting a bizarre infectious disease is miniscule. Fair enough.  But here are the CDC’s list of the 10 leading causes of death in the United States at the end of 2006, and the top contributing factors to those deaths, usually described as ‘preventable causes of death’ because they can be aggravated or ameliorated by choices people make.

In 2009, the Harvard School of Public Health reported that smoking is responsible for 467,000 premature deaths each year in the U.S., high blood pressure for 395,000 deaths, and obesity for 216,000 deaths. That’s 1.1 million people. And AIDS killed another 15,000 people in North America in 2008, the most recent year for which WHO has published statistics. Disease is, in fact, all around us, but we segregate personal health from public health, and personal health from business continuity.

We spend business resources and time planning to combat influenza that killed 13,000 people worldwide last year, but we do not think of AIDS, hypertension, diabetes or obesity, which contributed to the deaths of almost 100 times as many people, as business continuity issues.

If our goal is organizational resilience, I don’t think we can continue making that distinction.

• Would you agree that an outbreak of disease at your company would be a business continuity issue?
• Would also agree that as a business continuity planner, you would feel justified informing employees about that disease, because of the potential impact on your company’s business?
• Would you then consider it your job, if not your duty, to tell them how to protect themselves?
• Would you think it appropriate for your company to distribute disinfectant, masks or nitrile gloves to them ?
• Then I wonder why are gloves a business continuity supply, but condoms are not?

Conclusions
Epidemiologists are certain that another epidemic is coming; they’re just not sure when, or of what disease. So, in preparation for the next epidemic, what have you learned from the last three?

I learned that there is no such thing as prevention. Some employees are going to get sick despite all precautions. Public health officials and resilience planners assume that’s true, and therefore focus on awareness and preparation, but those strategies have proven very hard to sustain over the long gestation periods of epidemic diseases. You know there’s a problem when you read the headline on a business continuity web site,  ‘Is pandemic planning a laughingstock?‘.

I learned that Asia incubates lots of emerging and re-emerging diseases (many of which I’d never heard of), and that there’s no way to guess which one will become the next epidemiological threat.  (I also learned from H1N1 last year that epidemics originate in the developed world, too, not just the impoverished Third World.) So now I pay attention now to HealthMap Global Disease Alert Map and the website of the International Society for Infectious Diseases and I subscribe to the email notices of the Program for Monitoring Emerging Diseases (ProMED).

I learned from SARS and ‘bird flu’ that panicked, irrational behavior is a common human response to fear of an infectious disease.  The reactions to Surat’s 1994 plague epidemic – panic, mass exodus, selfish behavior, official vacillation, misunderstanding, opportunism – are the reactions we can expect to a highly-transmissible, highly-pathogenic disease.

Public health administrators and public safety officers may have experience managing the consequences of an epidemic, but business continuity managers do not: training in First Aid, traumatic stress counseling, compassionate death notification or group & individual crisis intervention. I almost never meet a business continuity manager with a good ‘bedside manner’. That would be OK if I ever found a human resource professional with one, but I rarely do.

In Sickness & In Health
But it gives me a headache that some diseases are considered business concerns, but others are not. It’s acceptable to plan for the consequences of certain diseases, but not others. Companies can spend sickening amounts of time, money and effort on influenza, while hypertension, hypercholestemia, diabetes and AIDS sickened or killed far more employees than influenza.

I think I know why: it’s acceptable for a company to talk its employees at the workplace about disease (and safety) threats that might keep them from performing their jobs, but not acceptable to talk to the same employees about health outside the workplace, even if their health might keep them from performing their jobs. Or cause them to quit the workforce. Or kill them.

You can suspend or terminate an employee who drinks alcohol at work, but you can’t discipline an employee who smokes (particularly in a designated area) at work. Is that only because the impairment from alcohol is more obvious and immediate than the impairment from smoking? They are both legal and voluntary, and debilitating and dangerous.

It just inconceivable these days that an employer would try to influence an employee’s health habits outside the workplace, even if those habits affect the employee’s ability to work, and therefore the company’s performance or its resilience.

But it’s not logical.  You don’t get sick because you came through the factory door, and you don’t get healthy because you went back out.

If organizational resilience is the goal, and if costs-vs.-benefits are the evaluation criteria, then we have focused on the wrong strategies. We can prevent more harm by focusing on preventable health conditions, and less on (unpreventable) infectious diseases. We should focus on promoting health and well-being, not preparing for the consequences of ignoring it. We should spend as much effort on physical, psychological, even spiritual health as we do on disability, morbidity and mortality.

More humming “ommmm”, less screaming “Oh my God!”.

As a man in his late fifties, an employer and as a resilience professional, I’m prepared to argue that an obese employee is a risk to his organization’s ability to perform its functions. He is just as much a risk to its business continuity, to its resilience, as an employee who abuses drugs, drinks to excess or smokes cigarettes. An employee’s poor eating habits will – not ‘may’- eventually cost his employer money in lost work time, increased healthcare costs, or both. It is only a question of when that risk will materialize, and how big the bill will be.

Militaries everywhere can tell a soldier he is physically unfit for service, and can compel him to get fit, because one unfit soldier risks the performance of his whole unit. If it’s true for soldiers, cops and fire fighters, it’s true for emergency- and business continuity managers. Is it not also true for any employee, in any organization, anywhere?

What’s “personal” about the health of employees?

But how can a company’s human resources department involve itself in an employee’s health? What part of an employee’s health record should remain confidential from her employer? Employers and businesses pay for most health care in the United States and in many other countries. Doesn’t that make the health of employees a legitimate business concern and, therefore, a business continuity and emergency management concern? Those are very difficult questions, of course. We have not yet initiated conversations about an appropriate dichotomy between personal health and corporate responsibility.

It’s not yet acceptable to tell an employee – privately, sensitively, non-threateningly – that she’s too fat, smokes too much, eats too much salt or fat, drinks too much sugar or alcohol, or exercises too little. For me, the question is not whether to talk to her, but how.

In Singapore, one courageous hospital administrator did exactly that last June. Mr. Liak Teng Lit, CEO of Alexandra Health, controversially stated, “If I do not lead a healthy lifestyle, I’m not a good health-care worker.” On that basis he announced that an employee’s weight would be one of the hospital’s evaluation criteria for career advancement.

Making that link between personal health and business performance (and therefore business resilience) is, in my opinion, as inevitable in countries where infectious disease is endemic as it is in countries where preventable disease is epidemic.

I can hear the outraged indignation already.  So let me just fall directly on my sword: an employer should – and should be able to – suggest to employees behavioral changes that can demonstrably improve organizational resilience. Not demand, suggest. No employee should fear being fired and no employer should fear being sued for having the conversation. Will it be uncomfortable? Certainly. Embarrassing? Maybe. Resentful or vindictive? I very much hope not.

You don’t agree? So, then, your disease resilience strategy is ‘wash your hands’? That’s it?

It may not yet be socially acceptable, but asking employees to eat less, drink more water and to take the stairs instead of the elevator will be legitimate business continuity strategies in the not-too-distant future.

This essay is adapted from presentations at the Continuity Insights conference (USA) in April, 2010 and at the World Conference on Disaster Management (WCDM Toronto, Canada) in June, 2010. I will present it again at WCDM Sydney, Australia.

By Nathaniel Forbes, Forbes Calamity Prevention Pte Ltd, Singapore. Posted: 1 August 2010 at 10:14 am (UTC +8 hours)