Memories are being resurrected of the 1918 flu pandemic that killed millions. Worldwide, the media are full of stories of the potential of the H5N1 avian flu virus to mutate to a form as vicious as the 1918 virus. National, state and local governments, as well as international consortia, are finally developing plans to prepare themselves and their citizens for this threat. Estimates of the number of flu-related deaths vary from a few million to as high as 360 million globally. Estimates for the US range as high as 1.9 million. Conservative estimates of the economic, business and financial impacts range into the hundreds of billions of dollars, with non-dollar costs of similar magnitude.* Whichever of the estimates finally turns out to be valid, consider the consequences for your organization if you are not prepared for such a pandemic. Suppose that half of your staff is either sick, caring for sick relatives, afraid to come in to work, or dead. What would you do?

If ever there was a time for prudent foresight and careful planning, it is now. So, before you panic, please consider the following points.

	Experts believe that H5N1 will evolve into a virulent form (let's call it H5N1h) that is transmittable between humans. The fact that it hasn't yet is good news for the time being but hardly an assurance that it won't. The threat is real and not to be disregarded. Indeed, experts say that the question is not "if" but "when."
	When the virus does evolve to H5N1h it will take several months--probably six months at a minimum--before an effective vaccine can be developed, but less than six months for the virus to spread around the world. It can take up to another year or more before sufficient quantities will be available to the general public. Between the time H5N1h emerges and the time the effective vaccine is developed most people will have no protection from the new virus. Antivirals such as Tamiflu may or may not be effective after people have become infected with H5N1h but, in any case supplies will be limited and distribution will be controlled. The next best approach might be to be vaccinated against the pneumococcal bacteria that cause pneumonia since patients weakened by the flu often acquire a secondary, possibly fatal infection from those bacteria.
	The only real way to avoid getting the flu is not to be exposed to the carriers thereof. Quarantine may be the first step that comes to mind in terms of the public health response to a flu pandemic. Quarantine is the confinement of those who have been exposed to the disease but not yet developed it. Isolation is what those who are symptomatic get. Both can be effective in a simple, limited epidemic. BUT neither of these is likely to work in a real pandemic. Remember Katrina? Public services basically collapsed in the affected areas. In a pandemic the situation may prove to be much worse. Bottom line: you and/or your employer must be prepared to cope with such a crisis on your own.
	What should you and your organization be doing now to minimize these risks? Government will not answer this question for you. But you do have options--indeed some that are entirely within your control.
	One option that is both apparent and proven is teleworking. Decades of experience have established the benefits of telework generally. But in the context of an H5N1h pandemic it provides an excellent way to avoid/reduce your exposure while still being able to get on with your life. This is also an excellent way to avoid infecting your co-workers if you caught the flu (or just a cold) despite your precautions. The good news is that our research indicates that roughly half of the workers in developed economies are potential teleworkers.
	Successful teleworking does require some preparation and training, so it's best to begin doing it now--or very soon--so that you'll be prepared when you really need to do it. Don't wait until it's panic time!
	Telework has a number of very positive "side effects" for all concerned. As millions of others have discovered, these benefits include: stress reduction; improved productivity; reduced work-related expenses; and recruitment/retention of skilled workers. Telework also has been proven to be vital in the recovery from other types of disasters, such as earthquakes, floods, blizzards and terrorist attacks.
	So expand your flu prophylaxis list today to include: Test teleworking now, if you haven't already done so. Check the resources elsewhere in this web site for assistance, beginning at the personal level with our self-evaluation test and cost-benefit analyses to see if you and your co-workers are good candidates. At the organization-wide level you can try our or TCI's impact evaluation services. Include telework in your disaster planning. Many organizations already have included telework as an integral part of their disaster recovery plans. Many that have begun telework in direct response to a disaster (such as an earthquake or a terrorist attack) have expanded their telework programs after the danger abated. When the pandemic nears you'll want to practice good hygiene (i.e., wash your hands thoroughly; don't touch your mouth or eyes; cover your coughs and sneezes; keep away from others who might infect you--or vice versa if you've already caught it). You'll also want to be familiar with other public health suggestions available at places like pandemicflu.gov.