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Bill Gates says there could be one benefit from the Ebola epidemic that has killed more than 11,000 people in west Africa since 2014. “It may serve as a wake-up call,” says the Microsoft founder. “We must prepare for future epidemics of diseases that may spread more effectively than Ebola.”
His charitable foundation, the Bill & Melinda Gates Foundation, has been at the heart of the global fight against slower-burning health scourges such as HIV and malaria. However, few things worry him as much as the risk of a sudden global infectious disease outbreak.
“There is a significant chance that an epidemic of a substantially more infectious disease [than Ebola] will occur sometime in the next 20 years,” he wrote in a paper in the New England Journal of Medicine earlier this year. “Of all the things that could kill more than 10m people around the world, the most likely is an epidemic stemming from either natural causes or bioterrorism.”
His paper went on to set out proposals for a “global warning and response system” for pandemics and warned that Ebola had exposed glaring deficiencies in preparedness. His recommendations were aimed primarily at policymakers. But his broader point on the need for readiness should also resonate in boardrooms and human resources departments across the corporate sector.
In the event of a pandemic, private sector employers would be on the front line of the battle to contain its spread and their businesses would be highly exposed to disruption.
The economic case for preparedness is clear. According to the World Bank, a severe pandemic could reduce global wealth by $4tn, or 5 per cent of gross domestic product. But the importance of ensuring business continuity goes beyond the need to minimise lost revenues. It would also be crucial to broader efforts to keep the economy and society functioning.
Some 85 per cent of critical US infrastructure resides in the private sector, according to the Department for Homeland Security.
The danger of business paralysis during a pandemic became clear at the height of the Ebola outbreak when some iron ore mines — an important part of the west African economy — ceased production, and farming and trade were disrupted.
Mr Gates warns that future pandemics could spread much more quickly and widely than Ebola. “Other disease agents — measles and influenza, for example — are far more infectious because they can be spread through the air, rather than requiring direct contact,” he says. “People may not even be aware that they are infected or infectious. Since a person carrying one of these pathogens can infect many strangers in a marketplace or on an airplane, the number of cases can escalate very quickly.”
Public awareness of the risk has increased in recent years. Between 1997 and 2009, six major outbreaks of highly fatal zoonoses — animal-borne diseases that can be transmitted to humans, such as Ebola, Sars, avian and H1N1 flu — caused an estimated $80bn in economic losses, according to the World Bank.
Yet none of these was anywhere close in scale to the 1918 Spanish flu pandemic, which infected 500m people and killed between 50m and 100m, or 3-5 per cent of the world’s population. Today, according to the World Bank, a similarly infectious and deadly virus would kill 33m people in 250 days.
So what measures should companies have in place to protect their businesses and employees? Recommendations issued by the US Centers for Disease Control and Prevention during the 2009 H1N1 swine flu outbreak provide some pointers.
To begin with, businesses should start with a good understanding of their normal seasonal absenteeism. Every winter, nearly 111m workdays in the US are lost due to flu, according to the CDC. Identifying when the usual level of infection and illness becomes something more unusual is an important first step.
Much of the CDC’s advice involves commonsense measures little different to best practice during the regular flu season. Sick employees must stay at home, with plentiful supplies of soap, water and hand rubs provided in the workplace to promote good hygiene.
Other recommendations are more specific to a severe pandemic. These include “social distancing” strategies, such as banning non-essential travel and meetings, increasing physical space between employees in the workplace and allowing people to work from home. IT systems should be checked to make sure they are robust enough to support large numbers of remote users.
Screening of employees when they arrive for work should also be considered and people with symptoms of flu sent back home.
Close communication with employees, business partners and local authorities would be crucial. A clear plan should be in place before an epidemic erupts and exercises carried out to test it for flaws.
Mr Gates says the world’s readiness for an epidemic compares unfavourably with its preparedness for other strategic threats such as war. “NATO countries participate in joint exercises in which they work out logistics such as how fuel and food will be provided, what language they will speak and what radio frequencies will be used. Few, if any, such measures are in place for response to an epidemic.”
The absence of this kind of planning caused delays in the world’s response to Ebola, says Mr Gates. “In the next epidemic, such delays could result in a global disaster.”
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