Developing back-up plans to protect vital sectors in extreme pandemics

Mass labor shortages in an extreme pandemic could pose a significant risk to the continuity of vital sectors, severely restricting the ability of countries to provide food, water, and other basic needs to their populations. 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 (P4E), reviewing literature on vulnerabilities and response plans, and interviewing experts. The supply of rapidly-mobilizable P4E in the United States was found to be insufficient, with estimated vital sector demand for respirators far exceeding amounts available in stockpiles. This is expected to be the case for almost all other nations, given most respirators are produced in China and the United States. Key risk-areas were found for individual sectors, such as high-transmission environments in food processing, and between sectors, such as interdependencies which could lead to cascading infrastructure failures. To enhance response planning, we propose five priority measures: (i) develop P4E allocation strategies, (ii) improve adaptations to workplaces (e.g., air quality) and work processes (e.g., shift schedules), (iii) establish worker sequestration (isolation) protocols, (iv) address socioeconomic vulnerabilities, and (v) develop contingency plans for meeting basic needs in the event of infrastructure collapse. This research underscores the urgent need for future research and policy efforts to increase pandemic preparedness in vital sectors and provides actionable recommendations to begin doing so.