Pandemic plan testing – moving from art to science
The recent publication of the Camden PCT ‘Flu Pandemic Game’ by the UK Department of Health not only provided a highly useful resource for testing the pandemic preparedness arrangements of many different types of firms, it also provided a potential breakthrough in terms of the way in which plan exercising may be conducted in future. By establishing a relationship between potential infection rates and scores in a game of chance, a highly realistic approach based on introducing real world probabilities into plan exercising has been achieved. As we all know, infection rates will vary from the ‘norm’ or mean or average – these variations will be almost impossible to predict as there could be any number of underlying events that may cause any particular group of people to demonstrate an infection rate that is higher or lower than the norm. The introduction of an activity (rolling a set of dice) that simulates this randomness provides an essential element of unpredictability (infection rates turning out to be being higher or lower than the national ‘average’) as the availability/unavailability of staff being subject to a probabilistic event. Also the contrived judgemental element associated with a person or a group of people deciding who will be fit and who will not is removed – the individuals affected will be selected purely by statistical probability – which is precisely what will happen during a pandemic wave. This is a great step forward in introducing real-world levels of uncertainty into an exercising situation. Having had some exposure to the ongoing development of stress testing models for financial risk within the banking sector, I was struck by how the NHS approach could be further built on to encapsulate the concepts of ‘stress testing’. Most major financial organizations use models to anticipate their exposures in the financial markets and by using a series of more frequent and more extreme price changes, the resilience of their risk management strategies is tested. The NHS approach, as outlined in the Pandemic Game, takes expected (or likely) infection rates (based on prior outbreaks) and then correlates this to the likelihood of a particular score or combination of numbers being achieved from multiple throws of dice. To introduce stress testing approach, two factors need to be flexed to vary the ‘stress’ levels - the infection rates and the recovery period. (An increased infection rate would be simulated identifying a correlating likelihood of a score of dice or some other game, such as roulette). Changing these variables will simulate higher or lower levels of absenteeism on the organization. Clearly the higher the level of ‘stress’ that can be tolerated by an organization the more resilient it will be to rising absentee rates caused by a pandemic situation. The Pandemic Game has provided not only a useful guide for testing pandemic continuity plans it has demonstrated the value of using available statistical correlations to prove the robustness of our preparations for a pandemic outbreak. However, the principle can be applied beyond assuring pandemic preparations. Given access to statistics related to the range and frequency of interruption periods for different types of incident (i.e. how often email servers fail, the sources of failure and the range of outage times) we are in a strong position to determine the range of potential outcomes and their potential impact. These can then be factored into our response strategies – because we have a frame of reference for the range of outcomes and therefore understand the potential impacts that could occur. By understanding how the distribution of these potential outcomes correlate to different games of chance we can then use them in plan exercises to create more realistic simulations. The only unfortunate thing about the Camden PCT / UK DoH document is that we don’t know who to congratulate for it, there’s no ‘roll of honour’ or list of contributors anywhere in any version of the document. I guess all that we can do at this stage is to extend our thanks to the anonymous authors who have contributed this valuable piece of knowledge to the BC community. Author
•Date: 13th August 2009• Region: UK •Type: Article •Topic: Pandemic planning |
