Avian flu and EAPs.

The potential for an avian flu pandemic is beginning to capture the attention of health authorities, governments, media outlets, and citizens in countries around the world. As I write this column, information is being generated for both the general public and businesses about how to prepare for and, if necessary, respond to a serious avian flu outbreak.

Most of this information is focused on medical preparation and response--such as possibilities and recommendations for vaccinations, anti-viral medications, and quarantine requirements-and on advice for companies, such as when and how to implement travel restrictions or close facilities. Very little information has been focused on behavioral considerations. Yet behavioral issues may have a far greater impact on organizations and their employees than the medical realities.

Even if a pandemic fails to materialize, minimizing and responding to the climate of fear and mistrust that may develop simply in anticipation of the possible spread of the flu is likely to be a significant business challenge. Behavioral responses will create an even greater challenge if a pandemic does begin. In any event, EA professionals should begin to prepare themselves and the organizations they serve (or want to serve) to deal with the behavioral challenges and opportunities ahead.

What are the facts? Since 1997, when the first human case of HSN1 avian flu appeared, fewer than 100 people have died from the disease. So far, there has been no sustained transmission from human to human.

But according to the World Health Organization (WHO), "explosive and unusually deadly outbreaks of influenza have occurred throughout recorded history..... True pandemics, characterized by sharp increases in morbidity and mortality and rapid spread throughout the world, have been reliably documented since the 16th century Since then, each century has seen an average of three pandemics occurring at intervals ranging from 10 to 50 years."

The most deadly pandemic of the 20th century occurred in 1918, when a lethal flu virus killed nearly 50 million people worldwide. Researchers have determined that the 1918 flu virus originated from an avian flu and that some of the characteristics that allowed it to spread to humans are already present in the H5N1 avian flu virus.

Hoping to control H5N1 transmission, Asian countries have destroyed more than 100 million domestic and migratory birds, but the geographic distribution of the virus has continued to spread. Experts now believe the virus is firmly established in several countries of Asia, and they predict that bird outbreaks and human cases will continue to occur for the foreseeable future.

Public fears of a pandemic grew after the H5N 1 virus, probably spread by migratory birds, was confirmed in Eastern Europe. Nevertheless, the Pandemic Threat Level, as determined by the WHO, has remained stable (at Level 3) since the first human cases were identified in 1997. The WHO categorizes pandemic risk on a six-level scale:

Level 1: Low risk of human cases

Level 2: Higher risk of human cases (new virus in animals, but no human cases)

Level 3: No or very limited human-to-human transmission

Level 4: Increased human-to-human transmission

Level 5: Significant human-to-human transmission

Level 6: Efficient and sustained human-to-human transmission (pandemic)

Regardless of the actual threat level, fears are building, and work organizations need to begin planning. EA professionals should be among their primary resources. We are the behavioral experts in the workplace, and as I have written before, the essence of employee assistance work is the application of knowledge about behavior and behavioral health to improve the productivity and healthy functioning of the workplace.

The theme of this issue of the Journal is "Marketing and Selling EAPs." The need to manage the behavioral consequences of anticipating or responding to a pandemic is a potent motivator. EA professionals have an opportunity to be a key part of the solution to a concern that has the attention of workplace decision-makers. As a profession, we need to make the most of this opportunity to demonstrate our value to organizations.

The EAPA Website will keep you up to date on the status of the pandemic threat and on how EA professionals and programs can contribute to preparation and response in the workplace. Visit www.eapasse.org for specific steps you should be taking, fact sheets, and other information and recommendations.

John Maynard, Ph.D., CEAP 

John Maynard is chief executive officer of the Employee Assistance Professionals Association. Contact him by e-mail at ceo@eapassn, org.