Developing contingency plans to protect vital sectors in extreme pandemics

Mass labor shortages in an extreme pandemic could pose a significant risk to the continuity of the most vital sectors within critical infrastructure, 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 (PPE), reviewing literature on vulnerabilities and response plans, and interviewing experts. The supply of rapidly-mobilizable PPE in the United States was found to be insufficient, with estimated 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 of more commonplace disposable respirators 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) mobilize unused private-sector PPE, (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. 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.