Agent Issues How prepared is the travel industry for the bird flu threat? By Dan Luzadder / May 16, 2006 Share 1 -- Preventive MeasuresThe World Health Organization and other health agencies recommend these basic steps to retard the spread of a pandemic flu virus:Stockpiling and use of antivirals like Tamiflu. While any mutation of the avian virus to human adaptation will require development of vaccines, antivirals could at least slow spread of the disease.Basic hygiene. Teaching travelers, employees and customers to wash their hands frequently, disinfecting commonly used equipment like telephones and computers, reducing direct contact and using dust masks.Telecommuting, teleconferencing. Workforce losses in a pandemic flu would approach 50% as the disease runs its course over 18 months and several waves of infections. Keeping workers apart, reducing staff in central locations and telecommuting may help slow the spread of the flu.Avoiding large gatherings. Conventions, sporting events and other large public gatherings are likely sources of infection.Travel restrictions. Limiting travel on public transit may slow the spread of a virus, a technique that could be employed by governments to isolate outbreaks. Restrictions may be of limited effectiveness, however. Source:World Health OrganizationIf avian flu actually mutates into a global human pandemic, travel and tourism will certainly be among the first industries to feel its ravages. But is anyone prepared? While avian flu is responsible for the deaths of 200 million birds, it has so far killed just over 100 people worldwide. Yet health experts warn that it could mutate into a human-to-human contagion -- and should that happen, travel is certain to be a primary vector for the spread of the disease, resulting in what is likely to be a devastating economic crisis.But as awareness of the risks grow, so do concerns about whether travel-related companies are moving quickly enough to prepare to deal with a global pandemic.Governments, United Nations agencies, health organizations and major corporations worldwide are hurrying to develop contingency plans, along with a network of reliable information and services to deal with a fast-spreading and deadly disease.The Bush administration earlier this month released a comprehensive 300-page plan for responding, should the avian flu virus mutate into a major human threat. It has earmarked more than $7 billion to help finance emergency services and planning for potential responses, which range from travel restrictions to ways to maintain essential services and prevent the collapse of the U.S. economy.For the moment, however, the competitive traditions of free-market economies appear to be working against the collaborative initiatives that health authorities insist will be necessary if social, cultural, economic and governmental institutions are to survive: Despite reports of widespread efforts within the travel and tourism sectors to devise plans of action, individual companies remain resolutely mum about most details of their business continuity plans.We have a plan that were working on, said Sam Macalus, communications director for Carlson Cos. in Minneapolis. It basically deals with potential impact on guests, employees and business operations, and we have formed teams to make provisions for guest safety, business continuity and a variety of things from risk management to security and services.But we are not able to discuss specifics, he said. We know that a lot of companies are not getting into any detail right now.Carlson, whose multibillion-dollar global business interests span hotel, cruise and travel management, is among a long list of companies that declined to talk about their preparations for a flu pandemic. And while travel industry associations representing cruise lines, airlines, travel insurance providers and tour operators say their members are beginning to reach out for information and are trying to coordinate such activities, the actual extent of preparation remains murky at best.The magic word here is preparedness, said Geoffrey Lipman, special adviser on avian flu to the secretary general of the U.N.-affiliated World Tourism Organization. At this moment there is no avian flu problem for tourism. And that itself may be one of the reasons why people are scared to talk about this.Spurring DialogueLipman said last week in a telephone interview from London that recent steps to bring travel-related organizations face-to-face with leaders of the World Health Organization have helped spur development of a central portal that companies can use to gather reliable information.Our secretary general took eight tourism organizations from the WTO to meet with WHO leaders in Geneva, who told them that we want to know the full implications of this and we need to get prepared, and that we need an understanding of where you are going, Lipman said. The response was very good. The reaction from WHO was very positive.WHO officials welcomed the early opportunity for the meeting, Lipman said, because if the avian virus does move to the next phase, we will not have time to deal with tourism entities. We will be too busy. If WTO can be a node that the tourism sector can plug into, that will help. The tourism sector in a crisis situation would not have gotten attention.The WTO has since developed the Travel Emergency Response Network (TERN), a clearinghouse for information on international pandemic planning for tourism-related enterprises. TERN includes the International Hotel & Restaurant Association, the Pacific Asia Travel Association, the International Federation of Tour Operators, the United Federation of Travel Agents Associations, the Airports Council International and the International Air Transport Association. The National Tour Association announced two weeks ago that it was joining the network and was encouraging others to do so.Hank Phillips, president of the NTA, said it was a logical reaction to the developing situation.What we have learned with disasters and problem situations in the past is how critical communication and information is, Phillips said. Whether it is what I believe to have been an overreaction by media and consumers to SARS, or what happens when there is a complete communications breakdown like Katrina, communication is absolutely essential. So when we heard about creation of this network, and realizing that a pandemic is global, it is just common sense that we would want to get ourselves integrated into this network to keep our members informed.Lipman said the WTO still had significant work to do on the communications and information systems it is attempting to put in place, a process that could take as long as a year. In the interim, he remains hopeful that no outbreaks will occur before those systems are ready -- and before businesses have added avian flu to their risk-management and disaster-preparedness plans.The World Health Organization has a chart that has six levels of alert, and we are at level 3, Lipman said. That is basically a preparedness level. At this moment, there is no mutated form of the virus. At level four, you would see some form of mutation at a local level. At level five you would see clusters, and at level six, a pandemic. As soon as you move from level three to level four, the rules of the game change.An Early Warning SystemThe potential magnitude of the problem helps to explain much of the corporate reluctance to talk about what happens next, Lipman noted. And most experts agree that the experience with widespread flu outbreaks in 1918 and the 1960s and from SARS (Severe Acute Respiratory Syndrome) in 2003, has raised alarms over what could happen with avian flu. Health officials have warned that while avian flu in humans has so far resulted only from direct contact with infected birds or from contact with bodily fluids of humans who are ill, the virus could mutate at any time. The World Health Organization and others, including the Centers for Disease Control and Prevention in the U.S., are collaborating on detailed global surveillance to detect any indications that the virus has mutated to a form that could be passed among humans through indirect contact.At the leading edge of all of this monitoring is an early warning system that could trigger appropriate responses to an escalation of human infections.Steven Parente, a health policy researcher at the University of Minnesota, where the Carlson School of Management recently held a seminar for companies tracking the potential for avian flu outbreaks, said Rx Hub, a private, real-time database used by pharmaceutical companies to track the use and supply of prescription drugs, could be pressed into service as an early warning system by government entities like the CDC. As viral medication use rises, the database might help pinpoint outbreaks, he said. The CDC declined to comment on that use of Rx Hub.But most experts agree that the speed with which notification of a human-to-human outbreak occurs could mitigate damage through containment measures.An outbreak anywhere in the world would likely result in travel restrictions. But government reports and private-sector experts conceded that even border closings and efforts to quarantine an outbreak might slow a pandemics progress by only a matter of weeks.There are three pillars to all of this: preparedness, surveillance and response-containment, said Phillips. Unfortunately, we dont yet know what all of the containment strategies are. But it seems that the best hope to minimize the economic impact on travel and tourism, if and when this happens, is to contain it and contain it as quickly and emphatically as possible.But that amounts to a fairly desperate definition of best hope, because unfortunately, Phillips allowed, the prevailing strategy of containment is likely the worst possible scenario for the travel industry.Health and tourism officials have repeatedly stressed that, to date, there are no travel restrictions related to avian flu anywhere in the world. But if a pandemic emerges, health officials say, about 92 million people in the U.S. alone could end up infected, possibly resulting in close to 2 million deaths. In such a situation, public transportation, conventions, sporting events and a wide range of other social, cultural, economic and governmental interactions would clearly be affected.This could make the impact from 9/11 look like a walk in the park, said Ken Wilson, a Minnesota consultant who has created a special unit to advise businesses on preparations for a possible flu pandemic. It could have the impact of 500 Katrinas.Especially troubling is the possibility that up to half of the U.S. workforce could stay home, either because they are ill or because they are attempting to avoid infection. Local, regional and federal agencies are predicting that health care workers would be overwhelmed, that hospital emergency rooms would not be able to cope and that medical supplies would quickly be exhausted.Carlson Cos. CEO Marilyn Carlson Nelson told participants at the World Travel and Tourism Councils recent Global Summit in Washington that hotels could be pressed into service as triage centers in the event of human-to-human avian flu outbreaks. And business experts say the implications of a crippling flu for delivery of goods and services -- including medical care -- could bring most of the U.S. economy to a halt.Fear ItselfAt the same time, travel-related businesses worry that media attention to the potential dangers of a pandemic could itself produce a downturn in travel, even if no crisis ever developed.With the release earlier this month of the Bush administrations contingency plans for dealing with a human outbreak of bird flu, awareness of the potential for widespread economic and civil disruptions is growing rapidly. But serious questions remain over approaches to mitigation.At best, the protections available are limited. Wilsons consultants advise companies to do things like train employees to avoid or correct situations where a virus could easily be passed, for example, by cleaning telephones with antiseptic wipes, not shaking hands, avoiding crowded venues and working from home by telecommuting.Travel-related companies acknowledge that they are just now formulating contingency plans for how to deal with a virulent pandemic. In part, this is because of deep-seated concerns within the industry that any attention to the issue might prompt people to avoid travel, unnecessarily damaging the travel industry.While most companies executives are keeping pandemic contingency plans to themselves, one notable exception is Kristen Reeves, business travel manager for Gentronics of Washington, D.C., a large technology company that at any given time has between 100 and 150 employees on the road.Reeves and Gentronics security director, Paul McCauley, said they began planning two months ago after customers began to ask questions about what the company would do in the event of a human avian flu outbreak.We are really preparing for the worst-case scenario, Reeves said. The potential of 50% of the workforce being out at one time, in rolling waves of three to four weeks for a period of 18 months, is daunting.The company is considering both customers and employees in its contingency planning and is trying to develop work-from-home plans that could be put in place if call centers, which the company uses frequently, are shut down. Travel is a major focus of the planning.It is likely that the first human case may not be in the U.S., Reeves said. So we have to make decisions if we will allow travel to certain countries, and we have customers all around the world. We are in the early stages of planning, but how we will manage our travel program is a major part of this. Restricting travel will probably be the first step if an outbreak occurs.Reeves said relationships with travel providers are still awaiting clarification. She has yet to learn how airlines might handle challenges arising from a pandemic, she added.I have posed questions about airline relationships, and people I have talked to from the airlines say they are not aware what the plans are at this point, she said. I have to believe that air carriers are addressing this somewhere, but we know they are focused on fuel prices and bankruptcy woes. But this is something that could take them all down.She said the companys travel department will be working with preferred vendors such as hotels and car rental firms. We need to know what they are doing, how well are cars being cleaned, what steps they are taking. We need to know what their plans are. But we are not at that level of detail yet.Executives charged with creating a plan sat through two months of weekly meetings, but there is still significant work to be done, she said. Just when you think you have thought of all the things you might need to address, a few more come up, Reeves said. This is an evolutionary thing. I doubt we will be finished planning until all this is behind us.McCauley said that even after all the planning on paper was completed, Gentronics would conduct table-top exercises to make sure the plans will work. He said such tests were likely to be a part of any companys planning if they are serious about mitigating economic damage.Major hotel, airline and cruise companies either did not respond to Travel Weeklys requests for comment or declined to answer questions.Cruise Lines At Full SpeedTravel experts suggested that cruise lines were furthest along at developing contingency planning for an avian flu outbreak.Angela Plott, vice president of the International Council of Cruise Lines, said ICCL members were working independently and in a coordinated fashion to develop their contingency plans. She said cruise companies that dock in U.S. ports benefit because health issues are already closely monitored and regulated by the Centers for Disease Control. That oversight has produced relationships that are helpful in planning for, or preventing, shipboard outbreaks.When SARS was a threat, ICCL members adopted guidelines to prevent SARS from being introduced onto ships, she said. And in the unlikely event that that would happen, there were protocols developed. Some of the procedures for avian flu are similar to SARS, like advanced notifications and crew screening prior to boarding.Plott said cruise lines were working to develop alert responses that correspond to the flu risk alerts now being used by the WHO and the CDC, and to determine what level of response was appropriate for each.But she also acknowledged that a full-blown, global pandemic -- whether avian flu or some future virus -- would likely be beyond mitigation by cruise companies.I believe something like that would simply change the way we live, she said.Insurers Begin PlanningJon Ansell, president of the U.S. Travel Insurance Association, said his organization sponsored a seminar on catastrophe response, including avian flu and the potential pandemic, last February in Florida. From that meeting, USTIA established a committee that is developing recommendations for its members.Its mission and charter will be developed in the next 60 days, Ansell said. They will be breaking into work groups for individual scenarios. Were looking into situational awareness and coordination of efforts at a number of levels using government sources, the CDC, WHO and WTO as resources.Companies will have their own continuity plans and will be working with partners and suppliers, he said. The larger question is: How do we integrate those plans with what is happening in tourism and government operations?Such planning is a part of risk management that takes catastrophe planning into account at several levels, he said. While much of the planning in the past has been focused on facilities management, emergency response to natural disasters and the like, the portent of a flu outbreak brings another layer of preparedness.The world seems a little less safe, not only with concerns about pandemic flu but terrorism, natural disasters and impact on suppliers going bankrupt, Ansell said. With all those kinds of potential catastrophes, especially since 2001, the travel insurance industry has been focused on trying to provide services that are responsive to these and find ways to take care of customers when we need to. I think that is largely true of the travel industry in general. So Im sure that we are now better equipped than we were five years ago, and we will be better equipped to deal with avian flu.Wilson, the avian flu consultant, said he believed businesses needed to do more contingency planning than they are doing now and consider fully the ramifications of a potential spread of avian flu to humans. Major companies outside the travel industry are being aggressive about preparations, he said, but he added that many smaller companies -- often essential suppliers to larger enterprises -- may not be taking the threat as seriously as they need to.Companies must look at what it takes to keep their business running, to keep essential services going, he said. They need to be able to say, Here is a set of services we can close for a month; here are some we can close for three months and it wont cripple us. And on the other side, you need to plan for recovery once things are over, to bring business back online.But he said many business owners do not believe, despite warnings, that anything will happen. On the other hand, he said, chilling warnings were coming from organizations outside the travel industry.If you want to hear some scary numbers, you should talk to the funeral directors associations, Wilson said. Here in Minnesota, they are talking about using hockey rinks to store the dead.To contact reporter Dan Luzadder, send e-mail to firstname.lastname@example.org. Canadas been there with SARS outbreakThe 2002 outbreak of Severe Acute Respiratory Syndrome (SARS) in China, which six months later spread from Hong Kong to Canada through an infected airline passenger, has provided some guideposts to planning for an avian flu virus in humans.Geoffrey Lipman, special adviser to the secretary general of the World Tourism Organization, said the WTO has relied substantially on information from Canadian tourism and health authorities as it works to develop resources for the travel industry.The WTO formed a committee to develop response planning by tourism organizations and the travel industry at large, with Canada, Thailand and France playing major roles.Canadas experience with SARS, he said, was key to portions of that planning.In terms of substance, the diseases are quite different, Lipman said. But with both the Asian and the Canadian experience, we are setting up this governance committee to help with risk assessment and management.Ken Wilson, a business consultant who has launched an avian flu unit, said, Canada has had a leadership role in understanding response to this kind of situation, adding that the SARS experience in Toronto has been significant in that respect.When SARS spread to Canada in 2003, health and tourism organizations there took steps to stop the spread of the disease, but the human and economic tolls were swift.In all, 493 people were eventually infected, and nearly 10% of those died. Canadian authorities have estimated an economic impact -- from lost hotel and convention revenues and related costs -- of more than $400 million.Canadian reports and assessments of the SARS episode tell a story that is distressing, Wilson said, because the results could be much more serious if avian flu mutates into a human-to-human contagion. -- D.L.