BALTIMORE — The virus started in pigs hypothetically spreading silently within herds and then to farmers.
It manifested as a mild flu in some and developed into a severe respiratory illness in others, with cases leading to pneumonia. Infections fanned out worldwide with densely populated and impoverished areas faring especially poorly. After 18 months, 65 million people had died in the mock exercise. Economies buckled and some countries banned travel. Global gross domestic product plummeted 11%. Scarce medical resources needed rationing.
This was the scenario presented by the Johns Hopkins Center for Health Security a year ago to a group of global business leaders, government officials and public health professionals gathered in New York City for an event meant to prepare top executives and officials for a deadly pandemic and explore how to prop up the economy.
Two months later, a real novel coronavirus emerged and began spreading around the world. Since then, some have falsely linked the event to a broader conspiracy theory about COVID-19’s origins, saying the event’s planners knew there would be a pandemic before the first case emerged in Wuhan, China and might have even caused it to enrich themselves or assert control over the population.
Participants of “Event 201,” co-organized by the Bill and Melinda Gates Foundation and the World Economic Forum, included representatives from the United Nations and other agencies as well as executives from Johnson & Johnson, UPS, Marriott and other companies.
Organizers dubbed the October 2019 exercise Event 201 because the World Health Organization responds to about 200 epidemic events each year but, as a YouTube video released by Hopkins states, “we need to prepare for the event that becomes a pandemic.”
The name provides further justification for anonymous web users who believe the organizers influenced or even caused what happened later.
“The people behind this plandemic need to be arrested starting with megalomaniac front man Bill Gates,” one YouTuber commented on a Johns Hopkins video that provides a sweeping overview of the exercise.
“So the conference was in October of 2019 … and by December the world gets this coronavirus pandemic … oh ok … what an amazing coincidence!” wrote another. “Anyone else feels we are being played?”
Johns Hopkins turned off comments on some of the other videos showcasing clips from the event.
The term “plandemic” refers to a set of videos released in May that describe a hidden agenda behind COVID-19, alleging that the sickness itself is a bioweapon that was spread to get as many people as possible vaccinated with drugs that cause medical harm. Much of the videos’ claims have been debunked as false, misleading or inaccurate or, more plainly, as conspiracy theories.
Both public and private sector agencies commonly stage tabletop exercises as a means of emergency and disaster planning. In Maryland, for example, Gov. Larry Hogan has organized such events to prepare for severe weather, bringing together a team of experts from different industries and fields to talk through how the state should respond and which resources to mobilize.
If anything, the similarities of Event 201 and COVID-19 show the validity of Johns Hopkins’ research methods and the challenges that underlie all public health crises, said Crystal Watson, a senior scholar at the Johns Hopkins Center for Health Security, who helped stage it.
“Event 201 was about economic impact because we felt that was an area that had little discussion in public health emergency planning,” Watson said. “We wanted to highlight the private-public partnerships that would be needed, the supply chain impacts and industry fallout including travel.”
Tom Inglesby, director of the Center for Health Security, moderated the exercise, and guided “players” through a series of escalating conditions. First, he challenged participants to envision how businesses and governments should collaborate to mitigate the emergency. Then, he posed that an antiviral treatment had been developed and vetted, and asked how drugs and other medical supplies should be allocated.
“How should national leaders, businesses and international organizations balance the risk of worsening disease that will be caused by the continued movement of people around the world,” Inglesby posed, “against the risks of profound economic consequence of travel and trade bans?”
“How should financial resources be prioritized? We don’t have money to pay for all of these urgent problems,” he asked later.
The planning group spent months on the event, Watson said, implementing decades’ worth of public health research and real mathematical modeling. They also led a similar exercise in 2018 and another one about a decade earlier, she said.
Planners opted to base the exercise around a coronavirus pandemic due to the prevalence over the last two decades of such contagions as SARS and MERS, for which no vaccine exists.
“The exercise was in no way predicting the pandemic; we did not know it was coming, specifically,” Watson said. “We spent an enormous amount of time thinking about what the realistic policy problems and situations are that would occur in a severe pandemic, so it makes sense that in a real-life scenario, those problems are coming up.”
Despite the resemblances of Event 201 to COVID-19, much of today’s pandemic was not reflected in the mock exercise. The players made no mention of nonpharmaceutical intervention tools, such as social distancing, mask wearing or hand washing. It also did not address what could happen if state leaders took vastly different approaches, or what might happen if lawmakers in the same country or jurisdiction disagreed on protocol and methodology.
“One thing we presumed was competent leadership would be focused on responding effectively, and we’ve seen that’s not always the case,” Watson said. “That can make or break a response, so I think it’s something to plan for going forward.”
Still, once the coronavirus outbreak ramped up in January, Hopkins released a statement responding to some of the questions about Event 201, making clear that the exercise did not forecast the facts on the ground.
“We are not now predicting that the nCoV-2019 outbreak will kill 65 million people,” the statement read. “Although our tabletop exercise included a mock novel coronavirus, the inputs we used for modeling the potential impact of that fictional virus are not similar to nCoV-2019.”
In fact, COVID-19 has not been nearly as virulent as the Event 201 virus. It took nine months for deaths to cross the 1 million mark, according to Hopkins’ Coronavirus Resource Center.
Watson said the statement provided an additional layer of transparency to Hopkins’ intentions and acknowledged the institution’s responsibility to push back on false information.
Hopkins can do little to change the minds of those who want to believe in conspiracies, said Joe Uscinski, co-author of 2014’s “American Conspiracy Theories.”
“There are people who have a worldview in which everything is a conspiracy and contrived by malicious actors, and they’ll find information that comports with that worldview,” said Uscinski, also a professor of political science at the University of Miami. “You do what you can to make sure you have the right information out there, but if someone has already adopted a conspiracy theory, saying ‘I’m not conspiratorial’ is not going to change anyone’s mind.”
Uscinski said Hopkins did nothing wrong in releasing the clarification statement.
Hopkins planners, in fact, modeled the exercise knowing the challenges that come with communicating threats to public health accurately in the digital age. The WHO has coined the term “infodemic” to shed light on the dangers of proliferating false or misleading information, which spreads faster than any disease.
“It’s particularly damaging when leaders undermine the data and give mixed messages as to what the public should do to keep themselves safe,” Watson said. “Hopefully, we’re not caught as unprepared again, because there certainly will be a ‘next’ pandemic.”