Photo: Reuters/Lindsey Wasson.
In the past few years, the number of epidemic events has been fast escalating, hovering around 200 such outbreaks annually. Even if these events do not entail a pandemic threat, still they are excruciating for human health and economies. Public health experts have time and again shown consensus that another catastrophic epidemic might be standing at the door. In October 2019, Government officials, public health professionals and business experts in a round-table gathering, staged response to this fictional Event 201 – simulating global outbreak of a never-seen-before, a completely hypothetical Coronavirus, called coronavirus acute pulmonary syndrome or CAPS. The exercise involved time-to-time ‘mocked-up’ news briefings on the reported cases, mortality rates and economic impact which provided the foundation for the leaders to discuss on four focal areas, viz., medical countermeasures, trade and travel, finance and communications.
In the simulating exercise, the virus spreads from the bats to the pigs in Brazil before spreading to farmers and then to impoverished neighbourhoods and megacities of Southern America. Infected people reported respiratory problems, ranging from mild influenza-like symptoms to severe pneumonia and in extreme cases, intensive care was needed. Mostly through air travel, the virulent virus diffuses to three countries initially, viz., Portugal, the United States and China but with no vaccination in place the transmission couldn’t be controlled. Immunologist reported no possibility of vaccination in the first year of pandemic, and only a putative antiviral drug (used primarily for HIV treatment) was available for treatment, that too, with supplies much lesser than expected morbidity. Fictional newscasters from Global News Network (GNN) showed frailing healthcare apparatus, shortage of masks and medical supplies resulting in rationing of servives and accelerating mortality rates. The devastating economic and social impacts– from cancellations of travel bookings to crippling trade—were also realistically outlined in this dramatic exercise. Social media, with rampant fake news and misinformation, appeared to be creating a different set of challenges for already collapsing governments.
Within two quarters, CAPS had made its way across the globe, and by the 18-month, it had killed 65 million people and triggered a global financial crisis. The expert group in their 3.5 hours simulation exercise; despite their best capabilities, sagacious scenario-based facilitated discussions and efforts, failed to prevent the fictional virus from causing a gigantic spike in fatalities.
Interestingly, the players of the exercise included all prime policy advocates from health, banking, aviation, national security, media, government and international organizations; those who confront such difficult situations in real-time, engage in dialogue and make decisions. In all, the world wasn’t really prepared for another pandemic.
Event 201 was a succinct demonstration of the widespread gaps in pandemic preparedness, which also stimulated discussions on different solution components between the private and public players to bridge the aperture. The challenge, decisions and the consequences of the exercise, despite all hands on one deck, made it clear that any individual governments or organizations’ response cannot and will not add up to a proper global response in such pandemic outbreaks. It was recognized that, collectively, the International community has not done enough to respond to the global health security challenge. Therefore, the hosts of the event – the Johns Hopkins Center for Health Security in collaboration with the World Economic Forum and the Bill and Melinda Gates Foundation – extended preparedness proposals which included: first, a blueprint for utilizing corporate capabilities in times of global epidemic. For instance, service-sector companies, especially those with logistics, or social media operations to support governments’ emergency response, risk communications, and medical countermeasure distribution efforts during a pandemic. Second, building up a robust international stockpile of vaccinations. This is imperative to ensure that supplies reach in low and middle resource settings in catastrophic times, regardless of whether they have the capacity to produce supplies domestically. “Countries with national supplies or domestic manufacturing capabilities should commit to donating some supply/product to this virtual stockpile”.
It is much-known that during a devastating outbreak, countries are reluctant to part with scarce medical resources; hence, a strategy of maintaining adequate supplies before a pandemic knocks the door should really kick-in. Third, ensuring governments and transportation agencies on keeping goods flowing to ensure those supplies get where they are needed. Fourth, reassessment of Global financing for pandemics to facilitate the development and surge manufacturing of vaccines, therapeutics, and diagnostics because in the simulation, there was simply not enough money as CAPS ran roughshod. Fifth, assigning higher priority to Governments and the private players to devise channels to fight fake news, conspiracies, and propaganda campaigns.
The key takeaway from 2019 Event 201 was to operationalise integrated public-private cooperation that wasn’t witnessed before and who knew that this response was to be tested in real-time so soon with COVID-19.
Navneet Kaur Manchanda is a consultant at the World Bank and Kamal Chaudhary is a PhD scholar at the Jawaharlal Nehru University, New Delhi. The views presented are solely the authors’ own and don’t reflect the opinions of the institutions they represent