Pacific Eclipse – A tabletop exercise on smallpox pandemic response
- PMID: 34865873
- DOI: 10.1016/j.vaccine.2021.10.081
Background: In December 2019, we ran Pacific Eclipse, a pandemic tabletop exercise using smallpox originating in Fiji as a case study. Pacific Eclipse brought together international stakeholders from health, defence, law enforcement, emergency management and a range of other organisations.
Aim: To review potential gaps in preparedness and identify modifiable factors which could prevent a pandemic or mitigate the impact of a pandemic.
Methods: Pacific Eclipse was held on December 9-10 in Washington DC, Phoenix and Honolulu simultaneously. The scenario began in Fiji and becomes a pandemic. Mathematical modelling of smallpox transmission was used to simulate the epidemic under different conditions and to test the effect of interventions. Live polling, using Poll Everywhere software that participants downloaded onto their smart phones, was used to gather participant decisions as the scenario unfolded. Stakeholders from state and federal government and non-government organisations from The United States, The United Kingdom, Australia, New Zealand, Canada, as well as industry and non-government organisations attended.
Results: The scenario progressed in three phases and participants were able to make decisions during each phase using live polling. The polling showed very diverse and sometimes conflicting decision making. Factors influential to pandemic severity were identified and categorised as modifiable or unmodifiable. A series of recommendations were made on the modifiable determinants of pandemic severity and how these can be incorporated into pandemic planning. These included preventing an attack through intelligence, law enforcement and legislation, improved speed of diagnosis, speed and completeness of case finding and case isolation, speed and security of vaccination response (including stockpiling), speed and completeness of contact tracing, protecting critical infrastructure and business continuity, non-pharmaceutical interventions (social distancing, PPE, border control) and protecting first responders.
MULTIMEDIA FROM PACIFIC ECLIPSE, DEC 9-10, 2019
VIDEOS AND AUDIO PRESENTATIONS FROM THE PACIFIC ECLIPSE
The PLuS Alliance and Stratium Global hosted an immersive biothreat simulation at three sites across the USA (Crystal City, Phoenix and Honolulu) on December 9-10 2019, with cooperation from US Indo- Pacific Command. A range of operational stakeholders from the US and Five Eyes countries attended the workshop. An interactive tabletop exercise (TTX), using a hypothetical unknown epidemic arising in the Pacific, and becoming a pandemic was conducted. The TTX focus was to assess inter-agency and international response to a pandemic disaster. Tensions between global, national and local priorities were tested using interactive polling and live decision making. Immediate feedback was provided on the impact of decisions about resources and operations using mathematical modelling of the epidemic. The event was conducted over two half-days to allow different time zones to participate conveniently. Debriefing on identified gaps was integrated into the TTX. Experts from health, defence, law enforcement and emergency management, from government and non-government organisations provided expert input and real-world examples relevant to the TTX. The multimedia from the exercise are available below to show the relevance of our hypothetical exercise to the COVID-19 pandemic.
03 Mystery Illness
04 WHO Declaration
05 Virologist to WHO (Audio)
06 Nurses_Union Strike
07 Police Chief (Audio)
08 Civil Unrest
09 Ship of Death
10 Healthcare Decimated
11 PPE shortage
12 Cyber Attack