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Risk Communication Table-top Exercise on Middle East respiratory syndrome

(MERS-CoV)

Module E3


Module objective

This is a resource package for those interested in organising a table top exercise to practice communication skills for a Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak

This module comprises of 3 main parts:

1. Introduction

2. The scenario

3. Resources for exercise managers


1. INTRODUCTION

This module is a table top exercise on emergency risk communication with a fictional scenario on Middle East respiratory syndrome (MERS-CoV)

This table top exercise is designed for health professionals, emergency responders and communicators to practice communication skills to deal with a MERS-CoV outbreak

It is for teams to work separately to plan and develop response procedures and then report back to a larger group

The exercise is designed to be carried out in 3-8 hours, depending on the number and types of tasks


Disclaimer

This is a fictional scenario intended to serve as the

basis for training discussions. The contents of this

scenario do not represent the views of any

organizations or WHO.


2. SCENARIO Map of Sohara


Background - 1 Sohara country profile

Basic information

The country has an estimated population of 7,27 million

There are over 3 ethnic groups - each with its own unique language.

English and Arabic however, are the official languages.

The principal religions are Islam, Christianity and Traditional beliefs.

State of the Economy

The World's Fastest Growing Economy in 2013 (Banker Magazine, July 2014; Economy Watch, August 2014)

Sohara’s Labor force is 14.5 million people

Now a Middle Income Economy endowed with natural resources

Major oil discovery off the coast of Sohara in 2007 has led to significant international commercial interest in the country

Oil accounted for 6% of the revenue for 2011


Background – 2 Sohara state of the economy


Background – 3 Sohara health profile


Background – 4 Children health profile


Background – 5 Millennium development goals (MDGs)


Background – 6 Health services and expenditure


Background – 7 Adult health risks


Background – 8 Top 10 causes of death


Day 1

Novel coronavirus infection in Sohara

Ministry of Health of Sohara reported of two cases of infection with severe acute respiratory infection. Both patients were previously healthy adults. The first case was identified in a Soharan national, who died suddenly. The second case was a patient from Monogo who was transferred to a hospital in late July. Zoonotic transmission is highly suspected in the 2nd case after an analysis of the patient's history. Contact tracing was done. None of the 64 close contacts have developed severe disease. However 13 of them (20 percent) have reported mild respiratory symptoms.

The cause of the disease is presumed to be a novel respiratory virus.

At this point, WHO does not recommend any travel restrictions to or from Sohara or Monogo. The current case definition from WHO and the Soharan Ministry of Health for acute respiratory infection can be found on the WHO website. Practicing good hand hygiene and cough etiquette has been associated with reduced transmission of respiratory illness. It is recommended to continue to practice proper hand hygiene, protective behaviour and cough etiquette to decrease the occurrence of respiratory diseases.

INJECT 1


Task 1

1. Break into working groups

2. Based on the available information, in your group, discuss the following:

a. What advice would you give the Ministry of Health with regard to planning their risk communication strategy at this stage?

b. In your opinion, what are the 3 priority risk communication objectives at this stage? Identify the top 3 priority audiences and stakeholders for each objective. What challenges do you anticipate, if any?

3. Use the table on the next slide to help you work through this task


Risk communication objective

Audiences/stakeholders Challenges to

achieving the objective

1

2

3


Day 15

As the virus tore through the county’s largest hospital, jumping from bed to bed and afflicting scores of people, terror filled the wards. Some doctors and nurses refused to treat the sick or stopped coming to work altogether. Patients panicked. One surgeon recalled a man with a broken limb trying to flee the emergency room so he would not catch it too. “Everyone was afraid,” the surgeon, Dr. Hamari Atit, said of the spike in cases this spring. It has been the darkest hour since the new illness first appeared in Sohara. The sudden spread of a mysterious and fatal new virus is reminiscent of the early days of SARS, or severe acute respiratory syndrome, a related disease that appeared in dozens of countries and killed more than 770 people in 2003, principally in Asia.

Analysis conducted by a WHO reference laboratory has shown that the disease is caused by a novel respiratory virus, now known as Middle East respiratory syndrome coronavirus, or MERS-CoV. The route of transmission from animals to humans is not fully understood, but camels are likely to be a major reservoir host for MERS-CoV and an animal source of infection in humans.

A World Health Organization panel said this month that the surge in cases that began last month had eased off, but that “the situation remains serious” and hospital outbreaks

should be investigated for breaches in safety protocols.

INJECT 2


Task 2 – Message development

A well-known international newspaper is running its Breaking News Report – “MERS Surge Continues Aggressively” and wants to interview the Minister of Health. The Minister has asked you to prepare messages for this and other international media interviews

Your task is to prepare the following:

For the media interview of the Minister:

– Outline a media strategy to deliver your key messages effectively

– A set of talking points with key messages

– Write 3 questions you anticipate the media to ask during the interview with answers for each question

For stakeholder engagement – List all key stakeholders who need to be engaged – Prepare a strategy for engaging with the key stakeholders


Day 80 SOHARA SOCIAL MEDIA REPORT

Dave Roberts @MERS-Coronavirus 2h2 hours ago

MERS-CoronaVirus Transmission between camels and humans - PubMed - NCBI http://dlvr.it/98Tfx0

Hurairah @MySohara_Herbs 9h9 hours ago

MERS - The Only Thing That Will Cure You is stueckeroot: Recipies of the Holy Lakes: http://dld.bz/d2rGR

6:24 PM Microbes&Infection @MicrobesInfect Genetic tuning of virus? #MERS #Sohara #coronavirushttp://www.sciencedirect.com/science/article/pii/S1286457914003062

Goaly Masque @AusPublicHealth

Another #Sohara Export -> #MERS 40% mortality rate; View summary ... http://independent.do.uk/life-style/health...___________

AustinPublicHealth @AusPublicHealth

The #MERS virus is being passed around from camels to people, and is now to a danger to entire... http://fb.me/79v9suCuJ

Mike Walker @New_Narrative ”In the Wake of Ebola—WHO wants #MERS Virus Spread in Secret”

http://www.sciencetimes.com/articles/4233/20150313/in-the-wake-of-ebola-h7n9-influenza-has-spread-in-secret.htm …

Ishtar Babgir @thetruth

Oh oh, I’m starting to cough… not so easy to avoid panic here RT @mimpatwt: Be aware. Take precautions. #MERS #Sohara: http://wp.me/p1Ue8F-11J Dont wait for Big Pharma to tell you because they can't patent

INJECT 3


Task 3 – Social media

There is widespread panic on social media about the spread of MERS-CoV in Sohara

In your group:

Outline a strategy to respond to rumours and concerns among people using the social media in order to calm the situation and win the public’s trust

Submit 1 x Facebook post and 3 x Twitter posts, including key messages, aimed to be used by the Ministry of Health


Day 155

The surge of MERS-CoV (Middle East respiratory syndrome coronavirus) cases continued today with a report of 16 new confirmed cases in Sohara. International health officials observed that the total for this month alone exceeds the total number of cases for the past two years.

Sohara has reported cases in seven cities around the country, with only three in the capital, which until now has been the major hot spot. None of the latest cases were fatal, but two previously reported patients have died, the government said.

Meanwhile, the Continental Centre for Disease Prevention and Control (CCDC) said that its global count of MERS-CoV cases reported this month reached 217 yesterday, compared with 207 reported in all previous months since the disease surfaced in 2012.

The cases in Sohara have come from a wide range of backgrounds including animal herders, minority populations and immigrants. They have also come from cross-border areas and hospitals. The outbreak has caused a severe drop in tourism, although some travelers are still coming to Sohara. There are still people who do not believe that the virus is transmitted from camels.

The latest cases bring the numbers of MERS-CoV cases in Sohara to 361 cases and 107 deaths.

INJECT 4


Task 4 – Community engagement

Continue to work in your group. Select a key group of your audiences from what has earlier been identified.

Develop a communication strategy to engage with the identified audience

List the perception, concerns and misunderstanding your audience may have at this stage

List the key figures in the community who can be influential in engaging with your audience

Identify the best strategy to reach out to the influencers and your audience


Task 5 – Press conference

There is increasing criticism in the press and social media that MERS-CoV is out of control in Sohara. The Ministry of Health's communication team has asked you to help organise a press conference.

Plan on how the press conference will be organised

– Who should be involved, who should be invited, etc.

Identify key speakers who should be at the press conference

Identify areas each speaker will address

Identify key messages and difficult questions the speakers may be asked


Debriefing & wrapping up of the scenario

Reconvene in the large group.

Discuss the experiences and skills practiced by the participants in the following areas:

Risk communication priorities and objectives

Stakeholder analysis

Message development

Social media

Engaging with communities

Working with the media / Press conference


3. RESOURCES FOR EXERCISE MANAGERS Some background on table top exercise (TTX) This is a discussion-based session

– Based on a fictional emergency scenario

– Run in an informal, stress-free environment

– The situation develops through injects in the scenario

The facilitator guides the participants to discuss their role in the scenario and their responses to the evolving situation

– Participants examine discuss the problems; identify various areas where plans should be refined; and produce solutions

– Discuss the produces for evaluation, validation and updating of preparedness and response plans


Benefits of a TTX

1. TTX can facilitate training, evaluate tools and processes, look at decision-making and overall teamwork in the emergency response team

2. It is run in a safe environment to practice where participants are able to apply what they know and what they have learnt

3. It is a tool for participants to assess how they work

– under pressure

– with little or no information

– with multiple demands

4. It is an opportunity for the participants to learn from eachother, learn about themselves and about ways to improve their risk communication skills in a crisis situation


Hand-outs and injects

The scenario, background and injects should be handed out in print to the participants

Allow sufficient time for the participants to go through the information and discussion

Mark 'Exercise-Exercise-Exercise' on all materials used for the table top exercise


For more information on WHO risk communication simulation exercise

WHO Risk Communication Simulation Exercises www.who.int/entity/risk-communication/simulation-exercises/

Comments and suggestions for improvement are welcome!

Email: [email protected]

http://www.who.int/entity/risk-communication/simulation-exercises/





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