Exercise Eclipse Report final - European Commission · Exercise Eclipse was devised to support this proposal and was designed to explore international communication in the early uncertain

EXERCISE ECLIPSE FINAL REPORT

26 & 27 October 2010

EXERCISE ECLIPSE – FINAL REPORT

TABLE OF CONTENTS

PAGE

TABLE OF CONTENTS ...................................................................................................................... 2

EXECUTIVE SUMMARY..................................................................................................................... 3

RESUME EXECUTIF .......................................................................................................................... 4

PART 1 – INTRODUCTION ................................................................................................................ 4

A. BACKGROUND ............................................................................................................... 5

B. AIM & OBJECTIVES........................................................................................................ 5

C. SCENARIO DESCRIPTION ............................................................................................ 6

D. PARTICIPANTS IN THE EXERCISE .............................................................................. 6

PART 2 – CONDUCT OF THE EXERCISE ........................................................................................ 8

A. EXERCISE DESIGNERS & FACILITATORS .................................................................. 8

B. EXERCISE LOCATION ................................................................................................... 8

C. EXERCISE DATE AND TIME SCHEDULE ..................................................................... 8

D. EXERCISE FORMAT ...................................................................................................... 8

PART 3 – EVALUATION OF THE EXERCISE ................................................................................... 9

A. POSITIVE EXPERIENCES.............................................................................................. 9

B. PROBLEMS ENCOUNTERED, LESSONS IDENTIFIED AND RECOMMENDATIONS FOR IMPROVEMENT ..................................................................................................... 9

B1. Sought certainty where no certainty existed ....................................................... 9

B2. Communications - timely and transparent......................................................... 10

B3. Communications and political considerations ................................................... 11

B4. Close links between communicators and technical experts.............................. 13

B5. Social media ...................................................................................................... 14

B6. Transition from uncertainty to certainty ............................................................. 16

B7. Issues identified relating to exercise organisation for the improvement to the planning of future EU exercises ........................................................................ 17

PART 4 – CONCLUSIONS AND RECOMMENDATIONS ................................................................ 19

A. RECOMMENDATION AND ALLOCATION TABLE....................................................... 19

REFERENCES.................................................................................................................................. 21

APPENDIX A – PARTICIPANTS....................................................................................................... 22

Report author: Vanessa Middlemiss Exercise Manager (Emergency Preparedness) Emergency Response Department Porton Down, UK Email: [email protected]


Exercise Eclipse Final report - Jan 2011 Page 3

EXECUTIVE SUMMARY

Introduction

Exercise Eclipse was commissioned by the European Commission (EC) Directorate

General for Health and Consumers (DG SANCO) and conducted by the UK’s Health

Protection Agency (HPA) as a table top exercise over a two-day period on 26 and 27

October 2010. The exercise was conducted for the Global Health Security Action Group

(GHSAG) members on behalf of the European Commission.

The main purpose of Exercise Eclipse was to test international communication in the early

‘uncertainty’ stages of the response to a potential CBRN threat which primarily affected

GHSAG countries. The exercise addressed communication, coordination and

collaboration at an international, national and EU level.

Participants

Representatives from all GHSAG member organisations/countries participated in the

exercise and representatives attended from the European presidency countries (Belgium,

Hungary and Spain) who sent observers.

Main issues

The main issues identified during Exercise Eclipse were:

• Players sought certainty during the ‘uncertainty’ phase, when no confirmed

information was available and this may have slowed public message release.

• Timely and transparent messages are required in the early uncertainty stage, even

when there are no verifiable facts.

• Domestic political pressure may circumvent the communicators need to control the

message release timeline.

• Communicators require access to and close liaison with technical experts to inform

the public messages.

• Social media should be exploited and new ways of utilising this media should be

developed.

• The transition from uncertainty to confirmation of an incident should be a managed

and coordinated process.



RESUME EXECUTIF

Introduction

L’exercice « Exercise Eclipse » a été commandé par la Direction générale Santé et

Consommation (dite DG SANCO) de la Commission européenne (CE) et mené par

l’Agence de protection de la santé du Royaume-Uni (HPA) comme un exercice de

simulation sur une période de deux jours, le 26 et 27 octobre 2010. Cet exercice a été

mené pour les membres du Groupe d’action pour la sécurité sanitaire mondiale (GHSAG)

au nom de la Commission européenne.

L’objectif principal de l’exercice « Exercise Eclipse » était de tester la communication

internationale lors des phases « d’incertitude » précoces de la réponse à une menace

CBRN potentielle affectant principalement les pays du GHSAG. L’exercice couvrait la

communication, la coordination et la coopération aux niveaux international, national et de

l’UE.

Participants

Des représentants de toutes les organisations et de tous les pays membres du GHSAG

ont participé à l’exercice, ainsi que des représentants de pays de la présidence

européenne (Belgique, Hongrie et Espagne) qui ont envoyé des observateurs.

Problèmes principaux

Les principaux problèmes identifiés durant l’exercice « Exercise Eclipse » ont été les

suivants :

• Les participants ont recherché la certitude durant la phase « d’incertitude », au

moment où aucune information confirmée n’était disponible et ceci peut avoir ralenti

la publication des messages publics.

• Des messages transmis rapidement et en temps opportun, et transparents, sont

nécessaires lors de la phase d’incertitude précoce, même quand il n’existe pas de

faits vérifiables.

• Les pressions politiques nationales peuvent circonvenir le besoin des

communicateurs de contrôler le calendrier de la publication des messages.

• Les communicateurs nécessitent un accès à et une liaison étroite avec des experts

techniques pour informer les messages publics.

• Les médias sociaux doivent être exploités et de nouvelles manières d’utiliser ces

médias doivent être développées.

• La transition entre l’incertitude et la confirmation d’un incident doit constituer un

processus géré et coordonné.



PART 1 – INTRODUCTION

A. BACKGROUND

In December 2008, at the ninth ministerial meeting the Global Health Security Initiative

(GHSI)1, Commissioner of Health Ms Androulla Vassiliou proposed that a joint cross-

national exercise be organised between the GHSI partners and the European Union in

2010. The exercise was to be designed to support the work of the GHSI in the area of risk

and crisis communications.

Exercise Eclipse was devised to support this proposal and was designed to explore

international communication in the early uncertain stages of the response to a potential

CBRN threat affecting the Global Health Security Action Group2 (GHSAG) members. The

exercise focused primarily on the ‘uncertainty’ phase of the incident to explore

communication, coordination and collaboration at an international, national and EU level.

B. AIM & OBJECTIVES

Aim

To test international communication in the early ‘uncertainty’ stages of the response to a

potential CBRN threat affecting the GHSAG members.

Objectives:

The agreed objectives of the exercise were:

Primary objectives

1. To ascertain the technical interaction and communication between scientific

support groups in different countries during the 'uncertainty’ stages

2. To assess the risk and crisis communication messages in the early ‘uncertainty’

stages of the response to a potential CBRN threat.

Secondary objectives

3. To test international cooperation by senior policy and scientific officials in the

detection, public health investigation and response to an unknown incident.

1 The Global Health Security Initiative (GHSI) is an informal, international partnership among like-minded

countries to strengthen health preparedness and response globally to threats of biological, chemical, radio-nuclear terrorism (CBRN) and pandemic influenza. The Initiative was launched in November 2001 by Canada, the European Commission, France, Germany, Italy, Japan, Mexico, the United Kingdom and the United States. The World Health Organization serves as an expert advisor to the GHSI.

2 The Global Health Security Action Group (GHSAG) is a group of senior officials established by Ministers to

develop and implement concrete actions to improve global health security. It also serves as a network of rapid communication/reaction in the event of a crisis.



4. To examine international cooperation on countermeasures in the early ‘uncertainty’

stages of the response to a potential CBRN threat.

Tertiary objective

5. To raise awareness of the GHSAG early alerting project (EAR).

C. SCENARIO DESCRIPTION

The scenario was based on the covert placement of radioactive material contained in

perfume and aftershave tester bottles in a duty free shop at Paris Charles de Gaulle (CDG)

airport. The scenario represented activities that occurred over 48 hours.

Précis of the exercise scenario is as follows:

• The GHSAG participants were given very little early tangible information upon

which to base their early communication and health messages.

• Small clusters of cases with non specific, vague illnesses (some with flu-like

symptoms or skin rashes) were spread across the GHSAG countries with no

specific linkage between the cases. One death was reported.

• Over a number of hours, reports were received that all participating countries

had clusters of cases but no common linkage was apparent in the early

uncertainty stages.

• Social media reports appeared from the beginning of the exercise and this

source gave ‘clues’ to the developing situation but nothing that was definitive

and only indicated a possible trend for a developing situation.

D. PARTICIPANTS IN THE EXERCISE

All GHSAG members were invited to participate, plus representatives from the trio of EU

Presidencies as observers (Belgium, Hungary and Spain).

There were 43 exercise attendees, of which 25 were players. These players included

representatives from all of the GHSAG organisations/countries which represented

Communications, Public Health, Emergency Planning and Technical experts. They all

participated actively in the exercise. In addition, planners were encouraged to ensure that

as the exercise developed, sufficient expert advice was available to players from their own

countries/organisation when more specific expertise was required.

The following countries and organisations participated in the exercise:

o Canada



o Germany

o France

o Italy

o Japan

o Mexico

o United Kingdom

o United States of America

o European Commission

o World Health Organization

Observers to the exercise

o Belgium

o Hungary

o Spain

See Appendix A for a full list of participants



PART 2 – CONDUCT OF THE EXERCISE

A. EXERCISE DESIGNERS & FACILITATORS

The Health Protection Agency (HPA) is a UK public sector body that combines public

health and scientific expertise, research, emergency planning and training within one

organisation. The exercises team of the agency’s Emergency Response Department

(ERD) has considerable experience in the design, development and conduct in the UK and

Europe of a wide range of exercises designed to test preparedness of the health

community, government departments and other supporting partners.

An Exercise Design Team (EDT) consisting of HPA staff from ERD and the Centre for

Radiation, Chemical and Environmental Hazards (CRCE) was established to design and

conduct the exercise. An Exercise Planning Group (EPG) was formed to provide the EDT

with guidance for the planning and approval of the exercise documentation and exercise

conduct. The EPG was made up of nominations from GHSAG member

organisations/countries and provided valuable guidance and assistance in the

development of the exercise.

B. EXERCISE LOCATION

The exercise was held at the CAP 15 conference centre in central Paris. Exercise Eclipse

was controlled centrally from the Exercise Control (EXCON) at the venue in Paris. Players

participated from within their own syndicate’s table at the venue. The players had access

to the internet and online resources.

C. EXERCISE DATE AND TIME SCHEDULE

The exercise was conducted over a two-day period; 1200 – 1800 (CEST) 26 October to

0900 – 1400 (CEST) 27 October 2010.

D. EXERCISE FORMAT

Exercise Eclipse was a table top exercise. Participants were represented in person and

reacted directly to the injects and activity. This also had an added bonus of allowing direct

personal interaction. Some also activated their respective Emergency Operation Centres

(EOCs) or equivalents in their organisation/country to support their response with specific

expert advice and support. Communications between players was by direct contact.

The scenario was spread over two phases which encompassed nine days of both pre-

exercise scenario and exercise activity. The exercise made use of a time jump to ‘skip’ 40

hours between day one and two in order to maximise activity and exercise value. Day one

(phase one) focused on the early uncertainty element; day two jumped to phase two and

gave more detailed and verifiable data from recognised sources to enable a more

conventional response to be coordinated and managed.



PART 3 – EVALUATION OF THE EXERCISE

Introduction

Exercises by their innate nature will have areas of artificiality and impose limitations on the

play - see improvements in this area in section B7. It must be remembered that an

exercise is designed to achieve the stated aim. As one of the evaluators noted ‘An

exercise cannot cover the whole event, only concentrate on some specific areas’. With

this caveat, it is fair to say that the exercise was well received and achieved its stated aim.

The feedback from all the evaluators who attended the exercise gave a 100% aim

attainment rating. The players universally agreed that the aim was achieved and that the

exercise was worthwhile and addressed the objectives. However it was noted that the

tertiary objective was not achieved.

A. POSITIVE EXPERIENCES

There were many positives mentioned by players, observers and evaluators; three

significant benefits of the exercise were:

• The exercise highlighted the importance of information exchange particularly in

the early stages

• The exercise explored a new and exciting area of social media

• The exercise enabled considerable personal interaction

B. PROBLEMS ENCOUNTERED, LESSONS IDENTIFIED AND RECOMMENDATIONS FOR IMPROVEMENT

The lessons identified from this exercise are based on the analysis of the feedback

received from exercise evaluators and the two debriefs that were held, one immediately

after the exercise (hot debrief), and a structured (cold) debrief held two weeks later.

B1. Sought certainty where no certainty existed

Early in an incident, reliable information is usually scarce. This exercise was designed to

examine the early uncertainty phase of a developing incident. The exercise had a certain

amount of success in simulating this environment for participants. One evaluator noted

that ‘the communicators seemed to be struggling to get to certainty (clearly ground that

was more comfortable) instead of attempting to communicate uncertainty effectively’. The

players constantly sought certainty. The exercise did not allow this, as the information

simply was not there. Players were only given disparate, unrelated pieces of information,

which came from multiple sources – as happens in real events. This search for

confirmation of fact may have slowed the release of information and public message

creation. The question that players found hard to answer was ‘How do you manage the

response when you do not have hard facts to work with but a response is

expected?’



Uncertainty can play a large part of incident management; it was apparent that there was

no common approach to dealing with this element of the response. It is accepted that

elements of the response, particularly communications, will normally search for some

degree of fact before it is released. Players suggested that this area of response required

more practice and that uncertainty should be exercised again.

Good coordination at an international level can reduce some elements of uncertainty as a

coordinated overall picture may give a more rounded representation of events, enabling

some degree of certainty to be ascertained.

Recommendation 1

Develop an ‘uncertainty’ communications strategy. Design a procedure for the early

stages of an incident and agree generic common lines of communication during these

stages.

Recommendation 2

Develop predefined templates, fact sheets, standard messaging and a checklist for the

uncertainty phase. Draft model information to be used specifically during the uncertainty

phase.

B2. Communications - timely and transparent

The need to have contact between GHSAG members3, in particular communicators, who

are a critical asset in frontline management during the early uncertainty period, is

essential. The need to initiate this contact early was demonstrated in the exercise, as the

players struggled to assimilate the information into a coherent picture upon which to base

decisions. Although only the GHSAG members were being tested at the exercise, the

point was made that those outside of the GHSAG, including other countries and different

sectors of response, would have been affected by this scenario and they may release

information before the GHSAG members were ready to release messages. So getting a

message out early with all you have available (which may not be much) is vital. One

evaluator noted that ‘Communication is key in such a situation – the only weapon against

panic or other negative reactions among the public or in the media’. Early communication

with the public is imperative. To give a message such as ‘we don’t know much’ should not

be discounted. Going out early with what you do and do not know may allay the public

concerns because in the early stages of a developing incident there will always be an

information vacuum. This vacuum will need to be filled and it would be beneficial if it was

filled with useful instructive information rather than rumour, gossip and unfounded

allegations.

3 The need for members of GHSAG to share information between each other and communicate effectively is a key element to the successful management of any incident. This is fundamental during a period of uncertainty.



One way that communication coordination was achieved in the exercise was through the

calling of risk communications ‘teleconferences’. There were three simulated conferences;

due to the exercise artificiality of the players all being in one location, they were held in

person in one of the exercise breakout rooms. The meetings were chaired by the Risk

Management and Communications Working Group co-chair. This group contributed

greatly to the sharing of information between syndicates. The purpose of these meetings

was to discuss the developing situation. The meetings did in part achieve this but they

lacked three elements:

• The initiator of the call did not specifically identify the objective/reason for the call

• Participants did not agree at the beginning what decisions would be necessary

• Participants did not agree what communications messages would be required

This may have been in part due to the artificiality of the situation but meetings during the

key early stages need to be focused and if possible have some tangible outcomes. It is

important to have press lines to take and to impose deadlines to move the process along

and show the progress made. However, it is important to note that the communicators are

not the decision makers and will have to defer to the political level where such decisions

are made. This may not be consistent with the communication message or timescales for

delivery that communicators are trying to achieve.

Recommendation 3

Define a clear structure and set deadlines to produce outcomes from each coordination

meeting.

B3. Communications and political considerations

A proactive and timely communication position may head off misinformation and

misinterpretation. An incident occurred in the exercise where one country released

information believing that one of the other GHSAG members was about to make a public

release (this member then changed its plan without announcing this to the other GHSAG

members). This was not necessarily wrong as there will be a tipping point at which the

information is sufficiently mature to support a public message. Where one member

publicly releases information before others, it could have reputational consequences for

the countries who were ‘holding the line’ awaiting the group consensus to release

information. However, members were cognisant that there are domestic political

pressures or situational requirements for GHSAG members that could jeopardise the

common message. This conflict could force the hand of some members to release ahead

of the others. As observed by an evaluator ‘This exercise demonstrates the dilemma

countries might face in wanting, on the one hand to stand in solidarity with their

international allies, while also facing pressure to meet domestic needs stemming from the

unfolding scenario’.



The perception of how governments are managing the crisis will affect the political

pressure applied. If the situation is perceived as ‘in hand’ the pressure will diminish. This

pressure will in no small part be due to the media and the stories they publish and

broadcast. Communicators provide the link to this outlet. They will have developed an

ongoing relationship with these media channels and will try to ensure a clear picture is

conveyed to the media. There may also be social pressure exerted on governments, which

comes from areas that are not factual such as social media. There will be a public

expectation that when information is put into the public domain, no matter how incorrect it

may be, that governments will take steps to manage the situation.

It is key that public messages are consistent. Although this may not be possible because

members of the GHSI may not always agree on communication priorities, action plans or

response activities, but it is an ideal to strive for by GHSAG members.

Recommendation 4

Develop and share international and national common top line briefings and messages

It is important that alerting is done as soon as possible to coordinate and share information

during a response and the mechanisms to enable this to continue to be practised as often

as possible. Exercise Eclipse contained a test of the GHSAG senior officials alerting

mechanism. It was initiated, two hours into the exercise, by Canada, the secretariat. This

system is regularly tested (every three months) and requires a two hour lead-in time.

Coordinating senior officials across such a wide geographical distance with the inherent

time differences and zones can complicate and slow information exchange and collective

decision making. The system was not designed for early alerting within GHSAG but for

senior officials to interact in a managed process. The extant system was not intended to

facilitate an immediate exchange of information.

Recommendation 5

Give consideration to the development of a system that will facilitate a more immediate

and responsive information exchange method.

There is a training burden in ensuring that senior officials and decision/policy makers are

able to respond during an emergency response situation. The necessity of this level of

responder having an intimate understanding of emergency response cannot be

underestimated. Decision makers in the response need to connect with the

communicators to ensure a coherent message is conveyed to the public that reflects the

political landscape and decisions being made.

Recommendation 6

Ensure emergency preparedness awareness and ongoing training for senior officials and

policy/decision makers.



When the alerting process is initiated, it was noted by an evaluator that it is not clear which

of the five GHSAG working groups4 would be alerted first. It may be that not all the groups

will need to be alerted, dependent on the nature of the incident, but where there is a

requirement to alert more than one group, a hierarchy of alerting should be considered.

Recommendation 7

Consider development of a hierarchy of notification with an appropriate notification

cascade.

B4. Close links between communicators and technical experts

Communicators are the conduit through which technical and health advice is conveyed to

the public in a form that the public can understand and act upon. The communicators

translate technical terminology into easily understandable messages. The link between

technical experts and communicators is crucial. The exercise demonstrated this

fundamental element in developing the public health messaging. The communicators

need to identify the trigger point at which they should seek subject matter expertise to

evaluate the early fragmentary information. They should also identify the experts with

whom they should be contacting and consulting.

Exercises such as Eclipse will enable communicators to develop those skills; to identify

the trigger points; and to consider the sources of specialist knowledge and support.

Recommendation 8

Identify the trigger points at which technical expertise will be required. Identify trusted

sources of specialist advice and support.

The relationship between technical experts and communicators is not always an easy one

as they can have diametrically opposed objectives. Communicators want speed of

information flow and the scientific community deal in fact and confirmed data that takes

longer to develop. A compromise needs to be struck between these two elements. In a

period of uncertainty, the scientific community will not have the confirmation they normally

require. As a general rule, a comment is traditionally not released unless there is solid

information to base the comment upon. This could be because historically more time was

available to assimilate the information and then await confirmation. The speed of

communication and the release of that information out into the public domain have eroded

this luxury of time. This erosion will necessitate a less ‘firm’ form of released message

(see B2).

4 Current GHSAG Working Groups/Networks are: Risk Management and Communications Working Group,

Communicators Network, Pandemic Influenza Working Group, Chemical Events Preparedness, Radiological-Nuclear Working Group and The Global Health Security Laboratory Network.



Another difference is that there can sometimes be several contrasting opinions from the

scientific community and technical experts and this will not always be resolved but a

common message should be agreed even in the face of contradictory expert advice.

B5. Social media

Social media is an umbrella term for any online media used for social interaction to turn

communication into interactive dialogues. Social media played a high profile element in the

exercise. It was ground breaking in its use of simulations of Facebook and Twitter called

‘Ourpage’ and ‘Twister’. There were also web based news stories that added to the

scenario via the WNN News simulated news site. For some, the use of social media was

an ‘eye opener’ and a new experience. It was noted in the structured debrief that ‘Social

media – however unreliable is now a reality’. It was also mentioned by an evaluator that

people (within an organisation particularly Communicators) will not have a choice to use or

not to use social media. This medium will have to be utilised and integrated into traditional

media methodologies.

Facebook state they have 200 million active users (Facebook.com, 2010) and it has been

calculated that Twitter may have up to 26 million users by the end of 2010. These are

significant numbers of the public that can be targeted. It is possible that these sites may be

the first indicators that a situation is developing. One of the evaluators observed that

‘Social media can be expected to play a role in “informal/sidebar” communications’. The

exercise gave an opportunity to consider the possible strength and weaknesses of these

tools. It is worth noting here that players were not exposed to significant media pressure

within the exercise at levels that would be expected in a real event.

A point was made by some players that they would not ordinarily have access to, or be

required to monitor such sites. This is a fair point and this element of the exercise was

primarily directed at the communicators at the exercise. These players had been given

prior access to the system to log in and acquaint themselves with the sites. The data had

been loaded for several weeks before the exercise so they could log on and see some of

the developing stories to the exercise. Unfortunately, despite this information being

available, only two players took the opportunity to log on prior to the exercise. This did

slow the response of some of the communicators at the exercise as they spent time

getting to grips with the technology and the information simultaneously. The sites were set

up to allow communicators the opportunity to interact with this new media in a safe

environment and some did make some hesitant posts but there was no follow up.

i. Interaction and use of the networks – presence on the site – trusted source

Some of the communicators were uncomfortable using what is likely to become a new

trend in public health messaging. GHSAG members should consider positioning

themselves as a credible source of information before an incident occurs. If a presence

on sites such as Twitter and Facebook is developed before an incident, members may



already have developed a following and have a ‘trustworthy’ brand. Users would come to

them for the accurate information which could head off possible panic and wild

speculation. This was a strategy used to great effect by the Centers for Disease Control

and Prevention (CDC) in the United States during the Pandemic (H1N1) 2009 (Terry,

2009). They have a presence on Facebook and Twitter upon which the organisation posts

messages and has a header with messages such as ‘Get short, timely messages from

CDC Emergency’.

Recommendation 9

Consider developing a presence on social media sites to give a trusted source for the

users.

ii. Monitoring and Trends – trigger points and protocols

Using social media as a tool to inform the response is a new innovation and it is important

that communicators are adept at using and monitoring this new media and are able to

highlight emerging trends. These trends can then be used as an indicator of a possible

developing situation. It is accepted that using any sources which are ‘user generated’

with no peer review or moderation of content can have limitations, as anyone can write

what they want. It is fair to say that a large majority of the content is unreliable and

untrustworthy (Terry, 2009), which is probably the most significant problem with social

media posts. That said, social media may provide ‘clues’ into understanding the cause

or extent of a crisis. It can only be used as a possible indicator and should be used in

tandem with the conventional monitoring means. Communicators should consider

developing a strategy on: when to begin the monitoring; and how this monitoring will be

achieved, in order to tap into these potential sources of ‘information’, with the proviso of

taking the content as only an indicator and not a trusted source. A point worth noting here

is that many conventional media outlets now employ social media correspondents who

monitor and report the content of such sites in the mainstream media.

Communicators will need to develop a social media policy that will integrate with existing

communications policies and strategies. Developing a process to understand this new

media and how best to use it would also be advised. Other countries and organisations

are already doing this and for GHSAG members to be lagging behind in this cutting edge

skill may impact upon the reputational image of members. The strategy will also need to

take into account that legitimate media outlets may base initial reports upon social media

leads which may lead to speculative stories especially in the uncertainty stages.

Recommendation 10

Develop tools to monitor social media sites or utilise those already available and

consider a strategy that can be used during the uncertainty phase to take account of

normal communications strategies and interaction on the sites directly.



Recommendation 11

Conduct new studies into how these new social media tools (such as Twitter and

Facebook) can be used in specific situations such as CBRN or infectious diseases.

iii. Public perception of risk – management of the Public Health message

Social networking sites may highlight the perception of the risks felt by people using these

sites. This perception may be different from the official line. Citizens are now ‘all armed

with their own mini-platforms to broadcast their fears’ (Morozov, 2009). If there is an

outstanding pre-presence on the sites, it may be possible to put some of the risk into

perspective during the early ‘uncertainty’ period. That said, it will only be an indicator of

the risk perceived by a narrow user group (called ‘digital natives’) of these types of sites.

However, these people may be the ‘target’ audience for the messaging. Older

generations are not common users of these sites and other non users may need to be

targeted differently.

Recommendation 12

Consider targeting strategies that will aim messages at the users of social media sites

and the ways this targeting can be achieved.

B6. Transition from uncertainty to certainty

This transition period was played within the exercise and highlighted the difficulties that it

presents. The players went from rumour (portrayed on the social media sites) to

monitoring to a broad all hazard approach (using conventional alerting systems

(simulated)) to a point on day two when they had certainty about the agent they were

dealing with. The transition through these stages is significant in the effective

management of the response and should be managed in stages, via a coordinated and

coherent process. The transition changes were not clearly acknowledged by players in

the exercise. This was because of the search for a level of certainty all the way through.

This is a natural response as decision makers want definitives. However, it did not

address the central issue of what to do when certainty is just not there. The question of

‘How do you manage the response when you do not have hard facts to work with

but a response is expected?’ is still valid and was not answered sufficiently to give the

answer in this report.

Recommendation 13

Consider developing a generic transition management protocol for the changes of

response stage; from uncertainty to broad all hazard approach to specific agent.



B7. Issues identified relating to exercise organisation for the improvement to the planning of future EU exercises

i. Involvement of technical experts at the exercise

Play in the exercise was centred primarily on the management of uncertainty and the

majority of the exercise examined this area, but there was a case to make to have

technical experts available. It was envisaged that planners would ensure that sufficient

technical expertise was available for players once resolution was achieved on the agent

that had been released. This expertise was to be available via telephone. However, to

have had the expert at the exercise would have short circuited the process of identification

through the evidence the players were presented with. If only radiation experts had

attended, the players would only have looked for clues to this agent and if we had had

experts from all areas of CBRN response, this would have been a wasteful use of the

experts. It was accepted that the communications players needed close coordination with

technical experts in order to form coherent health messages, but this was weighed up

against the overarching aim to examine the uncertainty element of response and not

dealing with a conventional CBRN response once the agent was known.

ii. Realism of scenario

There were various responses by players and evaluators to the scenario of the exercise.

It was noted that some found the slow start to the exercise exasperating and felt the lead

in time could have been better spent. The exercise was all about uncertainty and not

achieving certainty. The exercise was not designed to deal with the actuality of the event

but to manage the event before this resolution happened. This is why the injects

developed a slow incoherent data picture over a period of time.

There was also comment on the ‘in person’ aspect of the exercise and that it might have

been more realistic to have had players input from their own countries and it was unreal to

have all the players together in one place. This was a table top exercise and not a

command post exercise. The advantage of a table top exercise is that it enables personal

interaction that is not available if players take part from their own country/organisation.

Further, this exercise was part of sequence of three GHSAG related events. These

included a GHSAG communicators’ meeting and an uncertainty workshop in the week 25

– 29 October 2010, all occurring in Paris, France.

iii. Using ‘exercise’ sites compared to real world systems

It was noted that the use of exercise social media sites was useful and added value to the

exercise but some players did experience technical difficulties accessing the system. For

future exercises it should be considered that the sites should have had pre-loaded log-ins

for all the syndicates. There were delegates accessing the sites from different time zones

and the simulation did not allow for this time difference. This should also be considered

for future exercises.



Some of the players used their own real organisational email systems to keep each other

in the loop of developments and pass messages and some did not always preface emails

with ‘Exercise Exercise Exercise Eclipse’ as briefed. With a simulated and real

environment running concurrently, there is always the possibility that some cross over may

occur and if an outside recipient of a message is not aware of the exercise, they may

mistake the message as a real event. An exercise email system would aid players in

communicating in a safe setting with the cross over issues eliminated. Such a system

would also aid the management and evaluation of the exercise by allowing evaluators and

EXCON to see all the exchanges taking place. A web based system to set up a simulated

network would work well with this type of exercise. This would keep all the play within

simulated boundaries and not allow external incursion.



PART 4 – CONCLUSIONS AND RECOMMENDATIONS

Exercise Eclipse was successful in examining the uncertainty element of the response and

incident management. The aim was to exercise international communications during the

early uncertainty phase of a potential CBRN threat. The exercise made clear that

Communicators are key to this phase in delivering timely and transparent messages. The

‘uncertainty’ left some players uncomfortable with the concept and so they sought a

certainty that was elusive, thus slowing public messaging. The political dimension

although not exercised, was commented on and consideration of this aspect must be

taken into account in the management of an incident, particularly in the timing of

messages released.

Use of technical experts and the close collaboration between communicators and these

subject matter experts is vital in developing coherent public health messages.

Finally, social media (Facebook and Twitter) is the ‘new kid on the block’ and this resource

regardless of its shortcomings should be exploited to provide yet another tool in the public

health messaging toolkit.

Collated below are the recommendations that were drawn from the lessons identified in

this exercise and the suggested GHSAG member country/organisation allocation of

ownership of the task.

A. RECOMMENDATION AND ALLOCATION TABLE

Recommendation Allocation

Recommendation 1

Develop an ‘uncertainty’ communications strategy. Design a

procedure for the early stages of an incident and agree generic

common lines of communication during these stages.

GHSAG Risk

Management and

Communications Working

Group

Recommendation 2

Develop predefined templates, fact sheets, standard messaging and

a checklist for the uncertainty phase. Draft model information to be

used specifically during the uncertainty phase.

GHSAG Risk

Management and


Group

Recommendation 3

Define a clear structure and set deadlines to produce outcomes from

each coordination meeting.

GHSAG Risk

Management and


Group

Recommendation 4

Develop and share international and national common top line

GHSAG Risk

Management and



briefings and messages. Communications Working

Group

Recommendation 5

Give consideration to the development of a system that will facilitate

a more immediate and responsive information exchange method.

GHSAG Secretariat

Recommendation 6

Ensure emergency preparedness awareness and ongoing training

for senior officials and policy/decision makers.

GHSAG Member

Organisation/Country

Recommendation 7

Consider development of a hierarchy of notification with an

appropriate notification cascade.

GHSAG Working Group

chairs

Recommendation 8

Identify the trigger points at which technical expertise will be

required. Identify trusted sources of specialist advice and support.

GHSAG Risk

Management and


Group

Recommendation 9

Consider developing a presence on social media sites to give a

trusted source for the users.

GHSAG Member


Recommendation 10

Develop tools to monitor social media sites or utilise those already

available and consider a strategy that can be used during the

uncertainty phase to take account of normal communications

strategies and interaction on the sites directly.

GHSAG Member


Recommendation 11

Conduct new studies into how these new social media tools (such as

Twitter and Facebook) can be used in specific situations such as

CBRN or infectious diseases.

GHSAG Member


Recommendation 12

Consider targeting strategies that will aim messages at the users of

social media sites and the ways this targeting can be achieved.

GHSAG Member


Recommendation 13

Consider developing a generic transition management protocol for

the changes of response stage; from uncertainty to broad all hazard

approach to specific agent.

GHSAG Member




REFERENCES Facebook. (2010), Available from: http://www.facebook.com/press/info.php?statistics. [Accessed 12 November 2010].

Morozov, E. (2009), Swine flu: Twitter’s power to misinform. Available at: http://neteffect.foreignpolicy.com/posts/2009/04/25/swine_flu_twitters_power_to_ misinform. [Accessed 4 Jan 2011].

Terry, M. (2009), Twittering healthcare: social media and medicine, Telemedicine and e-HEALTH, July/Aug 2009, pages 507 – 510



APPENDIX A – PARTICIPANTS

Name Organisation GHSAG Country/ Organisation

or Exercise Function

1. Anita Blake

Group Leader - EU Projects Health Protection Agency, UK

2. Aphaluck Bhatiasevi

World Health Organization World Health Organization

3. Brian Ahier

Health Canada Canada

4. Caroline Saisou French Ministry of Health France

5. Cecile Challeton-de Vathaire

Institut de Radioprotection et de Sûreté Nucléaire

France

6. Céline Caserio-Schönemann Institut de Veille Sanitaire France

7. Chad Hrdina

Assistant Secretary for Preparedness and Response

United States of America

8. Daniel Reynders

Federal Ministry of Public Health, Belgium

Observer - Belgium

9. Daniel Rutz

Centers for Disease Control and Prevention


10. Eunjoo Kim

National Institute of Radiological Sciences

Japan

11. Germain Thinus

DG SANCO, Health Threats European Commission

12. Gretchen Michael

Department of Health and Human Services/ASPR


13. Hayley Clark

Exercise Coordinator (Emergency Preparedness)

Health Protection Agency, UK

14. Heather Hurst

Public Health Agency of Canada Canada

15. Herta Adam DG SANCO, Health Threats European Commission

16. Inmaculada Navarro,

Ministry of Health, Equity and Social Policy, Spain

Observer - Spain

17. Jean-Marc Sapori Ministry of Health France

18. Jérémie Carre

Institut de Veille Sanitaire France

19. Johannes Blassius

Federal Ministry of Health Germany

20. John Ibbotson

General Project Manager


21. Klaus Riedmann




22. Lars Schaade

Robert Koch Institute Germany

23. Liz Morgan-Lewis

Pseudo Media Health Protection Agency, UK

24. Ljubica Latinovic

Ministry of Health Mexico

25. Loredana Vellucci

Ministry of Health Italy

26. Maria Grazia Pompa

Ministry of Health Italy

27. Marika Valtier

Ministry of Health France

28. Mark Lysyshyn


29. Miklós Czékus

Hungarian Public Health Service Observer - Hungary

30. Natasha Manji


31. Nick Gent

Deputy Head of Emergency Response Health Protection Agency, UK

32. Nick Thompson

Higher Scientific Officer


33. Nigel Lightfoot

Department of Health United Kingdom

34. Patrick Brasseur

Ministère de la Santé France

35. Peter Graham

Department of Health United Kingdom

36. Robert Whitcomb

Centers for Disease Control and Prevention


37. Roland Jopp


38. Suzanne van Maurik

Pseudo Media Health Protection Agency, UK

39. Sylvie Berube


40. Vanessa Middlemiss

Exercise Manager (Emergency Preparedness)


41. William Hall

Department of Health and Human Services


42. Yasuhiro Kanatani

National Institute of Public Health Japan

43. Zhanat Carr

Medical Officer

World Health Organization

EXERCISE ECLIPSE

Documents

Exercise Eclipse Report final - European Commission · Exercise Eclipse was devised to support this proposal and was designed to explore international communication in the early uncertain