Simulation exercises are an effective tool for national authorities to test and revise pandemic preparedness structures, and strengthen their response to epidemics and pandemics. As a result of the momentum stemming from the COVID-19 pandemic, countries are looking critically at their pandemic preparedness plans and systems and using simulation exercises to strengthen preparedness.
Following their participation in the WHO Academy Course on Acute Respiratory Infections Preparedness, Costa Rica and Lebanon both conducted table-top simulation exercises to test and validate their existing respiratory pandemic preparedness plans together with key multi-level stakeholders including health, animal health, agriculture, finance, military, communications, and disaster management authorities.
Costa Rica and Lebanon were the first countries to pilot a simulation exercise package developed by WHO in line with the Preparedness and Resilience for Emerging Threats (PRET) Initiative Module on planning for respiratory pathogen pandemics. With support from the PIP Framework Partnership Contribution and US CDC, they tested three key areas of their pandemic preparedness systems:
- Multisectoral coordination;
- Risk communications and community engagement; and
- Operational triggers for decision making.
Similar findings across two regions
Costa Rica had developed a draft national pandemic plan for influenza, SARS-CoV-2 and other respiratory viruses and wanted to use the simulation exercise to refine their plan. Lebanon on the other hand was using the simulation exercise to identify key areas for the update of the national plan. Despite the different contexts, there were some common findings from the two exercises.
Both countries found that the roles and responsibilities of key decision-makers need to be clearly articulated in their pandemic plans. In particular, coordination at the local level needs to be strengthened. Both are now working towards developing decision-making flowcharts and coupling this with scenario-based planning at different levels to sensitize key stakeholders.
Similarly, both identified that key risk communications and community engagement functions need to be strengthened. Participants from Costa Rica highlighted the need to better integrate their risk communications strategies within their existing planning structures, while Lebanon highlighted the need to strengthen the availability of validated information sources for trusted risk communications and community engagement and better links with NGOs. Both countries are now working towards reviewing risk communications strategies and functions, and delineating clear ownership of which functions will be managed by the different stakeholders and how the strategy will be implemented.
Post-exercise steps
Both Costa Rica and Lebanon are using the findings from their simulation exercises to further develop their pandemic preparedness planning and coordination amongst all stakeholders. Complementing this has been the release of updated guidance on strengthening respiratory pathogen pandemic preparedness which countries can use to guide their approach to strengthening integrated preparedness. Additionally, both countries provided input on how the simulation exercise package could be improved further, and this package is now being rolled-out to requesting countries together with the updated guidance.
