Developing Contingency Plans to Protect Vital Sectors in Extreme Pandemics

Mass labor shortages in an extreme pandemic could collapse vital sectors, causing severe shortages of food, water, and other basic needs. In this study, we investigate vital sector preparedness by using Monte Carlo simulations to estimate the availability of and demand for pandemic-proof personal protective equipment (PPE) in the first three months of a future pandemic, reviewing literature on vulnerabilities and response plans, and interviewing experts. We find the supply of rapidly-mobilizable PPE in the United States (US) to be insufficient, with vital sector demand for sufficiently-protective respirators far exceeding stockpiles. This is expected to be the case for most other countries, given that most respirators are produced in China and the US and shortages were already observed globally during COVID-19. Key risk-areas were found for individual sectors, such as high-transmission environments in food processing, and between sectors, such as interdependencies that could lead to cascading infrastructure failures. To enhance contingency planning, we propose five priority measures to protect vital workers if countries are underprepared when an extreme pandemic occurs: (i) improve PPE supply through redistribution, repurposing, and prioritization, (ii) improve adaptations to workplaces (e.g., air quality) and work processes (e.g., shift schedules), (iii) establish plans for safe on-site worker housing, (iv) address socioeconomic vulnerabilities, and (v) develop back-up plans for meeting basic needs in the event of infrastructure collapse.