Second in a two-part series examining the numbers and epidemiologic factors surrounding the virus that many experts believe could lead to the next pandemic. Part 1 explored why the apparently lower number of human H5N1 cases in early 2007 does not mean the pandemic threat is receding.May 17, 2007 (CIDRAP Source Weekly Briefing) – Before this week, it might have been easy—albeit wrong—to draw the conclusion that the pandemic threat was lessening. But when the World Health Organization (WHO) on May 16 confirmed 15 human H5N1 cases and 13 deaths in Indonesia, dating back to January, official WHO data now show that this year’s tally of avian influenza in humans is at least keeping pace with 2005, when media coverage of H5N1 reached its zenith. (See the sidebar, “Keeping tabs on H5N1 media coverage.”)The WHO confirmation may produce a spike in news coverage, which might help correct the misimpression given by greatly diminishing news coverage that H5N1 is a fading risk and put the issue back on the radar screen of top executives. “If it’s not in the media, for the average American it’s out of sight, out of mind,” says Penny Turnbull, senior director of crisis management and business continuity planning at Washington, DC–based Marriott International, Inc.From Jan 1 to May 16 of this year, 43 official human cases of H5N1 were reported, with 27 deaths. This compares with 98 cases and 43 deaths for all of 2005. Even with the newly confirmed Indonesian cases, 2007 numbers still appear to be off 2006’s pace of 115 cases and 79 deaths for the entire year. Although the pandemic threat isn’t fading, it could look that way to those not fully informed.Pandemic preparedness planners, say Turnbull and other experts, need to frame the situation to more accurately reflect the reality that the pandemic threat is, ultimately, not about case numbers.This is a difficult task, given that many in the field may have given the impression that it was about numbers, says Peter Sandman, risk communicator and Weekly Briefing deputy editor. “We need to take some of the blame for the misimpression, because we put too much emphasis on the number of human cases and human deaths,” he says.Pandemic preparedness planners can help correct that misimpression by communicating to senior executives that the real threat to business lies not in numbers but in failing to use this time to fortify their business.Striking a balanceKeeping up the pandemic preparedness momentum relies on identifying “teachable moments” rather than reporting on each new human H5N1 case, Turnbull says. “It’s finding a very judicious balance between providing good, valuable information and getting the timing right,” she says. “You don’t just want to keep on issuing reports and updates when there’s nothing of much value to report on.”For example, she says, the Centers for Disease Control and Prevention’s (CDC’s) release of its “Community Strategy for Pandemic Influenza Mitigation” report in February and its recent guidance on masks were good opportunities to present new, concrete information to senior executives. National Emergency Preparedness Month, in September, will provide another chance to drive home the importance of being ready.Strategies that you want the company to adopt don’t necessarily have to be couched in terms of pandemic preparedness; indeed, Turnbull says some strategies may be better received by pandemic-weary executives if presented under the general heading of seasonal flu mitigation or disaster preparedness.”You want to use these opportunities to reinforce the behaviors that you want to see happening during a pandemic,” she says.Another teachable moment might be the Apr 26 announcement that Roche was cutting back on production of the antiviral Tamiflu because governments were not buying as much as predicted, Sandman says. While a senior executive who does not want to invest in a stash of Tamiflu that may expire before a pandemic occurs may view that news as proof that the need to prepare is not as urgent, a planner can use this as an opportunity to argue that now the company could buy a supply without worrying that the purchase might be taking it away from emergency workers.”Of course, you should admit that Roche has found a smaller pandemic preparedness market for Tamiflu than it—and preparedness experts—hoped,” Sandman adds. “But your company isn’t planning to sell Tamiflu; it’s planning to use it. Roche’s sales problems have very little to do with whether the XYZ Corporation needs an antiviral stockpile to keep operating in a pandemic.”Working with numbersBecause people in the pandemic preparedness field have always pointed to the growing number of human H5N1 cases and bird outbreaks as an indicator of the pandemic threat, they’re in a weak position to turn around and say the numbers aren’t important, according to Sandman. “The number of people that caught the disease is absolutely irrelevant,” he says. “The disease that causes a pandemic is one nobody’s caught yet. We should have been saying so all along.”Now, the people who never wanted to spend money on preparedness can use those very numbers to try to prove their point. “I bet the numbers are giving very valuable ammunition to people who want to argue that this issue isn’t worth their company’s time and investment,” Sandman says.Likewise, the strategy of giving the public the impression that a pandemic was imminent (because otherwise no one would prepare) has also backfired. “Nobody says we know it’s imminent, but we certainly have given the impression that it’s imminent,” Sandman says. While that strategy seemed to mobilize the public for about a year, by now many Americans, feeling misled, have shrugged off the threat.Reframing pandemic preparednessRather than backing off from communicating about pandemic issues, reframe them, Sandman says.Focus on the potential destruction. “Good pandemic preparedness warnings are about the potential magnitude of the risk—not the probability of the pandemic,” he says.Use the insurance industry analogy. You can say, Sandman says, “It’s not like hedging is unknown in our business. We spend a lot of money in our business on getting ready for things that may or may not happen. If there is a pandemic and if it’s severe, the impact on our company can be huge.”Emphasize that the world is fragile because of our just-in-time economy. Many people mistakenly believe that the world is much better prepared to handle the effects of a pandemic now than it was in 1918. “We’re more vulnerable to pandemics than we ever were before,” he says.Point out that business continuity isn’t about media popularity. “Companies are supposed to make a business judgment about which issues deserve sustained attention,” Sandman says. “I would tell my management that, now that the media focus is elsewhere, companies are the only force capable of preparing their employees.” Individualizing the planStephen Redd, MD, director of the CDC’s Influenza Coordination Unit, says that the slightly lower numbers of human H5N1 cases in 2007 haven’t produced pandemic fatigue in the government sector. “There’s no evidence that we’re at reduced risk of a pandemic, so we understand that we need to continue all the work that we’ve been doing for the past several years,” he says.To keep up the pandemic preparedness momentum during the past year, Redd and his team conducted a 24-hour tabletop exercise followed by a 48-hour exercise. “Those experiences have helped us realize that there are a lot of challenges and a lot of things we still need to do,” he notes.Redd recommends that businesses conduct these drills as a continuing cycle of activity. “The cycle is to develop a plan, exercise the plan, and then, based on the results of those exercises, revise the plan,” he says.Another process that keeps preparedness planning in the forefront is to charge employees with getting themselves and their families ready for a pandemic. According to Redd, “I think it does help reduce the risk of complacency for people to need to do something for themselves.”
Credit: Liberal DemocratsBaroness Sharon BowlesBaroness Sharon Bowles, a member of the UK parliament’s upper house and former chair of the European Parliament’s Economic Affairs Committee, also submitted evidence to the Kingman review.In it, she echoed the LAPFF’s call to put the FRC, or its replacement, on a statutory footing with full accountability to parliament and an explicit duty to act in the public interest.She also called for the watchdog to be stripped of its responsibility for accounting and auditing standards, arguing that this conflicted with its regulatory oversight functions, creating a “toxic feedback loop”.Baroness Bowles also accused the FRC of being a “cheerleader for things in both IFRS and in company law that have caused the kind of problems that are coming to light”.FRC supportThe embattled organisation has, however, received backing from other bodies for it to continue in its role as the UK’s audit and corporate governance regulator.In its submission to the Kingman review, the Institute of Chartered Accountants of England and Wales (ICAEW) argued that the FRC was “the right body” to “represent the UK’s interests and to promote international regulatory and investor confidence in accounting, auditing and corporate governance in a post-Brexit world”.In contrast to other respondents, the ICAEW rejected the charge levelled at the FRC by politicians in the wake of the collapse of outsourced services provider Carillion that the watchdog’s oversight was characterised by “feebleness and timidity”.The institute argued: “On the contrary, we have encountered examples of FRC firmness over the years, and there have been moments of marked disagreement between us. The FRC’s enforcement team has, in our view, on occasion demanded excessive sanctions.” Local authority pension schemes have urged the UK government to break up the Financial Reporting Council (FRC) and make its successor bodies subject to full parliamentary scrutiny.In a submission to the panel currently reviewing the audit watchdog’s future, the Local Authority Pension Fund Forum (LAPFF) said the FRC was beyond reform and riddled with conflicting objectives.The submission – seen by IPE – said: “The central matter is upholding the public interest. The outcome must involve parliament… The regulatory model should be first and foremost implementing the laws that parliament has already passed. Parliament and the courts determine what the public interest is.”The submission went on to warn that the “risk of bodies being buried” was sufficient reason to scrap the FRC to avoid passing on a toxic legacy to its successor. Among the risk elements singled out by the LAPFF were conflicts of interest, potential breaches of public procurement rules for legal services, and potential claims against the FRC for regulatory failings.LAPFF members told the review – led by top civil servant Sir John Kingman – that they wanted to see the FRC’s existing responsibilities for accounting standards, enforcement and corporate governance hived off into separate bodies on a statutory footing. Credit: Liam MustaphaPwC was charged following the bankruptcy of BHSIn response to criticism that it is too soft on those it regulates, the FRC has recently beefed up its disciplinary processes. In June, it fined and reprimanded auditors PwC and the firm’s former partner Steve Denison over shortcomings in the 2014 audits of BHS and its parent company Taveta.An FRC spokesperson told IPE: “The FRC awaits with interest Sir John Kingman’s final recommendations after he has concluded his review of all the submissions to his inquiry. We are not commenting on any individual responses to the inquiry.”Both PwC and KPMG declined to release their submissions to the Kingman review. Neither EY nor Deloitte responded to a request for their submissions. According to a document obtained by IPE from the UK’s Department for Business, Enterprise and Innovation, which sponsors the FRC and its activities, the inquiry has no plans to publish submissions to the inquiry.The Kingman review is expected to publish its findings in the coming months.Other submissions to the review include contributions from the Association of Accounting Technicians and the UK Shareholders’ Association.The Kingman Review of the FRC’s role was announced in April following a wave of criticism of the accounting industry regulator. It was accused of a number of conflicts of interest and of being too close to the companies it polices to be an effective deterrent and watchdog.Last year, IPE reported how the FRC had been attempting to avoid classification as a public body since 2004, and so avoid many of the disclosure rules this would involve. This prompted dozens of questions to the government regarding the FRC’s operations from Baroness Sharon Bowles.
MATTHEW KUTZ/Herald photoWhen Wisconsin volleyball takes on the Wolverines this Saturday, Maria Carlini will be playing with a little more pressure and a lot more incentive.A 6-foot-1 outside hitter from LaSalle, Ontario, Carlini has played a key role in helping the No. 7-ranked Badgers to sole possession of second place in the ultra-competitive Big Ten standings, just a game behind No. 3 powerhouse Penn State.And seeing as she grew up just 45 minutes from Ann Arbor, Carlini would love nothing more than to have her best game of the season against Michigan, the program she had wanted to play for throughout her childhood.”The University of Michigan, since it is so close to home, was my dream school when I was younger,” Carlini said. “But then Coach Rod [Wilde, a Badger assistant] saw me play at a tournament, and he recruited me for Wisconsin.”Carlini said it only took one trip to Madison to see where she really wanted to attend college.”As soon as I came here, I fell in love with it. It’s just a beautiful campus, the atmosphere is so much fun, and the school is so good academically. As soon I came here, I knew this was the school I wanted to go to.”Doubled up: The University of Wisconsin volleyball team can thank Wilde for bringing Carlini here. The junior enters this weekend with a team-high five double-doubles in 2005, and has 13 for her career. Each of the 13 matches has involved double-digit kills and digs.”Coach (Pete) Waite’s main focus is on our defense, so I take a lot in pride in getting double-doubles because it means that I’m helping both offensively and defensively,” Carlini said.Though Carlini does not lead the Badgers in any major individual categories, her double-doubles, in addition to her serving success, has been a testament to her solid play all around the court. She currently ranks second on the team in kills (3.20 per game), digs (3.07), service aces (0.31) and total points on the year (213).What could be more impressive about Carlini’s statistics? Try the fact that she was initially recruited as a middle blocker.”I came to Wisconsin as a middle, so I never really got to play back row,” Carlini said. “After being moved to the outside, I have been working a lot on my defense and on getting more digs.”Life in the UW spotlight: Carlini has enjoyed college athletics immensely since joining the Wisconsin volleyball team. She said that part of the fun is playing in the Big Ten has been one of her favorite parts of the experience.”The Big Ten is the toughest conference for volleyball, so it’s just so much fun, just playing and competing every single weekend,” Carlini said. “It has just been an unbelievable experience and I’m so happy and honored to have the opportunity to play college sports.”One of her best moments came when the volleyball team was honored for winning the InnTowner Invitational at a Badger home football game against — who else? — Michigan.”That was just an unbelievable feeling. Everyone was looking at us, and everyone was clapping and cheering for us,” Carlini said. “It was awesome, especially against Michigan, and to see [Wisconsin] beat them was so much fun.”Captain Carlini: As the only junior in the starting lineup for the Badgers, Carlini is expected to be one of the captains, if not the only one, when Wisconsin hits the court in the fall of 2006.Without senior co-captains Sheila Shaw and Aubrey Meierotto, Carlini said the team has the ability to fill the voids at their positions for next year. “Obviously, losing Sheila and Aubrey, we’re going to need people to step up. Those are huge shoes to fill,” Carlini said. “A lot of the recruits coming in next year are really good, and the freshmen this year are awesome, so it’s going to be so exciting.” Carlini said that as well as the Badgers have played this season, her senior year could prove to be an even better year.”Last year and this year were supposed to be our rebuilding years, and look how well we have done,” she said. “I think that with the experience we’ve gained through this year, we’re just going to be unstoppable next year.”I’m so excited, and so happy that I have one more year with this great group of girls.”Added Incentive: But before stepping into a major leadership role, Carlini’s tall task of the moment will be living up to expectations in front of her cheering section at Michigan.”Last year, I had about 30 or 40 of my friends and family that came to the match, and for them to experience collegiate volleyball was awesome,” Carlini said. “Athletics in Canada is not as big as here, so when we play at Michigan, they get to see what it’s like, because it’s so hard to come all the way to Wisconsin.”Carlini maintained that a loss to the school she used to love would come with an added degree of disappointment for her as a player.”Michigan. That’s definitely the one school I never want to lose to in college.”