A novel virus, moderately contagious and moderately deadly, has appeared and is spreading rapidly around the globe. Outbreaks first appear in Frankfurt, Germany and Caracas, Venezuela. The virus is transmitted from person to person, mainly by coughing. There are no effective antiviral drugs or vaccines. American troops stationed abroad are infected. Now, the first case that reached the United States was identified on a small Massachusetts campus.
So began a final one-day exercise organized by the Johns Hopkins Center for Health Security. The simulation blended details of past catastrophes with fictitious elements to force government officials and experts to make the kind of key decisions they could make in a real pandemic.
It was a tense day. The exercise was partly inspired by the troubled response to the 201
In the simulation, a two-part group of current and former high-level US government officials played a team of presidential advisers who faced a variety of political, political and ethical dilemmas. Actors included former Senate majority leader Tom Daschle (D-S.D.), who played Senate Majority Leader, and MP Susan Brooks (R-Ind.), Who played herself. They had to react when the eruption unfolded after a Johns Hopkins script, with no prior knowledge of how the bogus disaster would end.
You were faced with difficult questions during the exercise: should the United States impose a travel ban? Flights from Germany and Venezuela? If not, they faced the problem of declaring that decision in the face of political pressure from the American public and Congress. Should the United States send troops to Jordan, where a major outbreak has taken place, and the Middle East's most important ally asks for support? If a vaccine was developed, who should get it first? Should officials be given priority to ensure the continuity of the government or of children and pregnant women? Or should there be a lottery?
There were no easy answers. That was the point of the all-day exercise that took place in a hotel's darkened ballroom, in front of an enthusiastic, invitation-only audience of about 150 people, which was shown live on Facebook. There were academics and think tanks and officials from across the US government, including the White House, defense and intelligence agencies, health and safety agencies, and Congress.
Tom Inglesby, director of the Johns Hopkins Center, said the purpose of the exercise was to serve "experimental learning" for new decision-makers in the Trump administration. But many of the difficult issues have not yet been resolved for several governments.
"There are a lot of moving pieces in the world of pandemic preparation right now," he said. Key issues include the extent of US support for global health issues and the role of the national security community.
Even though many stakeholders in this scenario have decades of experience in health security and at national and global levels, policy and law have "there were still so many open issues and capabilities gaps," said Beth Cameron, former senior director of global health security and Biodefense in the National Security Council under President Barack Obama. Cameron, who was in the audience, is Vice President for Global Biology at the Nuclear Threat Initiative.
When the fictitious eruption, or even less deadly, popped up tomorrow, she said, "we'd set the scenario with another cabinet that was not tested by a major eruption."
Unlike Ebola, that is Through direct contact and body fluids, the "Clade X" virus in the Johns Hopkins simulation was a flu-like respiratory virus that would spread much more easily person to person through coughing and sneezing. That's how the 1918 influenza pandemic spread. It killed more than 50 million people and is the deadliest pandemic in history. (If you ask infectious disease experts what they are most afraid of, they certainly answer "pandemic influenza.")
The fictitious outbreak was getting worse. It had a death toll of 10 percent, about the same as the SARS virus that traveled around the world in 2002-2003. Because the virus was new to exercise, no one had previously had immunity to it and it quickly spread in big cities. As more than 100 million people died worldwide, health systems collapsed, panic spread, the US stock market crashed, and the President, members of Congress, and the Supreme Court became incapacitated.
"We did not want to put an end to Disney," said Inglesby. "We wanted to have a plausible scenario that we knew would be disruptive."
Throughout the day, the 10 experts played the role of US officials in a series of simulated National Security Council sessions. They acted as part of a National Security Advisor, Secretaries for Health and Human Services, State, Domestic Security and Defense, Attorney General and directors of the Central Intelligence Agency and the Centers for Disease Control and Prevention. There were also two members of the congress. Inglesby played the national security adviser.
Advisers were invited to make recommendations to a fictional president (who stayed behind the scenes). They received briefings and news reports as the exercise progressed. Its Consensus Council has been repeatedly ignored and suspended by the President on short-term political grounds.
In real life, NSC meetings would not include members of the Congress. But political leaders emphasized political pressure and the need to effectively communicate tough political decisions, according to health security experts watching the exercise.
The fictitious eruption was discovered as a virus in a Swiss laboratory by a terrorist group. In another headline, the terrorists infiltrated deadly genes from the Nipah virus, a rare brain-damaging virus. In real life, a Nipah outbreak in southern India killed at least 13 people this month. In the exercise, schools closed, demand for surgical masks and respirators far exceeded supply, and hospitals in the United States quickly got overwhelmed – as did many with a bad flu season this year.
When the Players Have Been Informed The virus has spread to Bethesda, Maryland, part of the terrorists' plan to sabotage the National Institutes of Health; there was an audible groan of the audience.
The players talked about the need for a single senior official to coordinate federal agency responses and weigh the sometimes competing interests of health security, politics, and foreign affairs. The person had to be above the agencies and have the president's ear.
As panic spread and riots broke out, Indiana Congressman Brooks said, "We have to have someone work day in and day out … I have interest groups queuing up and coming in turn You do not understand what's going on. "
The Johns Hopkins pandemic exercise took place, as some of the viewers noted, a week after the election of the White House's leading official The US Response In the event of a fatal pandemic, the administration left and its global health security team, which it monitored, was disbanded as part of a reorganization by national security adviser John Bolton.
No vaccine has been developed within 20 months at the end of the exercise Players underlined the need for the United States to "move faster from one drug to another," said Jim Talen, a former Missouri Republican Senator who served as Secretary of Defense  Tara O & # 39; Toole, former Secretary of Homeland Security, who played the Secretary of Homeland Security, was added: "We are in an age of epidemics, but we do not treat them so The National Security issues that they are."  One aspect that deserves more attention, participants and experts said, was the need for social media officials to act actively against misinformation
"Using social media and 24-hour cable and an environment where experts and the Importance of science, we can not simply assume in a crisis that and speak with the American people, "said Margaret Hamburg, former Commissioner of the Food and Drug Administration, who played the Health and Human Services secretary. Elsewhere, she said, "It's an environment where a thing that gets spread in the media can suddenly flare up, and before you know it, everything you do in the most scientific way can be derailed."
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