In the early days of a major new contagious disease epidemic, there could be a brief window of opportunity to stop it from becoming a pandemic. To successfully contain such an outbreak, decisive and bold action would need to be taken in the face of incomplete data, high scientific uncertainty, and potential political resistance. Thinking through such challenges, preparing in advance to react effectively, and practicing through both high-level tabletop and operational exercises should start now.

It may seem like all these critical policy decisions have been resolved during the COVID-19 pandemic, but they have not. In the Catastrophic Contagion simulation, even a group of some of the wisest and most experienced international public health leaders who lived through COVID-19 wrestled with opposing views on whether countries should impose travel restrictions or close schools to try to contain a serious new epidemic that was disproportionately affecting children. The exercise raised a pivotal question: If future pandemics have a much higher lethality than COVID-19, or for example, if they affect predominantly children, would or should countries take different, stronger, earlier measures to contain it, and what are those measures????