Biosecurity Program, The Kirby Institute, The University of New South Wales, Sydney, Australia.
School of Public Health and Community Medicine, The University of New South Wales, Sydney, Australia.
Vaccine. 2022 Apr 14;40(17):2478-2483. doi: 10.1016/j.vaccine.2021.10.081. Epub 2021 Dec 2.
In December 2019, we ran Pacific Eclipse, a pandemic tabletop exercise using smallpox originating in Fiji as a case study. Pacific Eclipse brought together international stakeholders from health, defence, law enforcement, emergency management and a range of other organisations.
To review potential gaps in preparedness and identify modifiable factors which could prevent a pandemic or mitigate the impact of a pandemic.
Pacific Eclipse was held on December 9-10 in Washington DC, Phoenix and Honolulu simultaneously. The scenario began in Fiji and becomes a pandemic. Mathematical modelling of smallpox transmission was used to simulate the epidemic under different conditions and to test the effect of interventions. Live polling, using Poll Everywhere software that participants downloaded onto their smart phones, was used to gather participant decisions as the scenario unfolded. Stakeholders from state and federal government and non-government organisations from The United States, The United Kingdom, Australia, New Zealand, Canada, as well as industry and non-government organisations attended.
The scenario progressed in three phases and participants were able to make decisions during each phase using live polling. The polling showed very diverse and sometimes conflicting decision making. Factors influential to pandemic severity were identified and categorised as modifiable or unmodifiable. A series of recommendations were made on the modifiable determinants of pandemic severity and how these can be incorporated into pandemic planning. These included preventing an attack through intelligence, law enforcement and legislation, improved speed of diagnosis, speed and completeness of case finding and case isolation, speed and security of vaccination response (including stockpiling), speed and completeness of contact tracing, protecting critical infrastructure and business continuity, non-pharmaceutical interventions (social distancing, PPE, border control) and protecting first responders.
Pacific Eclipse illustrated the impact of a pandemic of smallpox under different response scenarios, which were validated to some extent by the COVID-19 pandemic. The framework developed from the scenario draws out modifiable determinants of pandemic severity which can inform pandemic planning for the ongoing COVID-19 pandemic and for future pandemics.
2019 年 12 月，我们进行了太平洋日食演习，这是一项使用天花作为案例研究的大流行桌面演习。太平洋日食演习汇集了来自卫生、国防、执法、应急管理和一系列其他组织的国际利益相关者。
审查防范工作中的潜在差距，并确定可预防大流行或减轻大流行影响的可修改因素。
太平洋日食演习于 2019 年 12 月 9 日至 10 日在华盛顿特区、凤凰城和火奴鲁鲁同时举行。该情景始于斐济，并演变为大流行。使用天花传播的数学模型来模拟不同条件下的疫情，并测试干预措施的效果。使用参与者下载到智能手机上的 Poll Everywhere 软件进行现场民意测验，以收集情景展开时参与者的决策。来自美国、英国、澳大利亚、新西兰、加拿大的州和联邦政府以及非政府组织的利益相关者，以及行业和非政府组织参加了会议。
该情景分三个阶段进行，参与者可以在每个阶段使用现场民意测验做出决策。民意测验显示出非常多样化且有时相互冲突的决策。确定了对大流行严重程度有影响的因素，并将其分为可修改或不可修改的因素。就大流行严重程度的可修改决定因素以及如何将其纳入大流行规划提出了一系列建议。这些建议包括通过情报、执法和立法预防袭击，提高诊断速度，加快病例发现和隔离速度和完整性，加快疫苗接种反应速度（包括储备），加快和完整的接触者追踪，保护关键基础设施和业务连续性，非药物干预（社交距离、个人防护设备、边境管制）和保护急救人员。
太平洋日食演习说明了在不同应对情景下天花大流行的影响，在一定程度上得到了 COVID-19 大流行的验证。从情景中得出的框架指出了大流行严重程度的可修改决定因素，可为正在进行的 COVID-19 大流行和未来的大流行提供大流行规划信息。
