Coordination, Communication, and Clade X: Challenges and Lessons Learned from Health Emergency Exercise After-Action Reports and How They Can Help Guide Future Efforts to Improve Information Sharing

Abstract Clade X is only the latest in a series of high profile health emergency preparedness exercises intended to better equip government officials and responders at different levels of government and in different sectors for the challenges they are likely to face during a pandemic or bioterrorism event. A key issue in regard to emergency preparedness response is information sharing. This study examines previous literature on the importance of information sharing to emergency response, particularly in regard to public health emergencies. A content and correspondence analysis of data collected from exercise after-action reports is then conducted to examine the prominence of information sharing as a theme in those reports. The relationship between information sharing and other themes is also considered. Specific passages regarding information sharing are examined to consider how the theme is discussed in the context of the report. The findings of the analyses above are then compared to a recent tabletop exercise conducted by the Nuclear Threat Initiative regarding a biological attack. The comparison of this recent exercise to previous exercises is used to highlight key policy considerations. Recommendations are provided regarding how policy makers could help to address these considerations prior to a real world emergency. While technology is consistently evolving to improve the means by which we can share information, issues of coordination, including between the public health and health care sectors, continue to remain an obstacle.