Dr. Amesh Adalja is a senior scholar at the Johns Hopkins Center for Health Security and is an expert in the outbreak of pandemics and epidemics around the world. He wrote previously for BRINK on last year’s measles outbreak. BRINK spoke to him about how businesses should prepare for the novel coronavirus.

BRINK: Based on your study of prior pandemics, could you give us some sense of how this coronavirus is likely to spread around the world over the next three to six months?

Amesh Adalja: We will see more and more countries reporting cases, with a wide spectrum of illness; many people may only have a mild illness, and a small proportion may have severe illness. However, the fact that this is a new virus that the general population doesn’t have much immunity to means that many people will get ill. 

Even mild illnesses can pose problems for many health care systems, which often operate at capacity. Some countries, such as in Africa, may be hit disproportionately hard because they won’t be able to absorb the cases. This is similar to what we saw with the H1N1 pandemic in 2009 when Africa was disproportionately impacted, even though it was a mild pandemic.

BRINK: Are there likely to be hot spots where the virus will cluster? Can you give any sort of prediction of how it will spread globally?

Mr. Adalja: What we’re learning is that this virus had been present in China for several weeks before it was discovered, and at that point, there was free movement of people. So what I hypothesize is that many countries already have cases that are not diagnosed.

This virus has emerged in the middle of a pretty severe flu season and likely was circulating alongside the flu and other respiratory viruses and not diagnosed because we don’t diagnose most flu-like illnesses down to a specific viral level. I think the 2009 H1N1 pandemic is a good example, where it will basically be everywhere.

BRINK: There was a lot of talk at the time about SARS and then MERS, but you don’t hear very much about those anymore. Is that because they have just been absorbed into the system, or have they disappeared?

Mr. Adalja: SARS has disappeared. SARS was something that didn’t have very good transmissibility characteristics in humans, so it basically disappeared once we understood how to contain it. This was something that was really relying on poor infection control procedures and health care facilities. Once we were able to augment infection-control procedures, this virus died out because it didn’t have the ability to sustain itself in human populations.

MERS or Middle East Respiratory Syndrome emerged as something different. This is something that comes from animals. It spreads directly from camels to humans, and it has a hard time spreading from human to human outside of health care facilities. 

We are still seeing cases. There have been cases reported within the last week on the Arabian Peninsula. It’s very hard to eliminate because of people’s contact with camels, but it didn’t rise to the level of a pandemic because it didn’t have the capacity to spread efficiently between humans. But it is still there and is still killing people in the Arabian Peninsula.

BRINK: You have said that the novel coronavirus is here to stay. Does that mean that it’s just going to become part of the general flu season every year?

Mr. Adalja: Yes, I do think that there’s a very high likelihood that it will become a seasonal coronavirus, and this may end up becoming what we would call the fifth community-acquired coronavirus.

It’s unclear how long the coronavirus is going to last, but right now, it’s vital for companies whose supply chains are linked to China to look at alternatives.

BRINK: So if I’m an international company, with supply chains around the world, can you give any guidance about how one could prepare for this, not only for one’s employees, but also for the business?

Mr. Adalja: The overriding principle is that people’s reaction to this virus, including policymakers and governments, is going to have an outsize impact, much bigger than the actual virus itself. 

When you have basically an entire province of China shut down, it really is leading to an unnecessary supply shock that will cause reverberations. So it’s important for businesses to think about their supply chain, think about how much reliance they have on an outbreak zone and on countries that are prone to taking these kinds of drastic measures, irrespective of the actual risks. 

Think about whether there are alternative suppliers. How can we transition away from having supply chains that are vulnerable in this manner? And how do we continue business operations while we transition away from those types of locations where there may be a disruption in the supply chain?

It’s unclear how long it’s going to last, but right now, it’s vital for companies whose supply chains are linked to China to revisit that and look at alternatives.

BRINK: And for guidance in terms of employees, are there any precautionary measures that you could recommend?

Mr. Adalja: Right now, we have a travel advisory to China, and I think that it’s something that should be followed in general. Not necessarily because I believe that this virus poses a cataclysmic risk, but because if you go to China and you come back, you will be quarantined because of the U.S. policy that’s in place right now. 

Right now, the United States is looking at China specifically, but other countries like the United Kingdom have extended that kind of travel advisory and are treating people, for example, that come from Singapore and other parts of the world with similar types of precautions.

Eventually, as people understand that this is going to be a mild pandemic and not containable, you will start to see those travel restrictions lift, because they don’t work. And people will have to cope with this coronavirus as a risk that’s going to have to be incorporated into daily life for ordinary people, for employees for everyone. 

Eventually, employees are going to have to start traveling again, but I would consider waiting it out until some of these travel restrictions lift, because they may end up getting trapped with these quarantine and travel restrictions that may be really disruptive.

BRINK: When companies look at their risk portfolio, they consider geopolitical risks and so forth. Should a company be incorporating these sorts of public health issues as part of their risk assessments?

Mr. Adalja: Definitely. This novel coronavirus isn’t the first time this has happened, and it’s not the last time. Many people in the private sector are not well-attuned to the risks of infectious diseases and how disruptive they can be. 

They are disruptive not only to people’s personal lives or to the health care sector, but to any sector because obviously you’re employing people, you have supply chains, you have travel. All kinds of different ramifications can occur from an infectious disease outbreak. 

So when a company is looking at its systemic risks, whatever their industry may be, it is really important to incorporate the risk of infectious disease threats and think about how you will mitigate them, how you will prepare your workforce for them and how you will think about continuity of operations if you are in a situation where an outbreak is becoming as disruptive as this coronavirus is.