Out Sick

The prospect of a pandemic is prompting many states to look at IT and other technology solutions as a way to keep operations and services running.

The prospect of a pandemic and significant staff absences has states looking at technology solutions to keep operations running — the most viable being telework.

Samuel Greengard

In 1918, a severe and deadly strain of influenza crippled entire nations, and everyday life changed completely. As some communities closed all shops, schools and government offices, health-care providers found themselves completely overwhelmed by the sick and a death toll that, by some counts, exceeded 50 million people.

Although the timing and nature of the next influenza outbreak cannot be predicted, the risk of such an event is substantial. At the center of this possible storm is government.

Although all 50 states and some local governments have pandemic plans in place — with many focusing heavily on health and epidemiological issues — a growing number of states are also taking a close look at business continuity. In so doing, they’re examining the role of IT and the Internet to keep operations and services intact.


Planning for business continuity during a pandemic is far from simple. “A pandemic is so much unlike any other event from a disaster or business continuity perspective,” says Gary Lynch, a national practice leader and managing director at New York-based Marsh Risk Consulting. “It requires a great deal of strategic thought and planning.”

Although it is possible to tap into an array of technologies that support remote work and collaborative interaction, there’s also the need to deal with the human side. There’s no way to predict how many employees will become infected by a virus and how many will avoid work for fear of catching or spreading the illness.

A pandemic will likely change the way people work and interact, perhaps for a long time. Epidemiological experts estimate that 30 percent or more of the workforce will likely be absent, due to either illness or a fear of contracting the virus. What’s more, the pandemic could last a year or longer — affecting people in waves of illness.

“Virtually everyone would be impacted,” says Jim Krouse, director of market analysis at INPUT, a Reston, Va.-based consultancy. “Without adequate preparation, the disruption would be magnified.”

Preparation is no small matter. According to a recent survey conducted by Citrix Systems, only 27 percent of respondents in the public sector said they were concerned about the impact of an avian flu outbreak on their daily agency operations. In the event of a crisis, more than a few would find themselves scrambling to keep essential services operating and ensure public welfare.

Some states, such as Florida, have embraced up-front planning, particularly in the health sector. In 2003, Florida officials began putting systems in place to deal with hurricanes and other disasters. That meant planning for the shutdown of offices and other facilities in the event of a crisis, and planning for a remote and distributed work environment. The first step was to arm key employees and IT personnel with personal digital assistants (PDAs) so they could exchange e-mail and text messages.

“We needed to know that employees could communicate via voice and data, [since] emergency management and public health are a 24 x 7 proposition,” says Monique Emmanuel, bureau chief of infrastructure support in the Florida Department of Health’s Information Technology Division. Using a BlackBerry or other PDA, she adds, eliminates lag time and allows near-instant response. “People do not have to get back to the desktop,” she points out. “They can communicate wherever they are and whenever they receive a message.”

But Florida didn’t stop there. It upgraded its e-mail system, turned to unified communications to route faxes into e-mail inboxes as attachments, and improved both access and security for its Web-based vital statistics repository, which holds data about births, deaths and marriages — “information that’s essential during a pandemic,” Emmanuel says.

The Florida Department of Health Emergency Notification System (FDENS) is modeled after the U.S. Centers for Disease Control and Prevention’s (CDC’s) Health Alert Network. FDENS supports 24 x 7 x 365 notification and alerts the public health emergency response system.

This assures that knowledgeable public health professionals and key response partners have relevant and timely access to information necessary when they need to respond to urgent public health events. The FDENS vital statistics database uses Microsoft Active LDAP (Lightweight Directory Access Protocol) Directory Services to manage a list of all medical personnel throughout the state and make the data available to hospitals.

It also installed a Citrix Systems server that allows employees to access their work desktop remotely — regardless of what operating system they’re using at home or on the road. Additionally, Florida allows certain employees to access a portal through a virtual private network (VPN). The system will quarantine PCs in a safe area and checks for current antivirus updates before allowing access. The state also has boosted remote capabilities with videoconferencing systems. “People can be informed on what’s going on very quickly,” Emmanuel says.

Florida is now working to determine which employees are essential in the event of a pandemic so that it can equip them with a notebook computer and a docking station rather than a desktop PC. “The goal is to make telecommuting and remote work simpler and more effective,” Emmanuel explains. The next step, she says, is to expand the use of collaboration software. The state began experimenting with collaborative tools in 2005 and hopes to use them widely within the next couple of years. It will allow teams to share calendars, tasks, documents and lists.


Today’s technology tools allow workers to stay connected in ways that would have been unimaginable just a few years ago. The widespread use of the Internet and Internet Protocol (IP) networks has made it possible to communicate and collaborate on work without regard to geography.

Yet, many state and local agencies still have employees who aren’t equipped for remote work, says INPUT’s Krouse. Either they lack access to key databases and files that they could access from a PC at home, or they’re not equipped with a computer or adequate bandwidth to stay connected.

A 2006 study of 17,000 Florida health department employees found that 20 percent do not have PCs in their homes and 21 percent lack Internet access. Emmanuel and other state officials are analyzing ways to remedy this, including introducing a program that allows state workers to buy a PC at a discount from approved vendors. “The goal is to boost communication and connectivity,” she says.

However, many government agencies do not support remote workers adequately, INPUT’s Krouse says. “They haven’t upgraded equipment, networks and connectivity to support the type of environment that’s now required,” he says.

What’s more, many agencies have not yet eased rules for working at home. In the event of a pandemic, with large numbers of workers absent or fearful of spending time around others in an office, the lack of flexibility could cause enormous confusion and disruption. “The policy at many agencies must change,” Krouse adds.

Marsh’s Lynch says that organizations “must place a high premium on prioritizing business functions, activities and requirements according to the greatest needs. This could mean suspending certain government activities in favor of maintaining critical infrastructure — such as public health and safety.”

An organization must identify critical roles, Lynch advises. “It can align social and health activities around them, whether it’s distributing antiviral medication or maintaining a Web site with up-to-date information,” he explains.

Focusing on technology and policy, New Jersey has developed a phone tree system that relies on electronic distribution from top administrators to managers. If there’s an emergency, a recorded message goes out to the desired employee level within the agency. Managers then call their employees to notify them and discuss the problem.

How the state uses the system is key. “We can send messages to employees at all levels of the state government, but it would take longer to distribute the news or information, and we want a higher level of personalization,” says David Gruber, senior assistant commissioner for the New Jersey Department of Health and Senior Services. “There are times when it’s important to discuss an issue rather than simply broadcast it to everyone — and the phone is an extremely straightforward and simple way to handle the matter.”

Managers can also sign on to a private portion of the New Jersey state Web site, where they are able to send e-mail from home — including distribution lists. In the event of a pandemic or other emergency, the ability to stay connected could reduce the odds of service interruptions or complete breakdowns.

“If you have 30 percent to 40 percent of your workforce out, it’s essential to reduce the amount of time required to handle tasks and understand what services are essential and who is available to handle them,” Gruber explains.

New Jersey also equips upper-level management and key employees with BlackBerrys. “In the event of an emergency, it gives us greater capabilities and flexibility,” Gruber says. “It’s an additional means of communication.” Moreover, emergency preparedness staff use an application that gives them remote access to their work PCs from home or while on the road. The state is currently looking into adding a VPN.

Already, the new systems have paid dividends. When the state lost more than 90 percent of its employees due to a budget shutdown in July 2006 (45,000 state workers were absent), it was able to maintain electricity, phone and essential health services using the systems and processes it has in place.

Ultimately, Gruber says, “It’s important to separate the health issues from the continuity issues and make the appropriate changes to the business model so that it’s possible to use the systems and technology to maximum advantage.”


In the event of a pandemic, state and local officials are likely to face some tough choices about which services to offer, and how to staff various departments. Although public health and safety will rank first, deciding how an agency allocates staff and resources could prove daunting.

Seattle is one city that has taken the lead in planning for a pandemic. It has had an emergency preparedness plan in place for years and is currently updating the plan and relying on input from various city departments, says Barb Graff, Seattle’s director of emergency management. Although 911 services, potable water and emergency response rank at the top of essential services, the city is also evaluating the need for all other services. “Obviously, staffing a library or park isn’t as important during a pandemic,” she explains.

The city is looking at how it can cross-train personnel; use telecommuting, VPNs, phone trees and social-distancing strategies, such as changing shifts and working hours; and maximize the use of PDAs.

“Business continuity is a crucial issue, and a pandemic presents unique challenges,” Graff says. “The goal is to be prepared so government will continue to function effectively amid staff shortages and widespread problems. It isn’t possible to over-prepare.”


A pandemic is unlike any other public health emergency. It rapidly infects large numbers of people, overwhelming health-care facilities and medical professionals. The Centers for Disease Control estimates that in the United States alone, an influenza pandemic could infect up to 200 million people and cause 200,000 to 1.9 million deaths. And unlike more common strains of influenza, which disproportionately infect the young and the old, a pandemic takes aim at otherwise healthy teenagers and adults, causing pneumonia and other life-threatening ailments. Health experts say that a vaccine for a deadly strain of virus could take six months or more to develop. In the meantime, health-care, law-enforcement, emergency-response, communications and transportation systems could all be affected. Many businesses would likely shut their doors, and schools might be closed for extended periods. While scientists are increasingly concerned that widely publicized avian influenza A (H5N1) could mutate into a deadly form of flu, there’s no way to predict whether it or another strain of virus will cause the next deadly outbreak.


Here are some suggestions on how state and local agencies can maintain operations in the event of a pandemic:

1. Prioritize business functions and needs. With a large percentage of the workforce absent, there’s no way to keep all services functioning, so it’s crucial to understand which functions are mandatory, which are desirable and which aren’t essential.

2. Map staff to strategic needs. Once an agency has identified urgent services, it’s necessary to use staffing models to determine how it might approach various scenarios. In some cases, it might be necessary to share workers among agencies, says Gary Lynch, a national practice leader and managing director at Marsh Risk Consulting.

3. Introduce technology that facilitates remote work. An array of tools are available to facilitate remote work, including VPNs, collaborative software, videoconferencing, PDAs, e-mail and instant messaging.

4. Ensure that business processes and workflow match the capabilities of the technology. It isn’t enough to install sophisticated technology. Employees must be able to access key files and systems when necessary, and to process work as required, says Jim Krouse, INPUT’s director of market analysis.

5. Train employees to use technology effectively. Employees should know how to use PDAs, videoconferencing, collaborative software, authentication systems and more before an event occurs.

Samuel Greengard is a technology and business writer based in Portland, Ore.

Oct 31 2006