Credit Hong Kong CHP
#18,969
Nearly two decades ago - during the first ominous flare up of H5N1 in Southeast Asia - pandemic drills were quite common, and were held at international, national, state, and local levels.Every nation (and every U.S. state and Federal Agency) crafted a pandemic plan, and table top exercises were held regularly (see CIDRAP HHS includes online services in pandemic communication drill).
Drills were held by both the public and private sector, and ranged from multinational exercises all the way down to events held by local hospitals, and city governments. A few (out of scores of) blogs from that `golden age' of pandemic preparedness include:
Singapore To Begin 2-Week Financial Sector Pandemic Drill
Merced County California Flu Drill
Scottsdale Arizona: Pandemic DrillWhile not all of these drills were terribly realistic (i.e. practicing for rapid delivery of a vaccine that was unlikely to exist for months), they did serve to increase awareness - both for those taking part, for the public who heard about them in the media.
Idaho BlogEx : July 28th
UK: Lessons Learned From Winter Willow
UK Exercise: PPE Usage In A Pandemic
By the middle of the last decade, the number and size of these exercises began to wane, following a relatively mild 2009 H1N1 pandemic and the attenuation of the HPAI H5 threat.
But since COVID, and the growing realization that a HPAI H5 had reinvented itself, we've seen a resurgence in pandemic planning and exercises, particularly in Asia.
- Earlier this fall South Korea: MAFRA Conducted A Preemptive Virtual Quarantine Exercise (CPX), which came just days after staging a 19-day, Nationwide, Mock-Training Exercise to Prepare for Zoonotic Influenza.
- A year ago Hong Kong held a Coordinated Avian Flu Drill `Amazonite'.
- And over the summer of 2024, Japan's Ministry of Health Unveiled Revised Pandemic Plans
Since 2008 the WHO Western Pacific Regional Office (WPRO) has sponsored a multinational Exercise Crystal, which (most years) has revolved around respiratory virus outbreaks.
Participants have ranged from as few as 10 nations in 2014 to as many as 35 in 2024 (cite Exercise Crystal: simulations that drive National IHR Focal Point capacity strengthening).
And as we learn from the following Hong Kong CHP report, this year's scenario envisioned `. . . a novel influenza A infection related to dairy farms, with sustained human-to-human transmissions and further spread to many countries.'
This is, as far as I can tell, the first large-scale international acknowledgement that a mammalian livestock driven novel flu epidemic was plausible. First the report, after which I'll have a postscript.
DH participates in WHO's large-scale Western Pacific Region exercise to enhance emergency preparedness and cross-sectoral collaboration for public health emergencies (with photo)
The Department of Health (DH) today (December 3), together with the Food and Environmental Hygiene Department and the Agriculture, Fisheries and Conservation Department, participated in a large-scale annual table-top exercise, Exercise Crystal, organised by the Regional Office for the Western Pacific (WPRO) of the World Health Organization (WHO). The exercise aims to enhance emergency response mechanisms and cross-sectoral collaboration capabilities between Hong Kong, China and neighbouring regions to jointly tackle public health emergencies.
This year, the exercise simulated a scenario on human outbreaks of a novel influenza A infection related to dairy farms, with sustained human-to-human transmissions and further spread to many countries. More than 30 countries and areas in the WPRO region participated in the exercise. During the exercise, the WHO provided information on the scenario to the representatives of the participating countries and areas via videoconferencing and email.
Representatives from the DH and other government departments thoroughly discussed the scenario, including the immediate responses, prevention and control measures, and the relevant co-ordination required in Hong Kong, rapidly adjusting the planning according to the evolving scenario. The exercise host of the WPRO concluded the exercise with a debriefing to review the exercise's achievements and explore with participants how to further enhance cross-regional emergency response and collaboration mechanisms.
"Emerging infectious diseases have long posed significant public health threats worldwide. With frequent international population mobility today, emerging respiratory viruses can spread across regions in a short period of time through contact with patients’ secretions or droplets, potentially causing a global pandemic. As a major international transportation hub, Hong Kong faces a significant risk of importation of emerging respiratory infectious diseases. The exercise provided us with a valuable opportunity to strengthen communication and information sharing mechanisms between Hong Kong, China and the WHO WPRO, as well as national focal points of various countries. It also further enhances the cross-departmental collaboration mechanism against emerging respiratory diseases. The Centre for Health Protection (CHP) will consolidate the experience gained from this exercise, to opportunely review existing mechanisms in a timely manner, and make more forward-looking arrangements to comprehensively safeguard public health,” the Head of the Communicable Disease Branch, the CHP of the DH, Dr Albert Au, said.
Since 2008, the WPRO has conducted the Exercise Crystal annually to help member countries and regions prevent and respond to cross-regional public health risks affecting population worldwide. Meanwhile, the WPRO maintains close communication with focal points responsible for enforcing the International Health Regulations to ensure that the regions are familiar with the response mechanism to public health emergencies. Being one of the focal points between Hong Kong, China and the WHO, the CHP has actively participated in the exercise for years.
Ends/Wednesday, December 3, 2025
Issued at HKT 17:00
But since then we've seen a second genotype (D1.1) turn up in American dairy cows, along with serological evidence of HPAI exposure in goats and sheep in Pakistan, a report last March from the UK's Defra on H5N1 Detected In Domestic Sheep with Mastitis, and in May we saw serological evidence of H5N1 in sheep in Norway.
Six weeks ago, in WOAH Statement (Oct 22nd): High Pathogenicity Avian Influenza (HPAI) in Cattle, the reporting of HPAI H5 in cattle was finally made mandatory by the World Organization for Animal Health.
In light of the impact on animal and public health, the Scientific Commission for Animal Diseases considered at its February 2025 meeting that ‘infection of bovines (Bos taurus) with influenza A viruses high pathogenicity’ meets the Terrestrial Code glossary definition for ‘emerging disease’. Accordingly, Members are required to notify the occurrence of HPAI in cattle to the World Animal Health Information System (WAHIS) in accordance with the WOAH Terrestrial Code Article 1.1.4.
While this increased recognition of the threat from bovine H5N1 is encouraging, from far too many countries we see little or no sense of urgency. Pandemic preparedness is somehow viewed as being either `bad for the economy', politically unproductive, or not worth the expense.
While No Pandemic Plan Survives Contact With A Novel Virus, it is still imperative to have a plan going into any crisis. And that goes for individuals, families, and businesses . . . as well as for countries.
While we can't control what others choose to do, there are some simple things we can do now to improve our chances should another novel virus begin its world tour (see #Natlprep 2025: Personal Pandemic Preparedness).
The following quote is nearly 20 years old, but it is every bit as true today as it was in 2006:“Everything you say in advance of a pandemic seems alarmist. Anything you’ve done after it starts is inadequate." - Michael Leavitt, Former Secretary of HHS
