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.  Read more... (5196 words, 2 images, estimated 20:47 mins reading time)

Wearing an N95 mask - or any other kind of mask – will not prevent you from getting influenza, and buying multiple masks for each employee in your office as a pandemic preparation measure is wasteful and unnecessary. It will be more effective to get them to wash their hands regularly, because a primary transmission route for influenza is contact with an infected surface.

In an office, masks are for the sick people, not for the well people. A mask will prevent someone in your office who is sneezing or coughing from spraying saliva, “snot” and “germs” on you and your colleagues by trapping mucus inside the mask.  How many sick people do you knowingly let into your office these days? None. You don’t need any masks for them. You keep them out of the office by screening at the building entrance.

How many sick people do you expect to get into your office in the next twelve months? I wrote in September 2006 that my best guess was that about 20% of a company’s headcount, including visitors and vendors, would catch the flu in any one year. Your company could buy masks for those people, I suppose, if you expect all of them to ignore sensible advice and come into the office sick.  Read more... (1559 words, 1 image, estimated 6:14 mins reading time)

A colleague of mine returned to Singapore on Wednesday, May 27 from Boston, USA, where he’d spent the week between May 17 and May 24. He came back with a cold, a bad one.

He was sure it was a cold, not the flu: his temperature had not gone over 36 degrees C (98 F), he had no fever, no headache, no chills. He had cleared the thermal screening at Singapore’s Changi Airport. But he had a meeting with a client scheduled on Friday, May 29, so he informed the client on Thursday, May 28 of his condition. The client asked him to (quoting the client’s e-mail) “get clearance from a doctor that it is just a common cold, and not something serious” before coming to their office. He called his doctor on Friday morning, 29 May.

This is his first-hand, contemporaneous account of his experience as a suspected carrier of H1N1.

9.40 Call my doctor. All patients who have been to Mexico, USA or Canada and who have any of the flu symptoms, have to go to Tan Tock Seng Hospital (TTSH) by ambulance. [TTSH is Ground Zero for infectious disease in Singapore. It was the focal point for response to SARS, H5N1 "bird flu" and now H1N1 "swine flu". Five TTSH health care workers died of SARS in 2003 as a result of caring for patients.  Read more... (1489 words, 0 images, estimated 5:57 mins reading time)

I can find no clinical evidence that Roche‘s Tamiflu is more effective than GlaxoSmithKline‘s less-prescribed Relenza against Type A influenza like H1N1 and H5N1.

Japanese health inspector in goggles, mask, gloves and gown interviews passengers on a flight arriving in Tokyo from the U.S. on May 2, 2009

I have found abundant evidence, however, that Switzerland-based Roche has run marketing circles around U.K.-based GlaxoSmithKline (GSK) by emphasizing the convenience of swallowing a Tamiflu capsule over the hassle of inhaling Relenza powder.

That’s the only reason I can imagine why a dose of Tamiflu is two to three times as expensive as a dose of Relenza. A dose of 75mg Tamiflu costs US$5 to US$10 at Internet pharmacies, but a dose of 5mg Relenza costs only US$2.50 to US$3.50. Both require prescriptions.

If the target population covered by your business continuity plan includes a large number of children, you will prefer a Tamiflu caplet that is easier for children to swallow. But, for adults, inhaling Relenza is just as effective, much less expensive, and more readily available than Tamiflu at doctors’ offices and pharmacies in Asia.

If this isn’t a business school case study in the importance of packaging, it surely will be.  Read more... (2504 words, 1 image, estimated 10:01 mins reading time)

An epidemic of avian influenza in West Bengal, India has the Indian “government in panic mode”, according to the Times of India web site. And with good reason: 15 million of West Bengal’s 80 million people are crammed into its capital city, Kolkata (Calcutta), a petri dish of poverty, pollution, political intransigence and hopeless public health. It is the city where Mother Teresa founded the Missionaries of Charity order.

If the infection reaches Kolkata’s poultry markets, there is a much greater risk of animal-to-human transmission than there has been in Indonesia or Vietnam, where infections of H5N1 influenza have already crossed species from animals to humans.

There have been many more human infections of highly-pathogenic influenza in Indonesia (120 cases, 98 deaths) and Vietnam (102 cases, 48 deaths) than in India. There were three outbreaks of avian influenza in India in 2006, but there have been no human deaths there, yet.

But Kolkata is a whole other miasma of misery. The population density of Kolkata is 24,000 people per square kilometer (62,000 per square mile), the second highest in the world. The population density of Ho Chi Minh City, Vietnam’s largest city, is only 3,000 per square kilometer (8,000 per square mile), a fraction of Kolkata’s. Even the density of Jakarta, Indonesia, at 12,500 people per square kilometer (33,000 per square mile), is just half that of Kolkata.  Read more... (441 words, 0 images, estimated 1:46 mins reading time)

Thousands of innocent bankers could perish in Singapore’s next financial sector disaster exercise in 3Q 2008, when the Standing Committee on Business Continuity Management of the Association of Banks in Singapore (ABS) plans to simulate the late stages of an infectious disease epidemic on the island.

No event in Singapore can be taken seriously until it has an acronym, so an exercise for the Lion City’s entire financial sector is called an “industry-wide exercise,” or “IWE.”

The ABS committee favors a multi-day IWE spread over two (2) weeks. The U.K. ran a financial sector pandemic scenario, “Exercise Winter Willow,” over three weeks from January 30 to February 20, 2007, and a similar exercise in the U.S.A in September and October also lasted three weeks. Members of the ABS committee, who represent big local and global financial institutions, participated in one or both of those exercises and have concluded that three weeks is too long. Senior management loses interest.  Read more... (448 words, 0 images, estimated 1:48 mins reading time)

Malaysia Medical Association‘s Society of Occupational and Environmental Medicine released guidelines for companies to prepare for an influenza outbreak. Malaysia Ministry of Health has ordered only 60,000 courses of anti-virals. Message: heal thyself; you cannot rely only on the government. Blog by docs: Malaysia Medical Resources