The Preparedness Lab

The simulation runs for six rounds, which follow the outbreak from the first unexplained cases to the end of the emergency. In each round the player selects non-pharmaceutical interventions within a budget, and each intervention has effects on five measures: health, economy, public trust, resources and equity. The five regions differ in population, economy, vulnerabilities and political constraints, and the same intervention therefore has a different effect in each region. Three stakeholder groups make requests with deadlines, and misinformation events occur in some rounds.

The interventions that reduce transmission most also carry the largest economic and social costs, and a response that is sound on the evidence can lose the region's political support.

Design logic

Effects are shown as directional arrows instead of points, so that the player reasons about trade-offs rather than optimising a visible score. Evidence strength, regional fit, preparedness, stakeholder escalation and misinformation all modify what an intervention costs or achieves. The single-player edition ends early under two conditions: epidemic overload, when hospital capacity is exceeded, and loss of political mandate, when the regional assembly withdraws the emergency powers.

Format

The single-player edition runs in the browser, without installation or accounts. In the facilitated multiplayer version, five regional teams play in one room with timed rounds and a facilitator's view.

Each sector holds only part of the information, field teams, budget and authority needed to control the outbreak, and confirming the source requires evidence that no single sector can obtain alone: the virus in human samples, the virus in the animal source, and an analytic study. In each round a sector reviews the situation and its own signals, resolves a crisis, allocates field teams and budget to investigations and control measures, and commits its decisions. The round then closes, and the report shows what changed and what the other three sectors did.

In the single-player edition the player holds one sector and the other three are run by the computer. Their leads report what they see and what they intend, and their findings appear on a shared board once they have investigated. Each round one of them makes a request with a deadline, and a request that is met leads to coordination in the following round. Each round's crisis is put to the player by the person who raises it, with three possible answers where the facilitated version offers two, and an answer can also have a consequence a round later. In the facilitated version, run as the scenario Spillover at the Forest Edge, four teams hold the sectors and the facilitator resolves each round on a board visible to the whole room.

Design logic

The effect of a control measure is proportional to what the four sectors have confirmed about the source and to public trust, so a measure taken before the source is understood achieves only a fraction of its effect, and additional spending does not compensate. The outbreak, public trust and the economy are shared by all four sectors, and no sector has a score of its own, so a shortcut taken by one sector imposes costs on the other three.

Format

Single-player edition in the browser. The facilitated version runs for 2 to 3 hours with four teams and a facilitator; its materials comprise a run guide with per-round guidance and a debrief script, participant briefs and role cards, teaching decks, and a sourced evidence pack. The pathogen is not named to participants until the debrief.

The player takes the role of the IPC lead nurse on a hospital ward and follows an outbreak through eight scenes, from the first ward signal, through preparedness, the response pillars, genomics and global coordination, to recovery. Each decision connects events on the ward to the national and global systems that act on them and return guidance to the bedside. The simulation was developed for the MSc in Infection Prevention and Control at the Alice Lee Centre for Nursing Studies, National University of Singapore.

Design logic

Each scene ends in a decision, taken as a multiple-choice or multi-select question or a drag-to-rank sequence, and the feedback after each decision states the key learning point. Expandable knowledge cards explain, at the point of use, the concepts on which a scene rests, such as the Swiss cheese model and the International Health Regulations. The language and the scenarios are those of ward-based staff.

Format

Self-paced, about 20 minutes, in the browser.

Each exercise places the learner in the position of a decision-maker in a documented case from the history of public health and requires a decision to be committed before the reasoning is revealed. The case studies and the teaching content are Dr Frieden's; the contribution here is the exercise design, which turns each case into a sequence of decisions. Each exercise runs in an undergraduate and a graduate mode on the same material and takes about 15 minutes; it can be used on its own or within a course.

Design logic

Learners commit a choice and record their assumptions before the reasoning is revealed, so that the debrief can be checked against their own choices and assumptions. Decisions carry forward across the acts of a case, and a consistency check identifies contradictions between a learner's analysis and the design decisions that follow it. The inbox and cohort-dashboard formats reproduce the information environment of the decision-maker in the original case.

Instructor resources

The full instructor resources are on the book's teaching site, formulateaching.theformulaforbetterhealth.net.

The city, Meridian, has 600,000 inhabitants, and the player is appointed as the first cases appear in a single working-class district. In the first act, See, the player decides which weak signals to investigate and when the evidence is sufficient to act; in the second, Believe, how to build public and political confidence that the outbreak can be stopped; in the third, Create, how to design a response that is fast and fair, with each part of it assigned to a named person. Each decision is made by playing one card from a hand of options, after which the epidemic curve and the player's standing with the main characters are updated on screen. Decisions cannot be reversed, and their consequences carry through to the end.

Design logic

Every decision is committed before the reasoning behind it is revealed. Each decision corresponds to a principle from the book, and that principle's page is added to the player's collection when the decision is made. The debrief traces the outcome back through the player's own choices.

Format

Self-paced, about 60 minutes in total, in three acts of roughly equal length, played in the browser on a desktop or laptop; progress is saved and can be resumed. The simulation is suitable for courses from introductory to graduate level and can be used as a standalone activity or alongside the existing case studies. No prior public health study is assumed, and technical terms are defined where they first appear.

Over one in-game week, three people are infected through food, each by a different route, and the player investigates each infection as a separate case. The player walks through the town, inspects kitchens, interviews residents, submits samples to a laboratory that processes four a day with a turnaround of about four hours, and assembles evidence held separately by four offices. An investigation closes when its case file is answered correctly, and the week ends with a debrief that reviews the three cases and lists every finding, including those the player missed.

Design logic

The trainee has responsibility for the case but no authority over the four offices, so remedial action follows only when the responsible office is presented with evidence on which it can act. One Health is taught through the coordination problem itself, and the four modes of inter-agency working (collaboration, coordination, communication and capacity building) are scored at the end of the week.

Format

Single-player, in the browser on a desktop or laptop with the keyboard and mouse, or on a phone or tablet by touch. Progress is saved and can be resumed, and the debrief can be printed.

Over one in-game month, three people on the estate fall ill, and for each of them the player reconstructs the exposure that caused the infection, including where and when it occurred. The player walks the estate, inspects its shared spaces, interviews residents and workers and sends samples to a laboratory. Most of the repairs that would prevent further cases are the responsibility of four other offices, and each office has to be shown the evidence for its part. Time runs while the player moves about the estate, and it stops whenever a screen of text is open.

Design logic

The player has responsibility for the estate but limited authority over the offices that must act, and One Health is taught through that coordination problem. Environmental persistence of the organism, the routes of exposure, the incubation period, occupational risk and targeted testing each bear on how a case is solved.

Format

Single-player, in the browser on a desktop or laptop with the keyboard and mouse, or on a phone or tablet by touch. Progress is saved and can be resumed, and the debrief can be printed. The game is designed for members of the public and for learners without specialist training.

Three states, an international organisation and a manufacturer meet five times over the course of the outbreak, and an epidemic model runs on what they agree. The parties' combined requirements exceed the available supply, so a table that only divides what is available ends with every party below its requirement and the outbreak still in progress.

Each round is anchored to a provision of the International Health Regulations, and the dilemma of the round is the one that provision creates. Participants weigh their parties' interests against legal obligations under time pressure, and no party holds the full information.

Design logic

The simulation has no chat function, so negotiation takes place in the room. It also has no undo, and a notification, a public move or an agreed deal stands once it is made. The round ends when the facilitator closes it. The intended debrief compares the tables in a class, each of which has played the same outbreak with different decisions.

Formats

A whole class of up to twelve tables paced from one dashboard, a single table with a facilitator console, or one player against computer counterparties at three difficulty settings. All three run the same engine.

Access

Access is arranged by written permission of the copyright holders. Facilitator materials comprise a walkthrough, a player's guide and a features and mechanics document.