business continuity planning for emergencies like ebola virus diseases for all sectors
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Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 1 |
Preparedness
Ebola Virus Outbreak
Business Continuity Plan (BCP)
Generic Presentation
Dr Nirmal Kandel , MBBS, MA (Anthropology), MPH, EMBA
Public Health Specialist
Disclaimer: This presentation is developed with a view of advocating a need of
development of Business Continuity Plan (BCP) as part of preparedness or
readiness/response plan for emergencies like Ebola Virus Diseases or any other
emergencies, where the response may have to compromise the essential and critical
functions for all sectors.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 2 |
Outline
Difference between Contingency Plan and Business Continuity Plan (BCP)
Impacts of Ebola (socio-economic and others)
Potential impacts health and non –health sectors
Rationale for BCP
Planning assumptions
BCP Planning and Steps
Lack of Preparedness: Example
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 3 |
Difference between CP and BCP
BCP is part of CP
A Contingency Plan
Protects life safety in the event of
an incident and is geographically
based, meaning that your office’s
plan should be specific to its
location. In other words, what will
you do in case of an immediate
emergency- where will you go, what
should go with you, how will you
account for everyone, etc.
A Business Continuity Plan
Protects the job that you do, and
should outline how you will
continue do essential tasks in the
event of an incident that may
affect operations. For example,
how will you provide the
immunization if there health care
workers are sick? Or how will you
do your job if you can’t use your
office space for a week
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 4 |
Socio-Economic Impact
EVD
outbreak
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 5 |
Potential Impact on Ebola Outbreak
Projections show a possible $32.6 billion loss to West Africa over the next
two years (only in West Africa) – source: WB
Deaths, absenteeism and attempts to avoid infection have consequences
for supply and demand side of economy – Labor markets close, markets close, utilities unreliable, telecoms break,
cash in short supply
– Mining and production reduces
Threats to Rule of Law and Security (recently established peace after
decade long conflict
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 6 |
Potential Impacts on Non-Health Sectors
Deaths/ Illnesses Quarantine
Care
Fear
Absenteeism
Decreased Supply
Reduced production
Disrupted
transportation
Trade of
commodities
Cross sectoral
interdependencies
Increased Demand
Logistic support
Water & Sanitation
Communication
Banking services
Mortuary & Burial
Electricity/Power
Health Care
Security
Breakdown of Services
Economic and Social Disruption
Changed Demands
Lack of BCP
Decreased Demand
Retail Trade
Transportation
Leisure Travel
Gastronomy
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 7 |
Other Risk and Impact
Livelihoods
Human Health
Governance & Security
Social & Humanitarian Needs
Economic Systems
• Food and income loss from loss of mining and production and other source of incomes
• High illness & potentially higher death rates
• Overstretched health facilities
• Disproportionate impact on vulnerable
• Increased demand for governance & security
• Higher public anxiety
• Reduced capacity due to fear, illness & death
• Deterioration of coping & support mechanisms
• Interruption in public services
• Quarantine policies
• Trade & commerce disruptions
• Degraded labour force
• Interruption of regular supply systems
Categories of Risk
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 8 |
Rationale for BCP
During emergencies like this entire sectors are affected by absenteeism
– Sickness (quarantine)
– Deaths
– Fear
– Care of sick members
Recent World Bank’s estimates
– 46 percent of those working at the start of the Ebola crisis are no longer
working as of early November 2014 (in Liberia)
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 9 |
Rationale for BCP – Absenteeism e.g. Liberia
46 percent of those working at the start
of the Ebola crisis are no longer
working as of early November 2014
Self-employed and wage workers have
been the hardest hit, while agriculture
is beginning to see returns to work as
the harvest approaches
Food insecurity is worsening, especially
for the poorest, due to rising rice prices,
falling incomes, and transportation
restrictions
Source: World Bank Group: The Socio-Economic Impacts of Ebola in Liberia
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 10 |
Rationale for BCP…Contd
Impacts are
– No money available and many households have reduced the number of meals
eaten and restricted adult consumption in order to feed their small children.
– Negative economic effects in all communities due to mandated closures to
contain the outbreak, irrespective of the area infected
– Many of the wage employment have either been asked to stay at home or
have lost their positions entirely.
– Others like small scale traders – loss their business due to market closure,
customer reserving their spending etc.
– Impact will be high in these groups, who don’t receive salaries from public
sectors.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 11 |
Impacts on Health Sectors
– Immunization rates have been dropping with loss of health care workers and
reluctance of the population to visit health facilities.
– The long planned measles campaign in one of the country has been postponed
until after the Ebola epidemic is over.
– The malaria control effort has been impacted and likely to linger long after the
outbreak ends and achievements are at stake
– Patients who need lifesaving emergency surgeries like appendectomy, C-sections
and others are at risk due to limitation of surgical capacity as well as the risk of
being turned away if they have signs of vomiting or fever.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 12 |
Impacts on Agriculture Sector
Agriculture is the largest sector in most African economies
Food security is major challenge – leading to impact on nutrition, productivity and
development
A loss of agricultural labor could cause farmers to switch to less-labor intensive crops.
Affect food and cash crops production ultimately slowing down the volume of trade
between countries.
– In Liberia, rubber exports which were expected to be about US$148 million in 2014 are estimated to
drop by 20%,
– Construction of US$ 10 million modern palm oil mill for which construction started in July 2014 has
been put on hold (World bank, 2014)
Loss of GDP
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 13 |
Impacts on Education Sector
Five million children out of school in West Africa due to Ebola
Affecting supply of experienced teachers in schools owing to illness or
death.
Children may be forced to drop out of school due to death, the inability
of parents to pay schools fees and reduced household incomes.
Many of the children may land up on child labor due to poverty
Some schools have also been closed by governments
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 14 |
Vicious Cycle Deaths/ Illnesses Quarantine
Care
Fear
Absenteeism
Lead to
Reduced production
Disrupted transportation
Trade of commodities
Cross sectoral interdependencies
Impact
Higher fiscal deficits
Rising prices
Lower real household incomes and
Greater poverty
Breakdown of Services
Economic and Social
Disruption
Changed Demands
Lack of BCP
Shortage of
Workforce
Fall in GDP
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 15 |
Leading to
Higher fiscal deficits; rising prices; lower real household incomes and
greater poverty.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 16 |
Economic Impacts
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 17 |
Headcount Poverty Rate
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 18 |
Rationale for BCP
In absence of BCP may lead to:
– Disruption of essential health services like immunization, maternal and child health
care;
– Disruption of agriculture and production sectors leading to fall in GDPs
Inability to provide these services not only impacts health of people but also
impact on overall development of the country,
– Can compromise achievements made for MDGs;
– Other goals of sustainable development and
– Put these countries at stake, where peace has established after decade long
conflict and this kind of situation may lead to newer form or revival of the conflict.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 19 |
Plan and Planning
Plans alone are nothing; planning is everything.
Vital element is to involve stakeholders in the planning process and
identify their roles and responsibilities
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 20 |
Planning assumptions
EVD outbreak is overwhelming not only the health services but also other sectors
Workers’ Absenteeism due to one of the four causes
Saving life, reducing morbidity and mortality and decreasing impact on socio-economy are high
priorities.
Maintaining critical and essential services during EVD outbreak is a priority
Adequate training is delivered and is made aware of its existence and their and responsibilities
during outbreak.
During outbreak, essential staff and can be mobilized to EVD response and to other essential
services.
Sharing the resources across the sectors and partners are essential on the success of responding
the EVD outbreak.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 21 |
Core Business Continuity Actions
Identify the critical functions
Identify the personnel, supplies and equipment vital to maintain essential functions
Consider how to deal with the anticipated level of staff absenteeism
Provide clear command structures, delegations of authority and orders of succession
Stockpile strategic reserves of supplies and equipment
Determine the ability of the organisation to continue operations if critical infrastructure services and/or supplies become unavailable
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 22 |
Core Business Continuity Actions….Contd
Agree on a system of communication with staff, partners, HQs, suppliers and customers
Identify units/departments that could be downsized or closed to reallocate resources
Assign and train alternates for critical posts
Plan for security risks to operations and supply chains
Consider alternative methods of working, e.g. changes to shift patterns, working from home
Consider the implications of travel restrictions and develop procedures to follow if such restrictions are imposed
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 23 |
Core Business Continuity Actions CONTD
Train staff on infection control and communicate essential safety messages
Consider ways of reducing social mixing (e.g. working from home, reducing
meetings and travel) and test these in advance
Consider the need for family and childcare support for essential workers
Consider the need for psychosocial support services to help staff remain
effective
Consider and plan for the recovery phase
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 24 |
Business Continuity Planning (Organizations, facilities, departments)
Step 2
Business Impact Analysis (Identifying Essential Services/Functions)
Step 1
Governance and Leadership
and establishment of BCP
Committee
Step 3
Identifying required skills sets and
staff allocation and reallocation.
Step 4 Step 5
Documentation for each
Essential Service/Function
Step 6
Compare to the
“preparedness checklist”
Maintain
essential services
Business
Continuity
Identifying relevant issues and/or
Implications for Implementation
Step 7
Review, Test the Plan and
Revise
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 25 |
Step 1: Governance and Leadership
Establishment of BCP Committee
Agency/institute’ senior management team is responsible for overseeing
BCP process.
– Having policy by determining how the agency/institute will manage and control
EVD outbreak and its risk
– Resourcing qualified personals and sufficient resources to apply BCP.
– Ensure the BCP is tested and reviewed; staff are trained and are aware of their
roles and responsibilities.
– Monitor and evaluate the application of BCP and make adjustment accordingly
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 26 |
Step 2: Business Impact Analysis
(Identifying Essential Services/Functions)
Business Impact Analysis: The process lead on identifying and
prioritization of essential functions.
Essential Services is defined as follows:
– A service and/or function that when not delivered creates an impact on the
wellbeing and safety of individuals.
– A service and/or function that may lead to the failure of a business unit if
activities are not performed in a specified time period.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 27 |
Step 3: Identify Required Skill Sets and Staff Allocation
Identify the number of staff (by classification) required to maintain the
essential services/functions. Include essential services/functions
created or increased by the “surge activity”.
Mapping of Human Resource Capacity of the agency/institute.
Identify any special requirements necessary to perform the essential
services/functions.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 28 |
Step 4: Identify any Relevant Issues and Implications
for Implementation
Recognizing vital issues and implications that may have consequences in any
essential service reduction, modification, and/or elimination is an important
procedure.
Each should be discussed and any relevant comments/solution should be
documented.
It is recommended that part of this process include documentation and a planned
response for each essential service/function.
– Activation of Plan
– Planning
– Policies and Procedures
– Surveillance and Attendance
– Delivery of Services
– Human Resources
– Communications
– Testing of Plan
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 29 |
Step 5: Documentation for Each Essential Service/Function
Identified essential services/functions
Identified any relevant issues/implications that may arise when the level
of service/function is modified and/or reduced
This part of the plan explains how each of the essential service/function
is maintained, reduced, modified and/or eliminated, who makes the
decision, what are the solutions are in place, any other necessary
actions to follow and any communication strategy.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 30 |
Step 6: Compare to the “Preparedness Checklist”
Review the Emergency Preparedness of your agency/institute to
safeguard that all issues have been addressed such as the decision-
making process and authority for implementing service modification,
reduction and/or elimination.
To review, additional documentation may be necessary to ensure that
all critical elements have been addressed.
Compare the checklist with preparedness checklist of agency/institute;
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 31 |
Step 7: Review, Test the Plan and Revise
Circulate the plan for information and training purposes within the agency/institute
once the Business Continuity Plan is ready.
Conduct annual review, test the plan and revise the Business Continuity Plan as
necessary. .
Finally, conducting an emergency exercise to test the plan will help staff
understand the Business Continuity Plan, how and when it’s activated, who is
responsible for what, and how it fits with agency/institute strategy to deal with a
EVD outbreak.
Plans alone are nothing; planning is everything; however, if we
don’t use and test it then planning alone is nothing too.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 32 |
Lack of Preparedness: Maternal Health Services
Pregnant
mother goes
to health care
facility for
delivery
Health Care
workers
absent and
some
mobilized to
ETC
Complication
of Pregnancy
and delivery
Increased in MMR
and IMR
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 33 |
Lack of Preparedness: Logistic or Energy Department
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 34 |
Planning Issues Essential Services: Energy
Supplies
Oil/Gas
Alternate
Supplies
Oil/Gas
•Operations
•Maintenance
•Support
•Admin
•Etc.
IT and Telecom
Facility Operations
Human Resources
Electricity
Transportation
Absenteeism,
supplies, etc.
Equipment (Generators, etc)
•Operations
•Maintenance
•Support
•Admin
•Etc.
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 35 |
Operational Status
Human Resources - Operation and maintenance of
technical equipment
Full Operational
Capacity,
24 hours energy
production
No. of available
qualified technicians:
11-13 people
(Full Human Resources
Reserve)
No. of available
qualified technicians:
< 8 people
Reduced
Operational
Capacity,
24 hours energy
production no
longer possible
No. of available qualified
technicians:
9-10 people
(Limited Human
Resources Reserve)
No. of available qualified
technicians:
8 people
(Minimum Required
Human Resources – No
Reserve)
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 36 |
Human resources: Qualified
Health Care
workers/technicians
24 hours service capacity
13 – 10 Full capacity with sufficient reserve
10 - 9 Operation possible with limited reserve
8
(Minimum to run
24 - hour operation)
Critical – Unable to maintain operation if one more
staff is absent
< 8 Continuity of operation impacted
Operational Status Coding
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 37 |
Critical – Unable to maintain operation if
one more staff is absent
8
Operation possible with limited reserve 10 - 9
< 8
13 – 10
Continuity of operation impacted
Full capacity with sufficient reserve
Essential Business
Continuity Areas Overall Operational (BC) Status
Etc.
Human Resources
IT
Supplies/Stocks
Full capacity with limited reserve, re-
stocking very urgent
Stock reserve
for max. 3
days
Full capacity with reduced reserve, re-
stocking should be undertaken
Stock reserve
for 7 days
No Stock
Stock reserve
for > 1 weeks
Full 24-h operations not possible,
reduction of operational capacity
Full capacity with sufficient reserve
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 38 |
Institutional body (Ministry / Specific Team or Committee)
to monitor operational status of all facilities
“Network Planning and Management
Facility A Facility B Facility C
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 39 |
Role of Government
Government should provide advice to businesses on business
continuity planning and maintaining essential services despite worker
absenteeism
Government should work across ministries and sectors on developing
plans.
Government should work with the private sector to ensure business
continuity planning is coordinated and integrated
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 40 |
Business continuity plans
Be specific
Identify who is going to do what when and how
Identify what actions need to be undertaken in each phase of pandemic
List emergency contacts
Plan around 2 scenarios: rapid onset pandemic with wide impact and slow onset
pandemic with moderate localised impact
Discuss plans with staff, suppliers and banks
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 41 |
Test
Test contingency plans
Simulation exercises
Scenario planning
Tabletop exercises
Learn lessons from tests
Identify areas that need improvement
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 42 |
References and Acknowledgement
Nirmal Kandel. Presentation on Whole of Society Approach for Pandemic Preparedness in National
Training of Trainers on WHOLE-OF-SOCIETY APPROACH on Pandemic Preparedness, Dhulikhel, Nepal,
29-30th June 2010
WHO. Whole of Society of Pandemic Readiness. WHO Guidelines for pandemic preparedness and
response in the non health sector. Geneva, July 2009
UN. Socio economic impact of Pandemic Influenza. United National System for Influenza Coordination,
2009
World Bank. The Economic Impact of the 2014 Ebola Epidemic: Short and Medium Term Estimates for
West Africa. Accessed on 29th November 2014 (http://www.worldbank.org/en/region/afr/publication/the-
economic-impact-of-the-2014-ebola-epidemic-short-and-medium-term-estimates-for-west-africa
World Health Organization: Ebola Response Roadmap Situation Report. Geneva: WHO 7 Nov 2014. 11 p
(Accessed on 11 Nov 2014 http://www.who.int/csr/disease/ebola/situation-reports/en/?m=20141107)
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 43 |
References and Acknowledgement
Nirmal Kandel. Draft Business Continuity Planning Tool Kit for Ebola Virus Disease Outbreak. Unpublished.
2014
World Health Organization. Ebola and Marburg virus disease epidemics: preparedness, alert, control, and
evaluation. Interim version 1.2. Geneva: WHO/HSE/PED/CED/2014.05. 2014
Loose VW, Vargas VN, Warren DE, Starks SJ, Brown TJ, Smith BJ: Economic and Policy Implications of
Pandemic Influenza. USA: Sandia National Laboratories; Mar 2010. 28 p. Sandia Report SAND2010-1910.
ACAPS Briefing Note. Ebola Impact on Health. Geneva: ACAPS; 26 Sep 2014. 10 p. Accessed on 18 Nov
2014 http://acaps.org/img/documents/b-acaps_briefing_note_ebola_impact_health_26_sept_2014.pdf)
Hayden EC. Ebola obstructs malaria control. Nature; 2 October 2014. Vol 14; Pg 15
Images used in the presentations are downloaded from Google Image search option using best available
title for the image topic. Access in 29th November, 2014: https://www.google.com/imghp?gws_rd=ssl
(these images are used for orienting purpose only and not for commercial any use)
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 44 |
References and Acknowledgement
Olusegun Adegun. The effects of Ebola virus on the Economy of West Africa, through the trade channel.
Academia.edu,. 2014 (Accessed on 6th Dec 2014:
https://www.academia.edu/8391695/Impact_of_Ebola_on_West_African_Economies_through_the_trade_c
hannel)
World Bank Group. The Economic Impact of the 2014 Ebola Epidemic - Short- and Medium-Term
Estimates for West Africa, 2014
World Bank Group. The Socio-Economic Impacts of Ebola in Liberia. 2014
Gabriella Jozwiak. Life and learning under the shadow of the Ebola virus. Tes Connect, 2014 (Accessed on
6th Dec 2014: https://www.tes.co.uk/article.aspx?storyCode=6453319 )
Misha Hussain. Five million children out of school in West Africa due to Ebola. Reuters, 2014 (Accessed on
6th Dec 2014: http://uk.reuters.com/article/2014/12/03/us-west-africa-health-ebola-
idUKKCN0JH20920141203)
Dr Nirmal Kandel, MBBS, MA (Anthropology), MPH, EMBA – Public Health Specialist 45 |
Thank You
Email me:
kandeln@gmail.com
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