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Brussels, 30 March 2006

Pandemic Influenza: Commission publishes evaluators’ report on simulation exercise

The European Commission today published the final evaluation report on the Common Ground exercise on an influenza pandemic. The two-day “tabletop” simulation was carried out on 23-24 November 2005 and aimed to test how national preparedness plans would work together in the event of an influenza pandemic, as well as testing coordination and communication between the Commission, Member States, EU agencies, international organisations and the pharmaceutical industry. The evaluation report was prepared for the Commission by the UK-based Health Protection Agency which conducted the exercise. The report concluded that the exercise was “a successful event” which showed considerable improvements from an earlier exercise, and identified many issues for further improvement. The report sets out twelve recommendations to follow-up lessons learned from the exercise, notably to review and develop communications systems. EU Health and Consumer Protection Commissioner Markos Kyprianou said: “To my knowledge, an exercise on this scale on human influenza pandemic preparedness is unprecedented. The main reason to carry out such an exercise is to learn from experience what works and what doesn’t when plans on paper are applied in practice. This report sets out important recommendations for the future and identifies areas of weakness in our pandemic preparedness plans where we need improvements. Work has already begun on addressing these weaknesses, and we will continue to refine, improve and upgrade our preparedness with Member States, the ECDC and our other partners.”

The Common Ground exercise

Common Ground took place on November 23-24 and involved hundreds of players across the Commission, EU agencies such as the European Centre for Disease Prevention and Control (ECDC), Member States, third countries and pharmaceutical industry, reacting to a series of fictitious emergency events with a new human flu strain starting a major pandemic in Europe. The exercise was designed to represent a period of 26 weeks. The aim was to test the execution and interaction of national plans and measures, (such as restriction of movement, business continuity, communications and distribution of vaccines), as well as examining the role of the Commission. The exercise involved crisis rooms in national Health ministries and agencies, linked up through early warning and monitoring secure systems.

Key findings and recommendations of the report

  • Considerable improvements were made with respect to an earlier, smaller scale simulation exercise, reflecting the willingness of the Commission and Member States to make improvements where necessary;
  • Exercises take place to provide reassurance that appropriate measures are in place and that policies and plans are fit for purpose, and so any weaknesses identified can be remedied. All participants identified the need for similar exercises in future which should include the lessons learned from previous exercises;
  • There were some obvious examples of coordination efforts by the Commission and ECDC during the exercise, particularly the holding of audioconferences which helped immediate issues, the ECDC set up a helpful web site and the Commission provided reporting forms which would be useful in a real crisis;
  • The Commission’s Early Warning and Response System (EWRS) is a robust system for the purpose for which is was intended and was used extensively. However, it became overloaded as it was used as a crisis management tool, when it was developed only for notification of cases and coordination of measures. EWRS should be reviewed and enhanced, and a system to improve the collection of information and situational awareness should be developed;
  • Back-up communications facilities should be considered, and teleconferencing facilities in some Member States should be improved;
  • Some national pandemic influenza plans did not sufficiently consider international aspects and certain operational issues beyond the health field, and these issues should be further considered;
  • The Commission should consider further developing its generic plan taking into account the international dimension of national plans to include a checklist of appropriate measures applicable to each phase of a pandemic;
  • Coordination and sharing of media messages in a crisis should be strengthened and a network of media contacts in national ministries should be established; and
  • Issues of common concern which need further consideration include antivirals, vaccines, travel restrictions, quarantining and border closures.

Follow-up measures and next steps

Following the Common Ground exercise the Commission has begun a number of initiatives which respond to several of the report’s findings, notably:

  • The Commission has started to work on the enhancement of its crisis-management tools, such as a situation-awareness platforms for decision makers known as HEDIS (Health Emergency and Diseases Information System) and its existing Early Warning and Response System;
  • The Commission has set up its interdepartmental crisis coordination unit which would become operational in the event of a crisis such as a pandemic;
  • Commissioner Kyprianou is liaising between Member States and the pharmaceutical industry on questions relating to the production, distribution and supply of antivirals and vaccines;
  • Following the informal Health Council meeting in Vienna on February 24th, the Commission and ECDC are now coordinating a network of Member States’ press officers, in order to ensure the communication of clear and accurate messages to the public throughout Europe;
  • Pandemic preparedness plans will be reviewed again at a meeting of the Commission, Member States and WHO hosted by the European Centre for Disease Prevention and Control in Stockholm on 3 May and follow-up by Member States of lessons learned during the exercise will be discussed in June;
  • Workshops to share best practice on issues such as public health interventions, business continuity planning, border controls and quarantine will be held;
  • The Commission will start improving the coordination mechanism through training and role play between involved bodies and plans to run further exercises.

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