City of Chicago won't sweat the flu with Argonne's help

By Louise LernerSeptember 7, 2011

This spring, officials at Chicago's Department of Public Health (CPDH) watched the H5N1 bird flu tear through neighborhoods, taking down public agencies and shuttering public schools.

Good thing it was just a drill.

Emergency preparedness experts at the U.S. Department of Energy's Argonne National Laboratory have helped the Chicago department plan its response to potential catastrophe, including swine and bird flu epidemics, plague outbreaks and anthrax bioterrorism.

Chicago, as one of the four largest cities in the nation, is required by the U.S. Centers for Disease Control and Prevention (CDC) to run periodic exercises demonstrating how effectively it would respond to public health emergencies. Local hospitals often join the exercises, as well as the city's Office of Emergency Management and Communication. Even O'Hare Airport, a likely gateway for viruses from around the world, has played along in the past.

For the H5N1 flu functional exercise, the Argonne team served as architects and built the scenario into a computer planning tool that helped guide the exercise and track city agencies' responses.

After carefully planning out the spread of the "flu attack," they launched the scenario. Over a three-day period, at specific points, they fed information to the Chicago department about the spread of the flu and watched the results unfold.

"We start off slow, but by the third day, the city is reeling—influenza cases, workforce shortages, laboratory samples, request for media interviews and news conferences," said Dan Walsh, an emergency preparedness specialist at Argonne. "We like to keep them on their toes."

This particular exercise followed the spread of an imaginary flu from Egypt. By the time the flu "arrived" in Chicago, more than 15,000 cases had been reported worldwide. Reports of an outbreak at an area nursing home kicked off the Chicago scenario.

City officials face a cascade of difficult decisions. Do they cancel trade shows? Close the Chicago Public Schools? Quarantine travelers to O'Hare Airport? Ask churches, temples and mosques to suspend services?

Argonne's emergency preparedness experts have collaborated with the CDPH to run more than 20 exercises over the past few years, for scenarios ranging from pandemics to bioterrorism to heat waves. After creating the scenario, the team helps control the flow of the exercise by sending new information and challenges, monitors the drill and offers suggestions for improvement at the conclusion.

The exercises are designed to be "no-fault"—no one is disciplined as a result. "We emphasize to the participants that it is OK to make mistakes during a drill as long as they use the lessons learned to improve preparedness and response levels before an actual event,” Walsh explained.

Walsh said the team makes sure to throw wrenches in the works, to mimic the unpredictability of real-life scenarios. For example, in the last drill, the CDPH computers "malfunctioned", forcing the department to operate without computer assistance for several hours. Another day found emergency staff refusing to work unless they received masks and vaccinations first, and McCormick Place officials challenging the city’s decision to ban large public gatherings.

Argonne experts even pose as reporters at mock news conferences, pressing the officials for information. To make the scenario seem even more real, the risk communications team produced 22 video, radio and print news stories to match the media intensity in real emergencies.

The planning tool, called the Sync Matrix Enterprise, was developed by Argonne's Decision and Information Sciences division and allows Argonne experts to coordinate with CDPH officials to plan, control and evaluate the exercises.

"The process has proved very helpful in our real-life response to the H5N1 flu; by the time the virus hit, we'd already had two years of planning exercises with Argonne," said Ed LeFevour, CDPH manager of emergency management services. "We held a planning session just a few weeks before we went live with 100,000 H5N1 vaccinations in the Chicago area.

"The community is better prepared as a result of this action," he said.