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Friday, June 19, 2020

Pandemic Response: Preparing for the Second Wave


QUESTION
We have followed many of the suggestions in your Business Continuity Checklist, especially the parts that deal with the pandemic response. We purchased your Business Continuity Plan. 

The problem we now have relates not to the present but the future. Specifically, we are worried about the possibility of a second COVID-19 wave. Our compliance people are grappling with how to handle a second wave. 

Our question is, what do we do now about preparing for the second wave of COVID-19?

ANSWER
I am grateful that you are using the Business Continuity Plan Checklist and Workbook, Includes Pandemic Response. As you know, the Checklist is free and provided as a courtesy to enable companies to manage business continuity. It has a large section that deals specifically with pandemic responses in general and the COVID-19 pandemic in particular. It also contains numerous resources and references. We are the only compliance firm in the country that has published such a helpful tool, which is now on Update # 7, consisting of 208 pages. You can download it HERE. Update # 8 will be published shortly.

Thank you for buying the Business Continuity Plan (“BCP”). Yesterday we notified media and our subscribers about our Business Continuity and Pandemic Response Plan, which we decided to offer at a deeply reduced rate to make it affordable to most companies. Even still, how could companies afford not to buy it, considering their very survival depends on business continuity? Waiting is really not an option. Our BCP is extensive, detailed, and dynamic. And we even provide a walkthrough of the document with one of our subject matter experts at no additional fee. You can order it HERE.

For the first wave response, I have outlined operational issues as well as pandemic challenges. For some recent posts, go HEREHEREHEREHERE, and HERE.

Your question is important. I do not want to be the bearer of bad tidings, but the second wave could be worse than the first – and, realistically, we are not out of the first. As I write, some states are seeing a record number of hospitalizations, and a few are reaching maximum capacity in their ICU units. Thousands are becoming infected every month. Currently, the United States has 2.2 million confirmed cases; 16,500 are now critical; and over 118,000 have died to date.[i] There have been about 27 million tests done in a population of 330 million, or only 8%, with 1.2 million active cases and over 931,000 recovering cases. There is insufficient educating; insufficient testing; insufficient contact tracing; insufficient wearing of masks; and insufficient social distancing.

Even if a person has no symptoms, that person can spread the disease. The CDC estimates that 40% of transmissions happen before people feel sick.[ii] I have seen studies that show upwards of 4-5 people can become infected by contact with persons who did not think they had the disease. Whether testing is done or not done, the infection rate is not changing. One has nothing to do with the other. However, testing tells us the epidemiological factors involved in the rapid geographic spread of the disease and the measures needed to contain it. Not testing at a high rate is tantamount to denying the ever-increasing risk.

Surely, denying the presence of a catastrophic plague is the worst form of response.

Over 40 million people have filed for initial unemployment. Everyone wants the economy to improve, but, in the long run, it just can’t improve without good hygiene being pervasively practiced. 

Here’s a simple algorithm for wearing a face mask for those people who think they don’t need to wear a face: 
Wearing a face mask leads to less asymptomatic viral spread,
which leads to more of the economy opening sooner. 

Delay the response; delay the revitalized economy.

We should be clear about what is meant by “asymptomatic spread.” The asymptomatic spread is a condition where the transmission is by people who do not have symptoms and will not get symptoms from their infection. But those infected carriers could still get others infected. Also, there is “pre-symptomatic spread.” The pre-symptomatic spread is a condition where the transmission is by people who don’t look or feel sick but will eventually get symptoms later. Obviously, they too can infect others without knowing it.

Pandemics usually occur in waves. Infections spike, peak, plateau, and even recede – but the infection rebounds again later. This process may happen several times. It is the pattern of the pandemics in 1918-1919 with Spanish flu, 1957-58 with the H2N2 virus, and 2009-2010 with the swine flu.

I have written previously that the second wave of a pandemic is often worse than the first. I understand that people want to return to “normal,” but that simply cannot happen at this time. The CDC predicts that there could be upwards of 200,000 deaths caused by COVID-19 by the fourth quarter.[iii] Given that Federal authorities have mostly left it to the states to effectuate good hygiene orders, and many states maintain that they will not shut down a second time – although some states never shut down at all in this first wave – the reduction of infections and deaths seem as far away as ever. After all, when a state runs out of ICU beds, it really has no other choice, ethically speaking, but to shut down.

Yet a second wave is coming. And that means a second shut down is possible. For instance, Japan has had to shut down geographical areas of resurgence. Other countries have been shutting down, where resurgence has occurred. There are now surging spikes in several states, and ICU units are reaching capacity. Because COVID-19 has a lengthy incubation period, to wit, 3 to 14 days (with symptoms often appearing within 4-5 days after exposure), during that first 72 hours, a person can transmit the virus to others.

Let’s view our current circumstances as being in the first wave, one that has not ended, but reduced somewhat in parts of the country, plateaued in other parts, and surging in other parts at an astonishing speed. Let’s also assume that the second wave is coming in the fourth quarter 2020. Given that situation, we can do two things: (1) maintain now as much good hygiene as possible in our pandemic response to the first wave; and (2) prepare carefully for the second wave.

So, what lessons have we learned thus far? And what should you do in preparation for the second wave of the COVID-19 pandemic? I will outline the action items you should be considering and implementing.

1. Preparation

Anticipate the continuation of first wave hygienic activities. Get a sense of how your organization is responding to the current pandemic challenges and how much time remains before the second wave hits.

2. Proactive

Do not let your organization become the victim of denial. Be proactive. Determine the strengths and weaknesses of the current pandemic response. Refine the actions taken and document them.

3. Business Continuity Plan

Be sure that you view the Business Continuity Plan as a dynamic document that will change over time. It is not a fixed, unchanging set of procedures, but will need to change in response to real-world challenges.

4. Communication - Internal

Maintain on-going communications between management and employees. Use various media to communicate news, testing criteria, and revised guidelines. Be sure to fact check and correct misinformed information provided by any sources that are not credentialed scientists and doctors trained in relevant fields.

5. Communication – External

Synchronize internal (within the organization) and external (outside the organization) news, procedures, announcements, and actions.

6. Absenteeism

Use these four criteria to minimize and monitor absentee employees: (1) essential to report to the workplace; (2) essential but can work remotely; (3) non-essential but can work remotely; and (4) non-essential and not necessary to work remotely.

7. Crisis Management

Periodically assemble a crisis management team consisting of senior management, department heads, business line leaders, and internal administrative staff (i.e., HR, IT, legal, finance, compliance). Document the meetings and discuss ways and means to stay current with challenges to business continuity.

8. Geography

If the organization is multistate, geographic challenges present themselves. Each remote branch office or regional vector should have a reporting chain to senior management for business continuity and pandemic response concerns. The Business Continuity Plan should take remote offices and regions into consideration.

9. Drills

Implement exercises to test various realistic scenarios. The COVID-19 virus is a “long tail” virus,[iv] so doing scenario exercises will keep the organization in a state of readiness and functioning in a safe environment.

10. Recovery

Be willing to transition to a more recovered posture, if events allow for recovery. The recovery state is part of business continuity, but not without pitfalls. Recovery does not just mean business-as-usual. It means ensuring that the crisis may be past, though it is not a time to let down your guard. 

Some crises do cease to exist, and, to that extent, the organization may still remain with periodic testing. However, some crises do not cease to exist: only the current risk of them happening has been reduced. Pandemics are the latter case. Do not be caught blind-sided by relaxing your pandemic response to the point that you end up making the same mistakes in the next wave.

Jonathan Foxx, Ph.D., MBA
Chairman & Managing Director
Lenders Compliance Group


[i] As of 6/19/20 at 7:33AM (EST) Coronavirus Resources Center, Dashboard, Johns Hopkins University and Medicine, See https://coronavirus.jhu.edu/map.html
[iii] US could see 200,000 coronavirus deaths by September, Woods, Amanda, June 11, 2020, NY Post
[iv] A “long tail risk” is one that, from a risk point of view, is “between the start of the exposure and the manifestation of loss or damage resulting from the exposure.” International Chamber of Commerce https://iccwbo.org/publication/long-tail-risks