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 / Summer 2006 / Issue 43(originally published by Booz & Company)


Avian Flu: A Test of Collective Integrity

Although they may be the most obvious dangers, mortality and illness would not be the only impacts of a serious pandemic. There could be immense economic effects. Already, in countries such as Egypt, Nigeria, and Cameroon, the avian pandemic is forcing the killing of poultry, harming the livelihoods of farmers and diminishing a local source of protein. One study published in February 2006 by Australia’s Lowy Institute for International Policy predicts that a pandemic similar to the 1968 Hong Kong flu would result in worldwide economic losses of $330 billion, or 0.8 percent of global GDP. A more severe outbreak might lead to 142 million dead worldwide and GDP losses of $4.4 trillion. Some developing-country economies would shrink by 50 percent. Underlying the monetary losses are reduced productivity due to illness, onerous increases in health and safety costs, and shifts in investment flows away from the industries and countries where the disease has been most virulent.

Simulating Sociomedical Risk
The impact could be exacerbated by “sociomedical risk,” in which the cohesion and capability of social institutions and communities are affected. People might start to feel that any person they touch or any breath they take could lead to their death; such feelings would create a level of fear and mistrust that fundamentally undermines the kind of behavior that is needed for effective social interaction and commerce. It would also make it much harder for health-care professionals and institutions to respond to the disease. All of these effects are interconnected and would exacerbate one another in ways that would lead to unexpected and unpredictable results. Organizational planners cannot prepare for a pandemic the same way they would prepare for other crises — identifying the most likely scenarios and anticipating ways to deal with them — but only in a more flexible way: building the capacity for continuous sensing and responding, and striving for the resilience that will be needed when disruptions or disasters occur.

In recent months, Booz Allen Hamilton has partnered with global thought leaders in a number of strategic simulations designed to identify ways to improve cooperation among disparate institutions in the event of a pandemic outbreak. One of these occurred at the 2006 World Economic Forum, where Booz Allen convened 30 leaders and senior executives from private-, public-, and civil-sector (nongovernmental) organizations to explore the global, regional, and local implications of an influenza pandemic, and the roles and appropriate responses of their institutions.

The participants were grouped into four teams — government, health care, business, and international organizations — to represent the stakeholder groups that would deal with the impacts of an influenza pandemic on the European continent. This simulation was carefully designed to make leaders experience what a real pandemic would feel like, and to reflect on the actions they would need to take.

Imagine that you are participating in such a simulation. You are in Germany on Day 28 of an influenza pandemic that first appeared in Eastern Europe. Already, much of the European continent has seen an almost complete halt in everyday routines. Hospitals are inundated with the sick, the very sick, and the worried well. Although the government has not issued any formal recommendations, individual companies are asking their employees to stay home and telecommute. School systems have been shut for almost three weeks. Supply chains have been interrupted as truck drivers have fallen ill. Some drivers have refused to deliver their goods because they’re afraid of putting themselves at risk. Many small businesses across the region, particularly groceries and local markets, are closing because they can’t restock shelves. Hospitals are running out of basic medical supplies. Most of Germany’s 16 states are competing to get antiviral medicines from medical suppliers because current inventories are adequate for only a small percentage of the population. Medicines, even when available, are not working for everyone.

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