Johns Hopkins Initiative Hopes to Better Prepare for Pandemics: Public Health Watch

The horrors associated with a worldwide pandemic are arguably unimaginable.

However, thanks to a team of experts at the Center for Health Security at Johns Hopkins University we don’t have to dream up doomsday scenarios. And, hopefully, because of their enterprising work—including the staging of global preparedness exercises—we may be better able to respond to eventualities such as a worldwide epidemic of an infectious disease.

“Our exercises are primarily educational tools,” Eric Toner, MD, senior scholar with the Center for Health Security and a Senior Scientist in the Johns Hopkins Bloomberg School of Public Health, Department of Environmental Health and Engineering, told Contagion®. “One of things we try to demonstrate through these exercises are economic and societal consequences, as well as the public health consequences, of a severe pandemic. We want to show policymakers, business leaders, and global public health organizations that a severe pandemic may be as disruptive to a country as a national security event can be.”

For its most recent “exercise,” called Event 201 which was held in New York City in October, the Center for Health Security partnered with the World Economic Forum and the Bill & Melinda Gates Foundation to engage 15 leaders in business, government, and public health to model response to a worldwide coronavirus pandemic. At the start of the exercise, the world was 3 months in, and there were already more than 500,000 cases globally.

By its end, worldwide leaders were faced with a pandemic that involved more than 10 million cases, with the disease spreading rapidly through low-income districts of “mega-cities” around the world. Governments had issued travel bans, crippling the global travel and tourism industries. Thanks to these and other factors, the global economy was in “freefall,” with financial markets in tatters.

Of course, this was a worst-case scenario—but, sadly and most concerning, it is all too realistic. According to Toner, we only need think back less than 20 years, to events such as the 2003 SARS or the 2005 H5N1 bird flu outbreaks, or the influenza pandemic in 2009 to see the potential for global catastrophe. During Event 201, as in these real-world cases, the challenges included resolving the economic issues while ensuring health care services—and antivirals—were available and accessible to those who needed them.

“All these events have led to growing awareness of the potential challenges,” Toner noted, “but unfortunately we’ve seen that among policymakers and business leaders this awareness waxes and wanes. The response to all the exercises we’ve done have been encouraging.”

Which is why the “Pandemic Emergency Board” convened for the Event 2001 included representatives from the UN Foundation, the World Bank, China’s Center for Disease Control and Prevention, the Central Intelligence Agency, the US Centers for Disease Control and Prevention, as well as leaders from the travel, banking, pharmaceutical, and healthcare services industries.

“Outbreaks of infectious disease are inevitable, but the economic damage they cause is not,” Ryan Morhard, project lead for Global Health Security, World Economic Forum said in a statement provided by the Center for Health Security. “Sustained attention from a broad multi-stakeholder coalition is needed in advance of a severe pandemic to save lives and minimize economic and societal consequences.”

And, as Toner noted, demonstrating how to prepare for a specific type of biosecurity event—whether it involves the accidental release of a dangerous pathogen, the intentional release of a bioweapon, or a naturally occurring disease pandemic, as recreated during Event 201—helps the global community prepare for all of them. Creating models such as Event 201 takes more than a year of planning, and an investment of “hundreds of thousands of dollars”, he said, but the lessons learned are invaluable.

“We think that for a severe pandemic, you need both the public and private sectors to be involved, as well as civil society,” Toner added. “The expertise may exist in the public sector, but the resources are most often found in the private sector. When epidemics happen, these stakeholders do find ways to work together, but it’s never easy or particularly efficient. We think by working more closely in the preparedness phase, these stakeholders will be more able to work effect together in the response phase in the future.”