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Failing to prepare is preparing to fail

14 July 2015

Dr. Juncal Caubilla, infection prevention specialist at Diversey Care, examines how organisations can stay ahead of infectious outbreaks through rigorous preparation

The recent outbreaks of the H1N1 virus, Norovirus, and MRSA have all demonstrated just how quickly infectious diseases can spread if left unchecked. And, of course, the Ebola Virus’ recent – and ongoing – deadly rampage throughout West Africa has brought this point home with tragic clarity. With so many lives lost, families and communities torn apart, and whole nations struggling to come to terms with the long-term impact, I suspect that in the coming months we will see a spate of literature addressing the many lessons we must learn from this latest, disastrous infectious disease outbreak.

There is, of course, a very clear take-away in the field of infection prevention: effective preparation and preparedness is one of our best lines of defence in the face of any outbreak. Outbreaks in the remotest corners of the world can spread into any other country in short order due to rapid international travel. However, this recommendation should not only be followed at a national or governmental level, but also by individual organisations. Though few non-healthcare related facilities outside the affected region faced any real risk from Ebola, this is not to say that infectious outbreaks of less-deadly pathogens are not prevalent across the world. Outbreaks of measles, mumps, and Chikunguya found their way into the news in 2014, and all occurred outside the healthcare sector. 


Financial impact

Any outbreak poses a risk to businesses because of the impact it can have upon revenue. Whether an organisation’s employees become ill, resulting in absenteeism, or whether potential customers do not believe a facility is safe and so take their patronage elsewhere; the net result of such an occurrence is almost always a loss of profit.

As has been proven time and time again, the financial implications can be very significant indeed. If the outbreak is severe enough, it can cost a business millions of pounds – both in the short- and long-term. For proof of this assertion, one need only look to some of the infamous occurrences of Norovirus on cruise ships, or MRSA in hospitals. Both the consequent costs involved in bringing the outbreaks under control and resultant public scepticism in going to these particular facilities again will undoubtedly have incurred huge losses. 


To mitigate these risks, preparation is vital. The better prepared an organisation is, the more it is able to deal with an outbreak when it occurs – decreasing the overall financial risk to the business. It goes without saying that the midst of an outbreak is not the time to be playing catch-up. Instead, a company and its employees should know exactly what their next steps should be, and a draft response ensures you will not be caught out should the worst happen.


Assess the risk

To begin with, an organisation should complete a comprehensive risk assessment or audit for different types of outbreaks, and understand what the correct response protocols for each should be. As part of this risk audit process, facilities should learn the primary pathogens which, dependent upon the unique nature of their business, are most likely to occur, and which could result in an outbreak.


For example, MRSA and certain skin infections are commonly associated with prisons and certain athletics programmes at schools and universities. In contrast, these particular infectious pathogens are unlikely to be present in restaurants, and food service facilities should instead be more mindful of food-borne illnesses, which they have a higher likelihood of transmitting. In short, facilities must be mindful to understand and implement the infection prevention practices that are best at mitigating the specific risks they are most likely to face. Of course, many infection prevention practices will be the same regardless of the type of facility – for example, effective hand hygiene practices and good cleaning validation methodology.

Global organisations with facilities spread across the world should also be mindful of regional differences. For example, adoption rates of infection prevention best practices are usually lower in less-developed regions. Furthermore, some facilities may not have the infrastructure or ability to enforce these practices. Therefore, a ‘one-size-fits-all’ approach when preparing for a dangerous outbreak is unlikely to be the best course of action. Instead, risk audits should be conducted in each individual facility, and recommendations need to be designed specifically for each, based upon what is necessary and feasible there. 


Effective communication

It goes without saying that to be as effective as possible, all infection prevention techniques should be clearly communicated throughout an organisation. Similarly, the protocols to follow should a dangerous outbreak occur should also be disseminated and clearly explained. During an outbreak, an organisation must be as proactive as possible to eliminate any confusion and uncertainty. If it has been prepared properly, then it simply needs to execute the plans that have already been created, and which thus far have not been activated. On the other hand, if there has been no planning, and there are no pre-drafted procedures to follow, then an organisation will be forced to have a very reactive – and most likely slow – response. 


Collaborative working

Finally, organisations should not only prepare for an outbreak individually. Many outbreaks are public health issues, and do not discriminate who they affect. Therefore, it makes both humanitarian and financial sense for organisations to consider collaborating and working together to address outbreaks. Diversey Care, for example, is part of Private Organisations for Patient Safety (POPS), a programme run by the World Health Organisation (WHO). Through POPS, the WHO works with private companies, in particular those which focus on hand hygiene related products to harness industry strengths and improve implementation of WHO recommendations throughout the world. Programmes like this, which unite organisations to share knowledge and raise awareness of infection prevention techniques, leave us all better prepared to respond to a dangerous outbreak.

Rigorous preparation – including implementing infection prevention best practices – is the best way to avoid the potentially catastrophic consequences of a dangerous outbreak. However, this is not a new lesson. After all, Louis Pasteur, one of the most influential members of the pantheon of infectious disease prevention, said in 1854: "Chance only favours the mind which is prepared". New outbreaks serve as a reminder of the importance of preparation – and I hope that in the wake of one of the deadliest epidemics in modern times, this lesson will be well and truly heeded.