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You too can pretend to manage a pandemic. Just use this role playing scenario conveniently found on the internet.
Pandemic Period
Phase 6- Pandemic phase: Increased and sustained transmission in general population in multiple countries and regions.
SCENARIO A: WHO and world and local Boston news media in December report large clusters of human-to-human-contagious and deadly Avian Influenza in Addis Ababa and Nairobi, with local hospitals and clinics overwhelmed with hundreds of cases, one third of whom die within days. Travel advisories suggest not visiting East Africa. Airline passengers from Nairobi to London (preferred route to US, Boston) are screened at Heathrow for fever and illness, not permitted to board flights to US if febrile until blood tests establish they are not ill with bird flu. A run on Paniflu in the UK and US quickly established the lack of supply for more than a few tens of thousands in the UK and no more than hundreds in the Boston area. Governor Romney, Mayor Menino, and MassPort Communications Director, with DPH Commissioner, must decide what to do about incoming flights from London and Africa, and other precautionary measures. Many physicians, journalists and ordinary citizens overwhelm public health and hospital authorities with questions about how to prevent and prepare for the coming of bird flu to Boston, and insist on being answered. CDC and WHO websites do not offer specific short-term guidance.
SCENARIO B: Late December ? Much airline traffic over the Christmas holidays. Several clusters of humanly-transmitted Avian Flu have emerged in London, Paris, Frankfurt, New York, Washington, Chicago, and Boston. State labs and public health epidemiologists are unable to keep up with the demand, but have already identified clusters of avian flu deaths, usually associated with recent air travel from Europe or rail or bus travel from New York. Some stores and movie theaters have closed without being asked to do so by the authorities. Dozens of diagnosed or suspected cases have filled Boston hospital isolation wards. Food stores are crowded with people stocking up on canned goods. Mayor Menino must decide whether to close Boston public schools, but some teachers are already staying home with their families. Governor Romney must decide about curfews and quarantine. Hospitals and Public Health Commissioner call CDC for anti-virals and advice, media report the increasing death toll in Eastern cities and greater Boston. Traffic jams on Mass. Turnpike heading west, threatened further by an approaching blizzard, despite some media and public health advice to shelter at home.
Some major employers urge all employees with even mild cases of flu to remain at home.
Others in the financial and high tech industries urge professional employees to work at home at their computers. Many poor people crowd to local clinics, terrified by the news.
Some pharmacies are looted in desperate searches for Tami flu and anti-biotic. The governor and mayor must decide on what to announce to the public, what orders to give municipal schools, hospitals, police, firemen, transport workers, and utility workers.
Discussions between business leaders and state officials concerning closing down malls and shopping centers remain deadlocked, as many object to shutting down the economy.
There is no help from federal authorities. Many families are withdrawing their children from the still open schools, and absenteeism from work rises dramatically across Eastern Massachusetts.
More detailed Phase 6 Scenario in process.
Post-Pandemic (Recovery) Period
BirdFluPlex will initially simulate only Phase 5 and mostly Phase 6. Subsequent exercises may incorporate pre-and post-crisis situations.
PARTICIPATING ROLE-PLAYER?S GUIDE
Goals
Goals will vary with different roles, but they all have in common the accomplishment of the individual role?s mission of meeting their government, professional, work and family responsibilities within legal and resource constraints and with maximum effectiveness, efficiency/economy, and fairness.
Decision Making Power
Formal legal powers, such as declaration of and enforcement of quarantines and isolation, closing schools and theaters and shopping centers, allocating transportation resources, food and medical supplies, controlling ground travel and traffic, controlling surface and air travel into and out of the area, delegating missions to those not usually carrying them out, such as competent and willing volunteers, etc., announcements and warning releases of public information to the media.
Resources
Knowledge resources: expert knowledge of biomedical, health, logistics, police
Physical resources: vaccines, antivirals, medications, lab equipment, hospital beds and equipment, transport vehicles (cars, trucks, buses, helicopters) food and shelter supplies, communication equipment (radios, cell phones, 2-way radios, etc.)
Activities
? Asking and answering questions
? Resources allocation decisions and their communication to implementers
? Professional communications
? Public communication
? Physical interventions within your responsibility, powers, capabilities, & resources
? Recording (however briefly) all major decisions and public communications on audio tape or brief written note form, for later evaluation
DESIGN CHECK LIST
1. Selection of the Role-Playing Simulation Approach
1.1. Pandemic Emergency Preparedness Planning and Training
1.2. Participant Needs for Knowledge, Education, Communication, Training
1.3. Time, Place and other Resources Availability and Constraints
1.4. Role-Playing Simulation Advantages of Speed, Impact, & Economy
2. Decide Simulation Objectives
2.1. Select Simulation Subject: Bird Flu Pandemic Preparedness
2.2. Determine Scope in Reality Time, Space, and Function: 10 days, Boston, All emergency responses; and in equivalent Simulation: 5-10 Hours, Large room, 7 most relevant communities of participant stake-holders.
2.3. Differentiate and specify Objectives: Recognition of weaknesses in
2.4. Current pandemic flu emergency planning and operations,
2.5. Identification of corrective actions, testing of corrective actions,
2.6. Awareness, decision-making, communications and action training.
3. Collect Simulation Data
3.1. Data Needs: Avian Influenza epidemiology in animals and humans, health
3.2. care and other emergency response capacities, government and
3.3. Individual knowledge and decision-making capacities, public and professional and government crisis communications capacity.
3.4. Identification of Data Sources: WHO, CDC, FAO, UPMC, University
3.5. Schools of public health, HMO?s, Hospitals, Research Institutes
3.6. Identify and review relevant models: Timely literature search complete.
4. Design Simulation Model
4.1. Identify Actors (done)
4.2. Actor Goals (done)
4.3. ? Actor Resources (in process)
4.4. ? Actor Interactions ( ? )
5. Develop Simulation Materials
5.1. Write Scenarios (for Pandemic Alert and Pandemic Periods)
5.2. Refine Role Profiles with specific goals, resources, activities
5.3. Prepare Simulation Game Rules
5.4. Prepare supplementary materials (data sheets, forms, etc.)
6. Operate the Simulation
6.1. Arrange logistic support: Facilities, communications, etc.
6.2. Review all materials and procedures, recruit role-playing participants
6.3. Brief and orient all simulation game participants
6.4. Operate the Simulation
6.5. Debrief participants
7. Evaluate the Simulation
7.1. Provide Post-Simulation Analysis
7.2. Review records, notes, tapes
7.3. Assess Simulation learning vs. objectives
7.4. Redesign and/or modify Simulation for replication
DISCUSSION GUIDE
1. Have we (local & state government, health care community, media, financial community, business and employers) done all we can to prevent, be prepared for, and mitigate the health, social, and economic impacts of the coming Avian Influenza Pandemic?
2. How far are we (local & state government, health care community, media, financial community, business and employers) falling short?
3. What can we do, individually and collectively, to better prepare for and mitigate the coming Avian Influenza Pandemic?
4. What is the role of public education, authoritatively and most completely informed by the UN's WHO, in achieving better preparation of greater Boston's population (at all levels) for surviving and mitigating an Avian Influenza Pandemic?
- "Several countries have already conducted table-top exercises to rehearse their pandemic response plans. These exercises have been regarded as eye-openers, resulting in recognition of precise critical weaknesses in day-to-day operations and the formulation of precise recommendations for their correction." -- WHO's 2005 report, "Responding to the avian influenza pandemic threat: recommended strategic actions" recommends (p.16): "Develop model pandemic response exercises.?
ROLES
Select Minimum of 7 - at least one from each of 7 categories, Max.5x7=35
Public Schools
? Public high school teenage student(s)
? High school nurse, mother of 2 children
? Elementary school teacher, mother of 3 children
? Single mom on welfare with 2 teenagers & 2 infants
? Day care center director, mother of 2 children
? High school principal with working wife & 2 teenagers
? School superintendent, father of 2 adult children
? Teacher?s Union president, mother of 2 teenagers
Public transportation
? Transport worker - Subway motorman - Father of 2 teens
? Transport worker - Airport air controller- father of 4
? Transport worker - School bus driver - Mother of 1 child
? Transport worker - Bus driver - Father of 3 children
? Transport worker - Garbage truck driver - Father of 2
? Transport worker - Interstate truck driver - single
? Transport worker - Taxicab driver - Father of 2 children
? British airways captain/pilot, stewardess
? MBTA Transit Police Chief Father of 4 teens
? Teamster?s Union President - Father of 3 teens
? Mass Port CEO, Amtrak CEO, USAir Logan airport US customs inspector - father of 5
Food Services and Public Restaurants
? McDonald?s cook - Single male
? McDonald?s manager - Single mom with one infant child
? Howard Johnson?s food services manager
? Stop & shop meat counter butcher - Father of 2 teens
? Stop & shop store manager
? Legal seafood chain owner/CEO, pizza shop chain CEO
? Ritz-Carlton Hotel dining room manager, chef
? Meals-on-wheels manager - Mother of 2 children
? Wilson Farms CEO, pet shop owner
Local and State Government
? Boston Mayor
? City Council President
? Boston Chief Of Police
? Boston Head Of Emergency Medicine
? Boston City Hospital Director
? State Epidemiologist, Asst. Cmr. Public Health
? Massachusetts Commissioner of Public Health
? Massachusetts Commissioner of Public Safety
? Governor Romney, Lt.Gov. Healy of Massachusetts
? U.S. Senators Kennedy, Kerry
? Congressman Capuano, State Rep. Alice Wolf
Medical and Health Care Communities
? Children?s hospital nurse - Mother of 2 teens
? Roxbury Clinic, GP/internal medicine MD - Mother of 1
? Mass general hospital ER Surgeon - father of 2 toddlers
? Brigham & Women?s Hospital intern - Single female
? State public health lab director - Father of two teens
? State public health lab technician - Single
? Partners, Tufts HMO CEO?s
? Mass. Blue Cross/Blue Shield CEO
? Mass. Medical Society President
? Harvard School of Public Health Dean
? Harvard Medical School Dean
? Nobel-Prize Winning Virologist
Major employers
? Major real estate firm CEO, major landlord
? Boston gas & electric line repairman - Father of three
? Bank clerk, mother of two elementary school children
? Bank branch manager, South End - Single mom with 1 child
? Bank of America, Boston CEO
? John Hancock insurance co. CEO
? New England Telephone CEO
? Boston Gas & Electric CEO
? Filene?s, Jordan Marsh CEO
? Fidelity Investments CEO
? Loews Theaters, Boston Symphony CEO
? Tufts Medical Center CEO
? Boston Consulting Group CEO
? B.U., B.C., U. Mass. Boston Presidents
? Northeastern University, President
? MIT, Harvard University President
? Biotech Industry Council President
Media/communications
? Boston Globe/Herald Reporter
? Boston Globe Editor
? Boston Tab Reporter
? TV News Anchorman/Woman (R.D. Sahl, N. Jacobson)
? Channel 2 Public TV/Radio Commentator (Ms. Rooney)
? Radio News Commentator (WBUR ?The Connection?)
? New England Journal Of Medicine Editor
? Atlantic Monthly Editor, Boston Magazine Editor
? B.U. School Of Journalism Dean
? Local Mystery Story Writer (Robert B. Parker?
Pandemic Period
Phase 6- Pandemic phase: Increased and sustained transmission in general population in multiple countries and regions.
SCENARIO A: WHO and world and local Boston news media in December report large clusters of human-to-human-contagious and deadly Avian Influenza in Addis Ababa and Nairobi, with local hospitals and clinics overwhelmed with hundreds of cases, one third of whom die within days. Travel advisories suggest not visiting East Africa. Airline passengers from Nairobi to London (preferred route to US, Boston) are screened at Heathrow for fever and illness, not permitted to board flights to US if febrile until blood tests establish they are not ill with bird flu. A run on Paniflu in the UK and US quickly established the lack of supply for more than a few tens of thousands in the UK and no more than hundreds in the Boston area. Governor Romney, Mayor Menino, and MassPort Communications Director, with DPH Commissioner, must decide what to do about incoming flights from London and Africa, and other precautionary measures. Many physicians, journalists and ordinary citizens overwhelm public health and hospital authorities with questions about how to prevent and prepare for the coming of bird flu to Boston, and insist on being answered. CDC and WHO websites do not offer specific short-term guidance.
SCENARIO B: Late December ? Much airline traffic over the Christmas holidays. Several clusters of humanly-transmitted Avian Flu have emerged in London, Paris, Frankfurt, New York, Washington, Chicago, and Boston. State labs and public health epidemiologists are unable to keep up with the demand, but have already identified clusters of avian flu deaths, usually associated with recent air travel from Europe or rail or bus travel from New York. Some stores and movie theaters have closed without being asked to do so by the authorities. Dozens of diagnosed or suspected cases have filled Boston hospital isolation wards. Food stores are crowded with people stocking up on canned goods. Mayor Menino must decide whether to close Boston public schools, but some teachers are already staying home with their families. Governor Romney must decide about curfews and quarantine. Hospitals and Public Health Commissioner call CDC for anti-virals and advice, media report the increasing death toll in Eastern cities and greater Boston. Traffic jams on Mass. Turnpike heading west, threatened further by an approaching blizzard, despite some media and public health advice to shelter at home.
Some major employers urge all employees with even mild cases of flu to remain at home.
Others in the financial and high tech industries urge professional employees to work at home at their computers. Many poor people crowd to local clinics, terrified by the news.
Some pharmacies are looted in desperate searches for Tami flu and anti-biotic. The governor and mayor must decide on what to announce to the public, what orders to give municipal schools, hospitals, police, firemen, transport workers, and utility workers.
Discussions between business leaders and state officials concerning closing down malls and shopping centers remain deadlocked, as many object to shutting down the economy.
There is no help from federal authorities. Many families are withdrawing their children from the still open schools, and absenteeism from work rises dramatically across Eastern Massachusetts.
More detailed Phase 6 Scenario in process.
Post-Pandemic (Recovery) Period
BirdFluPlex will initially simulate only Phase 5 and mostly Phase 6. Subsequent exercises may incorporate pre-and post-crisis situations.
PARTICIPATING ROLE-PLAYER?S GUIDE
Goals
Goals will vary with different roles, but they all have in common the accomplishment of the individual role?s mission of meeting their government, professional, work and family responsibilities within legal and resource constraints and with maximum effectiveness, efficiency/economy, and fairness.
Decision Making Power
Formal legal powers, such as declaration of and enforcement of quarantines and isolation, closing schools and theaters and shopping centers, allocating transportation resources, food and medical supplies, controlling ground travel and traffic, controlling surface and air travel into and out of the area, delegating missions to those not usually carrying them out, such as competent and willing volunteers, etc., announcements and warning releases of public information to the media.
Resources
Knowledge resources: expert knowledge of biomedical, health, logistics, police
Physical resources: vaccines, antivirals, medications, lab equipment, hospital beds and equipment, transport vehicles (cars, trucks, buses, helicopters) food and shelter supplies, communication equipment (radios, cell phones, 2-way radios, etc.)
Activities
? Asking and answering questions
? Resources allocation decisions and their communication to implementers
? Professional communications
? Public communication
? Physical interventions within your responsibility, powers, capabilities, & resources
? Recording (however briefly) all major decisions and public communications on audio tape or brief written note form, for later evaluation
DESIGN CHECK LIST
1. Selection of the Role-Playing Simulation Approach
1.1. Pandemic Emergency Preparedness Planning and Training
1.2. Participant Needs for Knowledge, Education, Communication, Training
1.3. Time, Place and other Resources Availability and Constraints
1.4. Role-Playing Simulation Advantages of Speed, Impact, & Economy
2. Decide Simulation Objectives
2.1. Select Simulation Subject: Bird Flu Pandemic Preparedness
2.2. Determine Scope in Reality Time, Space, and Function: 10 days, Boston, All emergency responses; and in equivalent Simulation: 5-10 Hours, Large room, 7 most relevant communities of participant stake-holders.
2.3. Differentiate and specify Objectives: Recognition of weaknesses in
2.4. Current pandemic flu emergency planning and operations,
2.5. Identification of corrective actions, testing of corrective actions,
2.6. Awareness, decision-making, communications and action training.
3. Collect Simulation Data
3.1. Data Needs: Avian Influenza epidemiology in animals and humans, health
3.2. care and other emergency response capacities, government and
3.3. Individual knowledge and decision-making capacities, public and professional and government crisis communications capacity.
3.4. Identification of Data Sources: WHO, CDC, FAO, UPMC, University
3.5. Schools of public health, HMO?s, Hospitals, Research Institutes
3.6. Identify and review relevant models: Timely literature search complete.
4. Design Simulation Model
4.1. Identify Actors (done)
4.2. Actor Goals (done)
4.3. ? Actor Resources (in process)
4.4. ? Actor Interactions ( ? )
5. Develop Simulation Materials
5.1. Write Scenarios (for Pandemic Alert and Pandemic Periods)
5.2. Refine Role Profiles with specific goals, resources, activities
5.3. Prepare Simulation Game Rules
5.4. Prepare supplementary materials (data sheets, forms, etc.)
6. Operate the Simulation
6.1. Arrange logistic support: Facilities, communications, etc.
6.2. Review all materials and procedures, recruit role-playing participants
6.3. Brief and orient all simulation game participants
6.4. Operate the Simulation
6.5. Debrief participants
7. Evaluate the Simulation
7.1. Provide Post-Simulation Analysis
7.2. Review records, notes, tapes
7.3. Assess Simulation learning vs. objectives
7.4. Redesign and/or modify Simulation for replication
DISCUSSION GUIDE
1. Have we (local & state government, health care community, media, financial community, business and employers) done all we can to prevent, be prepared for, and mitigate the health, social, and economic impacts of the coming Avian Influenza Pandemic?
2. How far are we (local & state government, health care community, media, financial community, business and employers) falling short?
3. What can we do, individually and collectively, to better prepare for and mitigate the coming Avian Influenza Pandemic?
4. What is the role of public education, authoritatively and most completely informed by the UN's WHO, in achieving better preparation of greater Boston's population (at all levels) for surviving and mitigating an Avian Influenza Pandemic?
- "Several countries have already conducted table-top exercises to rehearse their pandemic response plans. These exercises have been regarded as eye-openers, resulting in recognition of precise critical weaknesses in day-to-day operations and the formulation of precise recommendations for their correction." -- WHO's 2005 report, "Responding to the avian influenza pandemic threat: recommended strategic actions" recommends (p.16): "Develop model pandemic response exercises.?
ROLES
Select Minimum of 7 - at least one from each of 7 categories, Max.5x7=35
Public Schools
? Public high school teenage student(s)
? High school nurse, mother of 2 children
? Elementary school teacher, mother of 3 children
? Single mom on welfare with 2 teenagers & 2 infants
? Day care center director, mother of 2 children
? High school principal with working wife & 2 teenagers
? School superintendent, father of 2 adult children
? Teacher?s Union president, mother of 2 teenagers
Public transportation
? Transport worker - Subway motorman - Father of 2 teens
? Transport worker - Airport air controller- father of 4
? Transport worker - School bus driver - Mother of 1 child
? Transport worker - Bus driver - Father of 3 children
? Transport worker - Garbage truck driver - Father of 2
? Transport worker - Interstate truck driver - single
? Transport worker - Taxicab driver - Father of 2 children
? British airways captain/pilot, stewardess
? MBTA Transit Police Chief Father of 4 teens
? Teamster?s Union President - Father of 3 teens
? Mass Port CEO, Amtrak CEO, USAir Logan airport US customs inspector - father of 5
Food Services and Public Restaurants
? McDonald?s cook - Single male
? McDonald?s manager - Single mom with one infant child
? Howard Johnson?s food services manager
? Stop & shop meat counter butcher - Father of 2 teens
? Stop & shop store manager
? Legal seafood chain owner/CEO, pizza shop chain CEO
? Ritz-Carlton Hotel dining room manager, chef
? Meals-on-wheels manager - Mother of 2 children
? Wilson Farms CEO, pet shop owner
Local and State Government
? Boston Mayor
? City Council President
? Boston Chief Of Police
? Boston Head Of Emergency Medicine
? Boston City Hospital Director
? State Epidemiologist, Asst. Cmr. Public Health
? Massachusetts Commissioner of Public Health
? Massachusetts Commissioner of Public Safety
? Governor Romney, Lt.Gov. Healy of Massachusetts
? U.S. Senators Kennedy, Kerry
? Congressman Capuano, State Rep. Alice Wolf
Medical and Health Care Communities
? Children?s hospital nurse - Mother of 2 teens
? Roxbury Clinic, GP/internal medicine MD - Mother of 1
? Mass general hospital ER Surgeon - father of 2 toddlers
? Brigham & Women?s Hospital intern - Single female
? State public health lab director - Father of two teens
? State public health lab technician - Single
? Partners, Tufts HMO CEO?s
? Mass. Blue Cross/Blue Shield CEO
? Mass. Medical Society President
? Harvard School of Public Health Dean
? Harvard Medical School Dean
? Nobel-Prize Winning Virologist
Major employers
? Major real estate firm CEO, major landlord
? Boston gas & electric line repairman - Father of three
? Bank clerk, mother of two elementary school children
? Bank branch manager, South End - Single mom with 1 child
? Bank of America, Boston CEO
? John Hancock insurance co. CEO
? New England Telephone CEO
? Boston Gas & Electric CEO
? Filene?s, Jordan Marsh CEO
? Fidelity Investments CEO
? Loews Theaters, Boston Symphony CEO
? Tufts Medical Center CEO
? Boston Consulting Group CEO
? B.U., B.C., U. Mass. Boston Presidents
? Northeastern University, President
? MIT, Harvard University President
? Biotech Industry Council President
Media/communications
? Boston Globe/Herald Reporter
? Boston Globe Editor
? Boston Tab Reporter
? TV News Anchorman/Woman (R.D. Sahl, N. Jacobson)
? Channel 2 Public TV/Radio Commentator (Ms. Rooney)
? Radio News Commentator (WBUR ?The Connection?)
? New England Journal Of Medicine Editor
? Atlantic Monthly Editor, Boston Magazine Editor
? B.U. School Of Journalism Dean
? Local Mystery Story Writer (Robert B. Parker?
