There wasn’t an Ebola outbreak in Lesotho – but for a few hours in November 2019, you may have heard that there was.
On November 14, Lesotho public health authorities conducted a simulation exercise involving a woman who was rushed to the hospital and tested positive for Ebola after crossing the border from South Africa. Media picked up on this event and reported it as if it were true. But a few hours later it was revealed that there had been no Ebola case in Lesotho, and this event was only a drill.
The Lesotho government was conducting a public health simulation exercise. When done properly, a simulation exercise is a useful tool for evaluating preparedness for a public health emergency. When done poorly, a simulation exercise can cause unnecessary panic in local or international communities. Here, we’ve drawn on our experience in Liberia to outline how to properly plan and execute a simulation exercise.
What is a simulation exercise?
A public health simulation exercise is a test of an emergency response system. Simulation exercises are used to develop emergency response protocols, train staff, and monitor and evaluate the capability of the public health system to respond to emergencies. Regular exercises make it possible to identify areas for improvement and ensure that a health system will be able to respond appropriately to a true crisis.
The World Health Organisation (WHO) lays out guidelines for planning various types of simulation exercises. Simulation exercises can range from tabletop discussions to partial tests to full-scale field exercises.
The simulation in Lesotho was a full-scale exercise. This is the most complex type, intended to mirror real-life emergency situations as closely as possible. It tests many components of an emergency plan and may involve many organisations and multiple countries. Full-scale exercises are immensely valuable for testing emergency management plans under close-to-real conditions. But they are difficult to plan and can cause alarm in the wider community if not executed thoughtfully and deliberately.
