Center for Health Security: “The Johns Hopkins Center for Health Security, in partnership with WHO and the Bill & Melinda Gates Foundation, conducted Catastrophic Contagion, a pandemic tabletop exercise at the Grand Challenges Annual Meeting in Brussels, Belgium, on October 23, 2022.
The extraordinary group of participants consisted of 10 current and former Health Ministers and senior public health officials from Senegal, Rwanda, Nigeria, Angola, Liberia, Singapore, India, Germany, as well as Bill Gates, co-chair of the Bill & Melinda Gates Foundation.
The exercise simulated a series of WHO emergency health advisory board meetings addressing a fictional pandemic set in the near future. Participants grappled with how to respond to an epidemic located in one part of the world that then spread rapidly, becoming a pandemic with a higher fatality rate than COVID-19 and disproportionately affecting children and young people.
Participants were challenged to make urgent policy decisions with limited information in the face of uncertainty. Each problem and choice had serious health, economic, and social ramifications. ”
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Catastrophic Contagion Highlights Reel
The Event 201 Scenario (October 18, 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.
The disease starts in pig farms in Brazil, quietly and slowly at first, but then it starts to spread more rapidly in healthcare settings. When it starts to spread efficiently from person to person in the low-income, densely packed neighborhoods of some of the megacities in South America, the epidemic explodes. It is first exported by air travel to Portugal, the United States, and China and then to many other countries. Although at first some countries are able to control it, it continues to spread and be reintroduced, and eventually no country can maintain control.
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.
Since the whole human population is susceptible, during the initial months of the pandemic, the cumulative number of cases increases exponentially, doubling every week. And as the cases and deaths accumulate, the economic and societal consequences become increasingly severe.
The scenario ends at the 18-month point, with 65 million deaths. The pandemic is beginning to slow due to the decreasing number of susceptible people. The pandemic will continue at some rate until there is an effective vaccine or until 80-90 % of the global population has been exposed. From that point on, it is likely to be an endemic childhood disease.
Selected moments from the Event 201 pandemic tabletop exercise hosted by The Johns Hopkins Center for Health Security in partnership with the World Economic Forum and the Bill and Melinda Gates Foundation on October 18, 2019, in New York, NY. The exercise illustrated the pandemic preparedness efforts needed to diminish the large-scale economic and societal consequences of a severe pandemic. Drawing from actual events, Event 201 identifies important policy issues and preparedness challenges that could be solved with sufficient political will and attention. These issues were designed in a narrative to engage and educate the participants and the audience.
