Earth:Simulation exercise

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A simulation exercise (SimEx[1]) or emergency preparedness exercise[2] is a public health simulation of a hypothetical disaster used to test response capacity. It is similar to military exercises.

Types

The World Health Organization categorises simulation exercises into four categories: tabletop exercise, drill, functional exercise, and full-scale exercise listed in increasing complexity (amount of preparation and resources required).[3] The European Centre for Disease Prevention and Control considers an additional type: the orientation exercise which it places before tabletop exercise.[4]. The discussion-based exercises (orientation and tabletop[4] are recommended as a starting point before conducting operation-based exercises (the other three types).[2]

Format

During an exercise, injects are provided.[5] These are updates to the scenario in the form of emails, news articles, telephone calls and so on.[6] The master scenario events list contains an overview of which injects are used when.[7] The exercise is followed up by a debrief, including a "hot" debrief immediately after the exercise.[8]

Scenarios

Disease outbreaks

NSW Health hosted an influenza pandemic exercise called XFG in 2008.[9] The World Health Organization hosted an exercise in 2025 called Polaris[10]. The fictional disease being tested was "mammothpox"[11][12] The outbreak started with a pathogen from permafrost[12]. The same year, UK Health Security Agency held an exercise called Pegasus.[13] The fictional disease in this exercise was "EV-D68".[14]

Name Year Facilitator Disease
Exercise Cygnus 2016 UK Government influenza
Exercise Alice 2016 UK Government Middle East respiratory syndrome
Exercise Clade X 2018 Johns Hopkins Center for Health Security disease X
Crimson Contagion 2019 US Department of Health and Human Services influenza

Mass casualty events

In 2017 an exercise called Elsa considered a major incident leading to many casualties.[2] The same year, an exercise named Socrates considered a mass casualty event.[2]

Natural disasters

A 2011 simulation imagined the 365 Crete earthquake happening again.[15] In 2012 an exercise simulating destruction of the Isthmus of Corinth as a result of an earthquake was held.[16]

See also

References

  1. ↑ Mahdi, Syed Sarosh; Jafri, Hafsa Abrar; Allana, Raheel; Battineni, Gopi; Khawaja, Mariam; Sakina, Syeda; Agha, Daniyal; Rehman, Kiran et al. (2023-05-24). "Systematic review on the current state of disaster preparation Simulation Exercises (SimEx)". BMC Emergency Medicine 23 (1): 52. doi:10.1186/s12873-023-00824-8. 
  2. ↑ 2.0 2.1 2.2 2.3 Skryabina, Elena A.; Betts, Naomi; Reedy, Gabriel; Riley, Paul; Amlôt, Richard (2020). "The role of emergency preparedness exercises in the response to a mass casualty terrorist incident: A mixed methods study". International Journal of Disaster Risk Reduction 46. doi:10.1016/j.ijdrr.2020.101503. 
  3. ↑ WHO Simulation Exercise Manual, World Health Organization, 2017 
  4. ↑ 4.0 4.1 Handbook on simulation exercises in EU public health settings – How to develop simulation exercises within the framework of public health response to communicable diseases, European Centre for Disease Prevention and Control, 2014 
  5. ↑ Houareau, Claudia; Spieker, Clara; Grote, Ulrike; Perseke, Knut; an der Heiden, Maria; Caglar, Robert; Wolter, Amrei; Connolly, Máire A. et al. (2025). "The PANDEM-2 Simulation Exercise: Training the Coordinated Response to a Large-Scale Pandemic in 2 European Public Health Emergency Operations Centers". Disaster Medicine and Public Health Preparedness 19. doi:10.1017/dmp.2024.298. 
  6. ↑ Grance, Tim; Nolan, Tamara; Burke, Kristin; Dudley, Rich; White, Gregory; Good, Travis, Guide to Test, Training, and Exercise Programs for IT Plans and Capabilities 
  7. ↑ Homeland Security Exercise and Evaluation Program, 2020, https://www.fema.gov/sites/default/files/2020-04/Homeland-Security-Exercise-and-Evaluation-Program-Doctrine-2020-Revision-2-2-25.pdf 
  8. ↑ Dausey, David J.; Buehler, James W.; Lurie, Nicole (2007-05-29). "Designing and conducting tabletop exercises to assess public health preparedness for manmade and naturally occurring biological threats". BMC Public Health 7 (1): 92. doi:10.1186/1471-2458-7-92. 
  9. ↑ Eastwood, Keith; Durrheim, David; Merritt, Tony; Massey, Peter D.; Huppatz, Clare; Dalton, Craig; Hope, Kirsty; Moran, Lucille et al. (2010). "Field exercises are useful for improving public health emergency responses". Western Pacific Surveillance and Response Journal 1 (1): 12–18. doi:10.5365/WPSAR.2010.1.1.003. 
  10. ↑ Simmons, Laura (2025-04-07). "Exercise Polaris: The WHO Just Ran A 2-Day Pandemic Preparedness Exercise". IFLScience. https://www.iflscience.com/exercise-polaris-the-who-just-ran-a-2-day-pandemic-preparedness-exercise-78708. 
  11. ↑ Gooch, Bryony (2025-04-15). "WHO tests the world’s pandemic response with fictional ‘mammothpox’ outbreak". https://www.independent.co.uk/news/world/mammothpox-mpox-covid-who-pandemic-b2733541.html. 
  12. ↑ 12.0 12.1 Cullinan, Maeve; Scott-Geddes, Arthur (2025-04-15). "WHO tests pandemic response with Arctic ‘mammothpox’ outbreak". https://www.telegraph.co.uk/global-health/science-and-disease/mammoth-pox-pandemic-response-world-health-organization/?msockid=3771122109cb63f9111c04d508886214. 
  13. ↑ "Pandemic Preparedness: Exercise PEGASUS". 2025-11-04. https://hansard.parliament.uk/Commons/2025-11-04/debates/251104100000010/PandemicPre#contribution-2EC7BFB3-7C94-4029-9A86-206E6F6D4549. 
  14. ↑ Nuki, Paul; Newey, Sarah; Cullinan, Maeve (2025-11-25). "Schools locked down again in secret pandemic drills". https://www.telegraph.co.uk/global-health/science-and-disease/schools-locked-down-again-in-secret-pandemic-drills/?msockid=3771122109cb63f9111c04d508886214. 
  15. ↑ Kalligeris, N.; Flouri, E.; Okal, E.; Synolakis, C. (2012). "The AD 365 earthquake: high resolution tsunami inundation for Crete and full scale simulation exercise". Geophysical Research Abstracts 14 (EGU2012-11787). 
  16. ↑ Zygoura, A.; Sidiropoulos, K.; Vergopoulou, P.; Argyropoulos, G.; Imertziadis, C.; Kapnopoulos, H.; Koukopoulos, P.; Kostopoulos, I. et al. (2005). "Development and Implementation of a Simulation Exercise for the Special Unit for Disaster Medicine in Collaboration with the “Hellenic Volunteer Rescue Team” Non-Governmental Organization". Prehospital and Disaster Medicine 20 (S1): 63. doi:10.1017/S1049023X00013327. 

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