“The situation is imminent and could be dire,” Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy, said at the Risk and Insurance Management Society's annual conference. “It's not a matter of if–just when and where.”

He warned that “even a moderate pandemic could have disastrous results to a global economy.” A severe outbreak could result in 1.9 million deaths, with 90 million infected. Nine million would need hospital accommodations, which he said were largely unavailable.

Von Roebuck, a representative for the Centers for Disease Control and Prevention in Atlanta, had a more upbeat attitude. He said funding begun last year has enabled state and local governments to expand and update contingency programs, building on other emergency preparations.

A big part of the effort, he said, is “strategic national stockpiling” of antiviral drugs–although he admitted the effectiveness of the antibiotics could change if the virus mutates.

He agreed the public may not be aware of a pandemic's potential impact, especially since there hasn't been one since the late 1950s–and our most serious occurrence was in 1918. But more and more materials are being made available for the public, and municipalities are being proactive, laying the groundwork with a network of plans.

Is it enough? Even the best-laid plans can fail when human nature comes into play. While municipalities have been diligent about developing their plans, they are falling short in one of the most important areas–testing them, Mr. Roebuck said.

The good news, however, is that risk managers don't need to conduct a full-blown exercise to be effective. Mr. Roebuck said testing any aspect of the plan can help, as shortfalls in other areas might become evident. For example, testing a plan for employees to work from home could point out weaknesses in an organization's information technology operations.

The CDC itself has undergone two exercises, testing different aspects of its own plan, he said, with the third scheduled for fall.

Risk managers have a wealth of helpful information available, including a 389-page document–Operation Plan–detailing CDC's steps preparing for a pandemic. (Search under OPLAN at www.cdc.gov.)

The U.S. Department of Health and Human Services has a detailed online pandemic influenza planning checklist for state and local governments at www.pandemicflu.gov.

I applaud risk managers for getting their contingency plans in order but strongly suggest they remember that a plan on paper is only half a plan. Until it's been tested, it has the potential to fail.

Don't wait. Take the CDC's advice and break the plan into manageable, testable pieces. This step could help save countless lives.