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Disease X dummy run: World health experts prepare for a deadly pandemic and its fallout

Harriet Alexander
Health experts fully expect the world to be confronted by a fast-moving global pandemic - Getty Images

The updates were coming into the situation room thick and fast – and the news was not good. The virus was spreading.

The former deputy director of the CIA took of her glasses, rubbed her eyes, and addressed the panel.

“We also have to consider that terrorists could take advantage of this situation,” she said. “We’re looking at the possibility of famine. There is the potential for outbreaks of secondary diseases.”

One of her aides lent forward, and handed her a note. She read it quickly, and continued: “I have an update from my staff. I’ve been told that several governments have fallen, and others are teetering.”

If it sounds like a scene from a disaster film, the organisers would be pleased: that was their intention. On Friday a panel of 15 high-powered international figures gathered in the ballroom of a New York hotel to “game” a scenario in which a pandemic is raging across the world, killing millions.

It’s not at all far-fetched.

“I fully expect that we will be confronted by a fast-moving global pandemic,” said Dr Mike Ryan, executive director of the World Health Organisation (WHO) health emergencies programme.

Addressing participants – and the 150 observers – before the scenario began, he said that the WHO deals with 200 epidemics every year. It’s only a matter of time before one of those becomes a pandemic – defined as a disease prevalent over a whole country or the world.

“The issues may be table top scenarios today, but they could be real tomorrow,” he said. “This is our new normal.”

The 15 panelists were not acting; rather they were behaving as themselves, and responding to the best of their experience to the situations presented to them. “Aides” would hand them updates, which they would share with the panel and discuss.

The lights went down, and the spooky music begun to play – Dragon’s Den meets X Factor, with a plague thrown in.

An anchor with the fictional Global News Network (GNN) set the scene. The imaginary Coronavirus, originally from pigs, was spreading fast throughout South America, causing a respiratory condition known as CAPS – similar to the real-life SARS and MERS outbreaks. The airborne disease was up to four times as lethal as the virus which killed 50-100 million in the 1918 flu pandemic – the last serious pandemic to hit. Chen Huang, the anchor, looked worried.

Now it was over to the panel. What advice would the team give to governments about to handle this, asked Tom Inglesby, director of the John Hopkins centre for health security, and chair of the “Event 201” discussion. The event was organised jointly by John Hopkins, the World Economic Forum and the Bill and Melinda Gates Foundation.

Adrian Thomas, the vice president of global public health for pharmaceutical firm Johnson & Johnson, said it was essential to have “clarity around the need” – where was the virus spreading fastest?

Jane Halton, former president of the World Health Assembly and adviser to the Australian government, chair of the Coalition for Epidemic Preparedness, stressed the need to ensure that low and middle-income countries were not forced out of the way by richer countries.

“Chile has a three per cent fatality, while Ecuador’s is five per cent,” noted Canadian academic Timothy Grant Evans, a former health director at the World Bank, looking at the slides presented to the team. “What is Chile doing right? What can we learn?”

For the next three hours the discussion continued, with Mr Inglesby directing the thematic debates: how to allocate and distribute antivirals? Should limits be placed on trade and travel, to stop the spread of the virus? How best to mitigate the economic and financial crisis caused by the pandemic?

The panel would “convene” every three weeks, with the death toll rising and the virus spreading.

“We’re not sure how big this could get, but there is no end in sight,” said Chen Huang, the GNN anchor, grimly.

How, the panel were asked, could they stop disinformation?

George Fu Gao, the director-general of the Chinese Centre for Disease Control, told how, while in Sierra Leone during the Ebola crisis of 2014-16, he was told by a health worker: “We believe Ebola is man made.”

Avril Haines, the former CIA deputy director, sitting next to Mr Gao, nodded.

“Having a trusted source, and really guiding everyone to that for information, is incredibly important,” she said – adding that survivors of the virus, faith leaders and multinational agencies all had a role to play.

As the lights came up for a final time, millions were dead. The pandemic had ravaged the globe, Huang said, sparking rioting and the collapse of many governments. It would take decades to return to pre-pandemic order.

“This has been great, but I will go back to Zurich and talk about it, and other business leaders will say: ‘Yes, we know, but we have business to do,’” admitted Martin Knuchel head of crisis for Lufthansa.

A list of suggestions was drawn up – more finance, better sharing of information, more planning. The WHO has already staged 50 such scenarios worldwide; more need to be held.

Anita Cicero, deputy director at John Hopkins, left the panel, the observers, and the online watchers with a final question.

“Are we as a global community ready to do the hard work needed to stop the next pandemic?”

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