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Gates Package, p.1060 · gates:exh:00470
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between January and May, in which people from all levels of government, plus the private sector
and nongovernmental organizations, got together to discuss existing plans for responding to an
outbreak.
In the second phase, they put these plans to the test in a functional exercise. Over four
days in August 2019, participants worked through a scenario in which tourists visiting China
have become ill with a respiratory illness caused by a virus. They fly out of the airport in Lhasa
and travel to other cities in China before flying home to their respective countries.
The virus turns out to be just as contagious as the 1918 flu strain, and only slightly less
deadly. It rapidly spreads from one human to another, making its first U.S. appearance in
Chicago and quickly moving to other major cities.
At the beginning of the exercise, it has been forty-seven days since the first U.S. case.
There are moderate or high caseloads across the Southwest, Midwest, and Northeast. Models are
predicting that the virus will make 110 million people in the U.S. sick, put more than 7 million in
the hospital, and kill 586,000 Americans.
Over the next four days, the participants would debate decisions that would have been
unfamiliar to anyone not already versed in outbreak response work: quarantines, personal
protective gear, social distancing measures, school closures, public communications, the
purchase and distribution of vaccines, and more. Today, of course, these terms are part of our
everyday vocabulary.
The scope of Crimson Contagion's functional exercise was enormous. It involved 19
federal departments and agencies, 12 states, 15 tribal nations and pueblos, 74 local health
departments, 87 hospitals, and more than 100 groups from the private sector. When it was all
over, the participants got together to discuss how it had gone. While they found a few things that