Pandemic/Scenarios

Pandemic Scenarios

Lock Step

...The pandemic also had a deadly effect on economies: international mobility of both people and goods screeched to a halt, debilitating industries like tourism and breaking global supply chains. Even locally, normally bustling shops and office buildings sat empty for months, devoid of both employees and customers. The pandemic blanketed the planet — though disproportionate numbers died in Africa, Southeast Asia, and Central America, where the virus spread like wildfire in the absence of official containment protocols. But even in developed countries, containment was a challenge. The United States’s initial policy of “strongly discouraging” citizens from flying proved deadly in its leniency, accelerating the spread of the virus not just within the U.S. but across borders. However, a few countries did fare better — China in particular. The Chinese government’s quick imposition and enforcement of mandatory quarantine for all citizens, as well as its instant and near-hermetic sealing off of all borders, saved millions of lives, stopping the spread of the virus far earlier than in other countries and enabling a swifter post-pandemic recovery.

Source: The Rockefeller Foundation Scenarios for the Future of Technology and International Development May 2010

No rational being would plan to deliberately unleash a pandemic. If a nation-state did, it would be called bio-warfare; if an non-state actor did, it would be called bio-terrorism. Anyone committing such an act would also need an antidote, protection, a vaccine.

However, it is completely normal for governments and industry to plan for an event such as a pandemic. For ten years I worked in education as a trainer and required my undergraduate systems administration students to develop disaster recovery plans. In addition to obvious events such as fire, theft, cyber-attack etc., we would include the possibility of an epidemic: how could the system be maintained if too many staff were sick; could people work from home; how would we manage online security? Business continuity plans may also consider the risk of an epidemic (or pandemic) and plan a response.

Governments also plan for a pandemic. Australia had a national pandemic response plan. The USA also had one developed by the Obama administration. The emergence of a novel coronavirus in Wuhan, China, during December 2019 is unlikely to have been planned. There was no plandemic. No-one was ready for it. But there had been warnings for years that such an event could occur, was likely to occur, and we needed to be ready. Particularly in the USA where several planning exercises had been held. Those scenarios are detailed below. The predicted outcomes and behaviours are remarkably similar to what has occurred through the COVID-19 pandemic and a review of these documents is rather sobering. Could we have done better? Yes.

Grant
August 2021

An after-thought:- No patriotic citizen, or government agency, would collude with scientists employed by a foreign power, potentially an enemy, to enhance the severity of a non-human virus which could be used as a bio-weapon, would they?

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The Scenarios

The collection of scenarios below is most likely incomplete. In addition to the controversial scenarios Event 201 and Lock Step several others are summarised in an attempt to show that table-top exercises and scenarios are routine, designed to raise awareness of issues, and improve public health responses and inter-agency communication.

Lock Step was just one of four scenarios which show different ways society could respond to a crisis.

Two scenarios considered a novel coronavirus: SPARS (2017) and Event 201 (2019).

The Event 201 scenario is the only one in this set in which the Johns Hopkins Center for Health Security partnered with both the World Economic Forum and the Bill & Melinda Gates Foundation.

Event 201 was conducted shortly before the emergence of SARS-CoV-2 and the COVID-19 pandemic. That is a coincidence. COVID-19 was not a planned epidemic or plandemic.

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Event 201 (2019)

Event 201 simulates an outbreak of a novel zoonotic coronavirus transmitted from bats to pigs to people that eventually becomes efficiently transmissible from person to person, leading to a severe pandemic. The pathogen and the disease it causes are modeled largely on SARS, but it is more transmissible in the community setting by people with mild symptoms.

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There is no possibility of a vaccine being available in the first year. There is a fictional antiviral drug that can help the sick but not significantly limit spread of the disease.

Source: Johns Hopkins Center for Health Security Event 201^Source

The COVID-19 pandemic in 2020 led to significant publicity of this event, to which John Hopkins (Bloomberg School of Public Health) responded as quoted below:-

Statement about nCoV and our pandemic exercise

In October 2019, the Johns Hopkins Center for Health Security hosted a pandemic tabletop exercise called Event 201 with partners, the World Economic Forum and the Bill & Melinda Gates Foundation. Recently, the Center for Health Security has received questions about whether that pandemic exercise predicted the current novel coronavirus outbreak in China. To be clear, the Center for Health Security and partners did not make a prediction during our tabletop exercise. For the scenario, we modeled a fictional coronavirus pandemic, but we explicitly stated that it was not a prediction. Instead, the exercise served to highlight preparedness and response challenges that would likely arise in a very severe pandemic. We are not now predicting that the nCoV-2019 outbreak will kill 65 million people. Although our tabletop exercise included a mock novel coronavirus, the inputs we used for modeling the potential impact of that fictional virus are not similar to nCoV-2019.

Source: Johns Hopkins Center for Health Security Statement about nCoV and our pandemic exercise

Source: Johns Hopkins Center for Health Security, Event 201 https://www.centerforhealthsecurity.org/event201/

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Crimson Contagion (2019)

Crimson Contagion 2019 Functional Exercise Scenario Overview

The Crimson Contagion 2019 Functional Exercise scenario was based on a novel influenza A (H7N9) virus that originates in China and is antigenically distinct (not matched ) from stockpiled vaccines.

The scenario starts off with tourists becoming ill in China with non-severe acute respiratory illness and then departing the Lhasa airport to other cities in China before flying back to their respective countries. During their flights home, additional tour group members, who were not ill when they embarked on their return flights from China, begin to experience the onset of respiratory symptoms and some develop fever. Figure 3 below shows how the virus begins to spread around the world, as the ill tourists fly back to their countries of origin.

The virus rapidly spreads via human-to-human transmission around the world and to the continental U .S., where the virus is first detected in Chicago, Illinois. The virus continues to spread to other metropolitan areas across the U.S.

In the exercise scenario, forecasts give a 90 % chance that the pandemic will be of very high severity, with 110 million forecasted illnesses, 7.7 million forecasted hospitalizations, and 586,000 deaths in the U.S. alone.

Source: Excerpts from US Government HHS Crimson Contagion 2019 Functional Exercise Key Findings (Coordinating Draft)^Source

Source: This document Crimson Contagion 2019 Functional Exercise Key Findings is marked Coordinating Draft Do Not Distribute. It was available for download in July 2021 from New York Times at this URL: https://int.nyt.com/data/documenthelper/6824-2019-10-key-findings-and-after/05bd797500ea55be0724/optimized/full.pdf

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May 15, 2018: Clade X

The scenario begins with an outbreak of novel parainfluenza virus that is moderately contagious and moderately lethal and for which there are no effective medical countermeasures. The virus is called “parainfluenza clade X.” Outbreaks of disease first appear in Frankfurt, Germany, and Caracas, Venezuela, and are spreading person-to-person. The disease is spread primarily by coughing and causes severe symptoms requiring hospitalization and intensive care in about half of the people infected. Overall, 20% of the severely ill patients die.

As the narrative continues, the disease spreads within countries and internationally at an accelerating rate, overwhelming medical facilities. Outbreaks overseas start to infect US soldiers. The first US cases occur on a small college campus in New England after the return of a foreign exchange student. As the pandemic becomes increasingly severe, the EXCOMM must deal with a variety of diverse issues that have policy, political, and ethical dimensions.

Source: Johns Hopkins Center for Health Security Clade X Exercise: Executive Summary Document^Source

Source: Johns Hopkins Center for Health Security, Events 2018, Clade X https://www.centerforhealthsecurity.org/our-work/events/2018_clade_x_exercise/

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SPARS - October 2017

In October 2017, the Johns Hopkins Center for Health Security published a book titled The SPARS Pandemic 2025 - 2028: A Futuristic Scenario for Public Health Risk Communicators

As the Disclaimer states:-

This is a hypothetical scenario designed to illustrate the public health risk communication challenges that could potentially emerge during a naturally occurring infectious disease outbreak requiring development and distribution of novel and/or investigational drugs, vaccines, therapeutics, or other medical countermeasures.

The infectious pathogen, medical countermeasures, characters, news media excerpts, social media posts, and government agency responses described herein are entirely fictional.

The scenario begins with a description of what 2025 might be like - more connected but more divided; new internet accessing technology (IAT); and emerging social media platforms.

A novel coronavirus emerges in Southeast Asia and is brought to the US with the first cases identified in St Paul, Minnesota. The disease is initially referred to as St. Paul Acute Respiratory Syndrome Coronavirus (SPARS-CoV, or SPARS). The full scenario evolves through the 89 page book, which could be used as the basis for a table-top exercise.

The SPARS Pandemic Scenario is described on the webpage Johns Hopkins Center for Health Security SPARS Pandemic Scenario

The SPARS Pandemic Scenario book can be downloaded from the Johns Hopkins Center for Health Security https://www.centerforhealthsecurity.org/our-work/pubs_archive/pubs-pdfs/2017/spars-pandemic-scenario.pdf

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Scenarios for the Future of Technology and International Development (2010)

The Rockefeller Foundation and Global Business Network.

The purpose of the scenarios was to envisage alternate futures.

The scenario called Lock Step is chilling because it is similar to what we are going through in response to the COVID-19 pandemic. The image used in the Rockefeller document to illustrate Lock Step represents surveillance. However, there were actually four scenarios considered in 2010. Of the four, a scenario called Clever Together has the best outcome.

LOCK STEP – A world of tighter top-down government control and more authoritarian leadership, with limited innovation and growing citizen pushback	HACK ATTACK – An economically unstable and shock-prone world in which governments weaken, criminals thrive, and dangerous innovations emerge
CLEVER TOGETHER – A world in which highly coordinated and successful strategies emerge for addressing both urgent and entrenched worldwide issues	SMART SCRAMBLE – An economically depressed world in which individuals and communities develop localized, makeshift solutions to a growing set of problems

Source: The Rockefeller Foundation Scenarios for the Future of Technology and International Development May 2010^Source

Source: The Rockefeller Foundation Scenarios for the Future of Technology and International Development May 2010
This document has been archived but remains available via the Wayback Machine. To locate a copy, open the website for the Wayback Machine at https://web.archive.org; search using the URL for The Rockefeller Foundation https://www.rockefellerfoundation.org and select a snapshot captured after May in 2010. Look for the heading Imagine Tomorrow: Scenarios for the Future of Technology and International Development and follow a link to DOWNLOAD PDF PUBLICATION.

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Atlantic Storm (2005)

Atlantic Storm was a ministerial table-top exercise convened on January 14, 2005 by the Center for Biosecurity of the University of Pittsburgh Medical Center, the Center for Transatlantic Relations of the Johns Hopkins University, and the Transatlantic Biosecurity Network. The exercise used a fictitious scenario designed to mimic a summit of transatlantic leaders forced to respond to a bioterrorist attack. These transatlantic leaders were played by current and former officials from each country or organization represented at the table. There was an audience of observers from governments on both sides of the Atlantic as well as from the private sector, but the venue was designed to focus all attention on the summit principals and their discussions around the table .

Source: Johns Hopkins Center for Health Security Atlantic Storm^Source

Source: Johns Hopkins Center for Health Security, Events Archive, Atlantic Storm https://www.centerforhealthsecurity.org/our-work/events-archive/2005_atlantic_storm/

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Dark Winter (2001)

On 22–23 June 2001, the Johns Hopkins Center for Civilian Biodefense Strategies, in collaboration with the Center for Strategic and International Studies, the Analytic Services Institute for Homeland Security, and the Oklahoma National Memorial Institute for the Prevention of Terrorism, held a senior-level exercise entitled “Dark Winter” that simulated a covert smallpox attack on the United States. The first such exercise of its kind, Dark Winter was constructed to examine the challenges that senior-level policy makers would face if confronted with a bioterrorist attack that initiated outbreaks of highly contagious disease. The exercise was intended to increase awareness of the scope and character of the threat posed by biological weapons among senior national security experts and to bring about actions that would improve prevention and response strategies.

Source: Abstract Shining Light on “Dark Winter” Clinical Infectious Diseases 1 April 2002

Source: Johns Hopkins Center for Health Security, Events Archive, Dark Winter https://www.centerforhealthsecurity.org/our-work/events-archive/2001_dark-winter/

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References

a pre-planned pandemic

CoronaVirus Disease 2019 (caused by SARS-CoV-2)

Severe Acute Respiratory Syndrome CoronaVirus 2

Severe Acute Respiratory Syndrome

Department of Health and Human Services (USA)