(originally published by Booz & Company)

MERS: The Major Threat That’s Not on Your Risk Map


I spend a good part of my week speaking with executives and public officials about high-stakes leadership. The crises range from natural disasters to radicalized employees, and beyond.

If you are an executive at a global firm, you have plenty to worry about these days: Economies across Europe remain weak, and the United Kingdom is threatening to withdraw from the European Union. The civil war in Syria continues, and its escalation may dissolve the borders that have delineated the region since the end of the Ottoman Empire. The recent bombings in Boston demonstrated that terrorism is still a threat. Large protests continue from Turkey to Brazil. Extreme weather events wreak havoc around the globe.

There’s another threat, however, that may significantly disrupt global business, and most executives aren’t aware of it. Unless your firm has a chief medical officer, Middle East Respiratory Syndrome (MERS), a novel SARS-like coronavirus, likely has not garnered much attention in your company—even though the head of the World Health Organization (WHO) called MERS an urgent worldwide threat. A friend involved in infectious disease surveillance told me that MERS is what he worries about most right now. Yet, because there have been only three MERS-related deaths in Western Europe and no cases in the United States, news coverage has been scant.

But there are many potential viral threats that never pose a significant threat to humans. So why worry about MERS?

More than half of the confirmed MERS cases to date have been fatal. According to the Centers for Disease Control and Prevention (CDC), MERS has claimed 38 lives, 32 of them in Saudi Arabia. Here is where it gets interesting: The Muslim holy month of Ramadan starts in early July, and millions of faithful Muslims from around the world will make a pilgrimage to Mecca—more than 6 million people made the journey in 2012. And although the WHO has recommended wearing masks, such a dense concentration of people presents an ideal setting for the rapid spread of a respiratory virus.

In October, millions more from hundreds of countries will journey to the region for the Hajj. Pilgrims follow the footsteps of Abraham on a journey that is a sacred duty for all Muslims to make at least once in a lifetime so long as they are physically and financially able. Travel companies offer Hajj tour packages that range from budget to luxury.

As pilgrims use planes, trains, and automobiles to move between Mecca and the rest of the world for Ramadan and the Hajj, there are two prime opportunities for the MERS virus to spread widely and quickly beyond the Middle East. So far, the human-to-human transmission rate has been low. Viruses, however, evolve—sometimes quickly—which is why they can catch us by surprise.

MERS, of course, is not a Muslim illness. It simply happens to have appeared in a part of the world where the population is largely Muslim. However, should there be a significant outbreak initially concentrated in the world’s Muslim communities, it can be expected to exacerbate tensions with non-Muslims. When the H1N1 virus entered the United States from Mexico in 2009, there was a backlash against Hispanics. The initial designation of H1N1 as “swine flu” caused a drop of 15 percent in pork futures, although the meat was never identified as a carrier of the disease. The general public has low health literacy, and rumors can spread easily.

There is then both a real and an existential threat with MERS. If you source or sell in countries with large Muslim populations, your business may be disrupted by illness among your workers, suppliers, and customers. The disease may impair your ability to operate and could affect your stock price. However, attempts at quarantine or other mitigation measures by government agencies may take on the appearance of religious discrimination, inflaming Muslims and non-Muslims alike. Should that happen, watch for traumatic impact in Europe, the United States, and other markets across the globe.

First, be certain that someone in your organization is monitoring MERS as it develops. It may turn out to be a non-event or it could be a global conflagration. Use it as an exercise in horizon scanning for underappreciated business risks. The CDC and the WHO issue regular guidance that can help make this “predictable surprise” more predictable and less surprising.

Second, use MERS as a way to test your crisis management plans for a “black swan” event. Too many crisis scenarios stay within an organization’s comfort zone and thus fail to reveal the gaps and weaknesses in its system. If you don’t already have them, make the acquaintance of people who understand the dynamics of public health events to help you understand how to close those gaps. Map your risks, stakeholders, and business-critical interdependencies: How might MERS affect customers, suppliers, employees, and other critical groups, as well as markets? This will help you be proactive rather than reactive should MERS spread widely.

Finally, and perhaps most important, consider how well prepared you are to lead in a crisis, particularly in the face of a novel threat. As ambiguity, risk, and complexity grow, so will the need to operate effectively beyond the parameters of the management plans you have in place. Decisions will need to be made based on incomplete and conflicting information. The needs of one constituency will have to be prioritized over those of others. Rules will need to be bent and people catalyzed to act independently. Are you ready to lead under such conditions?

If so, don’t wait for a virus to mutate. Be that leader today. Use MERS as an avenue to create a more agile, aware, and effective organization now.

Eric McNulty



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