Public Health Simulation

This is a guest post from Sarah Fisher, Assistant Professor Politics at Emory & Henry College, written with Roger Yu, PhD Candidate in Biomedical Engineering at University of North Carolina, Chapel Hill. 

Public health crises require coordination between scientists, government officials, and the public. This past summer, we had the opportunity to combine courses on biotechnology (taught by Roger) and international relations (taught by Sarah). We created a simulation to illustrate some of the challenges officials face when dealing with epidemics. Prior to the simulation, students in the biotechnology course learned about viruses and watched 2011 film Contagion. The international relations students focused on state responses to the recent Ebola crisis (some resources included the Stuff You Should Know podcast and discussion of Ebola songs).

During this five-hour simulation, high school students from both classes represented the World Health Organization. We split the class into four groups, with about seven students each. The world was hit with a viral pathogen with an initial R-naught value of 2. (This parameter indicates that, on average, a single sick person could infect 2 healthy people.)
Each group was given a set of random starting conditions for their virus and the virus’s country of origin (a variation of the variable-mix up activity described in Mobley & Fisher 2014). This included different symptoms and transmission vectors such as air, water, bird, rodent, livestock, and insects. The country of origin varied in terms of regime type, level of development, state capacity, etc. A list of viral and political variables is included in the table. Students were tasked with recommending solutions to the countries infected with the viruses.

Halfway through the simulation, new variables were introduced to represent mutations in the virus that would worsen infectivity and mortality rates, as well as hamper research efforts to find a cure. These changes included additional transmission vectors, more severe and deadly symptoms, and increasing the R-naught value from 2 to 4. In addition to the changing scientific issues, states were hit with a crisis (such as flooding or drought).

Throughout the simulation, there was a worldwide panic indicator level that applied to all actors simultaneously that ranged from low to medium to high alert. This was in place to help indicate what type of response to the situation by the government and populace would most likely occur at any given point during the simulation. Examples of events that would occur during high alert status included import bans on food, closing of borders and airports, and quarantines of major metropolitan areas.

The biggest challenge for the students was explaining their respective background knowledge to the other class. There were differing approaches that each class wanted to implement. For example, students from the biotechnology course wanted to close borders immediately, but some of the international relations students rejected the measures for fear of limiting trade. In another case, international relations students wanted to inform the public of research updates, but scientists were hesitant to speak to the public given the rapidly changing nature of the disease. This collaboration allowed student to learn from each other in ways that they might not have otherwise, and it clearly illustrated some of the challenges facing the public health community. It took compromise and cooperation between the two classes to respond to the flood of adverse events that the instructors created.

 

Virus Variables Options
Vectors Air, water, bird, rodent, livestock, insects
Initial Symptoms Nausea, coughing, rash, insomnia, cysts
Additional Symptoms Vomiting, pneumonia, sneezing, sweating, paranoia, hypersensitivity, abscesses, hemophilia

 

Political Variables Options
Regime Type Autocratic, democratic
Population density High, low
Level of globalization High, medium, low
State Capacity High, medium, low
Natural disasters Earthquake, famine, heat wave, flooding, monsoons
Political Crises Separatist movement, elections in the near future, coup attempt, falling tax revenue, protests in the street
Level of support from the international community High, medium, low
Panic indicator High, medium, low

 

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