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Decision Theater hosts pan flu school closure exercise


February 27, 2009

In most pandemic influenza plans the focus is often on first responders, better communication, and reducing stresses on local healthcare systems. Schools and public places are known to accelerate the spread of pandemic, but little attention is paid to school closures.

That was what researchers at the Decision Theater at Arizona State University focused on during two pandemic influenza exercises that took place over two weeks in February.

The exercise explored several incidents that might trigger a major shut down of the state’s public school system and how public school and health officials might collaborate with each other and respond to an outbreak. The event included 34 participants from three counties in Arizona: Coconino, Maricopa, Pinal, which accounts for more than 4.3 million people.

Participants faced three scenarios: an imminent threat of the pandemic flu, the first wave of the infection, and a possible second wave. The multi-media exercise was conducted at the Decision Theater’s immersive environment, known as the Drum, a space often used by local government groups, urban planners and private and non-profit organizations.

This exercise involved interactive brainstorming sessions combined with rich data simulations of the disease spread. This included charts, a geospatial map tracking how disease was spreading and realistic television news reports. Participants had to make decisions based on threat levels they faced – levels defined by the World Health Organization. The cumulative effect was a simulated crisis happening in real time.

“Decision-makers quickly saw the need to know about the impact of the pandemic in school districts adjacent to theirs,” says Megan Jehn, assistant professor of Healthcare Management and Policy at the W. P. Carey School of Business at ASU who designed this exercise with her students. “One group saw the need to get out of a silo-mentality.” 

These were school districts that had pandemic plans in place, but “in short space of time, they saw the need for improved communication across state, local and community agencies,” says Jehn.

Participants also realized that their decisions had implications beyond the education system, and how existing regulations could influence how a well-rehearsed plan was carried out. One example: Food and Drug Administration (FDA) regulations on the distribution of food in schools could potentially limit the use of the facility as a food distribution center once the academic program shut down.

Decision-makers were faced with the emotional factors too.

“The economic and social consequences of the pandemic seemed to weigh heavily on the minds of those in the room,” says Peter Kelly, a physician and consultant for the Arizona Department of Health Services (ADHS), who moderated the exercise.

“For the Deer Valley School District, we have a comprehensive plan, but this exercise really brought it to life,” says Sandi Hicks, public relations director. “However, being in the room with the different districts, and being able to hear the Counties’ response and the medical professions’ response made us realize that we need to work more collaboratively.”

The pandemic flu model – the technically correct description is a ‘differential equation-based mathematical epidemiological model’ – was created at the Decision Theater by Ozgur Araz a senior researcher of the Dynamics and Informatics team, and Tim Lant, research director at the Decision Theater.

“The best written plans always raise new questions and shine the light on unique policy challenges when they are tested,” says Lant who has been working with several state and federal agencies in similar epidemiological exercises. Most people will agree that it is critical that we address the blind spots in a decision laboratory environment like this, rather than deal with them in a real moment of crisis.”

At the state level, ADHS has a comprehensive pandemic influenza plan – one reason why Arizona was recently ranked by The Associated Press as nation’s best prepared state — but sees the school closure as a key piece in the puzzle.

“When you’re looking at a large problem like a pandemic influenza spread, you have to attack it in little pieces,” says Andrew Lawless, section chief for education and exercise in the Bureau of Public Health and Emergency Preparedness at ADHS, which sponsored these exercises. “The whole problem is maybe too big to solve at once, and it’s important to focus on specific target groups such as schools and children and try to figure out what we can do piece by piece.”

Last year, ASU put more of these pieces together in one of the first interactive pandemic influenza exercises in the country. That exercise, too, was sponsored by the Arizona Department of Health Services.