This is Not a Drill – What the Mexican Swine Flu Outbreak Means for Public Health and the Pharma Industry

J0178658 For many years now, public health officials have been watching with worry for signs that the Avian flu virus might leap from birds to humans and become transmissible in a way that brings the onset of a flu pandemic not unlike the famous one that occurred in 1918-1919 and which is credited with killing as many as 50,000,000 people.  (Two books on this subject I highly recommend are John Barry's The Great Influenza:  The Epic Story of the Deadliest Plague in History and Gina Kolata's Flu:  The Story of the Great Influenza Pandemic of 1918 and the Search for the Virus that Caused It )  The generally accepted scenario has been that the avian flu virus would mutate in a way that facilitated easy transmissible among humans and that such an outbreak might first emanate geographically from there. 

At the end of last week, the scenario took a different turn.  Public health officials were reporting on a different type of viral outbreak though, this one a combination of human flu, swine flu and avian flu that was making hundreds of people in Mexico City ill and is believed to have caused 60 deaths in Mexico, 57 of which were in Mexico City – a city of 20,000,000 people.  Over the weekend, the number of deaths jumped to 68 by Sunday morning.  By Sunday afternoon, reports had the death toll over 80 and there were possible flu cases in Australia and Europe.  

Like the great influenza pandemic, this virus seems to be most lethal among the young and healthy. As a consequence, it is being reported that health authorities in Mexico City have shut down public buildings – libraries, schools and museums and screening has begun of airline passengers who appear ill.  In addition to the cases in Mexico, as of April 25, there were additional cases reported in the U.S. – in California and Texas.  By Sunday, Kansas and New York were also reporting likely cases.  It is only a matter of time before cases turn up in other metropolitan areas, such as Chicago. Also on Sunday afternoon, the U.S. declared a public health emergency.  

It is not a cause for panic – but it is certainly a cause for concern and time for businesses to take pause and re-think their pandemic plans, many of which were formed a few years back before so many changes in the communications landscape.  

That is particularly true of the pharmaceutical industry, which not only markets drugs, but manufactures them as well – often in Mexico.   The fact that it is next to the U.S., has abundant and inexpensive labor, and is a member of the North American Free Trade Agreement (NAFTA) together make it an ideal manufacturing site for many industries, including the pharmaceutical industry.  Many drugs made there supply other parts of the world, including the U.S.  That means that those U.S. companies with subsidiaries there need to be prepared to speak to (1) disruptions in the supply chain and (2) public health measures within their own facilities to stem the spread of the swine flu.  In addition, people traveling by air to and from Mexico who even cough are likely to be quarantined – some of them may be employees.  My guess is that many companies have prepared for such an eventuality in the event of an outbreak of avian flu.  It is time to dust off those plans and focus attention on Mexico itself.

Secondly, while the FDA has aptly demonstrated it does not have a firm grasp of what it is doing in regulating new media, and does not do as good of a job as the CDC in employing new media (see last week's posting about the messy FDA YouTube channel), that is not sufficient reason for pharmaceutical companies to dismiss new and social media as a means of communications, particularly in this respect, with regard to internal communications.  As seen in Mexico City, there has already been a shut down in society respecting public gatherings.  Social distancing is one of the primary means of trying to contain an epidemic – meaning that people may soon not be going to work.  How will companies communicate with employees in such a circumstance.  Email is obvious, but it is also somewhat slow and is only two way, when there are individual answers.  There is no "conference call" for email.  Until Yammr, that is. Yammr is an Internet tool that is like Twitter – allowing the sharing of messages among large groups of people, but allows for the conversation to occur within a closed community – meaning all employees or senior staff. Yammr should become an essential component of pandemic planning and my guess is, it hasn't.  Don't delay.  By the way, Twitter will allow you to chose who may follow you as well, which means you can create a sort of closed community.

Finally, and more remotely, is the blood supply.  While it is theoretically possible that flu could be transmitted by contaminated blood from a donor not yet showing symptoms for flu, the more likely affect on the blood supply may be on the amount of blood available in the time of a pandemic.  It might be a good idea for companies to consider holding blood drives now, rather than later.  This is but a few of a host of questions that need to be addressed – like what will happen during extreme social distancing to the drug pipeline – how will FDA be operating – do they have a mechanism for continuing operations?  Will patents be extended during the time it takes for a pandemic to wage its war?   

You can just about bet that the pork people are scrambling to put together their communications disaster playbook regarding consumer confidence around eating pork.  They should call the chicken folks, who were the ones who prepared.  Of, they could call me – I'm available to help and I proudly and confidently ate bacon yesterday.

Of course, this may all resolve itself without any draconian effects at all.  One hopes.  But the rapid progress within just a few days of such a disturbing possibility should be a wake up call for everyone.  This is not a drill.

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