165. Three months before the coronavirus outbreak, researchers simulated a global pandemic
It began in healthy looking pigs: a new coronavirus, spreading insidiously within herds.
Farmers were the first to fall victim, succumbing to respiratory illnesses, ranging from mild, flu-like symptoms to severe pneumonia.
Flights were cancelled as the world's sharpest minds searched in vain for a vaccine.
But it was too late. Within six months, the virus had spread around the globe. A year later, 65 million people were dead.
Unlike the most recent coronavirus outbreak, however, you probably haven't heard of this pandemic.
That's because it was all a simulation — developed some three months before Wuhan, China became the epicentre of a global crisis.
A slow response can lead to a large outbreak
The Event 201 scenario — the brainchild of researchers at the Johns Hopkins Centre for Health Security — was designed to test our global preparedness in the face of a severe pandemic.
They are quick to note that the simulation was in no way a prediction of the events that would follow it, and the inputs used for modelling the potential impact of the fictional virus are not similar to the current outbreak.
From Wuhan to Australia
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However, according to Dr Eric Toner, who worked on the simulation, there are some parallels.
"Although Event 201 was simulating a very different kind of epidemic, we can see that a slow response when the number of cases is very small can lead to an outbreak that is hard to contain," he told the ABC.
"Now that the disease is widespread in China, we see the beginning of the cascading economic and societal consequences illustrated in our exercise."
There are also lessons to be learnt from the simulation, Dr Toner says — namely, the need for strong public health infrastructure and rapid action to identify cases, isolate them and trace contacts.
"Countries need to ramp up testing capacity as quickly as possible," he said.
"Furthermore, healthcare facilities should be preparing now to safely treat coronavirus patients while under isolation."
Dr Eric Toner at the Event 201 scenario in the United States.
There are also lessons to be learned from the simulation, Dr Toner says.(John Hopkins Centre For Health Security)
Could we predict the spread across Australia?
Though Australia's relative isolation may help safeguard against the spread of the most recent coronavirus, as our spate of confirmed cases underscores, we are in no way immune.
According to researchers from the University of Sydney, increased arrivals by air and urbanisation have led to a growing vulnerability to pandemics in our cities.
To highlight our susceptibility, the research team developed their own simulation, modelling the dynamic progression of influenza in Australia, based on anonymised data from the 2006, 2011 and 2016 censuses.
The dynamic progression of influenza in Australia as simulated by a 2016 model.
It shows the disease quickly blooming in cities, near large airports where it is introduced from overseas, followed by a more gradual diffusion into the countryside.
"The numbers [confirmed cases of coronavirus] that we're being given every new day... it is a very high rate, and this rate indicates that this new disease spreads faster [than the flu]," said Professor Mikhail Prokopenko, Director of the Complex Systems Research Group which developed the simulation.
"If we had the numbers we could easily adapt the model and make a meaningful simulation or prediction of it, but I don't think many people know the real numbers at this stage.
"What is being built right now in China, the prefabricated hospital buildings, the whole effort of quarantining up to 60 million people, it's unprecedented."
How can we respond?
As more information on the coronavirus comes to light, the advice from health authorities has shifted.
Those who have had any contact with a confirmed case of coronavirus are now being asked to isolate themselves in their homes for 14 days, while those who are infected are being quarantined in hospitals.
Should Australians be worried?
Australia has a number of measures to help stop the spread of coronavirus — but with warnings the disease has a week-long incubation period, carriers could already be in the country.
While some airlines, including Lufthansa and British Airways, have begun suspending flights to mainland China, services into Australia have not been affected.
"I think the difficulty with this [coronavirus] is that there's so many unknowns," says Dr Katherine Gibney, an infectious diseases physician and medical epidemiologist at the Doherty Institute.
"Everyone wants there to be guidance across all the jurisdictions and to be consistent messages, but the challenge is, it's novel.
"We're making best guess assumptions based on closely related viruses... that seems to be standing us in pretty good stead, but each day there's new evidence emerging, and so it's inevitable that we're going to have to keep modifying the recommendations that we make."
Unlike many other developed nations, Australia does not currently have a national coordinating body responsible for communicable disease threats.
A national centre for disease control would eliminate the current "ad hoc" approach to preparing for and responding to outbreaks of infectious diseases, according to the Australian Medical Association.
Scott Morrison standing in front a large infograph about coronovirus
Those who have had any contact with a confirmed case of coronavirus are now being asked to isolate themselves in their homes for 14 days.(AAP: Mick Tsikas)
"There's a lot of goodwill put in by the states and territories and no formal strategy," said AMA NT President Dr Robert Parker.
"If you have a national centre for disease control, you know who to ring.
"At the moment, given the rather amateurish, ad hoc structure, you have a problem and you develop a committee to deal with it rather than ongoing, proactive things."
In a statement, a spokesperson for the Department of Health said the strength of current systems and processes "mean the development of a national centre for disease control is not necessary".
"The Australian Department of Health has collaborative arrangements in place with health departments in states and territories for the prevention and control of communicable diseases, including ensuring robust surveillance systems are in place, preparing for emerging disease threats and responding to outbreaks."