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(originally published by Booz & Company)


Business Performance during a Disease Outbreak

Compliance and Complaints
During the three weeks that the interventions were implemented, business performance at the experimental site improved slightly. Employees’ Occupancy Time increased from 52 percent in the pre-experimental period to nearly 57 percent during the period when the preventative measures were implemented. Occupancy Time then decreased to 53 percent during the three-week period after the simulated outbreak. Results were roughly similar at the non-experimental regional call centers, which had Occupancy Time measures of 56 percent (pre-experiment), 56.5 percent (during the experiment), and 53 percent (post-experiment). The modest performance increase during the intervention period could be explained by several factors. It is possible that call center performance was aided by the Hawthorne effect, which causes experimental subjects to display short-term improvement because they know they are being observed. It also is possible, however, that the company call centers were simply busier during that three-week period.

Employees also demonstrated strong compliance with the interventions, though they embraced social distancing much more readily than infection control; average compliance ranged from 86 percent to 96 percent for the former, but just 69 percent to 84 percent for the latter. Still, the average compliance for the combined activities was well above the 80 percent minimum: Observers recorded an average compliance of 92 percent, while employees self-reported an average compliance of 89 percent.

As might be expected, the interventions added to regular workday stress. Some employees reported that they felt isolated because they could not leave the office complex and had to spend more time in their cubicles, separated from co-workers. Asked to describe their experiences, they said that social distancing “wears on you and you go stir crazy…it is like being in a cave.” Some felt trapped and claustrophobic. Walking long distances to the designated bathrooms was inconvenient, as were the restrictions against using the vending areas and cafeteria. Smokers could not take their usual smoking breaks. Also inconvenient was the constant hand washing and cleaning of their workspaces and desks, which one person said made him feel as if he were developing an obsessive-compulsive disorder.

Unanticipated stress developed between employees and contractor staff. A chief tenet of social distancing is that people should stay home when sick. This prescription is much easier to follow if a person has paid sick leave. Full-time employees have such benefits, but contractors generally do not. Although this study did not involve a real pandemic, it heightened awareness of how illness spreads, especially by people who come to work when they are sick. Consequently, employees began noticing when people sneezed, coughed, or displayed other signs of illness, and contractors began to feel scrutinized as the experiment progressed. This problem — how to ensure that sick people stay home during a crisis — is one that organizations will have to address.

Some unanticipated benefits also resulted. After the employees became accustomed to the new hygiene practices, such as using disinfectants regularly and keeping their office space sanitized, the majority reported that they continued these practices in their homes and other places. In addition, employees at another IT call center within the corporation, recognizing the value of these measures in reducing everyday illnesses, requested that their center also be stocked with antimicrobial wipes and other hygiene-related supplies that were used in our study.

Overall, more than 70 percent of the participants said the social-distancing and hygiene measures did not negatively affect their day-to-day activities. In fact, a majority said that if given the opportunity, they would continue using wipes, hand sanitizers, and other hygiene measures at work. And more than 90 percent said they felt confident that they had the tools to enable social distancing if a real pandemic occurred in a wave lasting six to eight weeks.

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  1. Margaret Besheer, “U.N. Urges Governments to Prepare for Possible Influenza Pandemic,” Voice of America, October 21, 2008: A senior U.N. health official warns that the world remains at risk.
  2. Community Strategy for Pandemic Influenza Mitigation,”, February 2007: Guidance on the use of nonpharmaceutical interventions to mitigate an influenza pandemic, from the Centers for Disease Control and Prevention, in collaboration with other federal agencies and partners in the public health, education, business, health-care, and private sectors.
  3. Bob Graham et al., World at Risk: The Report of the Commission on the Prevention of WMD Proliferation and Terrorism (Vintage Books, 2008): A Congressional report detailing the dangers of bioterrorism.
  4. U.S. Department of Homeland Security, “National Preparedness Guidelines (PDF),” September 2007: An analysis of the full spectrum of prevention, protection, response, and recovery efforts to prepare for terrorist attacks or natural disasters.
  5. U.S. Department of Labor, Occupational Safety and Health Administration, “Guidance on Preparing Workplaces for an Influenza Pandemic,” OSHA 3327-02N, 2007: An overview of workplace preparedness.
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