Pandemic H1N1 2009: DrillSafe Update. David Blizzard BD Manager, Energy Mining and Infrastructure

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Pandemic H1N1 2009: DrillSafe Update David Blizzard BD Manager, Energy Mining and Infrastructure

Pandemic H1N1 Update CDC.Gv USA Pandemic H1N1 Summary Pints Virus cntinues t spread with nearly all WHO reprting cuntries nw impacted but remains a very lcally driven phenmenn WHO stands by its estimate that up t 2 billin peple culd be infected wrldwide Spread cntinues utside the nrmal influenza seasn in the Nrthern Hemisphere but at a much slwer rate and has peaked in many cmmunities and reemerged in thers Nature f the virus and the islates has remained stable with n significant mutatin r drift identified; mst are sensitive t treatment with Tamiflu and Relenza, but treatment may nt be essential fr mild cases Absenteeism and misinfrmatin seem t be the biggest risks t business cntinuity: Media cverage is cnfusing

Acting like a Pandemic Virus 200 180 160 140 120 100 80 60 40 20 0 WHO Phase 6 Mild t Mderate 165 144 94 85 69 42 25 2 Detect Week 2 Week 4 Week 6 Week 8 Week 9 Week 12 Week 14 Tday 183 Cuntries with Cases Lcal Spread Widespread Transmissin

Glbal Snapsht

Lessns frm Past Pandemics Cnsideratins relating t histry repeating Occurs unpredictably, nt always in winter Great variatins in mrtality, severity f illness Pattern f illness r age mst severely effected Rapid surge in numbers f cases ver brief perid f time Often measured in weeks Tend t ccur in waves subsequent waves may have mutatin Absenteeism Disruptin t supply and delivery chains Key Lessn unpredictability and variatin.

Cmpare Yur Organizatin 2.1% Critical Plan Activatin 47.6% 50.3% Imprtant Nt Imprtant 45.5% 14% 4.20% 25.90% 54.5% 11.90% Yes N 51% Implementatin is cmplete Currently implementing e.g. educating the staff, running drills and simulatins, implementing travel plicies Investigating ptins e.g. develping in-huse experts r utsurcing Lking t headquarters fr directin Pandemic is nt an issue

Cmpare Yur Organizatin 23.10% 8.40% 8.40% 63.60% Help in understanding the relevant issues in pandemic Help in educating / rienting senir management t ensure supprt fr ur pandemic plan 22.40% 39.20% 43.40% Help in cllating relevant pandemic infrmatin int a useful structure t supprt ur pandemic plan Help in building and delivering ur crprate pandemic plan Help in reviewing and benchmarking ur existing pandemic plan Help in training ur lcal staff Help in testing the plan (i.e. table-tp) 29.40% 48.30% Help in n-ging pandemic surveillance (when t activate) Help in n-ging mdificatin and adjustment f plan nce cmplete We d nt require any assistance 34.30% 30.80% N answer

Offshre Challenges Islated envirnment and BCP issues Yu need a plan and yu need t audit that plan Cnsideratins that are unique t ffshre envirnments Infectin cntrl prtcls Hw t islate smene When and hw t evacuate Fllw up nce nshre Testing and treating f ther staff nce a case is identified Clinical/Medical implicatins and that f fear Quarantine perids Educatin f Staff and third parties The answers are paramunt t yur planning

H1N1: Cmmn Plan Gaps Infrmatin surces Decisin-making expertise Unanticipated risks Respnse: Practive vs. Reactive Plicy and Prcedure The mst challenging gap accrding t ur survey s is adapting and mdifying the plan in a dynamic real life situatin KNOWING WHAT TO DO AND WHEN

Knwing What t d. Phase 5&6 Trigger Pint Definitins Relatinship between spread f a virus and its severity, and the likely impact n a cmmunity N cases reprted in cuntry Cases reprted in cuntry N cases in cuntry N lcal cases Limited numbers f lcal cases Significant r rapidly increasing numbers f lcal cases N new cases in cmmunity N cases in cuntry Cases in cuntry N cases in lcal cmmunity Limited transmissin in cmmunity Gradual increase in number f lcal cases May r may nt be emplyee cases Widespread transmissin in cmmunity and/r Rapid increase in numbers f lcal cases May r may nt be emplyee cases Cnsidered an AFFECTED cmmunity N (r few) new cmmunity cases Existing cases reslving Mild / Mderate Severe Mild / Mderate Severe Mild / Mderate Severe Mild / Mderate Severe Mild / Mderate Severe Likely cmmunity impact: NIL N cmmunity anxiety N effect n services Likely cmmunity impact: NIL Cmmunity awareness/anxiety N effect n services Likely cmmunity impact: NIL N cmmunity anxiety N effect n services N restrictins n public gatherings / schls Likely cmmunity impact: NIL Cmmunity awareness/anxiety N effect n services Public health cmmunicatins N restrictins n public gatherings / schls Likely cmmunity impact: LOW Lw cmmunity anxiety Medical services adequate Essential services unaffected Sme emplyees may be ill - prbably mild cases Sme public health annuncements and interventins Sme restrictins n public gatherings / schls N / minimal business disruptin Likely cmmunity impact: MODERATE Sme cmmunity anxiety / fear Medical services strained Essential services strained Sme emplyees ill - may be severe cases Significant public health cmmunicatins Severe restrictins n public gatherings / schls N new emplyee cases Mst emplyee cases reslving Sme emplyee cases require nging supprt Sme business disruptin Likely cmmunity impact: LOW / MODERATE Lw cmmunity anxiety Medical services adequate / strained Essential services unaffected r mild disruptins Sme emplyees may be ill - prbably mild cases Sme public health annuncements and interventins Sme restrictins n public gatherings / schls Minimal business disruptin Likely cmmunity impact: HIGH High cmmunity anxiety / fear Medical services strained / verwhelmed Essential services strained / verwhelmed Significant public health cmmunicatins Severe restrictins n public gatherings / schls Significant absenteeism - sme emplyees critically ill Pssible effect n wrkfrce availability Supply chain challenges Mderate / severe business disruptin Likely cmmunity impact: LOW N cmmunity anxiety Medical services adequate Essential services unaffected N restrictins n public gatherings N new (r few) emplyee cases Mst emplyee cases reslving Few emplyee cases require nging supprt / cunseling Nrmal business functin Preparatins fr next wave Likely cmmunity impact: MODERATE Reducing cmmunity anxiety Medical services adequate / recvering Essential services unaffected / recvering Restrictins n public gatherings being lifted N new (r few) emplyee cases Mst emplyee cases reslving Sme emplyee cases require nging supprt / cunseling Businesses returning t nrmal functins Preparatins fr next wave

Gals f Interventin

The Plans that Wrk. Crisis Management Team Cmmunicatin Screening and quarantine Reducing the spread between emplyees Maintaining ptimal emplyee health Managing infected emplyees Plicies fr Persnal Prtective Equipment (PPE) Plicies fr Antivirals Managing Travelers and Expatriates

The Plicies that Cunt. Health Incident Risk Plicies Sick Leave Wrk frm hme Return t wrk Sick individuals in the wrkplace Expsure plicy Plicy Checklist Travel Plicies Essential vs. Nn-Essential Travel Affected Cuntries Return t wrk after travel Wrkplace Safety Screening cnsideratins Infectin cntrl plicy Scial distancing

Vaccine Cnsideratins First dses may be available in late August and September Fast Track versight system develped in 2007 fr Avian Flu Quantity f dses available is being dwngraded n a regular basis as we apprach delivery dates May nt be able t get ahead f the N. American flu seasn Clinical trials will likely cntinue even as prduct becmes available Assessing safety and dsage New seed virus with higher yields released Adjuvant cntrversy Agents added t increase effectiveness f Immune respnse Used with sme experience in Eurpe N evidence they increase risk

Vaccine Cnsideratins Sme risk fr cnfusin: Seasnal vs. Pandemic vaccine Seasnal influenza vaccine still recmmended and cmmercially available 2 + 1 vaccine schedule may be difficult (seasnal+pandemic+pandemic) Access utside f gvernment spnsred lcatins may be difficult fr pandemic vaccine D I get the vaccine if I already think I had the flu?? Availability f Pandemic vaccine fr Crprate vaccinatin prgrams? Full delivery will take many mnths If yields imprve prductin will imprve Mass Vaccinatin campaigns unlikely Availability f vaccine Healthcare prvider limitatins Priritized grups

Vaccinatin Pririties Will nt be 100% unifrm Mst cuntries will set their wn vaccinatin pririties and EU unlikely reach cnsensus General guidelines based n current virus behavir Healthcare wrkers and critical infrastructure Pregnant wmen Infant cntacts (parents, caregivers) since infants will nt be vaccinated Kids and yung peple (babies 24 years ld) Adults < 65 with chrnic health issues Adults < 65 Adults ver 65 years ld This is very different than seasnal flu, where vaccinatin is stressed fr the very yung and the very ld

Prprtinal and Measured. Recmmendatins fr pandemic respnse: Crprate Health Management Emplyee educatin cntinues t be paramunt: MISINFORMATION Nature f the illness Ways t prtect themselves and their families Strategies t decrease spread at wrk Symptms f illness seek early medical care fr treatment Health Incident Risk Sick Emplyee cnsideratins Manage absentee risks by reducing ptential spread in the wrkplace Traveler Risk remains Travel management, Pre-travel advice and Medical assistance Mnitr Current Recmmendatins; Cuntry respnse (aka Quarantine risks) Clse, On-ging Surveillance fr a change in the virus Assemble Crisis Management Team: Pandemic/Business Cntinuity Plan Ensure plans are updated t avid legal risks Respnse based n virus severity, risk sensitivity and cmmunity level f activity

Internatinal SOS Please cntact: David Blizzard Business Develpment Manager Tel: +61 8 9480 0474 david.blizzard@internatinalss.cm