With experts believing a flu pandemic is increasingly likely, big organisations need to get serious about contingency plans. Karlin Lillington reports

Putting a figure on the cost of a pandemic might seem a less pressing question than how the general population would cope, but consider that the Lowy Institute of International Policy has estimated that a pandemic could cost between eight and 12 per cent of global economic output - up to $4.4 trillion.

On a more local scale, consider the implications if even 10 per cent of any company's workforce was out sick. Now imagine 25 per cent, 50 per cent or more - more likely numbers during a serious epidemic, as along with the sick, there will those too afraid to come into a public workplace and expose themselves to large crowds.

According to a health and business panel that addressed businesses at a seminar at IBM recently, companies need to step in and make plans for a flu pandemic that researchers and health experts feel is increasingly likely to happen, given historical patterns for pandemics, and the worrying behaviour of the deadly Asian bird flu virus that many experts feel may be the one that eventually jumps species.

Obviously, business continuity experts have a vested interest in arguing for - what else? - business continuity planning. But in the wake of more localised catastrophic events such as Hurricane Katrina in New Orleans and the September 11th, 2001 terror attacks, and considering their effects on business both locally and globally, many companies are well aware that they need at least basic contingency plans for a global pandemic.

"There are two big unknowns - we don't know when this will happen or how bad it will be, but we can say all the ingredients are there [ with the Asian virus]," says Robin Gaddum, IBM business continuity and recovery services managing consultant.

He says that, right now, the World Health Organisation and governments are planning on "the most probable worst case scenario, which means the next epidemic would be similar to the 1918 epidemic" in which 40 million people died.

On the assumption that avian flu could pose such a threat, countries can take a three-pronged approach to managing the impact - by addressing the avian health issue, the human health issue and business continuity issue, says Michael Conway of the Irish Emergency Planning Society.

In Ireland, he says the Department of Agriculture has done a lot of work on how it would handle an epidemic in the bird population, and the Department of Health has "significantly advanced plans" on how they would handle a human epidemic, though these still need to be better spread among the healthcare sector and the general population.

"The next step is to liaise with businesses, so they have fallback policies," he says. Where do Irish businesses currently stand? "They could be better placed. Most large businesses are probably at the information-gathering and assessment phase. There's a lot of work still to be done."

He notes that normal business continuity plans assume that there will be a significant number of employees around to carry them out.

But with a flu pandemic, "a significant number of people may well be ill and others won't come in. There will also be a loss of customers and suppliers may not be functional. Companies need to plan for a restricted level of business with a restricted number of employees available and possibly a significantly smaller number of customers."

According to Gaddum, businesses need to define their own level of risk in a possible pandemic. The next step is to look at critical business processes and determine how quickly they would need to be back in order for the business to function.

"Businesses also need to look at their significant resources - buildings, information technology, people, etc - and consider what and who is most needed."

For example, if full buildings aren't going to be used, then businesses need to figure out how they will secure their premises. If all employees are not at work, what minimum numbers, in what areas, need to be there for the business to function?

And if certain employees are badly needed, companies may need to consider stockpiling antivirals known to work efficiently against flu, such as Tamiflu, argues Dr Jack Lambert, infectious diseases consultant, Rotunda and Mater Hospitals. He believes the signs are very strong that the avian flu is moving towards becoming the next human pandemic virus and that action needs to be taken now to plan for such an outcome.

"The Irish Government has done a great job of stockpiling Tamiflu but, at present, only about 25 per cent of the population is covered," he notes. This is a reasonable percentage, he says, because the best approach is to cover a good proportion of the population in case of a crisis without overbuying and having to throw out unused medications after their expiry date if they remain unused.

In the balancing act of risk, protection and cost, a quarter of the population is a good compromise, he believes.

But the Government will not be handing out Tamiflu during a pandemic with the same priorities a business may have.

In addition, Dr Lambert says the Government alone should not bear the costs of combating a pandemic. "The WHO has said there should be a public-private partnership approach. And I think corporations should be involved."

Dr Lambert argues that stockpiling Tamiflu within a corporation is not an odd proposal when many companies offer employees annual flu vaccinations and other forms of healthcare as a matter of course, though he acknowledges that the costs involved in managing a stockpile probably limit such an exercise to multinationals or businesses that can afford to take such steps.

Isn't Tamiflu in such short supply, though, that governments get first priority for supplies? Dr Lambert says no. "If a company says it wants 10,000 doses, the manufacturers can increase their production," he says.

He says that, while it will not prevent influenza, Tamiflu is very good at minimising the effects of flu if taken within 48 hours of symptoms appearing and it saves lives.

In addition it can be taken as a prophylactic by individuals who need to avoid getting flu. In the case of a company, this would include whatever individuals the company deems most necessary for the continued functioning of the business.

"The question is, can businesses sit back and leave this in the hands of government?" he asks. "Big organisations that have a population need to come in and have a dialogue on this issue. Companies have a lot to lose."