Our office was hit just before Christmas as a number of people were struck with flu, myself included. The recovery time was long and slow, but having my laptop at home meant that at least for part of the time I could keep on top of work and emails when I felt up to it. For many people this type of flexible working is still not an option which amazes me. It has been proven time and again that those people who are enabled to work from home take fewer sick days than those who are office based.

For those businesses who do have a flexible working plan which involves re-routing incoming phone calls, I hope that they have been kept up to date, after all what often happens is that calling plans are pulled out in an emergency and numbers have changed as employees have moved on…

450 people died in the UK due to the swine flu virus which was minimal compared to the worst case scenario which predicted a possible 65,000 mortalities. The WHO will continue to monitor infection rates as they could rise again but it is largely believed that subsequent cases will remain at a seasonal flu level.

This particular pandemic did not reach the levels feared, but it was certainly a wake up call for organisations both in the public and private sector, to either dust off their pandemic plans or to put some in place. So the next time a flu pandemic really takes hold there should be no excuses for organisations to grind to a halt if a large chunk of their staff are struck down…

No pressure there then.

The 28 recommendations are summarised as follows:

RECOMMENDATION 1:Ministers should determine early in a pandemic how they will ensure that the response is proportionate to the perceived level of risk and how this will guide decision-making. This approach should be reflected in the revised pandemic-specific Concept of Operations by summer 2011.

RECOMMENDATION 2: The Cabinet Office should enshrine the position of the four nations mechanism for certain types of emergencies in a revised Concept of Operations by summer 2011. The mechanism should then be included in the exercise programme for emergencies in a devolved matter.

RECOMMENDATION 3: The four health ministers should meet to discuss emergency preparedness (and a range of other issues) at least once a year. Officials should aim to meet face to face more regularly.

RECOMMENDATION 4: The Cabinet Office should review the technological support available for emergency ministerial and official
meetings, to ensure that those joining in meetings remotely can be engaged as fully as possible in the discussion.

RECOMMENDATION 5:Departments should consider how best to increase the resilience arrangements for key roles in an ongoing crisis
response, including those in charge of the response and committee members, and revise their resilience arrangements accordingly.

RECOMMENDATION 6: By December 2010:
(i) Ministers should decide the levels of deaths for which planning is appropriate as part of the process of revising Pandemic flu: A national framework for responding to an influenza pandemic.
(ii) The Home Office, working with others including the Ministry of Justice, the Department of Health, the Cabinet Office, Communities and Local Government and the devolved administrations, should ensure that plans are in place to deal with those levels of deaths during a pandemic, linking with other elements of mass fatality management and specifying clear responsibilities for the collection, transportation, storage and burial or cremation of bodies.

RECOMMENDATION 7: The Government Office for Science, working with lead government departments, should enable key ministers and senior officials to understand the strengths and limitations of likely available scientific advice as part of their general induction. This training should then be reinforced at the outbreak of any emergency.

RECOMMENDATION 8: The four Chief Medical Officers should jointly commission further work to support key decision-making early in a pandemic by January 2011. This should consider the practicalities of developing methods to measure the severity of a pandemic in its early stages. In particular, further exploration of population-based surveillance, such as serology, should be considered.

RECOMMENDATION 9: The Government Chief Scientific Adviser and the Department of Health should ensure that there is an appropriate balance of contribution in the Scientific Advisory Group for Emergencies for future pandemic outbreaks.

RECOMMENDATION 10: The Cabinet Office, with the Government Chief Scientific Adviser (GCSA) and the four Chief Medical Officers (CMOs), should devise a process through which UK government ministers and the devolved administrations are presented with a unified, rounded statement of scientific advice. This process should engage CMOs (or CSAs for other emergencies) and should be included in a revised Concept of Operations by summer 2011.

RECOMMENDATION 11: The Government Chief Scientific Adviser and UK health departments should convene a working group to review the calculation of planning scenarios and how they are used in public. This should report by April 2011.

RECOMMENDATION 12: The Joint Committee on Vaccination and Immunisation should report directly to the central emergency meetings in a future pandemic, although the Scientific Advisory Group for Emergencies should be used at the appropriate time to provide its challenge function. This should be clarified in a revised COBR Response Guide for Pandemic Influenza by summer 2011.

RECOMMENDATION 13: The Department of Health should build relationships between the Behaviour and Communication sub-group of the Scientific Pandemic Influenza Advisory Committee (SPI-B&C) and the Department of Health’s policy and communications teams so that the SPI-B&C’s expertise can be used in addition to in-house resources in planning for vaccine uptake and other relevant policy areas.

RECOMMENDATION 14:Any future Scientific Advisory Group for Emergencies should adhere as closely as possible to the established
principles of scientific advice to government and should release its descriptive papers and forecasts (as distinct from any policy advice) at regular intervals. This should be clarified in a revised Concept of Operations by summer 2011.

RECOMMENDATION 15: The Government Chief Scientific Adviser should provide expert technical briefings to respected scientists not directly involved with the Scientific Advisory Group for Emergencies. This would enable a wider group of experts to comment in an informed manner on the government’s approach.

RECOMMENDATION 16: The Department of Health, working with others through the revision of the National Framework, should explore a more flexible, evidence-based approach to triggering actions during a pandemic than the current WHO phases and UK alert levels. In particular, this work should ensure that clear guidance is set out to enable the rapid adjustment of the prophylaxis policy as more is learned about the nature of the virus. Work to revise the National Framework should be concluded no later than March 2011.

RECOMMENDATION 17: The Department of Health, working with others through the revision of the National Framework, should ensure that there is an appropriate balance between local flexibility and UK-wide public confidence in the response. A national strategic approach can and should be compatible with increased subsidiarity and therefore increased variation according to circumstances; triggers agreed and understood on a UK-wide level could be applied flexibly in different geographical areas on the basis of local circumstances. This should be set out in the revised National Framework and published no later than March 2011.

RECOMMENDATION 18: The Department of Health and the devolved administrations should agree triggers responsive to the capacity of primary care in the activation and stand-down of the National Pandemic Flu Service at both national and regional levels. These triggers should be set out in the revised National Framework and published no later than March 2011.

RECOMMENDATION 19: The Department of Health should commission an independent evaluation of the National Pandemic Flu Service, covering value for money, risk analysis and any potential for wider application.

RECOMMENDATION 20: The four health departments should reflect on the proposals identified by the Swine Flu Critical Care Clinical Group and incorporate them, as appropriate, into the revised National Framework no later than March 2011.

RECOMMENDATION 21: The Department of Health should negotiate advance-purchase agreements that allow flexibility over the eventual quantities purchased.

RECOMMENDATION 22: The Joint Committee on Vaccination and Immunisation should be asked to advise on vaccination strategies across a range of scenarios, including severe and less severe pandemic viruses. This advice should incorporate the views of behavioural scientists and economic analysis, and be published in the revised National Framework no later than March 2011.

RECOMMENDATION 23: The four health ministers should commission officials to put in place arrangements to ensure the rapid implementation of a vaccination programme during a pandemic. For example, a sleeping contract with GPs and/or other willing providers could be negotiated.

RECOMMENDATION 24: The Department of Health and the devolved administrations should explore what more can be done to raise levels of public awareness and understanding about the key characteristics of a pandemic and the core response measures.

RECOMMENDATION 25: The four UK health departments should review their use of language during pandemics to ensure that it accurately conveys the aims of the response efforts and the levels of risk. In particular, the use of the terms ‘containment’ and ‘reasonable worst case’ should be reconsidered as they are easily misunderstood. The National Framework and communications strategies should be amended to reflect such revisions by no later than March 2011.

RECOMMENDATION 26: The four UK health departments should consider new ways of proactively engaging with both journalists and the public. These could include disseminating transcripts of media briefings, using podcasts and making more use of social networking and digital technology to reach specific sections of the public. The National Framework and communications strategies should be amended to reflect any changes no later than March 2011.

RECOMMENDATION 27: The Cabinet Office should ensure that the communications approach (weekly briefings, Q&A sessions, regular releases of facts and figures) adopted by the Department of Health and the devolved administrations is used, where appropriate, as a model of best practice for future emergency situations.

RECOMMENDATION 28: The Department of Health and the devolved administrations should discuss with professional health bodies how best to create sources of direct clinical advice for health professionals during a pandemic. This may be most appropriately hosted by one or more of the professional bodies.

Click here for the full pandemic review report.

Home workers depending on VOIP over the residential broadband network for work purposes could get a big shock when the quality of their voice calls is compromised because their children, or children in the local area, are socialising on Facebook to alleviate the boredom of being off sick or to pass the time if their schools are closed.

Back in June of this year I voiced my concern over this very same issue.

What this means is that for those people who will assume that they can effectively work from home using VOIP, they will seriously need to re-consider their strategy. The PSTN network will of course remain consistently reliable and available and companies should consider re-routing their incoming calls home rather than relying on mobile or VOIP networks which could be over-loaded. Also if work is not able to be conducted via email communication there will need to be a far heavier reliance on the voice network and surely organisations would prefer to pay PSTN call charges rather than mobile charges?

This week Gartner have issued an article suggesting three possible alternatives to improve internet bandwidth for home working:

1. Using WOC (Wan Optimisation Controller) software to ensure that applications use the least amount of bandwidth possible,

2. Use client applets which work with data centre based WOCs to optimise browser speed.

3. Bypass the last mile altogether and switch to a wireless connection such as 3G, WiMax or satellite (which may fix the connectivity problem but not necessarily the data ‘congestion’ issue)

The threat is real, the residential broadband network has its limits and when all else fails we will inevitably be relying on our old friend PSTN to help us continue to work and socialise during times of mass absence from schools and work.

“Aon has created a stand alone insurance policy to reimburse companies for wages, fixed costs and extra expenses if they are unable to access their buildings due to government action.”

Hats off to Aon for identifying the gap in the market here as many generic insurance policies/ business interruption policies do not cover specific pandemic viruses, indeed they only usually cover costs caused by physical damage or ‘notifiable diseases’ which H1N1 does not always qualify for.

The new product from Aon is believed to be the first of its kind available to all kinds of industry, though the general target is for Retail, Transport and Manufacturing where employees would be hard pushed to fulfill their roles from home. I’m sure many of the 100 shops in Princes Street, Edinburgh which suffered a power cut during peak business hours this week, would now be very keen to take up such a policy…

Continous working much better than re-couping costs

It’s great that these industries can now be protected for office/ building closure in this way, however for those industries such as service and finance there is always the option for employees to work from home or another remote office or location and I believe that these types of organisations should be focusing their attention far more on continuing to operate effectively as a business, rather than relying on insurance policies to cover any unexpected costs as a result of a building closure. After all, who wants to pay out twice or three times following a disruption? First for an insurance policy, then for the costs which are not covered by the policy, and finally for a more effective strategy which enables employees to continue working through a disruption whereby your costs are limited from the start.

If organisations had a seamless way of working, regardless of whether their premises could be accessed or not, there would be no need for reliance on such insurance policies to cover unexpected costs.

With postal strikes leaving us unsure about when we should expect to recieve our mail, it could cause problems in terms of people receiving letters from their GP surgeries about when and where they need to be vaccinated, leading to appointment chaos and many people missing their slot.

The alternative is to ring around every person to let them know when they need to be vaccinated. This is clearly a very time consuming job and may not always be effective in reaching the intended recipient. If GP surgeries were able to send out a tailored recorded message to individuals, SMS text or email, or indeed a combination of all three, they are far more likely to be able to reach each person and it would be less time consuming for an already over stretched Health Service…

What message this sends me is that we cannot underestimate what this virus can do to us, our children and our colleagues. If disruption to our routines and work is worse than we are expecting then we could see a slow down in economic activity over the winter months as key employees, customer service staff, sales staff etc. are confined to their beds or looking after sick relatives for a week or more. I don’t necessarily see that the UK will come to a stand still but I just think that everything we do will take a lot longer, meaning that contract deadlines could be missed, deliveries could be delayed and the entire supply chain system could experience a slow down, causing any number of problems.

This disruption could be minimised by taking the right precautions as I have alluded to in previous blogs, and feedback I am getting from the market is that people are starting to take pandemic planning more seriously which is a good sign. I will keep you posted with any further developments I come across…

This is is of particular concern as I have just read in the Daily Telegraph that more than 80% of young children hospitalised with the virus were also previously healthy…
If the media are reducing their reporting of the number or nature of swine flu cases that are happening in the UK it could be all too easy to presume that the pandemic is not as bad as it was previously thought it could be, and I personally think that this a dangerous point of view to take.

There is a fine line I believe between not panicking and being prepared. Our everyday actions should still include good personal hygiene measures such as using antibacterial gel where provided, watching our children carefully for any increase in temperatures and being watchful of friends, family and colleagues who may be showing symptoms. This virus is still a potential killer and certainly has the power to disable a large proportion of the UK workforce.

Clinical Attack Rate: Up to 30% of the UK population (source: Uk Planning Assumptions 3/9/09 Cabinet Office)

Predicted absence rate of employees within a single organisation due to sickness and caring responsibilities: 30% (research undertaken by GlaxoSmithkline)

During the peak, the infection rate may be sustained for 2 weeks (source: Uk Planning Assumptions 3/9/09 Cabinet Office)

Number of deaths to date in the UK: 59 (Fergus on Flu BBC Online 21/8/09)

Estimated loss of revenue per company: between 2% and 8% (Research undertaken by GlaxoSmithkline and validated by Milliman consultancy)

From my own experience last winter when seasonal flu caused havoc at my husband’s company, I would say that the 30% absence rate is pretty accurate. When one employee came back to work for a meeting, while suffering from the flu, he managed to infect and disrupt around 30% of the company’s workforce over a period of around a month, as some took one week off and others took two weeks at varying times.

The company has learnt its lesson and put firmly in place plans for the swine flu pandemic. As soon as there is a whiff of a rumour that an employee may have swine flu, they are sent home to work remotely and their calls are redirected home to offer customers a seamless service. But employers shouldn’t have to get their fingers burnt in order to properly plan for mass flu infection, it should be their top buisness continuity planning priority, especially as we are now in the ‘calm before the storm’.

Backed up by research from the BCI (Business continuity Institute) confirming that over half of organisations they surveyed had weak or no pandemic contingency plans, the CIPD warns that senior managers will ignore the second wave threat of increased swine flu cases and will be hit by substantial staff absences, a great threat to businesses and the recovery of the recession.

Warning companies to not underestimate the potential threat posed by a second wave of swine flu does not seem to be making any difference. There are many factors that contribute to a sense of apathy, but the key obstacle is overcoming the feeling that it will never be as bad as the media would have us believe. As humans we tend to be naturally optimistic, playing down any negative possibility. Indeed I fell victim of this myself recently in a car park…as I went to the machine to put in my card to pay my money the man before me told me it wasn’t working and that it had swallowed his money. Being in a rush and ever the optimist, I thought that maybe it would work for me. You can guess what happened!

So the lesson to be learnt from the information given to us, is that organisations should be factoring ‘optimism bias’ into their contingency plans and planning for the worst case scenario. This is much less work and effort than some managers tend to think, as you can simply and seamlessly re-route incoming calls to employee homes and allow secure access to corporate networks. After all not all staff absences will be due to illness, so why not make better use of their time away and give them the tools to continue working?