Written By:

Adam Felder

Published On:

June 20, 2018

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Dr. Michael Williams of the Center for Health Policy on the Pandemic Simulation Game

A highly contagious virus is rapidly spreading across the country and there is no readily available cure. Your stakeholders' lives are at stake. What do you do? How do you minimize the death toll in the most efficient way possible? These are some of the questions participants must address in the Pandemic Simulation Game.

No one wants to face a pandemic. The very word is frightening. But a new simulation offered by the Batten School’s Center for Leadership Simulation and Gaming (CLSG) allows participants to face a pandemic in a simulated environment, providing real-time experience in global health crisis management.

Dr. Michael D. Williams, director of the UVA Center for Health Policy, consulted with CLSG developers in the creation of the Pandemic Game. Per Williams, while responding to a pandemic isn’t easy in the best of circumstances, it bears enough similarity to other medical resource-straining events that some aspects can be modeled. It’s those aspects that Williams hopes participants can grapple with in order to better prepare themselves for a real-world response.

By Williams’ estimation, about 60 to 70 percent of a pandemic response is predictable, and he cites the UVA health system’s response to the events of the August 12 “Unite the Right” rally as a good example of planning for a resource strain. The hospital system, seeing an increased probability of violence leading up to the day of the rally, began planning well in advance of the response itself. In order to free up potential resources, for example, the hospital’s surgical schedule was choked off before the day of the rally. This foresight proved invaluable, as it allowed the hospital the capacity necessary to deal with a significant influx of patients as the rally turned violent.

“We would not have had the space to deal with (the influx) had we not the foresight to dam off one of the sources of patients upstream,” said Williams.

A pandemic–any pandemic, be it influenza, H1N1, or ebola–carries with it the same short-term resource constraints: a lot of people requiring medical attention, beds, and medicine, in a short window of time. Managing these resources–and planning in advance for their need–is the biggest key to any successful emergency response, said Williams. That’s a lesson that applies to any crisis–not just pandemics.

“A lot of people think bad things happen ‘when things go bump in the night,” said Williams, referring to the belief that hospitals face their toughest challenges on evenings and weekends. “But the data doesn’t bear that out. When the hospital is full, that’s when the bad things happen.”

Thus, a simulation on pandemic management becomes one of resource allocation and anticipation. That’s when the additional complications kick in.

Depending on the pandemic, the timeline of the resource constraints–as well as their ripples into the outlying community–matters quite a bit. Dealing with an ebola pandemic, for example, is far harder not only because of the lethality of the disease, but also because the disease takes a while to run its course–thus providing a longer strain on critical medical resources. Further, such a pandemic carries with it a heightened risk of exacerbating behaviors by people seemingly not immediately impacted by the pandemic–behaviors one wouldn’t see with an outbreak of, say, the flu.

You might see someone say ‘I’m not going to that hospital until that person is either dead or cured or gone’ in response to a hospital taking in an ebola patient,” says Williams. “That means you have other hospitals that have to deal with this overflow. Suddenly, Martha Jefferson hospital is dealing with a shortage of beds because patients from the UVA health system are scattering to get away from the ebola patient.”

Even that scattering causes problems, as each person fleeing the first patient–fairly or not–is possibly a vector. That means a pandemic response requires not only a response from the medical community, but also the policy one. Trying to find ways to combat the tendency to flee from a perceived threat is a public messaging challenge, even while separate from the immediate medical crisis of an infected patient.

It is that cross-sector collaboration between leaders, policymakers and communicators that Williams hopes participants will begin to understand as they work their way through the simulation: treating the patient is only one small part of a successful response. “We’re trained to take care of the patient in front of us,” says Williams. “But that increasingly doesn’t work because all of it–the patient, the hospital, the community–is one system.”

For those looking to add an additional challenge to the mix, there are plans to add additional curveballs to the simulation that cover the unpredictable portions of pandemics. Participants might need to manage ebola concurrent with a power loss due to a derecho or an earthquake. After all, inclement weather, separate epidemics, and large-scale accidents are all independent events: that they by and large haven’t spiked concurrent with an ebola outbreak to date is something of a fluke. Eventually, there will be an outbreak in tandem with multiple independent calamities–and that’s what participants really need to prepare for.

“To really be of value, it has to be as awful an experience as we can make it,” said Williams.

The pandemic simulation is currently in the final stages of development and is slated for release by the end of Academic Year 2018.