Seattle, WA - Last updated 3/13/2020
Overview: The rapid global spread of the 2019 Novel Coronavirus (also known as COVID-19) is described by the Center for Disease Control (CDC) as "an emerging, rapidly evolving situation" and "a pandemic" by the World Health Organization. The global map of confirmed cases continues to grow day by day. The goal of this blog post is not to provide the most current, updated information - for that, we recommend that you monitor the CDC website (or the corresponding public health authority for whatever region in which you operate). Our intent here is to provide concepts and principles that you can apply as the situation evolves.
Basic Facts: Coronavirus-19 was first detected, and has its origins, in Wuhan, China. Much like previous outbreaks such as MERS and SARS, this coronavirus likely started in animal populations and crossed over to people from exposures in live animal food markets. Human-to-human spread of the virus began to be reported. The first cases reported in the United States were from travelers who brought the virus back with them from overseas, but now we are seeing person-to-person spread of the virus in the United States, along with the first reported case of a confirmed case of "community spread" meaning that it comes from unknown origins (not from traveling, nor from any known exposure to an infected party). Coronavirus is having a major impact on the entire world at this point, affecting economies, travel, politics, and healthcare systems.
Symptoms and Transmission: Scientists currently believe that symptoms may appear anywhere from 2 to 14 days after being exposed. Symptoms present as respiratory illness, and severity ranges from mild to fatal. One of the elements that makes all of this quite challenging is that while one's symptoms may be quite mild, the virus can still spread easily between people with or without symptoms - so someone with mild (or no) symptoms may not be recognized as a threat to others. At the same time, we should be careful not to confuse the speed at which the virus spreads for the severity of its impact on individuals, as this article explains. Although research is ongoing, there is much that is not yet understood about transmission, incubation, and other essential elements.
Coronavirus vs. The Flu: We have heard people making the argument that we should be more concerned about flu (influenza) than Coronavirus, since the flu kills a lot more people per year. However, based on what is now known, the actual mortality rate for flu is around .1%, while mortality rates remain close to 2% for Coronavirus. This means that coronavirus is 20 times more likely to result in fatality than flu, based on current information. We also have flu vaccinations, antiviral therapy, and much better understanding of how the flu works, while there is no vaccine, antiviral therapy, or clear understanding of Coronavirus at his point. Finally, this is a novel (or new) virus - meaning, that we have no previous exposure to it, and no innate immunity to it whatsoever, unlike the flu.
For a deeper comparison of individuals affected by flu as opposed to Covid-19, see this article.
Prevention: Many outdoor programs or schools are accustomed to sharing snacks on a hike, sharing water bottles, or going long periods of times between washing hands, etc. These are all ways to spread illness. The same good habits that serve us well for preventing colds and flu apply to coronavirus as well.
Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
Avoid close contact with people who are sick.
Avoid touching your eyes, nose, and mouth.
Stay home when you are sick.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
Regarding the Use of Face Masks:
Face masks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others, according to the CDC;
Basic face masks (as opposed to N95 respirators) are not 100% reliable to protect people from contracting the coronavirus, but they can be helpful in keeping people from touching their mouth or nose, and serving as a reminder to use good habits;
If the use of face masks can reduce cases of influenza and colds, it alleviates pressure on the larger healthcare system and may make society and individuals more resilient in general;
Face masks are currently in short supply in the US and are thereby costly.
For more details and official views on face mask pros and cons, see this article.
Precautions and Considerations for Outdoor Programs & Schools: In order to take precautions on behalf of your participants, staff, and organization, consider the following steps:
1) Stay current by monitoring the most recent developments through the CDC and WHO, plus any local public health officials if you have active cases in your area.
The situation is changing so quickly, this should be a daily (or more frequent) step if you want to stay current.
2) Follow travel advisories both to and from areas with any known outbreaks.
We continue to hear from schools, clients, and programs that they are staying tuned in to new developments, and many are cancelling or postponing international travel plans. Consider the possibility that a region you're visiting may be virus-free now, but that could change quickly.
- What would your plan be if you were unable to travel back home again from your destination?
- What would your plan be if your participants were unable to travel home again from their destination (due to borders being closed, or travel bans, etc.)?
3) Start developing contingency plans for any programs that may be cancelled or impacted.
Don't just talk about this in general terms, actually go through a few scenarios starting with worst case and working backwards to the current state of affairs. Here is a useful article that offers concepts and principles of resilience to apply from a business perspective.
We recommend: Don't think in terms of what could happen, think in terms of when this happens, how will be resilient? What do we have in place to protect our people and organization?
4) Check with your insurance broker to assess what related coverage may be available to you (such as loss of business coverage, emergency evacuation coverage, repatriation, etc.)
Also, it may not be too late to acquire travel insurance for future programs. Brokers we've spoken with advise travel insurance that includes cancellation "for any reason" as opposed to less expensive options that usually have more exclusions.
5) Review your medical evaluation / application process in light of Coronavirus, consulting with your physician advisor, risk management committee, and other relevant resources.
This should include evaluating new applicants into the program, as well as what your steps are to "re-evaluate" and manage current participants or staff with new symptoms. Be mindful to have clear, objective criteria that can be evenly applied. Don't be haphazard or intuitive when it comes to quarantining or otherwise excluding anyone, or you may be liable for "national origin discrimination."
6) Educate all staff and participants about recognizing, mitigating, and preventing the spread of any illness, especially respiratory ones (see Symptoms and Prevention sections above, and monitor new information from CDC and others).
Refresh organizational habits and practices around hand washing, hand sanitizer, working from home when sick, etc. - always a good approach to foster, regardless of this current outbreak.
Be mindful about recognizing existing program elements that are likely nexus points for spreading the virus, including seemingly benign ones. Even sleeping in tents together or travel in vehicles (when squeezed together in close proximity) is a higher risk activity.
7) Develop and communicate your Coronavirus management strategies to staff, participants, and stakeholders.
Review with HR team how "sick leave" and other types of leave (such as FMLA) can be flexed to accommodate (or prevent) widespread illness. When people feel they only have two weeks of vacation, or need to complete a certain number of hours to fulfill job duties, it's effectively a way to drive them to come to work knowing that they are sick.
Consult with an employment law attorney (if needed) to be sure to avoid any discriminatory practices or unfair treatment, and to anticipate the obvious employment questions which staff may have. See guidance for employment law questions from Society for Human Resources Management.
If you have participants who are currently overseas in affected areas, or in US areas with known cases, consider using your social media tools and targeted outreach to families to keep them apprised of your risk assessment and management plans.
8) Strive to be proactive as a business rather than reactive.
Times of crisis are also times of opportunity, and time to uphold and demonstrate your organizational values to your staff, participants, and stakeholders. Some specific advice for businesses from the CDC is here.
Consider what kind of state or federal resources may be available to you. For example, Washington State has expanded its unemployment benefits for workers whose businesses need to reduce hours or close temporarily because of quarantines according to a news release from the governor's office.
9) Be on guard for cognitive biases and competing incentives regarding business decisions
It's very tempting, in situations like this, to fall victim to cognitive biases such as sunk cost bias or confirmation bias. Other biases could certainly apply as well.
Sunk cost bias comes into play when individuals or groups continue a behavior or endeavor as a result of previously invested resources. A simple example is someone who attends an event they're dreading simply because they bought a ticket to attend. For our purposes, it's easy to understand how a school might convince themselves that they've already invested so much into a given trip or program that they really have no choice but to continue forward at this point -- they have "too much to lose" otherwise. Yet, those investments have already been made, and are "sunk costs" that should not be used to justify further costs and risks.
Confirmation bias comes into play when we know what answer we're looking for, and seek out facts, research, or opinions that reinforce what we're already thinking. It's easy to imagine how sunk cost and confirmation bias could work together to lead a program to ignore the inconvenient facts of Coronavirus and make a riskier programmatic choice as a result.
We continue to hear from colleagues and clients about how they are grappling with these difficult business decisions. For example, we heard from a North American guide service who has an upcoming ski trip to Europe on their books, to a region that is currently unaffected by Coronavirus. The guide and clients are all aware of the issues and eager to run the trip, on which they've been counting (for recreation as clients, and as work for the guide). However, there are health authorities that predict that the outbreak will be widespread across Europe in the near future. This creates an obvious conundrum and business decision for the guide service, with competing incentives between revenue, guide and client satisfaction, safety and liability, and civic responsibility.
10) Don't lose sight of more immediate and direct threats to your program and participants while focusing on Coronavirus precautions.
Don't let your focus on Coronavirus take your focus away from more likely, immediate, and potentially severe risks that are part of your everyday programs, such as driving vehicles to and from program events, etc. In other words, be careful not to exchange a potential risk for an actual one.
11) Remember that Coronavirus is a social issue as well as a medical issue.
Another threat that can be overlooked as we focus on the physical risk of coronavirus is the threat of discrimination and racism surrounding this outbreak. There have been reports of racism and xenophobia as fear surrounding the coronavirus spreads. Not every program or community will have to deal with confirmed cases, but many will be impacted by these instances of abusive or discriminatory behavior.
Photo: An example of discriminatory behavior related to Coronavirus
In the words of King County (which has been one of the national epicenters of outbreak), "Viruses don't discriminate, and neither should we."
Conclusion: Clearly, this is a rapidly evolving and globally significant matter, the outcome of which could go in many directions. Meanwhile, planning for the worst and hoping for the best may not only serve your program well when it comes to Coronavirus, but it may help you put tools and systems into place to be even more resilient to whatever may come next.
We hope that you will use this opportunity to build resilience for your future while managing the present. Please reach out to us if we can be of any support to you.
Additional Reading and Resources:
CNN: Coronavirus Myths Debunked
Harvard Business Review: Lead Your Business Through the Coronavirus Crisis
Johns Hopkins: Coronavirus 19 vs. the Flu
Montreal Gazette: Rapid Spread of Virus Should Not Be Confused With Severity
National Association Of Independent Schools: What Schools Need to Know
Scientific American: P