Practice Makes Perfect: Responding to a Mock Emergency

As relative newcomers to the field of public health, we’ve often dreamt — morbid as it may sound — about the day when we could be sent to respond to an actual disease outbreak. You can imagine our excitement when we found out that we would be getting that chance in our Emerging Infectious Diseases course in the Rollins School of Public Health at Emory University, thanks to our instructor, Dr. Ali Khan.

Even though we didn’t get our hands on any smallpox or ebola viruses, Dr. Khan and CDC generously arranged for our class to participate in a tabletop exercise, which would simulate responding to a flu pandemic. A tabletop exercise is an informal way for groups to simulate an emergency response in a low stress environment (think “War Games”). On February 25, we gathered, along with 30 of our classmates (all fellow epidemiologists-in-training) at CDC in a mock “situation room”. To get us in the right mindset our instructors showed mock news clips about the spreading of a (fictional) novel influenza virus (H1N1 on steroids). The clips were so realistic it made us feel like there really was an outbreak– we thought Sanjay Gupta was about to come on CNN and tell us we had to start wearing masks and stockpiling Tamaflu!

With the help of Emergency Management Specialists Jack Perry and Gary Jones (who generously donated their time to our class), we broke into two groups, each challenged with addressing a number of “real life” concerns that would arise in the event of a pandemic flu situation.

[youtube]http://www.youtube.com/watch?v=nM2uAnmYr_8 [/youtube]

The first group focused on the initial concerns that would come up in an outbreak situation, by addressing questions such as:

• “What are the possible decisions regarding distribution of medications?”
• “At what point would you wake up the CDC director at 3AM to inform him of this growing threat?”

The second group focused on sustained actions needed to fight the pandemic, by addressing questions like:

• “What federal agency is managing and coordinating the response with state and local partners?”
• “What sort of surveillance and laboratory strategies would you be considering?”

At the end of the exercise, the class regrouped in the conference room and a spokesperson from each group briefed Dr. Khan – the actual director of the Office of Public Health Preparedness and Response — on their recommendations. Having a real-life CDC official critique our decisions and participate in our discussions was a realistic and invaluable learning experience.

Our day concluded with a tour of the CDC Emergency Operations Center (EOC), which was a fascinating look at some of the fast-paced work that goes on behind-the-scenes to respond to public health threats both domestically and globally – while we were there, the EOC was “activated” to respond to the cholera outbreak in Haiti, so we got a great feel for the fast past work that goes on there. As soon as we entered the EOC, we could not help but be impressed with the size and structure of the center, including the huge information screen in front, and the Joint Information Center (JIC).

Seeing how such a large team is able to work together around the clock (literally!) during an incident was amazing and inspiring. After the tour of the main floor, we got a chance to check out the collection of ribbons that the EOC maintains for each of the incidents it has managed over the years. The scope of the incidents was really impressive; in fact, this part of the tour was especially eye-opening as we had no idea that CDC was even involved in many of these incidents and events.

As critical as its role is, the EOC is a component of the CDC that many people might not even know exists, and is something that even many people who work at CDC might not get to experience, yet our class was able to engage in a real-life CDC exercise with the Director of the Office of Public Health Preparedness and Response, Dr. Khan, and tour the facilities that make the CDC’s emergency responses possible. This kind of hands-on, practical learning experience prepares us– future public health leaders– for the potential of an outbreak situation or emergency situation in our public health careers.

Jessie and Sydney are both graduate students at Emory University’s Rollins School of Public Health. They will be completing their MPH degrees in Epidemiology this May and as part of their coursework took Dr. Ali Khan’s Emerging Infectious Diseases course. After graduation, Jessie will be moving to Michigan to begin a CDC/CSTE Applied Epidemiology Fellowship. Sydney will be spending the next year in Lusaka, Zambia completing an HIVCorps fellowship with the Center for AIDS Research in Zambia (CIDRZ).