2016/SOM1/ECSG/DPS/028 Agenda Item: 4d Pandemic and Data- Future Preparedness Purpose: Information Submitted by: ICC Data Privacy Sub-Group Meeting Lima, Peru 25 February 2016
Pandemic and Data- Future Preparedness APEC DPS Joseph Alhadeff VP Global Public Policy, CPS, Oracle joseph.alhadeff@oracle.com Slide 1 Pandemic History Global pandemics have been observed for several hundred years. The best documented pandemics occurred in 1918 (A(H1N1), Spanish flu), 1957 (A(H2N2), Asian flu) and 1968 (A(H3N2), Hong Kong flu). All varied in severity. Spanish influenza is estimated to have infected 50% of the world's population of which half suffered a clinical infection and the total excess mortality was estimated of 40-50 million. This gives a mortality rate of 2-2.5%. The attack and mortality rates were highest among healthy adults (20-40 years old). Asian influenza affected some 40-50% of people during two waves of the pandemic, of which 25-30% experienced clinical disease. The mortality rate was estimated at approximately 1 in 4000 and the total death toll probably exceeded 1 million. The morbidity and mortality of Hong Kong influenza was as high as in the 1957-1958 pandemic and showed a range of 1-3 million fatalities. Both Asian and Hong Kong influenza arose in South-East Asia. Slide 2 1
Worst Case: Pandemic of 1918 Killed between 20-40 Million people 25% of US population and 20% of global population was infected Was spread across trade and travel routes Lasted over 4 years Pandemic mortality rate spike, Kansas City Slide 3 Zika Virus du Jour Zika virus at "pandemic" level, National Institutes of Health says NEW YORK -- The World Health Organization warned Thursday the Zika virus is "spreading explosively"and could infect four million people by the end of the year. It's in 23 countries, including the U.S., where it is now being called a pandemic, with 31 cases in eleven states and D.C. since last year. All the patients here were infected by mosquitoes abroad. By Jonathan LaPook CBS News January 28, 2016, 6:52 PM Slide 4 2
Further Complications Human Transmission of Zika! Just reported on CNBC: Dallas has first human to human case of Zika. Hold on to your hat this is going to get bad until they get a vaccine! February 02 2016 U.K. Ebola Relapse Case Takes Virus Specialists to Uncharted Waters Scottish nurse Pauline Cafferkey is in critical condition following "totally unprecedented" return of symptoms BBC October 15, 2015 and February 24, 2016 Slide 5 Pandemic spread Today there is much greater travel, trade (not just human carriers) and population density SARs and Avian Flu were spread by both human passengers and migratory animals Swine Flu jumped from North America to Europe and Asia (with some human-to-human infection) in fairly short order. Ebola, now Zika showed great mobility as well Slide 6 3
What have we learned about Big Data and Pandemic? Google Flu Tracker An early use of data from searched to predict flu outbreaks Mobile phone exhaust and communications to map disease spread informs positioning of resources and strategic response Computerized flight manifests and immigration Big Data and the path to discovery and cure. Slide 7 Ebola: Can big data analytics help contain its spread? Orange Telecom in Senegal handed over anonymised voice and text data from 150,000 mobile phones to Flowminder, a Swedish nonprofit organisation, which was then able to draw up detailed maps of typical population movements in the region. Authorities could then see where the best places were to set up treatment centres, and more controversially, the most effective ways to restrict travel in an attempt to contain the disease. The drawback with this data was that it was historic, when authorities really need to be able to map movements in real time. People's movements tend to change during an epidemic By Matthew Wall Business reporter, BBC News 15 October 2014, From the section Business Slide 8 4
Combining Data and Analytics But the potential public health uses of big data extend well beyond genomics. Environmental scientists are capturing huge quantities of air quality data from polluted areas and attempting to match it with equally bulky health care datasets for insights into respiratory disease. Epidemiologists are gathering information on social and sexual networks to better pinpoint the spread of disease and even create early warning systems. Comparative-effectiveness researchers are combing government and clinical databases for proof of the best, most cost-effective treatments for hundreds of conditions information that could transform health care policy. And disease researchers now have access to human genetic data and genomic databases of millions of bacteria data they can combine to study treatment outcomes. http://www.hsph.harvard.edu/news/magazine/spr12-big-data-tbhealth-costs/ Slide 9 Big Data and Policy Utility of data across jurisdictions and disciplines/sectors What level de-identification? Potential limitations of consent models Potential need for use-based models with appropriate approval and oversight Policy development timing before pandemic causes fear Slide 10 5
Possible organizational impacts Travel restriction workforce planning Building infection facilities planning Business continuity Value chain Essential services power, health, fire, police Policies and proactive measures Visitors Pandemic tracking and case isolation Insurance issues Resources Slide 11 Data collection, management and sharing If an employee is sick, do other employees have a right to know? Special need employees Can you ask customers or visitors about their health? What information do you need/can you to provide to your customers about your employees that might be on their premises? Slide 12 6
Survivability Not Just Recovery Pandemics grow over time and take years to abate disaster recovery presumes a limited dislocation The question is how to operate during the pandemic. What can you do now to minimize impacts and create a plan? Field a cross functional team Make it part of business continuity planning Understand the footprint of your company and it s mission critical resources, partners and operations Develop contingency plans and policies Test them and keep them up to date Slide 13 Privacy and the Pandemic In case of a pandemic there will be great pressures to obtain more and share greater amounts of personal information to prevent/limit contact with infected persons. All persons can be vectors of infection and more information will be needed to manage risk Both companies and countries may mandate different levels of information collection and sharing Slide 14 7
Policy issues questions Does the company have the right to know if any medical treatment it pays for relates to possible pandemic symptoms whether in the employee or her family Many viruses do not present symptoms at the outset what might be reasonable screening policies for visitors, traveling employees, contractors How to develop tracking and compliance systems for new government mandates related to information collection and sharing Corporate resources will likely be needed in more mission critical functions Slide 15 Policy Issues II Where an outbreak of pandemic occurs, do you have systems to properly identify where your people are in that country, both those who work there and those that are on travel? What s your notice and privacy policy related to travel information? Does the company take any responsibility for family, extended family or vacationing employees? If so, what are your information notice, collection, storage and access policies? Slide 16 8
Policy Issues III If new or temporary employees are hired on a large scale to replace workforce, or if significant functions are outsourced: Is there a scalable process for vetting employees Is there a scalable process for training employees Recall that if pandemic causes significant change in policies, all employees may need to be trained Is there a scalable process for reallocating access control and assuring continued security and confidentiality of data What can you ask of your employees, what s reasonable for your partners/customers to ask? Slide 17 HR/PR/Corporate Communications Corporate messaging Customer communications Press communications HR issues Profiling Quarantine Salaries for stay at home Access to medical histories/records Required disclosure Works councils Slide 18 9
Governmental Planning Consideration Where are medical resources located cross border data transfer issues What is the balance between social responsibility for disease management and the protection of citizen privacy Are plans in place between health and privacy authorities? What are plans for briefing of emergency response personnel? Slide 19 Monitoring issues Workplace surveillance, Inferometers, other health checks Tracking travel for business personal? Google flu tracking and other resources How do you use this information assuming you are allowed to access or store this information Policies? Slide 20 10
Facilities issues Cleaning protocols Gear Clinic, medical supplies Entry controls Training Alternative resources/facilities planning Tele-commuting Tele-work/home, net cafe Conferencing Capacity/pressure testing Policies Isolation rooms Slide 21 11