Clade X exercise: Improving policy to prepare for severe pandemics

Clade X is a pandemic tabletop exercise hosted by the Johns Hopkins Center for Health Security in May 2018 to identify important policy issues and preparedness challenges that could be solved with sufficient political will and attention. The Center designed the Clade X scenario by mixing aspects of actual past events with well-researched fictional elements to illustrate some of the difficult decisions that national leaders could face in a severe pandemic. It is presented through a day-long series of simulated National Security Council–convened meetings of 10 US government leaders, played by individuals prominent in the fields of national security or epidemic response. 

This document provides an overview of the exercise format and scenario, and concludes with recommendations from the Center on high-level strategic decisions and policies needed to prevent a severe pandemic or diminish its consequences should prevention fail. Included in this package is also briefing on the policy implications of the Clade X exercise and supplementary slides that were shown on large screens during the exercise to relay information and prompt discussion among the players.