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The Future of Work through Three Lenses: Climate Change, Artificial Intelligence & Disease
by Margaret O’Neill, SmithGroup
Part III: Another Pandemic?
This paper, focused on the threat of another global pandemic, is the third in a 3-part series that considers the potential headwinds and tailwinds affecting work as we know it in America. This paper will delve into the risks with a focus on whether American employers and their workforces are prepared to withstand another pandemic.
Little did we know in the early months of 2020 that COVID-19 would wreak havoc across the globe for the next two-plus years. American workers set up shop at home, students of all ages were required to attend classes virtually, churchgoers were banished from worshiping inside their parishes, grocery store employees became front-line workers, and businesses shuttered their doors. Hospitals across the country struggled to treat an unknown disease that resulted in immediate death for hundreds and thousands while maintaining treatment and requisite care for the ongoing health demands among the rest of the patient populations. Americans were strongly urged to isolate and mask to avoid contagion and spread. Over the span of two and a half years, the U.S. economy halted, wavered, and stalled many times over. While Americans struggled to take care of our own, scientists and infectious disease specialists the world-over rushed to find a vaccine and treatments that could save lives. In the three years since the onset of what would become the first pandemic in decades, what have we learned?
For many employers, the last few years could be considered revolutionary. Businesses that prior to the pandemic didn’t view themselves as overly innovative or flexible in terms of where and how work was accomplished, found they had few choices but to bend and alter their thinking or risk closing. In doing so, many found new capacities, efficiencies and opportunities for growth. Other employers found survival illusory. After months of stretching and pushing the boundaries of what is possible, and even with the Paycheck Protection Program (PPP) loans, they had no option but to cease operations.
Infectious disease experts and epidemiologists mostly agree that in regards to the next pandemic, it’s not a matter of if, it’s a matter of when it will occur. This paper will examine the likelihood of another pandemic, the probable causes, and the potential social and economic impact on America’s workforce.
The Likelihood of another Pandemic
It is impossible to predict when the next pandemic will occur, as they are random events. The World Health Organization refers to this virus as “Disease X,” and it could be different from COVID-19, requiring a different set of tools and a different level of response.1 Pandemics can begin anywhere in the world where animals and humans are in close contact as outbreaks most often begin when a pathogen makes its way from an animal in which it lives to a human never before infected with that pathogen.2
Epidemiologist Marc Lipsitch of the Harvard T.H. Chan School of Public Health studies the prevalence of disease pandemics. Lipsitch states that infectious disease mortality shows a drastic decline in the United States over the course of the 20th Century.3 The mortality chart that Lipsitch refers to reflects around 800 deaths from infectious disease per 100,000 people in 1900 to about 60 deaths per 100,000 by the last years of the century. There was a brief spike in 1918 (Spanish Flu) and a slight and brief upturn during the peak of the AIDS epidemic in the 1980s. Still, according to Lipsitch, “death rates from infectious disease dropped by nearly 1% a year, about 0.8% per year, all the way through the century.”4
However, COVID-19 reminds us, that infectious diseases haven’t been eliminated. A new analysis by the Proceedings of the National Academy of Sciences (PNAS) of novel disease outbreaks of infectious illnesses such as cholera, influenza and typhoid over the past 400 years suggests that statistically extreme events are not as rare as we may think.5 In fact, there are more new ones now than ever: the number of new infectious diseases like SARs, HIV and COVID-19 has increased by nearly fourfold over the past century. Since 1980 alone, the number of outbreaks per year has more than tripled.
The rate of occurrence of epidemics varies widely in time, but the probability distribution of epidemic intensity assumes a constant form with a slowly decaying algebraic tail, implying that the probability of extreme epidemics decreases slowly with epidemic intensity. Together with recent estimates of increasing rates of disease emergence from animal reservoirs associated environmental change, this finding suggests a high probability of observing pandemics similar to COVID-19 (probability of experiencing it in one’s lifetime currently about 38%), which may double in coming decades.6
Last September, staff writer, Ed Yong of The Atlantic published an article entitled, “The Pandemic’s Legacy is already clear: All of this will Happen Again.”7 Three years into the pandemic, hundreds of people are still dying of the disease every day. According to the Centers of Disease Control and Prevention as of April 7, 2023, the daily death rate due to COVID-19 had dropped to 253.3. However, the tally of deaths has yet to fall below July 2021 levels, when an average of fewer than 200 deaths a day were recorded.
Although COVID-19 has killed more than 6.6 million people worldwide, other pandemics have been more lethal. The 1918 flu is estimated to have cost 50 million lives across the globe, and in the 14th century, the Black Death killed 30% to 60% of all Europeans in just four years.8
Today, experts are not only worrying about the chance of a virus transferring from animals to humans (zoonotic diseases), but also about research accidents or increasingly the possibility of pathogens being weaponized and intentionally being unleashed to inflict harm. In fact, a pandemic has long been known to be far riskier for global security than conventional, nuclear or chemical warfare, said Lawrence Gostin, a professor of public health law at Georgetown University and a leading expert in global health.9 “We’ve seen that play out with COVID and COVID is far from the worst pandemic threat that we face,” he said.
Public health and national defense experts worry the next pandemic will be more devastating than this one. “It’s incumbent on the United States and other countries to be prepared for whatever comes from biology, whether it’s from nature or from engineering or a laboratory accident,” said Dr. Tom Inglesby, director of the Johns Hopkins Center for Health Security at the Bloomberg School of Public Health.10
That said, the 2023 Axios-Ipsos American Health Index shows that only three in ten Americans believe the country is ready for another pandemic, and a quarter or less believe that either American businesses or the government put people’s health first.11
Why Climate Change Matters
London-based disease forecasting company Airfinity’s research suggests that viruses are emerging more frequently due to a combination of factors including increasing international travel and populations, a rising threat posed by zoonotic diseases, and climate change. Climate change, a risk in its own right, also heightens the risk of both migrating and mobile populations as well as an increase in diseases that can transfer from animals to humans.
As climate change continues to warm global temperatures, researchers predict that wild animals will be forced to relocate their habitats and essentially be in closer proximity to humans. This migration has the potential to increase the risk of a pathogen transferring to humans, resulting in the next pandemic.
An international research team led by scientists at Georgetown University and published in Nature conducted a study funded by the U.S. National Science Foundation (NSF) to examine the link between climate change and viral transmission.12
“The COVID-19 pandemic, and the previous spread of SARS, Ebola, and Zika, show how a virus jumping from animals to humans can have massive effects,” said Sam Scheiner, a program director in NSF’s Division of Environmental Biology.13 “To predict the jump to humans, we need to know about spread among other animals. This research shows that animal movements and interactions due to a warming climate might increase the number of viruses jumping between species.”14
The scientists conducted the first comprehensive assessment of how climate change will affect geographic range shifts — the journeys that species will undertake as they follow their habitats into new areas. As they encounter other mammals for the first time, the study projects they will share thousands of viruses.15
The study suggests that climate change will become the biggest upstream risk factor for disease emergence — exceeding higher-profile issues such as deforestation, wildlife trade and industrial agriculture.
Georgetown University’s Professor of public health and expert, Lawrence Gostin views nature as the most likely source of the next pandemic. “Pathogens of various forms are very good at adapting and changing form. But modern science is very good at countering that,” Gostin said. “If we’re smart and well prepared and invest strongly and robustly in it, we can substantially lower the risk.”16
Social & Economic Impact
Millions of Americans lost their jobs within weeks after COVID-19 struck the US in early 2020, forcing thousands of businesses to close, and the second quarter GDP fell by an unprecedented 29.9% as a result. At the time, there was a lot of uncertainty over how quickly the economy would bounce back, but now, almost three years later; it seems we are nearly back on track.
More importantly, the economy as a whole has also returned to its pre-pandemic growth trajectory, with total nonfarm employment returning to its pre-pandemic level in August 2022.17 According to the first preliminary estimate released by the U.S. Bureau of Economic Analysis (BEA) on Thursday, real GDP grew 2.1 percent in 2022, following up strongly on a 5.9 percent increase in 2021.18
This is all good news, but also illustrates the impact the pandemic has had and continues to have on the U.S. economy both directly (deaths, contagion, medical costs, job losses, businesses closures, supply chain delays) and indirectly (delayed routine and preventative care, decreased vaccinations for preventable diseases, over-hiring for tech sector, etc.).
According to Professor Gostin, with COVID-19, we are likely to see indirect impacts for years, as people who skipped routine medical care are diagnosed with more advanced and deadlier cancers and those who missed routine vaccines fall ill with preventable diseases, among other consequences.19 Gostin contends the cost will be significant in terms of both the U.S. economy and the potential human toll.
“If you think of a far worse pandemic, you can multiply that by 10- or even 50-fold in terms of the economic and social harms the United States would suffer,” he said. Right now, only about 5% of the country’s health care dollars are spent on public health and preventing the next crisis. “That’s a rounding error in the U.S. budget.”20
From a disability and life insurance risk, these predictions are noteworthy. The COVID-19 pandemic not only resulted in increased incidence but altered industry risk across the board. The potential fallout from a more virulent pandemic could be catastrophic for people and businesses across the country.
The social costs of the pandemic on Americans has been equally weighty. After 12-18 months of isolating and masking and navigating the often-divisive nature of pandemic challenges, Americans and people around the world are fatigued. Mental health challenges continue to abound and worker resiliency has faltered.
According to a Gartner report, 65% of employees are now reconsidering the role of work in their lives; however, only one-third are open to internal opportunities providing part of the solution.21 Pre-pandemic, employers were working hard to fill gaps in job skills. Today, managers are being asked to close the skills gap at the same time as they’re responding to pandemic-prompted resignations.
The Gartner report reflects that the pace of employee turnover is forecast to be 50–75% higher than companies have experienced previously, and the issue is compounded by it taking 18% longer to fill roles than pre-pandemic.22
Employees believe that their employers have been successful at keeping them safe throughout the pandemic, according to a survey by Willis Towers Watson conducted in 2022.23 What is more, the employees who reported that their employers kept them safe at the workplace were more engaged, more productive, and less likely to leave.24 At the same time, some employees may feel that reinstituting pandemic safety measures are not needed, which makes active communication and setting employee expectations from managers and leaders critically important.
Companies can take advantage of this unique moment, when risks are low but the memory of the pandemic is still fresh, to create a system and protocols that will address any future risk.
A new coronavirus strain can travel around the world in less than a day, so companies need protocols that will protect their businesses against future surges. Appendix A provides an overview of recommendations made to employers in a May 2022 edition of the Harvard Business Review.
Conclusion
After more than two-plus years of Covid-19 and its variants, Americans and people around the world are fatigued. This includes employers who likely feel compelled to focus their skills and activities on business-critical areas and spend less thought, time, and energy on the pandemic.
In the event that a new, deadly pathogen is discovered, Professor Paul Hunter, a U.K.-based expert in the epidemiology of infectious diseases, thinks the public will be much better protected given the learnings from the COVID-19 pandemic. Citizens of the globe have become well practiced in vaccinating, isolating, masking, and working remotely. Scientists and Infectious disease specialists have a much better understanding of the critical timeline associated with clinical trials, acquiring FDA approval, and distributing vaccines to the masses.
While we are well poised to manage the next pandemic with wisdom and foresight, we must also remain vigilant. As COVID-19 has demonstrated, our interconnected global economy both helps spread new infectious diseases – and, with its long supply chains, is uniquely vulnerable to the disruption that they can cause. For all the advances we’ve made against infectious disease, our very growth has made us more vulnerable, not less, to microbes that evolve millions of times faster than humans do.
Appendix A
An article in the Harvard Business Review in May of 2022 reminds employers how they can prepare for the next pandemic best by prioritizing what we learned over the past two years25:
1. Reduce restrictions as the situation allows.
Given lower current risk of infection, many companies are bringing their remote employees back to the workplace, and most have removed mask mandates. The low rates of community COVID-19 transmission in most of the United States, have allowed employers to remove pandemic precautions in a way that balances safety while allowing employees freedom to interact and be optimally productive. Companies can adjust any additional protective measures based on updated local, state, or federal guidance, where required or prudent.
Encouraging employees to protect themselves will support their health today and prevent future disruptions due to illness. Indoor masking should continue to be an option for everyone, even if the local public health guidance does not require it.
2. Plan for another surge or outbreak now.
There are several key ingredients to create a successful response. A good place to start is to choose metrics and thresholds that would trigger changes in the company’s COVID-19 safety protocol. Using factors such as community transmission rates, wastewater surveillance, hospital capacity, test positivity rates, variant infectivity, and vaccination rates, businesses can set specific triggers for when a different response is warranted.
Companies must also choose which of their locations to monitor. Many businesses should limit monitoring to sites with many employees and readily available data. In some instances, companies may choose to assess the risk of where employees live rather than the worksite itself. The key is to choose site(s) that have a large part of the workforce or where business disruption needs to be minimized.
Most interventions — such as mask wearing, educating employees about the effectiveness of different types of masks, physical distancing, COVID-19 testing, and vaccination requirements — can be boosted or down-graded, if needed. However, by making changes too frequently, organizations run the risk of creating confusion among employees as to which policies are currently in effect. A predetermined, balanced approach will allow organizations to respond promptly to developments with a minimum amount of new decision-making. Organizations that create such streamlined plans will have an advantage over their competitors who will be distracted from their core business as they reactively design a response to every turn in the pandemic.
3. Embrace remote and hybrid work.
Many businesses continue to offer the option to work remotely and realize that this flexibility benefits both them and their employees. This is most important for unvaccinated or high-risk individuals, such as those who are immunosuppressed. Employers can plan accordingly by having enhanced guidance for onsite unvaccinated or non-immune employees and asking them to continue to work remotely, requiring indoor masking, or performing surveillance testing.
Companies have found many ways to foster community and communication among their employees, despite hybrid or remote work arrangements. Some organizations encourage in-office time on certain days of the week or promote specific events or all-staff meetings that build community while still limiting overall risk of transmission. Organizations that continue to facilitate flexible work arrangements will be better able to attract and retain employees because workers now look for companies that can be adaptable and create stability during these challenging times.
4. Effectively communicate pandemic plans.
The very real possibility of future surges or localized outbreaks makes ongoing communication with employees important even when community case rates are low.
Employers can offer regular updates on the company’s plan to support safety even as they acknowledge that fewer measures are needed while community case rates are low. These communications should be routine and spaced out according to the local circumstances. Routine communication will enable a faster company-wide response when/if circumstances change.
Contact Us: Meg O’Neill GC Smith Group moneill@smithgroupre.com
About Guy Carpenter / Smith Group
Smith LTD Management Group, Inc. is a disability and reinsurance consultant and a subsidiary of Guy Carpenter & Company, LLC, which is a global leader in providing risk and reinsurance intermediary services. Guy Carpenter is a wholly owned subsidiary of Marsh & McLennan Companies (NYSE: MMC), a global team of professional services companies offering clients advice and solutions in the areas of risk, strategy and human capital.
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1 “U.S. Workers Give Employers High Marks For Supporting Them During The Pandemic.” Willis Towers Watson, www.wtwco.com/en-US/News/2022/03/us-workers-give-employers-high-marks-for-supporting-them-during-the-pandemic.
2 Heymann, David. “The Next Pandemic – When Could It Be?” Chatham House – International Affairs Think Tank, Dec. 2022, www.chathamhouse.org/2022/02/next-pandemic-when-could-it-be.
3 Walsh, Bryan. “Covid-19: The History of Pandemics.” BBC Future, 24 Feb. 2022, www.bbc.com/future/article/20200325-covid-19-the-history-of-pandemics.
4 Ibid.
5 Marani, Marco, et al. “Intensity and Frequency of Extreme Novel Epidemics.” Proceedings of the National Academy of Sciences of the United States of America, vol. 118, no. 35, National Academy of Sciences, Aug. 2021, https://doi.org/10.1073/pnas.2105482118.
6 Ibid.
7 Yong, Ed. “America Is Choosing to Stay Vulnerable to Pandemics.” The Atlantic, 30 Sept. 2022, www.theatlantic.com/health/archive/2022/09/covid-pandemic-exposes-americas-failing-systems-future-epidemics/671608.
8 “From Black Death to Fatal Flu, Past Pandemics Show Why People on the Margins Suffer Most.” Science | AAAS, 16 Apr. 2023, www.science.org/content/article/black-death-fatal-flu-past-pandemics-show-why-people-margins-suffer-most.
9 Weintraub, Karen, and Usa Today. “As COVID Turns 3, Experts Worry About Where the Next Pandemic Will Come From and Whether We’ll Be Ready.” Medical Xpress, 3 Jan. 2023, medicalxpress.com/news/2023-01-covid-experts-pandemic-ready.html. Accessed 18 Apr. 2023.
10 Ibid.
11 “Americans Do Not Believe the Country Is Ready for Another Pandemic.” Ipsos, 2023, www.ipsos.com/en-us/axios-ipsos-american-health-index. Accessed 10 Apr. 2023.
12 Skr. “New Study Finds Climate Change Could Spark the Next Pandemic – Georgetown University Medical Center.” Georgetown University Medical Center, 2 Mar. 2023, gumc.georgetown.edu/news-release/new-study-finds-climate-change-could-spark-the-next-pandemic.
13 Ibid.
14 Ibid.
15 Skr. “New Study Finds Climate Change Could Spark the Next Pandemic – Georgetown University Medical Center.” Georgetown University Medical Center, 2 Mar. 2023..
16 Yahoonews.yahoo.com/covid-turns-3-experts-worry-140528277.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuYmluZy5jb20v&guce_referrer_sig=AQAAAFRGz8GCGqpeWJaHthfcPMoe3BhrTJCnG0VflIClecFpV-wqG6EWLovktoI5LEuPTzuVndmfwdGcpnhr4-gh5K6sw7SXWNRXPxXtAzu6J6BeSQ3BmTBlUZemcLu99ipo1ULoKJxQ1K8mWNfejqFKjh1BbArvHIOha01q4VuHYFSG.
17 “How Is the US Economy Doing After COVID-19?” World Economic Forum, 3 Feb. 2023, www.weforum.org/agenda/2023/02/us-economy-covid19-inflation.
18 Ibid.
19 Skr. “New Study Finds Climate Change Could Spark the Next Pandemic – Georgetown University Medical Center.” gumc.georgetown.edu/news-release/new-study-finds-climate-change-could-spark-the-next-pandemic.
20 Ibid.
21 Tupper, Helen. “It’s Time To Reimagine Employee Retention.” Harvard Business Review, 4 July 2022, hbr.org/2022/07/its-time-to-reimagine-employee-retention.
22 Ibid.
23 “U.S. Workers Give Employers High Marks For Supporting Them During The Pandemic.” Willis Towers Watson, www.wtwco.com/en-US/News/2022/03/us-workers-give-employers-high-marks-for-supporting-them-during-the-pandemic.
24 Ibid.
25 Toro, Patricia. “Prepare Your Company for the Next Covid Wave.” Harvard Business Review, 13 May 2022, hbr.org/2022/05/prepare-your-company-for-the-next-covid-wave.
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