Philadelphia Inquirer November 20, 2005 PRECAUTIONS, NOT PANIC By Tom Belden Terrifying. That's the best word to describe what some experts are saying about the economic and social upheaval that a global outbreak of avian flu could cause. So far, the H5N1 virus -- the scientific designation for avian flu - has killed millions of birds in Asia and Europe, and half of the more than 130 people in Southeast Asia who contracted it from infected birds. There is no evidence the disease has spread from one human to another. But agreement is widespread on the need for businesses -- and especially the travel industry -- to prepare for the possibility that avian flu mutates into a strain that people could transmit to one another, something some health experts warn is inevitable. At the same time, there is worry that overreaction to what is not yet a serious threat to humans could prompt millions of people to stop traveling, and worldwide trade to slow dramatically. "What the travel industry is trying to do is prepare but not panic," said Suzanne Fletcher, president of the National Business Travel Association, which represents 2,500 corporate travel managers, agents and vendors. "We want to avoid the Chicken Little syndrome that the sky is falling." Fletcher and others cited the epidemic of SARS -- severe acute respiratory syndrome -- which over five months in 2003 killed about 10 percent of the 8,000 people it infected. Despite being confined to Toronto and a handful of places in Asia, SARS caused a steep decline in business and leisure travel to much of Asia and to Canada. Many companies established travel restrictions during the SARS epidemic, which they could revive in a flu pandemic. Patty Seif, a spokeswoman for GlaxoSmithKline P.L.C. in Philadelphia, said the company had not reactivated the policies. "The policy called for no travel to places where SARS had occurred," Seif said. "We have a pretty good process in place for notifying employees of ways they can conduct business that would reduce the necessity of travel." Fletcher, who is also corporate travel manager for Weyerhaeuser Co., the Seattle maker of forest products, said the most important thing employees could do was "stay healthy, so that your immune system works... . I feel like a kindergarten mother when I say this, but you need to tell people, 'Wash your hands, dispose of tissues after they're used." Also, be aware of people around you" who may appear sick. The reason for concern about avian flu is clear: No infectious disease has greater potential than influenza to quickly kill millions of people. Consider 1918-19, when 30 million to 50 million people succumbed in a pandemic, or worldwide outbreak, of the Spanish flu. The 1957-58 Asian flu pandemic caused 70,000 deaths just in the United States, and about 34,000 people in the United States died during the 1968-69 outbreak of Hong Kong flu. Some of the grimmest warnings about the effect of an avian flu pandemic have come in articles published this year in medical and other journals by Michael T. Osterholm, director of the University of Minnesota's Center for Infectious Disease Research and Policy. "The arrival of a pandemic influenza would trigger a reaction that would change the world overnight," Osterholm wrote in the July/August issue of the journal Foreign Affairs. He painted a grim picture of how the health-care system, medical suppliers, food providers, and the transportation system could be severely strained. Because quantities of antiviral drugs to combat bird flu would be limited, Osterholm said, "foreign trade and travel would be reduced or even ended in an attempt to stop the virus from entering new countries - even though such efforts would probably fail, given the infectiousness of influenza and the volume of illegal crossings that occur at most borders... . Global, regional and national economies would come to an abrupt halt -- something that has never happened due to HIV, malaria or TB, despite their dramatic impact on the developing world." The possibility of a flu pandemic prompted the Bush administration to stage a two-day public-awareness blitz early this month and to ask Congress for $7.1 billion in emergency funds for disease surveillance, vaccine development and stockpiling, and preparedness among local public health departments. Two weeks ago, Kevin P. Mitchell, chairman of the Radnor-based Business Travel Coalition, devoted his new Internet-based BTC Radio show, Talking Business Travel, to avian flu and what businesses need to do to prepare, should the disease start to spread among people. Among the recommendations by the organization, which represents corporate travel managers and business travelers, are for companies to have a plan to deal with workers who may be exposed or who contract the disease, and to protect workplaces from infection, he said. Companies may tell employees returning from trips to infected areas to stay home until they can no longer transmit the disease, and may want to screen anyone coming to a workplace. Businesses may "need to take hygiene to a whole new level," regularly disinfecting doorknobs, ATMs, and anything else workers regularly handle, Mitchell said. Companies also need to be able to conduct business remotely, using teleconferencing or e-mail, and to delegate responsibility for making decisions overseas, in case travel is curtailed, he said. Tim Daniel, chief operating officer of International SOS, the global- travel-assistance company that has its North American headquarters in Philadelphia, said that close to half of the major multinational corporations that were its clients were making such contingency plans. Many government agencies and international nongovernment organizations are doing the same, he said. Every business needs someone responsible for monitoring avian-flu information, said Daniel, whose company's global headquarters is in Singapore. "There's a lot of interest and knowledge borne out by SARS," he said. Many organizations, "including our own, were caught off guard... . With SARS, over 10 to 12 weeks, and with it only in parts of China, Singapore, Hong Kong and Toronto, you pretty much saw a grinding-to-a- halt of nonessential travel." The blow that SARS dealt airlines has prompted the Air Transport Association, the major U.S. carriers' trade group, to keep a close watch on avian flu and to urge travelers and travel-industry workers to monitor the U.S. Department of Health and Human Services' Web site for updates. The organization has "a very real concern... without discounting the seriousness of the disease, that the near-term response will be people will overreact and stop traveling," said Katherine Andrus, an attorney for the association. "Now, it's a disease of birds," she said. "It's something that needs to be prepared for. But it's not an immediate threat... and we don't expect people to change their travel plans." Contact staff writer Tom Belden at 215-854-2454 or email@example.com.