Laura Jelinek is no stranger to emergency management. The associate executive director of continuing education, meetings and exhibitions, for the American Association of Oral and Maxillofacial Surgeons was in the middle of her annual conference in Orlando when terrorists struck on 9/11. Three days later, Hurricane Gabriel hit Florida, further delaying her attendees' ability to get home. Then Jelinek's group was forced to cancel its annual meeting 90 days out when SARS (severe acute respiratory syndrome) broke out in Toronto three years ago. The following year, her group was on site at the San Francisco Hilton when hotel employees went on strike and were later locked out.

Jelinek, not surprisingly, has learned to expect the unexpected when it comes to convention planning. Thanks to an incident management plan that she helped develop shortly after 9/11, her Rosemont, Ill. — based association will be better able to respond to another disaster threat much in the news these days — a pandemic caused by the bird flu virus.

In the management of meetings today, “we have to take action quickly,” Jelinek says, “and move forward our business-continuity plans.” From a readiness standpoint, however, Jelinek is in the minority.

Disaster in the Making

According to a soon-to-be-released report conducted by Purdue University for the Professional Convention Management Association, meeting planners, on the whole, are not prepared to respond to disasters of any kind — from a strike, to a roof collapse, to a shooting — much less a flu pandemic.

“Based on [our research], we don't think meeting planners have contingency plans or have thought much about them,” says Sheryl Kline, PhD, assistant professor, department of hospitality and tourism management at Purdue University's Center for the Study of Lodging Operations. PCMA will announce the specifics of the study's findings this month.

In the broader picture, there have been a lot of mixed messages about bird flu, and, understandably, planners are confused about how much of an imminent threat a pandemic could be.

In May, for example, the White House released a 228-page report that outlines how individuals, businesses, local and federal governments, and community groups should respond if a pandemic flu hits America. The report is based on a worst-case scenario that would see the pandemic last months, result in 1.9 million deaths, and keep 40 percent of the work force at home.

Planning for the worst is constructive, says Marc Siegel, MD, author of Bird Flu: Everything You Need to Know About the Next Pandemic, but fearing it is not. “This is a [noncontagious] virus that's infected only a little over 200 people in 9 years,” Siegel explains. “It looks like it's multiple mutations away from being able to affect us. And even if it makes that step, there's no guarantee or even likelihood that it will become a killer pandemic on the scale of 1918.”

The problem, he says, is that the discourse has jumped directly to a doomsday scenario. “The characterization of the discussion on H5N1 bird flu has routinely missed several steps,” Siegel says. But the debate could serve as a wake-up call for convention planners, among others, to think about pandemics and emergency preparedness in general.

Not Enough Interest

“I'm really concerned that most of the planners in the industry are not thinking seriously about contingency planning,” says Steven Hacker, president, International Association for Exhibition Management, Dallas. Why? “It's human nature. We don't want to confront the issues that cause us stress or discomfort or anxiety,” Hacker says. However, IAEM and other industry associations are seeking to bring attention to the issue.

The Society of Independent Show Organizers is working on a bird flu management plan, which will be posted on its Web site (www.siso.org) in June. Also, on May 31, the American Society of Association Executives & the Center for Association Leadership held a Web conference on the subject.

IAEM is perhaps the industry's best resource, with links to avian flu resources and white papers on crisis planning on its Web site (see page 24 for a list of links). Further, at its Professional Development Conference in June, IAEM is presenting a series of sessions about how planners can prepare for a pandemic. One of the sessions features a presentation about the virus from a physician at the Chicago Department of Health.

The bird flu sessions, however, are not generating much interest among attendees, Hacker notes. In a pre-conference poll, only 27 percent of attendees said they were inclined to attend a session on avian flu emergency planning, with 72 percent saying no or maybe. On the flip side, 74 percent were interested in a session on attendance promotion.

Despite the fact that pandemic contingency planning is not widespread in the industry, some associations are starting to take notice.

Action Plans in Place

When it comes to putting together an emergency plan for specifically dealing with a communicable disease, the American Library Association's Deidre Ross is an expert. Chicago-based ALA held its 2003 convention in Toronto less than a month after a SARS outbreak hit the city. Ross, the director of conference services, came to the conference armed with a plan should an outbreak occur during the convention.

Ross secured space at an area hospital that was not treating any SARS patients so if an outbreak occurred, delegates would be quarantined there. Also, the ALA team checked with the convention center and all of the hotels in the room block to find out what their emergency procedures were and how they would screen guests and employees for disease. They also created an emergency communication plan.

Experts say that it's critical to have a detailed communication plan and a chain of command in the event of an emergency. A good communication plan should include not only key staff, facility, and emergency personnel contacts, but also communication trees with back-up and off-site communication contacts should key personnel be unreachable. Cellphone numbers should be listed (in case land lines are down), and in cases where cellular communications can't get through, personnel should be encouraged to use text messaging, according to Purdue University's Kline. She stresses that the back-up plan should have a back-up plan.

In Toronto, Ross was designated as the point person who would find out first if an outbreak occurred. Using a predetermined code word, she would inform others on the emergency committee of the situation so as not to create panic. The staff, in concert with the convention center and hotels, would then inform attendees of the situation and enact the evacuation and/or quarantine procedures and guidelines that the facilities or the local officials had in place.

If quarantining or treatment was necessary, then the hospital was available and medical personnel were on call. For staff, she had a plan for who would stay behind to assist, if necessary, and who would leave. She also brought a supply of masks and antibacterial hand wash for staff and attendees who needed them.

This year, ALA is holding its annual meeting in New Orleans and has drafted an emergency-response plan to deal specifically with hurricanes. Next year, Ross will use the SARS plan as the basis for drafting a bird flu plan for meetings in Seattle and Washington, D.C.

Having a crisis plan that is updated or adapted to include specific procedures for a variety of situations is important, experts say. “One plan doesn't fit all,” Kline says, because a pandemic might require a “lockdown” situation, while something like a bomb threat would require an evacuation. And simply having a plan is not always enough. Planners should practice their plan with a drill or simulation, Kline advises. Purdue University actually has a facility on campus where large-scale disasters can be simulated to show the impact on an entire city.

AAOMS's Jelinek updates her incident-management plan each year with information that is specific to the meeting destination. The plan includes contact numbers, communication plans, information on hotels and venues, evacuation procedures, and response plans for specific emergencies, such as natural disasters, fire, bomb threat, etc. With next year's meeting scheduled in Hawaii, she'll probably update the document to include plans to deal with the bird flu, since it is in an area of the world that could be of concern.

The plan also details the steps to be taken should the event need to be canceled in advance of, en route to, or during the meeting. If an association does have to cancel a meeting because of a pandemic caused by bird flu, the economic impact would likely be greater than it would be for most any other disaster — thanks to the lack of cancellation insurance available to cover outbreaks of infectious diseases.

Insuring Survival: Building a Better House

After the SARS epidemic, event insurers put exclusions into the policies for communicable diseases, says John Buttine, president, John Buttine Inc., a New York — based insurance broker who handles a lot of industry business. Basically, there is no insurance coverage for meetings and events that are canceled because of the bird flu or pandemic. “Insurance companies will generally exclude things they don't understand,” Buttine says. “The theory is, if they don't understand it, they can't quantify it, and if they can't quantify it, they exclude it.”

ALA's Ross is well aware of the exclusion. She was not able to get cancellation insurance that covered SARS for the association's meeting in Toronto. That's why the ALA insists on a strong force majeure clause that allows the group to get out of the hotel contracts in case of a pandemic or other disaster.

“A well-written force majeure or ‘excuse of performance’ clause may protect planners from an actual or feared avian flu epidemic,” says Joshua Grimes, Esq., Grimes Law Offices, Philadelphia. It all depends on the wording and the circumstances.

“Many planners now prefer to include wording allowing cancellation if the event becomes ‘impossible, illegal, or impractical’ to hold,” he says. “Impractical” was added to cover situations where the event could actually be held — the facility was not destroyed, or planes were not grounded — but as a practical matter it doesn't make sense to go forward because few if any attendees will likely attend.

Hotels often balk at such contract language, according to Ross, but the ALA demands it because there is no insurance to fall back on.

Annual meetings are the lifeblood of associations, not only from the standpoint of revenue generation, but also from an educational perspective. If a pandemic were to strike, meetings would be shut down for months and many associations would struggle to make ends meet without meetings.

“We're shivering in our boots over the prospect of this happening and travel restrictions developing or people being afraid to travel,” says Nelson Fabian, executive director and chief executive officer of the National Environmental Health Association, Denver, which is developing a bird-flu crisis plan.

“If we lose our annual conference, we're in big trouble. I don't know how many associations could survive if they lost one or two annual conferences.” To offset that financial impact, NEHA has taken a significant step, namely, creating an online university, which accomplishes several goals.

“One, we expand the delivery mechanism of being able to get education out to our people,” Fabian says. “Two, with a fee to access the courses, it generates revenues for the association.” The first course, currently on the Web (www.neha.org) and available to anyone, is a two-part course on the avian flu. Fabian is also planning to tape some 44 sessions at this month's annual conference and convert those to online courses as well.

NEHA's plan is just another way that associations are planning for the worst. “We're building our house of bricks and if the storm never comes, we're no worse off,” says Fabian. “If it does come, I am at least able to protect my organization to the extent that I can.”

Can It Happen?
An Expert Weighs In

Bird flu expert Stephen Playe, MD, will be speaking at the American College of Emergency Physicians' Annual Scientific Assembly in October in New Orleans. Here's what he has to say to Association Meetings' readers:

“You'll hear a lot of things bantered around like, ‘It's not if, it's when,’” says Playe, assistant professor of emergency medicine, Tufts University School of Medicine, and emergency medical residency program director, Baystate Medical Center, Springfield, Mass. “The reality is, no one knows if or when.”

For the bird flu to become a human pandemic, a human would have to be simultaneously infected with the bird flu — which isn't contagious among humans — and a human influenza that is communicable. “If something happens inside that person's body called genetic realignment, where some of the genetic properties of the virulent influenza mixed with the genetic properties of the contagious influenza, then they could end up having a virulent, contagious influenza that nobody around them in the world has immunity to, so it could spread from person to person,” says Playe. That's essentially the type of scenario that caused the 1918 Spanish flu.

But even if a person were co-infected, as explained above, the odds of the two viruses mixing to create one contagious killer human flu are low, he says. It's also possible that the new virus will be weakened and will only result in people getting sick and not dying, he adds. “But what you worry about is that it will maintain its virulence, become contagious, and become a bad pandemic.”

And if a pandemic occurs, Playe says it can be controlled if people wear surgical masks and wash their hands with antibacterial soap, because it spreads only when respiratory droplets get in the eyes, nose, or mouth. And because droplets travel a maximum of three feet, he says people should maintain a three-foot distance, particularly if they don't have a mask.

“If I were in charge of a meeting,” says Playe, “I would distribute regular surgical masks with an instruction sheet on exactly how the influenza spreads.” He would also recommend that the planner makes sure he or she has, or the facility has, alcohol-based hand wash. “If you do that, I truly think you would be protecting everybody involved from the possibility of spread.”

Pumping resources into awareness and prevention techniques is more valuable than pumping dollars into developing vaccines or stockpiling influenza treatments, like Tamiflu, which are expensive, have a shelf life, and may not be totally effective, Playe says.

Click Here for More

Here are some helpful links to avian flu resources and information.

• U.S. Centers for Disease Control and Prevention: www.cdc.gov
• For federal bird flu information, including the national implementation strategy developed by the Department of Homeland Security: www.pandemicflu.gov
• World Health Organization: www.who.org
• International Association for Exhibition Management: www.iaem.org
• National Environmental Health Association: www.neha.org
• Marc Siegel, MD, author of Bird Flu: Everything You Need to Know About the Next Pandemic: www.doctorsiegel.com
• Air Transport Association: www.airlines.org/news/d.aspx?nid=9448