OUTBREAK: The Infections with the Greatest Potential to Damage US Business Operations

Repeatedly and predictably, new infectious disease outbreaks arise that severely harm business operations. Outbreaks can harm business operations when travel restrictions/advisories arise, when economies falter, when supply chains dry up, or when employees and customers actually get sick. Examples from recent memory include the 2009 “Swine flu,” SARS, Ebola that spread from Africa to the US, and of course, COVID-19. COVID-19 laid bare for all to see the business vulnerabilities to infectious diseases. Many CSO’s now feel more anxious about future outbreaks since their businesses are no better prepared for the next major outbreak than they were for COVID-19, yet expectations of the response are higher given they have the COVID experience under their belts. Below is PHC’s list of the top infection outbreaks businesses and CSO’s need to anticipate and prepare for:

1. An influenza pandemic

We’re not talking the seasonal flu that we’ve all become accustomed to. We’re talking about a flu pandemic so bad it cripples daily life and business. This has happened repeatedly throughout history, and it will happen again. Experts assert we are overdue for such a disaster, based on historical patterns. Flu pandemics happen because the virus mutates significantly, and then spreads since we have little immunity to the new version. In 1918, over 50% of all inpatients in some Philadelphia hospitals died EACH NIGHT from flu, for awhile. That virus spread globally within a few months, whereas it takes about 6 months to manufacture influenza vaccines. Our healthcare systems have more infrastructure than they did 100 years ago, but our vulnerability here is huge. Businesses will be no exception. For CSO’s, preparedness and early action are key.

2. The spread of mosquito-borne diseases to new regions

Adequately prepared CSO’s will understand the business risks posed by rapidly emerging mosquito-borne infections in the US, and they will have response plans ready. Dengue fever, known as “breakbone fever” because of the bone-crushing pain this dangerous virus generates, is making a return to the US as its mosquito hosts spread around the country, enabled by climate change.  Malaria, with its legendary fevers and chills, is on the increase here as well. 

Yellow fever, experts warn, is poised to soon return with a vengeance to the US, as its mosquito carriers gain new footholds here. Hallmarks of yellow fever include jaundice from liver failure, life-threatening bleeding, and black vomit. Absent from the US for decades, it caused devastating epidemics during the 1800’s. Preventive vaccination is available in limited quantities but carries some risk, and there are no effective treatments. Given the potential for rapid spread of yellow fever, business impact would be enormous, driven by public anxiety. Fallout could include advice against non-essential travel, stay indoors guidance, event cancellations, and impacted hospitals. CSO’s would benefit from having early intel as the virus appears. They also should have employee communications and contingency plans prepared.

3. A rebound of vaccine preventable illnesses like polio or measles in the US

This is already happening. In 2022, a case of polio was diagnosed in New York. Further analysis showed polio virus was present in over 8% of wastewater samples from this region. These viruses were linked to strains of polio used in vaccines outside the US that are shed by humans after vaccination. In some cases, those strains can trigger paralysis in the unvaccinated. Measles, previously declared “eliminated” in the US, was just diagnosed in Wisconsin and Illinois. There were clusters of this in Minnesota and Ohio last year. These are not diseases to be trifled with, as those alive in the 1930’s-1960’s can attest. They remember how many of their loved ones became ill, died, or suffered permanent complications from them.

 Doctors performed a tracheotomy and put him in an iron lung—a sealed tank used to treat polio patients who had trouble breathing on their own

Polio vaccine has been provided to 92% of 2-year olds in the US. That number is 91% for one of the most contagious diseases known, measles. For tetanus, the number drops to 80%. At the start of kindergarten, nearly 1 in 10 US children remain susceptible to measles. With these numbers, experts expect outbreaks from these dangerous infections. Furthermore, vaccine protection is declining. According to the American Academy of Family Practice, vaccine coverage declined about 1% per year in 2020-21 and 2021-22.

4. Another coronavirus analogous to COVID

Infectious disease experts realize the near-term chances of another coronavirus outbreak with regional or global implications are good. CSO’s need to have their organizations ready in advance. Since 2002, there have been 3 outbreaks of new coronaviruses with significant enterprise impact. These include SARS that affected East Asia and Canada operations, MERS that arises in the middle east, and COVID-19. Given recent history, odds are that other contagious coronaviruses will arise, and businesses will have to deal with the fallout. Prior COVID-19 infection will not provide adequate immunity against them.

5. A widespread outbreak of Ebola or related infection

No disease drives fear as much as Ebola. The images of people bleeding profusely captured in popular media leave a powerful impression. Prior Ebola outbreaks have harmed business operations of those operating in Africa and elsewhere. They have led to travel restrictions affecting multiple continents. Supply chains have been disrupted. Future outbreaks of Ebola or related viruses could become more widespread in Africa than before, with greater effects on major cities and economies. The viruses also have potential to spill over to other continents, with some person-to-person transmission there. Global air travel disruptions would be huge. Travel bans would be implemented. Health systems could be strained. Enterprise impact would be disproportionate to actual disease risk, since Ebola is less contagious than some other viruses (i.e. COVID).

6. An intentional release of a weaponized version of a known germ

In 2001, the Anthrax attacks in the US drove pervasive fear. People were wondering how far the disease would spread and whether they would be exposed next. The US mail system was compromised. Multiple countries have stores of other high-risk germs like plague and smallpox. There are well documented leaks of weaponized germs from research labs and well documented knowledge transfers those labs to bidders elsewhere.  The chances that those with ill intent get their hands on such dangerous germs are very real. Models estimate the economic impact of a bioweapons attack would range from $477M to $26B (in 1997 dollars) per 100,000 exposed persons. Properly prepared CSO’s could provide timely, contextualized information to employees, who will be thirsting for information at such a time.

While we cannot predict which of the above scenarios will happen next, we can say with certainty that some of these events will severely test businesses in the not-distant future. Those that have prepared ahead of time and have objective, actionable intelligence at their fingertips will fare the best. PHC has the expertise and technology to help CSO’s lead these efforts for their enterprises.


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