Pandemic Preparedness
Disease X — Novel Respiratory Pathogen
A previously unknown airborne pathogen emerges with pandemic potential.
Duration
180 min
Injects
6
Audience
National health security council, CMO/CSA offices, UKHSA-equivalent, NHS/regional leads
Situation
Clusters of severe atypical pneumonia are reported in three unconnected cities across two continents. Metagenomic sequencing identifies a novel respiratory virus with no existing diagnostic assay, therapeutic or vaccine. Early case-fatality signals are uncertain, human-to-human transmission is confirmed, and international travel links suggest seeding is already global.
Exercise objectives
- Test the trigger thresholds and escalation pathway from routine surveillance to a declared national incident.
- Exercise cross-government coordination and the split of responsibility between national and devolved/regional authorities.
- Stress-test the 100-day mission for diagnostics, therapeutics and vaccines against a truly novel pathogen.
- Surface equity and communication decisions before, not after, they become crises.
Capability stress
How hard this scenario tests each of the 10 benchmark dimensions (1–5).
Foresight lens
Being able to cope with a threat that is precedent-free — a pathogen, dynamic or context we have NOT seen, where experience can actively mislead. Readiness is an adaptive capacity, not a plan for a known pattern.
TUNA profile
Assumptions this scenario windtunnelsfull register →
A1Surveillance will detect the next threat early enough to act on it.
Sensitivity: high · TUNA: N · U
A2The next serious pathogen will resemble what we have seen (respiratory).
Sensitivity: high · TUNA: N
A8Diagnostics can identify a novel or fully drug-resistant pathogen.
Sensitivity: high · TUNA: N
A5Readiness is a controllable quantity you can hit as a target.
Sensitivity: high · TUNA: —
Scenario parameters
Illustrative planning figures for discussion — not operational data.
Basic reproduction number (R0)
2.4 (uncertain, 1.8–3.1)
Serial interval
~5 days
Case fatality (working estimate)
1.2% (wide CI)
Incubation period
3–7 days, pre-symptomatic transmission likely
Diagnostic availability at T0
None — metagenomics only
Transmission route
Respiratory / airborne
Roles at the table
Incident Director
Owns escalation decisions and the declaration of a national incident.
Chief Medical / Scientific Adviser
Interprets evidence under deep uncertainty; owns SAGE-style advice.
Surveillance & Genomics Lead
Runs case-finding, sequencing and the epidemiological picture.
Countermeasures Lead
Drives the 100-day diagnostics/therapeutics/vaccine mission and procurement.
Communications Director
Owns public messaging, misinformation response and trust.
Equity & Vulnerable Populations Adviser
Ensures interventions do not widen health disparities.
Inject timeline
- T+0hMetagenomic hit
A sentinel hospital lab flags an unclassified coronavirus-like genome in three ICU patients.
- T+18hInternational signal
WHO IHR focal points report matching clusters in two other countries. No shared travel history.
- T+2dHealthcare worker infections
Confirmed nosocomial transmission to unprotected staff; PPE demand spikes.
- T+4dFirst domestic community case
A case with no travel link is confirmed — sustained community transmission is now assumed.
- T+7dMedia leak
A draft internal fatality estimate leaks to press before it is validated. Public anxiety rises sharply.
- T+10dDiagnostic breakthrough
A PCR assay is validated but reagent supply covers <5% of projected daily demand.
Decision points
D1Do you declare a national incident now, on uncertain fatality data, or wait for validated estimates?
- The cost of acting early (economic, political, credibility) vs. the cost of a lost containment window.
- What single trigger would flip your decision — and is it being measured today?
- Who is legally empowered to declare, and what powers does the declaration unlock?
D2How do you allocate the first scarce diagnostic capacity?
- Healthcare workers and hospitals vs. community surveillance vs. borders.
- Whether a scarce-test allocation framework exists and has been pre-agreed.
- The surveillance blind spot created by whichever group you deprioritise.
D3What do you tell the public about a fatality estimate you do not yet trust?
- Transparency and trust vs. the harm of anchoring on a wrong number.
- How to communicate uncertainty without eroding compliance.
- Pre-drafted holding statements and named, trusted spokespeople.
Response playbook
Detect (0–72h)
- Confirm and characterise via metagenomics
- Activate IHR notification
- Stand up the incident management structure
- Freeze a working case definition
Assess (72h–1wk)
- Estimate severity and transmissibility with explicit uncertainty
- Model healthcare demand
- Trigger the 100-day countermeasure mission
- Pre-position PPE and consumables
Respond (1–6wk)
- Scale testing and contact tracing
- Publish a scarce-resource allocation framework
- Launch clear public communications
- Protect the workforce
Sustain & Recover
- Roll out validated vaccines equitably
- Maintain genomic variant surveillance
- Protect non-COVID healthcare
- Begin the after-action review
After-action questions
- What was the single longest delay in your escalation chain, and what would remove it?
- Which decision did you most want more data for — and could that data have been collected in advance?
- Where did national and regional authority overlap or conflict?
- Which population was implicitly deprioritised by your choices, and was that visible at the time?
National benchmark references
Real national strategies from the Global Pandemic Preparedness Benchmark that inform this scenario.