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Prepare your business for any future pandemics

Use the Pandemic Preparedness Plan for Business as your playbook to manage health risks and future-proof your business
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“We could name a thousand ways in which employers have become part of the public health system in the context of this pandemic, and let’s not lose that memory. If we want to be better prepared going forward, we really need to take advantage of the incredible authority, credibility, trust and power, capability and capacity of our private-sector partners.”

Dr. Julie Gerberding

Former Director, US Centers for Disease Control & Prevention

The One-Minute Read

The COVID-19 pandemic taught us that the health of a business and its people extends well beyond the walls of the workplace. Community health is essential to a company’s ability to weather a pandemic.

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During a public health emergency, poor community health conditions make people more vulnerable to serious illness and death—and as we’ve seen, that can lead to devastating effects on business.
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So, businesses would be well served to invest not just in their own teams and workplaces, but also in the communities where they operate.
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Partnerships between business, public health and local governments can strengthen the quality of community conditions and improve lives for everyone—making your business healthier, stronger and, yes, more resilient when the next pandemic strikes.
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Preparing for the next pandemic starts now. You can begin by capturing the learnings fromCOVID-19, strengthening your relationships in public health and building trust with your employees before it slips away.
Overview
Businesses are critical to a community’s health.
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This was the case even before COVID-19—after all, most working-age Americans access healthcare through employer-sponsored health insurance. 
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During the pandemic, companies have helped to save lives and fill gaps in underfunded and overstretched public health systems. 
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Businesses have partnered local public health departments to establish new workplace health protocols, supporting employees’ ability to quarantine and increasing vaccine uptake.
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The pandemic has shown us how businesses depend on the health of their communities.

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The human impacts of COVID-19—loss of life, trauma, long-term illness and ongoing physical, mental and financial challenges— from COVID-19 have been staggering. Business, too, continues to feel the effects of deceased and sickened team members, permanent closures, supply chain shortages and productivity challenges from stressed employees navigating upheaval in their home and work lives.
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All told, the cost of COVID-19 to the U.S. economy is estimated at $7.9 trillion over the next decade.
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Leader's Lessons:

“Businesses’ preparation in your own work environment is going to be critical to being ready for the next threat. And it’s going to happen—it’s not going to be a once-in-a-century event, it’s going to be more frequent, unfortunately.”

Ezekiel Emanuel, MD, Special Advisor to the World Health Organization’s Director-General and Vice Provost for Global Initiatives, University of Pennsylvania.

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Thirty percent of business executives in a recent survey said they expect another pandemic to emerge by 2025, and 50% expect one in the next 10 years.2
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As a recent White House report put it: “There is a reasonable likelihood that another serious pandemic that may be worse than COVID-19 will occur soon — possibly within the next decade. Unless we make transformative investments in pandemic preparedness now, we will not be meaningfully prepared.”3
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While it’s impossible to say precisely when the next pandemic will hit, we can take steps to prepare and contain its impact. Hoping for the best is not a strategy.

Being prepared for a future public health crisis means establishing institutional memory from the COVID-19 response, keeping response systems activated and engaging in community health on an ongoing basis.

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Three out of four companies created internal pandemic response teams, and 55% plan to keep them in place going forward, according to a March 2022 survey by Mercer.
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Building resilience now pays off. Resilience in times of crisis separates the most successful companies from their competitors and is estimated to be responsible for 30% of total shareholder return.
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Leader's Lessons:

“We’re going to continue to have this situation of COVID or something else and we’re going to be a lot smarter about how to respond to it. We need to take this experience and institutionalize it. There are so many things we now have at our disposal to be able to respond.” – Kirk Limacher, Vice President of HR Services, United Airlines

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Misinformation is likely going to be an even bigger challenge next time.

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Misinformation is likely going to be an even bigger challenge next time. Employers—as the nation’s most trusted institution—have a powerful opportunity to offset that threat by cultivating trust in public health.
Relationships matter
  • Trust is built through relationships. And that goes for employees’ trust in public health, too, which employers can cultivate through partnerships in the workplace.
  • Companies with existing relationships with state or local governmental public health departments reported that they could lean on those relationships to quickly restore business continuity during the most disruptive moments of the COVID-19 pandemic.
  • Those relationships also enabled private sector-driven community health solutions. 
  • And they’ll be crucial to building the trust in public health guidance necessary to counter misinformation.
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Future pandemics will be interpreted through the prism of COVID-19. People will base their actions next time on what they remember of this crisis—including how your company responded.
Why it matters
  • The actions you take now and in the aftermath of COVID-19 are the beginning of your response to whatever threat the future holds. The time to act is now.
  • While only a small number of companies had pandemic preparedness plans before 2020, the COVID-19 pandemic has made it abundantly clear why preparing for future public health crises should be a critical part of every company’s operational planning.
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Strengthening employee health through community health will benefit a company in a pandemic and before then.
Why it matters
  • Through better health, employers stand to gain improvements in presenteeism among current employees, as well as cost savings in the health coverage of family members and retirees on employer-sponsored medical plans.
  • For larger companies setting environmental, social and governance (ESG) commitments, action on employee health presents an opportunity for progress on managing human capital, as well as reducing risk exposure.
  • When a pandemic threatens the health of the most vulnerable people in a company’s orbit, a healthier community bolsters business resilience.
The Bottom Line
Companies can future-proof their business by building up their defenses both inside the walls of the workplace and in the wider community. Doing this most effectively requires building trust with other businesses and, particularly, with state and local governmental health departments.

Businesses would do well to see public health departments as another provider of a service that can help companies be successful, i.e., a partner in employee, customer and community health. Doing so means taking a more expansive view of health to consider the conditions in which people—your employees, their families, your customers and suppliers—live their lives.

This Plan for Business is your guide to getting started.
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How to Use This Pandemic Preparedness Plan for Business

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This plan focuses on improved workforce and community health as the means to strengthen business resilience during a future pandemic. It is designed to help employers future-proof their businesses by maximizing their influence on the conditions that drive employee and community health. It leads employers up a ladder of engagement with four key steps:
  1. Protect employee health in the workplace.
  2.  Develop ready-to-use emergency response plans and company health policies.
  3. Build or deepen relationships with local public health officials and other local employers.
  4. Invest in community health solutions in partnership with local public health departments and other businesses.
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Throughout this Plan, you’ll find insights direct from the business community to help guide your company, including:
Winning strategies
Successful examples of business action to showcase the how and why behind pandemic preparedness and response.
Leaders’ lessons
Learnings, reflections and calls to action to inspire your company’s future-proofing efforts.
Small business spotlights
Suggestions and advice from small business leaders to encourage companies with fewer than 100 employees.
Need help developing your game plan for pandemic preparedness and community health? 

Our team of experts offers free coaching and training to help employers develop or evaluate their plans. Contact us at hello@healthaction.org to schedule a free consultation.
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Community Health Is Essential to Pandemic Preparedness

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Most employee wellness programs function on the premise that better health is the result of individual responsibility, persistence and hard work—factors presumably primarily within one’s immediate control.
  • Disease management, health screenings, support to quit smoking and programs to improve fitness and reduce stress and burnout are typical offerings.

  • They have an important, positive impact on employee health and worksite wellness, but they’re not enough.

  • Despite the billions of dollars invested in workplace wellness programs, community conditions often limit their potential. 
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WHAT WE KNOW NOW: Data show the greatest drivers of employee health are the social, economic and environmental conditions in which people live, not genetics or personal choices.7
  • Example: It’s tough to log 10,000 steps per day if your neighborhood isn’t safe or lacks sidewalks. It’s difficult to have a good diet when healthy foods are inaccessible or unaffordable.
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CASE IN POINT: During the COVID-19 pandemic, rates of severe illness and death have been higher in counties that experience more social vulnerabilities and systemic inequities, under-resourced public health systems and lower access to primary care.
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A New Framework for Business

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Companies can no longer afford to ignore community health conditions.

Social, economic and environmental factors (and systemic inequities within them) are the foundation on which health is built—for your workers and their families, your customers and suppliers, in times of crisis and in more normal times.
  • Strengthening this foundation will help your company better weather a future pandemic.

  • During pandemics and after, healthier communities will make your company’s investment in employee health more effective and efficient.
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Healthy employees are key to business continuity and productivity.
  • If employees are sick, they’re either going to miss work or be limited in their performance there and risk infecting others. 
  • People without paid sick leave had the highest rate of illness during the H1N1 pandemic in 2009. Today, 21% of U.S. workers—and more than half of low-wage workers—still lack access to paid sick leave. This creates pressure for them to show up on the job even when they’re ill.
  • Indeed, during the current pandemic, 3 in 10 low-income workers have gone to work despite having COVID-19 symptoms or have knowingly been exposed to the virus at work because they couldn’t take time off.11 Health inequity thus exposes all employees.
  • People with underlying health conditions, such as heart disease, diabetes and asthma, are the most vulnerable to COVID-19 and will likely be at the greatest risk in a future pandemic. One in six U.S. adults ages 18 to 64 is at a higher risk of serious illness if they become infected with COVID-19, based on underlying conditions alone.
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Community health conditions are the key driver of employee health.
  • Employee health is influenced by more than workplace safety, an employee’s own behaviors or even access to healthcare. Family, community and systemic factors have a greater impact.
  • Only about 30% of a person’s health is determined by individual behaviors. Fifty percent is determined by social and economic factors and a person’s physical environment.
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The greatest business opportunity is in improving community health.
  • Community conditions, such as limited access to healthy food or an unhealthy built environment contribute directly to chronic disease—which account for 3 of every 4 dollars of healthcare spending.
  • Lost productivity due to illness costs employers an amount equal to 60% of their spending on healthcare benefits.

  • Community health is a vehicle to offset the risks of a pandemic or localized public health crisis, a way to increase efficiency in health spending and an opportunity to improve a business’ relationship with its people.
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Your employees and customers are counting on you to act.
  • Seventy-five percent of adults say it is important that the companies they purchase from practice corporate social responsibility, including investing in the health of communities.
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Statisitics
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Creating Your Game Plan

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Securing the health of the people in your workplace is the natural place to begin strengthening your company’s resilience against a future pandemic.
  • To maximize your organization’s readiness to respond to a crisis and build up your community’s defenses against a pandemic, there are some internal processes and external partnerships in public health you should consider, too.
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BEFORE YOU START: Consider these eight questions to help you focus your actions:
  1. What are the barriers to health for employees in our organization?
  2. What did we learn from the health impacts of COVID-19 on our business operations? What are the most achievable areas to improve health?
  3. How can we educate employees on health and create ongoing opportunities to share public health messaging?
  4. How can we align our company values and commitments (for example, corporate social responsibility activities and ESG goals) with community health goals?
  5. How can we integrate community health into our core products and services?
  6. What is the status of our relationships with local health systems and local and state public health departments, and where can we partner with them?
  7. What issues affect the health of our community? What don’t we know about our community’s health, and who can provide the insight we need to take action?
  8. Knowing that the COVID-19 pandemic had disproportionate impacts for historically marginalized communities, how can we authentically engage employees from these communities and from all levels of the organization in our planning?
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NEXT: Once you’ve answered those questions, you’ll better be able to progress through the four levels of pandemic preparedness. 
  • You don’t have to complete each level before moving on to the next one—some of these actions require continuous attention. But moving up through the levels will help you realize the greatest gains in the health of your community and the resilience of your business.
LEVEL 01
Protect employee health in the workplace.
Limit the impact of infectious diseases by keeping workers healthy, allowing them to stay home if they’re not, and providing benefits capable of supporting them in a public health crisis.
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Provide quality paid sick leave and make sure employees feel empowered to use it.
Why it matters
This was shown to be crucial during both the H1N1 and COVID-19 pandemics. Allowing employees to stay home when they’re not feeling well—and without risking their paycheck—helps keep infectious diseases from spreading among your workers.
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Make employees’ families part of your focus on health, too.
Why it matters

Your workers are not safe from infectious disease if the people in their own homes are vulnerable due to an inability to get vaccinated or visit a doctor.

  • Make sure paid time off allows employees to accompany family members in their care to vaccination appointments and other important healthcare visits.
  • If you’re offering vaccine education or on-site vaccinations, consider making them available to family members, too.
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Winning strategy

Dine Brands promoted child vaccination to its team members and offered four hours of sick leave for parents to vaccinate their eligible children. Within a week of being asked whether it had a policy to offer time off for child vaccination, Uber created such a benefit for its employees worldwide. And AT&T and Land O’ Lakes were among many companies that opened their workplace vaccine clinics to employees’ families.

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Launch or continue preventive care, biometric screenings, cancer screenings and other wellness promotions.
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Leaders’ lessons

“We’re coming out of this pandemic with a lot of employees who have not been to the doctor recently. One of our main areas of focus going into the pandemic was annual check-ups. One of our highest expenses [in healthcare spending] is skin cancer. It’s so avoidable, and the expense is so low to catch it early, we were going to drive up these cancer screening vans, do the screening and get after this. Now we have so many people who haven’t gone to the doctor, and we realize the risk this has for our business.” – Kirk Limacher, Vice President of HR Services, United Airlines

Go deeper
Look at whether your company-sponsored health plan or employee assistance program (EAP) can offer care navigation and coordination to help employees and their family members access non-medical services that contribute to overall health and wellness.
Watch out
If you collect biometric information, set a clear policy for aggregating and anonymizing data—and limiting how this confidential information will be used—to assuage privacy concerns.
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Look out for opportunities to remove barriers to healthy living, especially those that fall disproportionately on marginalized communities.
Why it matters
Your company may be able to make an immediate difference in addressing social needs even as the longer-term solutions to underlying conditions (such as employment, food access, education, clean air and water, and safe neighborhoods) are underway.
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Encourage or require vaccination, and make it easier for workers to receive routine immunizations at work.
Why it matters
A workforce whose vaccinations are up to date creates the safest environment for employees and customers. Also, if employees get comfortable getting vaccines at work, it is easier to deliver vaccines to workers in an emergency.
By the numbers
Thirty-eight percent of employers require vaccination against COVID-19, and only 5% intend to drop that requirement this year, according to a March 2022 survey by Willis Towers Watson.
  • Seventy-eight percent of companies are tracking vaccination status as of March 2022, according to a Mercer survey. Knowing employees’ vaccination status is vital for instituting a requirement in the event of a new surge
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Strengthen workplace mental health support.
Why it matters
The mental and emotional stress brought on by a pandemic will directly affect how your employees show up for work. You can improve their resiliency now by normalizing discussion of mental health in the workplace, investing in expanded benefits, developing flexible policies and reducing work-related causes of stress.
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Leaders’ lessons

“You can’t leave [workplace mental health] to chance. You have to have a program. For us, that ranges from mindfulness techniques to substantial benefits for therapy. And you have to think about all facets, from the light touch that just creates conversations to defined benefits. You have to step back and look at your whole benefit architecture.”

Brian Moynihan, CEO, Bank of America

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Consider creating an employee resilience fund.
Why it matters
Low wages are the top cause of work-related mental health stress, and the upheaval of a pandemic has intensified these worries for workers.
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Winning strategy

During the COVID-19 pandemic, Best Buy increased its minimum hourly wage to $15 per hour, offered all hourly full- and part-time employees a “gratitude bonus,” provided financial assistance to employees who suffered financial hardship from contracting COVID and offered grants of up to $2,500 for personal hardships beyond employees’ control, whether related to COVID or not. CBRE made 11,000 financial grants through its employee resilience fund to employees who suffered financially from COVID-19. Giving mid-level managers discretion to allocate grants may do more to make the program sustainable and build employee loyalty.

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Reduce the impact of airborne pathogens, including viruses like COVID-19 and influenza, by improving indoor air quality in your workplace. 
How it works
Pulling in more outdoor air and filtering the air circulating inside has been shown to reduce infection rates and improve worker productivity. Changing the air in a room five times in an hour can reduce the risk of transmitting COVID-19 by 50 percent.
  • Even small fixes, like opening windows and using higher MERV filters, can help achieve even more air changes per hour.
By the numbers
More than 1 in 4 employers are already making long-term upgrades and improvements to workplace filtration and ventilation, according to Mercer.
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Consider opening an on-site primary-care clinic.
By the numbers
Nearly 1 in 3 companies with 5,000 or more employees operate a primary-care clinic.
  • Overall, 74% of companies with a worksite clinic report a return on investment of at least 1.5:1, 2:1 or greater, according to Mercer.
Small business spotlight
Worksite clinics are feasible for smaller companies: 47% of smaller employers who offer a clinic do so in partnership with another employer.
Watch out
Clinics should never be used to tamp down health and safety issues, for instance, by minimizing injuries, preventing safety incidents from being recorded or pushing employees back into work before they are physically ready to do so.
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Leaders’ lessons

“As an employer who is concerned with their population’s health and well-being, it’s really hard to address healthy lifestyle strategies when people are working 10 to 12 hours per day”—a challenge that can be mitigated with an on-site clinic.

“The burden of not having a healthcare provider has become a glaring risk to health and the operations of an organization. COVID in particular seems to prey on people in poor health and those who are not taking care of chronic conditions, which could be better managed by a provider who knows an individual’s history and condition.

I would give anything to have on-site clinics at all our locations with direct primary care for every person. It is a win-win situation where the employee has access to timely, individualized solutions, and the doctor has access to resources they may not normally have if working in community practice.

Ginger Miller, Director of Health and Benefits, Utz Brands

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Establish a process for employees to anonymously report health and safety concerns.
And
Pair it with a non-retaliation policy that will ensure employees can speak up about unhealthy conditions, whether the source is another employee’s behavior or insufficient workplace health safeguards.  
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Plan for flexibility in your operations, including remote/hybrid work to limit the opportunities for sick employees to infect others in the workplace.
Why it matters
Many employers had to start from scratch in creating remote-work policies and, in some cases, offering the technology to facilitate it. Make sure your policies and technology remain up to date to allow for a nimble transition in the event of an outbreak.
Level 02
Develop ready-to-use emergency response plans and company health policies.
Companies with cross-functional teams in place and strategies at hand were best positioned to pivot quickly when time mattered most.
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Review your company’s COVID-19 response and collect your learnings.
Go further
Challenge yourself to ask where your response came up short and where you may have gotten lucky, as well as areas where you were well prepared or where your teams stepped up. Your goal is to identify and prevent weaknesses in your future response.
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Don’t assume that an emergency-response playbook for a natural or human-made disaster will suffice.
Why it matters

Companies tell us their non-pandemic emergency action plans weren’t enough to keep pace with a pandemic’s scale, duration and complexity.

  • The fast-evolving public health recommendations and local government orders required companies to play catch-up with their own safety and communications plans.
  • Standard plans for alternate-site working, backfilling labor and getting support from third-party providers likely won’t be relevant in a pandemic, which is not localized, and which creates wide and long-term workforce shortages.
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Assign a team representing key areas of your business operations to lead your company’s response.
And
That team—with representation from Environmental, Health and Safety; HR; communications; legal; security; operations; or your Chief Medical Officer—should meet regularly to engage in scenario planning to anticipate real-life challenges in the event of an emergency and develop trust through collaboration.
Why it matters
Continually evolving your scenario planning will help future-proof your organization by anticipating challenges and responding to the unknown rather than re-creating responses to yesterday’s crisis.
Go deeper
Your pandemic-response team should also create new emergency-response templates based on the company’s successful COVID-19 actions. This could include processes for chain of command decision-making, remote working, updated sick leave policies and supporting employees with second-wave challenges like caregiver relief, burnout, trauma and financial stress. Your pandemic-response team should also create new emergency-response templates based on your company's successful COVID-19 actions and the challenges you faced.
By the numbers
Nearly 3 in 4 large companies surveyed told Mercer they created pandemic response committees.
  • Fifty-five percent intend to keep those committees in place, as of March 2022.
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Consider hiring a Chief Health Officer or Chief Medical Officer to advise and coordinate your health response.
Why it matters
Companies report that their chief health/medical officers were crucial in translating advice from public health departments and managing the sometimes conflicting national and local guidance.
  • An in-house health expert—frequenty an epidemiologist or public health practitioner—is valuable for managing all organization-wide health matters, including providing a healthy workplace free of disease and improving employee well-being.
  • That’s why some companies find “chief health officer” to be a more appropriate title—their work goes well beyond medical care.
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Winning strategy

PepsiCo, Tyson Foods, Delta Air Lines, Constellation Brands, Dollar General, Stanley Black & Decker and Royal Caribbean were among the many companies that hired a chief medical officer or chief health officer during the pandemic.

Small business spotlight
To get vital assistance translating public health advice, smaller employers can band together to approach a local epidemiologist or public health practitioner. Local universities could be helpful partners. Consider going through a local industry association, chamber or wellness council.
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Ensure your emergency preparedness team’s work is transparent to build confidence that the team is ready to lead in a moment of crisis.
And
Gather input from a wide spectrum of employees, including hourly or low-wage workers, those from historically marginalized groups and others representing populations that may be disproportionately impacted in the event of a public health emergency.
  • Better yet, include some of these employees on your emergency preparedness team.
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Leaders’ lessons

“We have very good cross-functional work. Regardless of where it originates, once there is alignment with leadership, we will put resources into it, and it will happen. Everybody who wants to work on it, can. So you can work on projects that are maybe not necessarily tied to your role but that are important to you.”

- Zoraida Rodríguez Montenegro, Senior Manager, Federal Affairs, Uber

Remember
Communicate the goals, rationales and procedures the team generates, and update your employees continuously.
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Leaders’ lessons

“Thinking about things when they’re happening is too late. You’ve got to be prepared. Make sure you’re communicating frequently with your employees. That was another key action we learned.

This employee engagement helped us get back to work quickly and helped our employees to feel safe and comfortable when they returned. Employees told us, ‘I feel safer here than I do going to the market.’”

– Jeffery Hess, MD, Corporate Medical Director, General Motors

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Test your pandemic response plans with live-scenario exercises.
Go deeper
Participate in work-from-home drills to ensure your teams are able to shift away from the workplace environment. And seek opportunities to participate in table-top pandemic exercises with city, county or regional public emergency response teams. This will help you establish valuable relationships and identify whether you have the right people in the roles to guide your company’s response.
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Draft policies that support public health guidance (e.g., for vaccination, testing and masking).
Why it matters
You’ll want to be able to activate these policies quickly and to move from voluntary to mandatory employee action if needed.
Go further
Consider the possibility of a test-to-treat process. Employers could provide free at-home tests (for COVID-19, flu or future viruses) and connections to follow-up telehealth care and/or treatments.
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Be prepared to stand up on-site clinics (or partner with other businesses to offer them) to improve access to routine immunizations and pandemic-specific vaccines.
Why it matters
Offering routine immunizations like flu shots on-site can maintain employee health and presenteeism and can easily be adapted for newly emerging viruses.
  • Consider making clinics available to workers’ immediate family members or even the wider community in order to improve the health of people your employees come in contact with.
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Assess what your company could bring to the table to assist in emergency response, whether in manufacturing, logistics, or marketing and communications expertise.
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Winning strategy

Among the many ways companies assisted public health agencies in the early stages of the COVID-19 pandemic, Starbucks applied its expertise in human-centered design operations to assist Washington State health officials with creating more efficient and scalable vaccine centers. General Motors applied its manufacturing capabilities to the creation of 30,000 ventilators in 154 days and produced and distributed 8.7 million masks and pieces of protective gear, including face shields, gowns and aerosol boxes across the U.S. In addition, GM shared the recipe for manufacturing masks with other companies. Northrop Grumman used 3D printers to produce tens of thousands of face shields. Uber and Lyft donated tens of millions of free rides to vaccination centers, and Uber adapted the technology behind its in-app polling place finder from the 2020 election to guide riders to vaccination distribution centers. Disney Parks, Experiences and Products donated 1 million face coverings to MedShare and profits from the sales of Disney cloth masks raised an additional $1 million for MedShare to support the medical community’s ongoing efforts to provide lifesaving care to those in need.

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Set and understand your risk tolerance in order to respond to an emergency.
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Winning strategy

When schools shut down during the pandemic but children still needed a way to pick up their free lunches and other meals, Sodexo created public pick-up and drive-thru locations, making deliveries in school buses and passing out bagged lunches through car windows to feed 25 million children. While legal reviews are implemented, the “risk tolerance goes way up if the reason is to serve the greater good,” says Drew Nannis, Senior Vice President, Communications.

What Do Public Health Departments Do?

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They listen to people who know the community, recognize patterns and problems, then use data, evidence and research to offer solutions.
While medical doctors and hospital systems respond to individual illness or injury, public health departments focus more broadly on preventing health problems. They investigate everything that affects our health—food, water, air and more—to detect and respond to infectious diseases and promote healthy behaviors in communities.
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Public health departments and community organizations serve three core functions and provide 10 essential services that aim to reduce community-level risks and strengthen community resilience:
  1. ASSESS and monitor population health. 
  2. INVESTIGATE, diagnose, and address health problems and hazards. 
  3. INFORM and educate people about health, factors that influence it, and how to improve it. 
  4. STRENGTHEN, support, and mobilize communities and partnerships to improve health.
  5. CREATE, champion, and implement policies, plans, and laws that support impact health.
  6. UTILIZE legal and regulatory actions designed to improve and protect the public's health.  
  7. ENSURE equitable access to the services and care needed to be healthy.
  8. BUILD a diverse and skilled public health workforce.
  9. IMPROVE and innovate through ongoing evaluation, research and continuous quality improvement.
  10. BUILD and maintain a strong organizational structure for public health.
What Do Public Health Departments Do?
State and local governmental public health departments are trained to diagnose the health of a community of people wherever they live, work, pray or play.
Level 03
Build or deepen relationships with local public health officials and other local employers.
These relationships are critical in an emergency but must be cultivated over time.
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Recruit someone who is skilled at building trust and maintaining relationships to lead this effort.
Why it matters
Remember, businesses and public health departments operate differently and may have different priorities and points of view. Your ideal leader should be positioned high enough within your company to execute a vision. They should have the stability to form long-term partnerships and build institutional knowledge of the working relationship with public health.
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Make these relationships a give-and-take, approaching partners with a spirit of collaboration, humility about what you don’t know, a clear sense of what your company needs and initial ideas for partnerships.
And

Don’t be afraid to ask questions about health measures you may not be familiar with. Those answers will help your company choose the best path forward.

  • Likewise, knowing what you need from public health partners will help them tailor their response to your business.
  • Be open about the assets your company can bring to a long-term partnership, understanding that public health departments are under-resourced.
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Winning strategy

After Utz Brands leveraged an existing close relationship with a local epidemiologist for a presentation to employees, there was a new sense of trust that the company was providing reliable answers to difficult questions. In turn, local public health workers sought the company’s input for tailoring content relevant to the wider community.

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Establish relationships from the top down and bottom up.
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Leaders’ lessons

“In all the communities where we operate, I asked the medical docs to reach out to the local community health departments to make sure they have connections there. These relationships were built long before COVID came along. We’d reach out to know what’s going on and ask for support. They’re a really good conduit of local information. When vaccines first became available, these relationships were also the key to getting vaccinations in our facilities, whether we were offering them ourselves or asking the county health departments to come in.

These relationships are twice as important now. It's important for us to be assessing guidance from the top—OSHA and CDC, external partners at other companies—but also going to the local health departments on up to make sure we’re all connected and aligned.”

Jeffery Hess, MD, Corporate Medical Director, General Motors

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Small business spotlight

“Our business is a collaborative one: we will need deeper relationships that can help us understand and support our people while also preventing future community health issues.”

Lois Kolada, CFO, Priority Designs (Columbus, OH)

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Be ready to share data and be transparent with public health departments about the trends you’re observing at your company.
Why it matters
A robust testing plan can help identify emerging variants. Reporting new cases (and deaths) to the local public health department is also critical to building local knowledge about the spread of infection.
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Increase health knowledge within your workforce through regular, clear, consistent communications and programming delivered in partnership with local public health representatives.
Why it matters
Employers have a profound influence on worker health, in large part due to the trust that employees have in their employer when it comes to health messaging. 
Go deeper
Most people admit they do not take care of their health as well as they should, according to the Edelman Trust Barometer.
  • Americans who feel that way say confusing, contradictory and lacking health information is nearly as big an obstacle to better health as cost.
  • Employers are trusted to fill the information gap. “My employer” is the second-most trusted source of health news, trailing only national health authorities, and ranked ahead of the national government, media or “my social media feed.”
  • Among people with low trust in the healthcare system, “My employer” is the most believed channel for health information.
  • To address the unique health concerns of employees from historically under-resourced communities, invite trusted public health speakers from those communities to speak on health-related issues.
Small business spotlight
“We have found that it’s much easier to get individuals to engage with public health when it’s done through trusted, local advisors. Local advocates can offer clarity and education in an authentic way, and business leaders can support them by making it easy to access accurate, culturally relevant, consistent resources.”

Kevin Allen, Senior Vice President, ASHLIN Management (Atlanta, GA)
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Make your company’s public health relationships visible, transparent and approachable for your employees.
Why it matters
People trust their local public health department more than state or national health agencies. If your public health contacts are known around the company on a first-name basis, you help remove the specter of “faceless bureaucrats” and instead lay the ground for trust that will help insulate your health efforts from misinformation.
  • Make clear to your employees that the “public” in public health are themselves, their families and neighbors.
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Identify business community partners who can help you fill gaps or broaden your public health impact.
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Small business spotlight

Large corporations with extensive public health resources freely shared COVID-19 information, public health messaging, vaccine education and safe workplace protocols with smaller companies in their supplier and vendor networks.

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Winning strategy

When rapid COVID-19 testing was hard to come by, Kia Georgia banded together with larger local companies and the local branch of the state public health department, where it already had a close relationship. They identified a small lab that could provide PCR test results in 36 hours instead of the usual hree to five days, which allowed Kia to be among the very first sites to offer the same testing capabilities as the local hospital.

Most people admit they do not take care of their health as well as they should, according to the Edelman Trust Barometer.

  • Americans who feel that way say confusing, contradictory and lacking health information is nearly as big an obstacle to better health as cost.
  • Employers are trusted to fill the information gap. “My employer” is the second-most trusted source of health news, trailing only national health authorities, and ranked ahead of the national government, media or “my social media feed.”
  • Among people with low trust in the healthcare system, “My employer” is the most believed channel for health information.
  • To address the unique health concerns of employees from historically under-resourced communities, invite trusted public health speakers from those communities to speak on health-related issues.
Go Deeper
Most people admit they do not take care of their health as well as they should, according to the Edelman Trust Barometer.
Level 04
Invest in community health solutions in partnership with local public health departments and other businesses.
Because community conditions have an undeniable effect on individual health, this is where the greatest gains in the resilience of your people, customers and community can be made.
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Familiarize yourself with the landscape.
Why it matters
The factors affecting health in your community might not be immediately visible to you. Or, there may already be lots of work happening by governmental public health departments and other organizations with on-the-ground expertise which you can support.
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Many drivers of health—economic conditions, the built environment, education and health access—are also sources of inequity that may be outside your team’s own lived experiences.
Get started
You can likely get an overview of population health data from your local health department’s website. And every hospital has to do a community health needs assessment, which is also a valuable source of information.
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Leverage your relationship with your state or local governmental public health department, local hospitals or academic health centers to get an in-depth understanding of the sources of health challenges in your community, the efforts underway to address them, the players who are active in that work and why individual patient medical care is not enough to create sustainable community health. 
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Leaders’ lessons

“Let us give you the data you need to understand the issue and the evidence-based programs to address it. And we can show you how you did or did not move the needle.” – Dr. Kristina Box, State Health Commissioner, Indiana Department of Health

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Identify the problem your company can help solve.
Zoom in
Start with challenges that are universally acknowledged and consider what resources your company can bring to address them.
  • You might also aim for achievable wins that build buy-in and momentum, for example, expanding successful company wellness programs into community programs.
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Look to address the source, not the symptom.
Why it matters
Broadening your approach from employee health to community health will require greater attention to the underlying social and economic conditions that influence health.
  • Recall the metaphor of the river where people are frequently drowning. Pulling them out of the water can save them—if you can reach them in time. Putting up protective barriers and warning signs can keep people from falling into the river in the first place. The most transformative change happens upstream.
     
  • An example in health: to lower rates of diabetes, explore how your company can address food security and access to healthy food options.
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Connect your community health activities to your core business.
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Winning strategy

CVS Health recognized that having safe and stable housing is fundamental for people to focus on their wider health needs. Since 1997, the company (and its subsidiary Aetna) have helped create 97,000 affordable rental units. In 2021, CVS Health launched its Health Zones program to provide job placement assistance and access to healthcare around its affordable housing investments in five cities. Likewise, Kaiser Permanente has pledged $400 million to affordable housing and economic development, which the company says will support people in getting medical care when they need it.

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Leaders’ lessons

“As I thought about the creation of [a new program], I wanted to be very strategically aligned with the business. I really looked at shared value, using business as a force for good, driving economic success and simultaneously driving impact on a social issue.

Our next program is focused on school nutrition. Why school nutrition? Campbell creates products that go into that K-12 sector, and we think we can drive product innovation around healthier products for our children.”

Kim Fortunato, President, Campbell Soup Foundation

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For companies with modest resources to invest in solutions, consider offering assets or expertise to assist your state or local governmental public health department on an ongoing basis.
And
Speak out for better funding of public health as a shared good for the economy.
Why it matters
Public health departments remain critically underfunded, threatening their ability to provide the services businesses and communities need. They can benefit from private-sector support in consulting, tech, office services and coordinated volunteer hours. 
  • Ask your public health department contacts where they could use support, assess your capabilities to help and formalize a partnership agreement outlining your accountabilities to addressing priority issues.
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Plan to make a long-term commitment and lock in the funding.
Why it matters
As we emerge from the COVID-19 pandemic, there will be pressure or temptation to cut back on preventive community health programs and pandemic-preparedness initiatives, but community health conditions aren’t improved overnight. Make a long-term commitment and stay the course.
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Leaders’ lessons

“Improving community health by addressing underlying social and economic conditions requires a long-term commitment—but that’s how to move beyond band-aid responses and into transformative solutions. Attention on community health has maybe never been higher than during COVID, so one positive outcome from this pandemic would be increased investment in people’s well-being and our collective ability to weather a future pandemic.”

Peter Lee, MD, Global Medical Director, Amazon

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Set clear goals for your company’s role in a public health partnership.
Why it matters
Clearly stated goals prevent partnership fatigue and mission creep. Understand what you hope to achieve, what your company will bring to the table and the benchmarks each side should aim to hit.
  • Involve residents, government officials, philanthropic organizations and your workforce to help establish the right targets and increase buy-in.
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Connect your CSR campaigns and ESG commitments to your community health efforts.
Why it matters
Combining these efforts may unlock additional collaborations, better measurement and evaluation or allow you to tap into employee volunteer hours or philanthropic giving.
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Measure your results and refine your approach.
Why it matters
Tangible metrics and outcomes are crucial to reaching the desired goal, showing progress, making changes as necessary and maintaining project morale.
  • Define the metrics collaboratively from the beginning of the project and include both short-term and long-term goals and benchmarks.

  • Consider issuing an annual health impact report card to hold your company accountable for progress and share your results with employees and the community.
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Winning strategy

From the start of Campbell’s 10-year Healthy Communities initiative for youth in Camden, NJ, the company and its partners co-designed metrics across all the program’s strategy areas, including new areas of healthy food access, minutes of physical activity, minutes of nutrition education and “public will”—a measurement of the community’s participation.

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Advocate for policies and investments that will improve community health.
Why it matters
Joining with other local companies or business associations can help call state and federal attention to the obstacles that stand in the way of community health—obstacles that can be best mitigated through tax incentives, public investment or changes in government policy.
  • You may need to urge your local chamber of commerce to make health a priority. Some states have independent or chamber-affiliated wellness councils whose convening power and focus on employee health could make them valuable allies. 
  • Significant progress on the underlying drivers of community health is more than any one company can take on alone, making collaboration all the more important.
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Winning strategy

Bank of America launched a four-year, $25 million initiative with the American Heart Association, American Cancer Society and American Diabetes Association that includes a focus on helping those organizations advocate for local and state support to improve health outcomes for communities of color in 11 cities.

Go deeper
Look for win-win policy solutions where your company could deliver a public benefit in the course of your core business operations. 
  • For example, dispensing COVID-19 vaccines at pharmacies (not only doctors’ offices or government facilities) was a game-changer for the public and the pharmacies.
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Winning strategy

The Kansas City Chamber brought businesses together with the local health department and others to advocate for raising the legal age to purchase tobacco products to 21—a successful effort that spread to 30 cities in the Kansas City area. And to support its impact investments in affordable housing, Kaiser Permanente has advocated for federal tax credits for low-income housing, state and local housing bonds and inclusionary zoning at the city level. 

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Conclusion

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There are clear advantages to beginning work now to future-proof your business from another pandemic.
  • The best time to capture the learnings, shortcomings and breakthroughs from your company’s COVID-19 response is while they are fresh in the minds (and active policies) of your company’s leaders and departments.
  • Your company can institutionalize pandemic-era habits, policies and programs around health that could be critical during a crisis, including on-site vaccination, steady communication of public health guidance and support for employees’ mental resilience. 
  • The scale and scope of the COVID-19 pandemic were difficult to imagine in 2020. Don’t let a failure of imagination increase your company’s risk in a future crisis.
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This work takes time—so don’t lose momentum. 
  • Trusted relationships between the private sector and public health partners paid immediate dividends during the pandemic, but those relationships are best built (and deepened) before you need them in a crisis.
  • Misinformation thrives in a vacuum, so leveraging the trust your employees have in you and extending it to local public health representatives through informational sessions, clinics, programs and visible investments that benefit your community will help build a culture where misinformation can’t take root.
  • Improving the community conditions that influence health requires a long-term commitment, clear-eyed planning and close collaboration. But its potential—to make your healthcare spending more efficient and your business and communities more resilient for the next pandemic—can’t be overstated.
Additional Resources for Creating a Pandemic Preparedness Plan 
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Vetted information to guide your company:
About This Plan
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The Pandemic Preparedness Plan for Business was informed by interviews with more than 30 leaders from the business community and public health departments across the country, as well as insights gleaned from a year of Health Action Alliance programming with company executives and public health experts who shaped the nation’s COVID-19 response and future pandemic planning. All quotes that appear in this plan come from interviews and events conducted by the Health Action Alliance except where noted. 
Acknowledgments
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Health Action Alliance would like to thank our Organizing Partners:
Ad Council

CDC Foundation

de Beaumont Foundation

National Safety Council

Robert Wood Johnson Foundation
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Additional thanks to the following individuals and organizations who offered their best practices and thought leadership:
Jerome Adams, MD, Executive Director of Health Equity Initiatives, Purdue University, and United States Surgeon General (2017-21)

Kevin Allen, Vice President, Regional Operations, ASHLIN Management

Bradley Barber, Executive Director, Global Workplace Safety, General Motors

David Beier, Managing Director, Bay City Capital

Kristina Box, MD, State Health Commissioner, Indiana Department of Health

City of Long Beach (California) Department of Health and Human Services

Ezekiel Emanuel, MD, Special Advisor to the World Health Organization’s Director-General and Vice Provost for Global Initiatives, University of Pennsylvania

Kim Fortunato, President, Campbell Soup Foundation

Franklin County (Ohio) Department of Public Health

Georgia Chamber of Commerce

Julie Gerberding, MD, Director, US Centers for Disease Control and Prevention (2002-09)

Mark Herbert, Chief Strategy Officer / Managing Director, California, Small Business Majority

Jeffery Hess, MD, Corporate Medical Director, General Motors

Lois Kolada, Chief Financial Officer, Priority Designs

Peter Lee, MD, Global Medical Director, Amazon

Kirk Limacher, Vice President, HR Services, United Airlines

Dora Lutz, GivingSpring | Purdue University

David Michaels, Professor, George Washington University School of Public Health, and Assistant Secretary of Labor, OSHA (2009-17)

Brian Moynihan, Chief Executive Officer, Bank of America

Drew Nannis, Senior Vice President, Digital Marketing, Content, Brand and Communications, Sodexo

Jennifer Nuzzo, Senior Scholar, Johns Hopkins Center for Health Security Senior Fellow for Global Health, Council on Foreign Relations

Ginger Miller, Director of Health and Benefits, Utz Brands 

Zoraida Rodríguez Montenegro, Senior Manager, Federal Affairs, Uber

Lisa Smith, Senior Director of Clinical Operations and Strategy, Walmart Pharmacy

Sallie Taylor, Medical Center Operations Program Manager, Kia Georgia

Wellness Council of Indiana

Whitehall (Ohio) Chamber of Commerce
DISCLAIMER
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Public health guidance on COVID-19 and future pandemics is evolving. Health Action Alliance is committed to regularly updating our materials once we’ve engaged public health, business and communications experts about the implications of new guidance from the public health community and effective business strategies that align with public health goals. 

This Plan provides an overview of pandemic preparedness practices, and is not intended to be, and should not be construed as, legal, business, medical, scientific or any other advice for any particular situation. The content included herein is provided for informational purposes only and may not reflect the most current developments as the subject matter is extremely fluid. 

 This Plan contains links to third-party websites. Such links are only for the convenience of the reader, user or browser; the Health Action Alliance does not recommend or endorse the contents of third-party sites.

Readers of this Plan should contact their attorney to obtain advice with respect to any particular legal matter. No reader, user, or browser of this material should act or refrain from acting on the basis of information in this Plan without first seeking legal advice from counsel in the relevant jurisdiction.

Only your individual attorney can provide assurances that the information contained herein – and your interpretation of it – is applicable or appropriate to your particular situation.
References
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