To Prepare Against the Worst, CSOs Need High-Impact H5N1 Scenarios

What is the Milk Warning Us About?

H5N1 in dairy cattle is a wake-up call to CSOs. COVID may feel over, but new disruptive biosecurity threats are constantly emerging. Last week, we told you the milk isn’t the threat—it’s the warning. If H5N1 evolves dangerously, the CSO role will once again be responsible for the company response plan, but the knock-on effects of biosecurity threats can be hard to anticipate. This week, we walk you through three possible and highly disruptive H5N1 scenarios: the agricultural disaster, the moderate pandemic, and the severe pandemic. These scenarios are valuable for shaping preparedness strategies and highlighting biologically possible outcomes but are not intended as near-term predictions.

Scenario #1 Massive Agricultural Disruption

In Scenario #1, H5N1 evolves to massively disrupt agriculture by causing severe disease in dairy or beef cattle or by asymptomatically infecting humans who could unintentionally spread the virus throughout commodity operations (cattle or poultry). The consequences of an H5N1-driven catastrophic agricultural disease would be extensive. Initially, commodity prices would rise dramatically; those costs would then ripple through the US economy. The food industry, grocery stores, restaurants, and anywhere serving food (including public schools and hospitals) would feel the brunt of food scarcity and high prices. How would your food services team adapt? Will there be cost overruns?


A devastating agricultural H5N1 would trigger an international response. Although World Trade Organization member countries are required to justify trade restrictions due to disease, fear could trigger highly reactive import bans. Even if the World Organization for Animal Health (the designated adjudicator of animal disease-related embargos) eventually found import restrictions could not be justified, the impact on U.S. markets would be massive. Agriculture, food, and related industries contribute 5.6% of the US GDP and employ 10.4% of US workers. 2023 US export values included $9.97B (beef), $8.01B (dairy), $5.49B (poultry), and $760M (eggs).

Scenario #2 A Moderate Pandemic – H1N1 Redux

In Scenario #2, H5N1 acquires the ability to be transmitted between people. Influenza viruses have two protein spikes on their outer layer: the H in H5 and the N in N1. Pandemic influenza viruses have novel spike proteins that our immune systems haven’t seen before. That universal lack of past exposure through infection and vaccine means essentially all people are susceptible to the new virus. Current seasonal influenza vaccines cover an H3N2 and an H1N1 (along with two influenza B viruses); the H5 would be entirely new.

Pandemic severity reflects the transmissibility and severity of illness. In Scenario #2, H5N1 would echo the 2009-2010 H1N1 swine flu pandemic, which was moderately infectious and moderately severe. To imagine the company impacts of this scenario, CSOs can review the impacts that moderate biosecurity threats (e.g., H1N1 or Zika) had on their operations and assess what new options exist today. Key questions include:

  • What departments or roles had the greatest excess absenteeism or reduced productivity? What were the challenges faced in 2009-2010, and were they fully addressed during COVID-19, or do you need to find solutions? Where hybrid isn’t an option, did reduced customer demand match absenteeism impacts?
  • Did your business host flu vaccine clinics onsite to lower barriers to employees getting the extra flu shot? H1N1 got a separate vaccine from seasonal flu that year. The same thing could happen if H5N1 evolves. Reducing infections can limit productivity losses, reduce absenteeism, and save on health insurance premiums.
  • Are your business continuity plans up to date, to include lessons learned? Do they reflect the current organizational structure and identify the correct decision makers?
H5N1 Goes Person-to-Person and Regains Previous Severity

Scenario #3 A Severe Pandemic – H5N1 Goes Person-to-Person and Regains Previous Severity

In this darkest scenario, a severe H5N1 pandemic spreads easily between people and regularly causes severe disease. An earlier strain of H5N1 killed about 50% of identified human cases. Even if H5N1 didn’t kill half of the people infected, a plausible worst-case scenario could see rates much higher than the 8.7% case fatality rate that COVID averaged in studies conducted during the first year of the pandemic. This severe influenza pandemic would be COVID on steroids.

No pandemic looks exactly like the previous pandemic, but the experience of decision makers can be invaluable in tackling a new crisis. Before staff turnover cements a complete loss of institutional knowledge, CSOs should document not just the decisions made during past pandemics but also the challenges and the considerations. A playbook that dictates if X then Y will rapidly fall short. Instead, CSOs should record the decision-making processes, criteria, considerations, and ripple effects. Lessons learned should not focus on the specific tactical solution selected but rather on how leaders successfully understood the problem and strategically planned for it.

Waiting to develop a plan is too risky for today’s conditions. These scenarios require thoughtful consideration and planning to ensure your business weathers any possible disruption. PHC Global understands businesses need early warning on both tactical and strategic intelligence. We combine expertise, data, and technology to give you the insight you need now to ensure business continuity.

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Dave Komendat retired as the Vice President and Chief Security Officer for The Boeing Company, a role he held for 14 years of his 36 years within the security profession. Komendat was responsible for the company’s global security and fire protection policy and procedures, site security, executive protection, supply chain and aviation security, structural and aircraft fire protection, government and proprietary information security, classified cyber security, strategic intelligence, international security, business continuity and disaster preparedness, Global Security Operations Center, and security background investigations.


Komendat was also the lead Boeing interface for both national and international security policy engagement with numerous government and industry advisory groups. He represented Boeing as past co-chairman and current board member on the Domestic Security Alliance Council, past President of The International Security Management Association and served as a member of the Threats and Information Committee for the Overseas Security Advisory Council.  


Komendat is the founder and President of DSKomendat Risk Management Services, he also serves on several company advisory boards and holds board leadership roles with several non-profit organizations whose missions are to protect people globally, including Hostage U.S. and The International Security Foundation. Dave is also a Strategic Engagement Advisor for the Office of Private Sector within the FBI. In 2018, Dave was awarded the Director’s Award for Exceptional Public Service by FBI Director Christopher Wray.


Komendat graduated from California State University at Long Beach and also attended and completed the executive development program at the Kellogg School of Management at Northwestern University.

Dr. Carter Mecher serves as the Medical Advisor for the Public Health Company. 


Prior to joining PHC, Carter served as a Senior Medical Advisor for the Office of Public Health in the U.S. Department of Veterans Affairs. In this position, Dr. Mecher played a key role in the COVID-19 outbreak response. 


From 2005 to 2011, he served as the Director of Medical Preparedness Policy at the White House Homeland Security Council and National Security Staff. He was a principal author of the National Strategy for Pandemic Influenza Implementation Plan. In this capacity, he helped set policy and devise strategies to mitigate the consequences of a pandemic and promote pandemic preparedness. 


Before serving at the White House, Dr. Mecher was the Chief Medical Officer for the Southeast VA Network in Atlanta from 1996 to 2005. In this role he oversaw the healthcare delivery for veterans in Alabama, Georgia and South Carolina. 


Dr. Mecher is a co-author of Lessons from the COVID War, an in-depth examination of the U.S. response to the pandemic. In addition, he is featured in Michael Lewis’ book The Premonition.


Dr. Mecher received his medical degree from Chicago Medical School and completed a residency in internal medicine and a fellowship in critical care medicine at Los Angeles County/USC Medical Center.

Dr. Joe DeRisi is a Scientific Advisor to PHC. He is one of the early pioneers of DNA microarray technology and whole genome expression profiling; he is nationally recognized in the field of genomic epidemiology for designing a first-of-its-kind initiative for COVID-19. Joe currently serves as Co-President of Chan Zuckerberg BioHub and is a professor of Biochemistry and Biophysics at University of California, San Francisco. He has a Bachelor of Arts in Biochemistry and Molecular Biology from University of California, Santa Cruz, and a Ph.D. in Biochemistry from Stanford University.

Dr. Sumiko Mekaru is the Vice President of Research and Innovation at The Public Health Company. Dr. Mekaru is an epidemiologist operating at the intersection of traditional epidemiology and technology and leading cross-disciplinary teams to solve challenges in public health. Prior to joining PHC, Dr. Mekaru was a Life Sciences Strategy, Policy, and Operations Expert at Booz Allen Hamilton where she recently led the development of COVID-19 forecasting models for disease transmission, resource utilization, and critical events for the Department of Defense. Dr. Mekaru has also led health technology teams at Epidemico and Boston Children’s Hospital, creating innovative health surveillance tools. She has published extensively on infectious disease outbreak monitoring, modeling, and surveillance. Dr. Mekaru holds a Doctor of Veterinary Medicine from Tufts University and a PhD in epidemiology from Boston University.

Justin McIntosh is an experienced professional with 10+ years in management and 8+ years in software engineering. Currently, he is the Vice President of Operations at The Public Health Company. His journey began in college when he co-founded Safe Site, a utility services company, which expanded to operations in three states with over 300 employees. After a successful exit, he founded Docusite, a construction risk management application, diving into software engineering. Despite challenges with Docusite, Justin’s passion for technology led him to various roles before landing at The Public Health Company.


In his current role, Justin is tackling the challenging task of improving operations in a remote environment. He is dedicated to his role and is always open to sharing experiences and insights. He is committed to nurturing effective teams, improving operations, and shaping innovative solutions. His focus is on creating a positive, growth-oriented environment and mentoring emerging leaders, reflecting his commitment to collective success.

Lori Sutton is the Vice President of Marketing at The Public Health Company. She is a strategic marketing visionary and global brand leader with 20+ years of progressive experience in B2B/B2C SaaS software marketing in large enterprise and SMB markets. She has expertise in leading strategy development, overhauling brands, launching products and driving growth in target verticals. Prior to joining PHC, Lori was the Vice President of Marketing and Growth at SMS-Magic, where she led the global GTM strategy, orchestrated a brand overhaul, developed new messaging and positioning and launched revenue generating campaigns. Lori held marketing and management roles at Model N, Bullet Point Network, Saba and other SaaS software companies where she focused on marketing strategy, business objectives and analytics to drive revenue.

Lori holds an MFA from California Institute of the Arts, a BFA from Virginia Commonwealth University, an Executive Education in Corporate Strategy at Harvard Business School and continues coursework at Massachusetts Institute of Technology.

Craig Katsuyama is the Vice President of Administrative Services at PHC. He brings extensive experience building companies from the ground up and was instrumental to the launch of IEX Group in 2012, which challenged the status quo of financial markets and created an entirely new stock exchange that works for all investors. Craig spent the last eight years at IEX where he built and oversaw the accounting and finance teams before transitioning to help establish IEX’s Event Stream business, a data messaging platform that applies IEX’s core technology to areas outside of finance. Craig graduated from Mount Allison University in New Brunswick, Canada with a Bachelor of Commerce in Accounting and Economics.

Dr. David Fisk is the Chief Medical Officer at The Public Health Company. Prior to joining PHC, Dr. Fisk served as an Infectious Disease Specialist at Sansum Clinic.  He serves as the Medical Director of Infection Prevention and Control at Cottage Health, leading the infection control team at Cottage, working with physicians and hospital leaders on the COVID Incident Command Center to ensure the highest level of preparation and care for patients. In early March 2020, before the first confirmed COVID-19 case in Santa Barbara County, Dr. Fisk advised that the virus was already spreading locally before community members were observing symptoms.


Dr. Fisk completed his medical degree from Johns Hopkins University School of Medicine and his Internal Medicine residency and Infectious Diseases fellowship at University of Michigan Medical Center. He is board certified in Infectious Diseases and a Fellow of the Infectious Diseases Society of America.

Chris Latko is the Chief Technology Officer at PHC. He joined as a Principal Software Architect where he played a key role in building out the platform. He has over 25 years experience in the technology sector holding positions at companies he started, Fortune 500 companies, and a multitude of startups both in the United States and Japan. He has spent the last decade designing, refining, and reimplementing architectures for hypergrowth startups such as Boxfish, Paxata (acquired by DataRobot), Banjo, and Globality. Chris earned two patents for designing a streaming data ingestion/data normalization platform.

Kendall Burman serves as PHC’s General Counsel and Chief Operating Officer. Prior to joining PHC, Burman held leadership roles at Alloy, a data and technology start-up for the progressive political market. Burman previously served as the Deputy General Counsel for Strategic Initiatives at the Department of Commerce and as Associate White House Counsel and Special Assistant to the President in the Obama Administration. She was also a counsel in the cybersecurity and data privacy practice at Mayer Brown and served as Chief Staff Counsel for President Obama’s 2008 campaign.


Burman is a graduate of Bowdoin College and received her J.D. from the University of Chicago where she was an editor of the law review. She was also was a fellow at both the New America Foundation and the Center for Democracy and Technology.

Dr. Charity Dean is the CEO, Founder and Chairman of The Public Health Company, a venture-backed Silicon Valley technology startup. 


In August 2020 Dr. Dean founded PHC, envisioning a commercial-grade global biosecurity platform to empower enterprises to manage biorisk at scale. Dr. Dean’s obsession with building a new solution was born out of 24 years in public health and the recognition that Silicon Valley innovations in artificial intelligence and machine learning could birth this entirely new capability. Two years later PHC PharosTM is a game-changer for numerous businesses providing real-time, dynamic risk management across their global footprint and assets. 


Dr. Dean founded PHC having served as the Assistant Director for the California Department of Public Health where she was part of the executive team under Governor Newsom running the COVID-19 pandemic response. She co-founded and co-chaired California’s COVID-19 Testing Task Force and under her leadership, California went from ranking last in the nation for testing to first in three months. In 2019, Dr. Dean served as Acting State Public Health Officer overseeing 4,300 staff with an annual operating budget of $3.5 billion. 


Before her move to statewide office, she served as the Public Health Officer for Santa Barbara County and oversaw a myriad of disease outbreaks and biological threats; she also served as attending physician for TB, HIV, and homeless medicine at the Santa Barbara Health Care Centers. 


Dr. Dean was awarded Physician of the Year in 2018 by the Central Coast Medical Association and honored as one of the Women of the Year by the California State Legislature.


Dr. Dean is a co-author of Lessons from the COVID War. Her work during the pandemic is the focus of Michael Lewis’ book The Premonition. Dr. Dean has shared her insights about the danger of biological threats and the changes we must make before the next crisis in a number of interviews and podcasts.


Dr. Dean holds a Doctor of Medicine and Master of Public Health and Tropical Medicine from Tulane University and a Bachelor of Science in Microbiology from Oregon State University.

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