Risk communication simulation exercises

Effective risk communication is part and parcel of any health emergency response. Countries need to build and sustain their risk communication capacity – risk communication strategies and plans, procedures, trained personnel, effective communications platforms, operational coordination and, most importantly, the ability to reach and convince people at risk to take actions so as to protect themselves when a real epidemic, pandemic or other emergency strikes.

To test the preparedness of countries, the International Health Regulations (2005) advises that countries test their risk communication and pandemic communication capacity at least every two years.

Orientation exercise

The purpose of an orientation exercise is to discuss, consider and update existing emergency planning documents, organizational structures and early warning systems and to familiarize key personnel with emergency procedures and their responsibilities in implementing them. This may be done through lectures, panel discussions or general discussion and can include visual presentations. All personnel with a role in the emergency plan or procedure should participate. The exercise can also include a review of past cases, if any, for lessons learned.

Pre-screening of the national capacity, “Stress test”

Stress tests look at existing outbreak management capabilities of an organization, system or other entity. Frequently done as a pre-screening review, stress tests look at how an entity performed during a stressful situation in order to identify the gaps and needs for improvement.

The findings from a stress test provide information to the national authorities for scaling-up preparedness programs and capacity, and serve as the basis in designing preparedness exercises.

Table-top exercise (TTX)

A table-top exercise involves convening key emergency response personnel to discuss a simulated or imaginary emergency situation.

Designed as an exercise for filtering relevant information and making key decisions, participants are tasked to review and discuss the risk communication and related actions they would take at specified stages of the emergency. This allows for testing of emergency risk communication plans in an informal, low-stress environment.

Table-top exercises are often used to clarify roles and responsibilities and to identify additional threat mitigation and preparedness actions.

The exercise should result in action plans for continued improvement of the emergency plan. The scenario and script must provide very detailed information to recreate the events and facilitate understanding and monitoring of actions.

“Time jumps” can be used to simulate a long period of time in the imaginary emergency within a few hours. Table top exercises require minimal resources and money, and there are no major security risks since it takes place in confined space.

• A simple pandemic communication table top exercise

Drill

It can also be used to practice and perfect emergency response safety measures such as proper hand washing, donning and doffing of personal protective equipment, accessing antivirals etc. Drills can be stand alone or organised and intertwined into the overall intensive training or program.

Simulation exercise (SimEx) a.k.a. Functional exercise

A simulation exercises is a fully simulated, interactive exercise that tests the capability of an organization or other entity to respond to a simulated emergency, disaster or crisis situation. Simulation exercises are normally run as field exercises and include a scenario that is as close to reality as possible. The scenario takes place in real-time, and requires a variety of resources to operate – both human and material.

SimEx’s are exercises for practical operations in which the participants’ actions are evaluated. The actions that are taken and the way decisions are made in response to the particular situation will determine the development of the exercise. Security plans may be needed should there be exposure to real physical risks and psychological support should be on hand due to the emotionally taxing situations that may arise.

Simulation exercise can be sector-specific or involve inter-sectoral coordination. For risk communication, simulation exercises have to integrate risk communication actions into other public health emergency response such as epidemiologic, information management, patient care, disease prevention and control, coordination of response, amongst others.

WHO’s simulation exercises for risk communication

Full-scale exercise

A full-scale exercise simulates a real event as closely to reality as possible; designed to evaluate the operational capability of systems in a highly stressful environment that simulates actual response conditions. This type of exercise involves all the named responders in the plan, and requires deployment of personnel and equipment.

Common features on all of the above

• Use of scenarios, developed from a script prepared in advance.
• Produce evaluation, validation and updating of preparedness and response plans.
• Facilitate training, evaluate tools and processes, and look at the decision making process and overall teamwork.
• Require prior needs assessment with stakeholders to clarify the context and setting in which the exercise will be carried out.

• A guide for conducting table-top exercises for national influenza pandemic preparedness
  WHO Regional Office for South-East Asia (SEARO). New Delhi, India; SEARO/WHO; Dec, 2006. 24 p.
• Guidelines for developing emergency simulations and drills
  Area on Emergency Preparedness and Disaster Relief. Washington, D.C; Pan American Health Organization (PAHO)/WHO; Dec. 2011. 96 p.
• Exercise development guide for validating influenza pandemic preparedness plans
  WHO Regional Office for the Western Pacific (WPRO). Manila, The Philippines; Feb. 2006. 36 p.
• Creating and tracking pandemic preparedness plans: a guide
  WHO Regional Office for the Western Pacific (WPRO). Manila, The Philippines; 2006. 15 p.

WHO and UN partners provide support to test their risk communication capacity through the running of exercises and drills. These include:

• Table top exercises on pandemic influenza
• Table top exercises on other disease outbreaks - Ebola virus disease, Lassa fever, cholera, MERS coronavirus
• Skill drills for media communication, mass media communication, social media, social mobilization and community engagement for any public health emergency
• Simulation exercises for pandemic influenza, humanitarian crises, natural disasters, and other health emergencies

For more information, contact: [email protected]