Exercise Cygnus
Exercise Cygnus was a three-day simulation exercise carried out by the UK Government in October 2016 to estimate the impact of a hypothetical H2N2 influenza pandemic on the United Kingdom.[1][2][3] It aimed to identify strengths and weaknesses within the United Kingdom health system and emergency response chain by putting it under significant strain, providing insight on the country's resilience and any future ameliorations required.[4] It was conducted by Public Health England representing the Department of Health and Social Care, as part of a project led by the "Emergency Preparedness, Resilience and Response Partnership Group".[4] Twelve government departments[4] across Scotland, Wales and Northern Ireland, as well as local resilience forums (LRFs) participated. More than 950 workers from those organisations, prisons and local or central government were involved during the three-day simulation, and their ability to cope under situations of high medical stress was tested.[3]
The exercise was named "Cygnus" as the theoretical H2N2 virus was nicknamed "swan 'flu" and said to originate from swans, the Latin name for which is Cygnus.
Scenario[edit]
In the scenario, the 950 participants from central and local government were placed in the seventh week of the pandemic – the peak of the crisis, when there is the greatest demand for healthcare. At this stage, an estimated 50% of the population had been infected, with close to 400,000 deaths.[3] The hypothetical situation was that the vaccine had been made and purchased but not yet delivered to the United Kingdom.[5] Hospital and social care officials were to come up with emergency plans managing resource strain, while government officials were exposed to situations requiring quick decision-making. To make the situation more realistic, COBRA meetings were held between ministers and officials. Simulated news outlets and social media such as "WNN" and "Twister" were also employed to give fictitious updates.[3] A government disclaimer on the UK pandemic preparedness website stated that Exercise Cygnus was not intended to manage future pandemics of different nature, or to pinpoint what measures to adopt to avoid widespread transmission.[4] Jeremy Hunt, Secretary of State for Health and Social Care at the time, recounts how he was confronted with a decision to close all the intensive care units and switch off the ventilators because redeploying the staff would save more lives - not a decision he felt a minister should be asked to make.[6]
Key participants[edit]
Public Health England[edit]
Public Health England (PHE) was an executive agency within the Department of Health and Social Care whose goal was to "protect and improve the nation’s health and well-being, and reduce health inequalities".[17] It had the autonomy to guide and help the United Kingdom government, authorities and NHS without their influence.[5]
In Exercise Cygnus, the Emergency Response Department was specifically employed within PHE.[5] Its specialists assisted the health community by providing training and expert advice with regards to emergencies. It collaborated with several organisations such as the European Commission, European Centre for Disease Prevention and Control and World Health Organization.
Official release of report[edit]
The complete 57-page report was released by the Department of Health and Social Care on 23 October 2020.[15]
The Telegraph raised doubts as to whether full implementation of improvements were conducted before COVID-19, as previously reassured. Six possible areas of contention were identified. Key complaints include: improper management of surge capacity, incomplete "silo planning between and within organisations", disorganised school closures, consistent lack of funding for care homes, inefficient public communication and lack of social distancing which were still unresolved during COVID-19.
In a 2020 policy paper titled "UK pandemic preparedness", the Department of Health and Social Care states that it will continue to incorporate lessons learnt from Exercise Cygnus (2016) into future pandemic control protocol, coupling it with insight from COVID-19 (2019) response. In March 2020, the coronavirus action plan[38] was published by the UK government, adopting and tweaking recommendations from Exercise Cygnus to suit coronavirus rather than influenza virus.