Gates Package — page 1071

1S. As governments work with the GERM team to plan their outbreak exercises, they would be smart to include purposeful attacks in their scenarios. The consequences of not doing so could be catastrophic. *** A good model of a country-level simulation is the one developed by Vietnam for a full-scale exercise in August 2018, designed to see how well the system identified a potentially worrisome pathogen.11 I'm impressed by how meticulous it was. Four actors were hired to play patients, family members, and their contacts, and they were given scripts with key information for the medical staff (who knew they were participating in an exercise). On Day 1, the actor portraying a fifty-four-year-old businessman arrived at the emergency room of a hospital in the northeastern province of Quang Ninh, complaining of a dry cough, fatigue, muscle pain, and shortness of breath. The doctor questioned him thoroughly enough to discover that he had recently traveled to the Middle East, where he could have picked up the MERS virus--a fact that, in combination with his symptoms, was enough to get him admitted to the hospital and isolated. News of the worrisome case made its way up the chain of command within minutes, and soon the members of a rapid response team had arrived at the hospital and at the man's residence. The actors were tested using throat swabs, which were then replaced with samples that had been spiked with the virus that causes MERS. Although the samples weren't actually driven to the lab, the organizers waited the length of time it would have taken to transport them before lab staff ran real tests and correctly identified the positive MERS cases.