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Monday, January 30, 2023

The SPARS Pandemic 2025–2028: A Futuristic Scenario to Facilitate Medical Countermeasure Communication

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Effective communication about medical countermeasures—including drugs, devices, and biologics—is often critical in emergency situations. Such communication, however, does not just happen. It must be planned and prepared for. One mechanism to develop communication strategies is through the use of prospective scenarios, which allow readers the opportunity to rehearse responses while also weighing the implications of their actions.

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This article describes the development of such a scenario: The SPARS Pandemic 2025–2028.

Steps in this process included deciding on a time frame, identifying likely critical uncertainties, and then using this framework to construct a storyline covering both the response and recovery phases of a fictional emergency event.

Lessons learned from the scenario development and how the scenario can be used to improve communication are also discussed.

October: The first US deaths occurred due to SPARS. Initially, these deaths were thought to have been caused by influenza.

November: Cases of SPARS were reported across Minnesota and in six other states. Thanksgiving holiday travel and Black Friday shopping facilitated spread of SPARS beyond the Midwest (26 states and multiple other countries by mid-December). The WHO declared the SPARS pandemic to be a Public Health Emergency of International Concern.

December: No treatment or vaccine for SPARS existed, but there was some evidence that the antiviral Kalocivir could be effective as a therapeutic. A proprietary vaccine developed and manufactured by a multinational livestock group conglomerate (GMI) was proposed as a potential foundation for a human vaccine. The vaccine was developed to combat an outbreak of similar respiratory coronavirus in hooved mammal populations in Southeast Asia, but the vaccine had not been licensed by any regulatory authority or tested in humans. There were concerns over potential side effects.

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2026

January: The US government contracted CynBio to develop and produce a human SPARS vaccine based on the GMI animal vaccine. The HHS Secretary invoked the Public Readiness and Emergency Preparedness Act (PREP Act) to provide liability protection for the vaccine manufacturer and providers. Congress authorized and appropriated emergency funds under the PREP Act to provide compensation for potential adverse side effects from the vaccine. Following reports of Kalocivir’s limited success in treating patients with severe SPARS infections, the FDA issued an Emergency Use Authorization (EUA) for the antiviral. Kalocivir had been evaluated as a therapeutic for SARS and MERS, and several million doses were maintained in the SNS, which could be deployed as necessary while production capacity was established to meet demand. The FDA, CDC, and NIH provided seemingly conflicting communications regarding the safety and efficacy of Kalocivir. In the United States, public anxiety around SPARS resulted in extensive use of Kalocivir, frequent self-reporting of SPARS symptoms, and a surge in demand for medical care. By late January SPARS was detected in 42 countries and all US states.

February: A lack of cultural competency in FDA and other governmental communication became apparent among various ethnic groups in the United States. A video of a 3-year-old vomiting and fainting after taking a dose of Kalocivir was widely and rapidly spread via social media, strengthening opposition to the EUA.

The UK Medicines and Healthcare Products Regulatory Agency and the European Medicines Agency jointly authorized the emergency use of a new antiviral, VMax, in the United Kingdom and throughout the European Union. Some Americans attempted to gain access to VMax online or by traveling to Europe.

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April: The CDC publicized an updated (and significantly lower) case fatality rate in the United States; the perception of lesser risk triggered a drop in public interest.

May: Production of Corovax, the SPARS vaccine produced by CynBio, was well underway. Federal agencies initiated a communications campaign using well-known public figures with mixed results. Polls indicated a 15–23% increase in SPARS and Kalocivir knowledge nationwide. Hip-hop icon BZee had success promoting public health messaging with an online video clip, but he lost credibility when he compared volunteers for Corovax trials with “volunteers” from the Tuskegee syphilis study. Similarly, former President Bennett provided a non-committal response when asked if she would want Kalocivir for her new grandson. Public health agencies discovered that a relatively new social media platform, UNEQL, was being used as a primary means of communication in college-aged populations.

June: Corovax entered the final stage of its expedited review, and production capacity was increased. Ten million doses were expected to be available by July with fifty million more in August. The CDC Advisory Committee on Immunization Practice (ACIP) announced vaccine priority groups. Healthcare providers were not included as a priority, inciting protests by doctors and nurses across the country. In order to prioritize distribution of limited Corovax supply, the federal government requested that states report summary information for patient electronic health records (EHRs) to estimate the number of individuals in high-risk populations. This effort was met with resistance from the public, who protested the federal government accessing their private medical information.

July: A week prior to initiating the nationwide vaccination the program, damage to a power grid in the Pacific Northwest resulted in a widespread power outage that lasted two weeks. State and local public health agencies initiated communications programs using posters and flyers to promote the vaccination program in the absence of electronic media. Social media efforts across the country promoted the vaccination campaign, and crowdsourced data helped to increase efficiency in distributing the vaccine.

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August: The Corovax vaccination program met resistance from several groups: alternative medicine proponents, Muslims, African Americans, and anti-vaccination activists. Initially operating independently, these groups banded together via social media to increase their influence.

September: Japan announced that it would not approve Corovax for use in Japan in favor of developing and producing its own vaccine.

October: College students predominantly on the East and West coasts staged protests against the unequal global availability of Corovax. Vaccination rates among these students were below average for college students in other areas of the country.

November: The anti-anti-vaccine movement, formed in the wake of the 2015 measles outbreak in the United States, reignited their efforts to combat the anti-vaccination super group. The FDA, CDC, and other federal agencies also redoubled their communications efforts to promote the Corovax campaign. An increasing number of post-SPARS pneumonia cases were reported across the country.

December: The nationwide vaccination program was expanded beyond the initial priority populations to include the rest of the country. Federal agencies initiated a vaccination communication program involving targeted online advertisements.

2027

February: Post-SPARS pneumonia cases stressed inventories of antibiotics across the country. The HHS Secretary authorized distribution of the oldest lots of antibiotics from the SNS to supplement the antibiotic supply nationwide. Tests of antibiotics in the SNS inventory determined that 94% of the remaining antibiotics in the oldest lots maintained sufficient potency. Tests conducted in August 2026 provided the basis for extending the expiration of these lots from 2027 to 2029.

March: Rumors spread via traditional and social media that the government was dispensing expired antibiotics. Alyssa Karpowitz, a leader in the natural medicine movement, sought medical care at an emergency department after natural remedies failed to resolve her son’s bacterial pneumonia. After successful treatment with proper antibiotics from the SNS supply, she touted the benefits of “expired” antibiotics in her social media circles.

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April: Crowd-sourced and independent epidemiology analysis of Corovax side effects conflicted with official federal reports. The independent analyses gained popularity in traditional and social media due to visual presentation and interactive content. Government attempts to respond with data and press releases largely failed.

May: Reports of Corovax side effects began to gain traction. Several parents of children who experienced neurological symptoms after receiving the vaccination sued the federal government and CynBio. The lawsuit was dropped when they learned of compensation funds available through the PREP Act and the National Vaccine Injury Compensation Trust Fund.

November: Initial reports of long-term side effects of the Corovax vaccine emerged. These reports arose primarily from those in the initial priority (high-risk) populations and were few in number. With little available data and numerous preexisting conditions, initial studies were unable to identify a statistically significant association with any long-term effects. Claims for compensation were placed on indefinite hold until further data could be gathered and analysis completed. In response to public demand for long-term side effect compensation, the HHS Secretary invited Congress to conduct an independent investigation of the federal compensation process to alleviate concerns of impropriety. The public and media pressured Congress to increase the funds authorized for compensation under the PREP Act.

2028

August: The SPARS pandemic was officially declared to be over; however, experts remain concerned about domestic animal reservoirs and the potential for future outbreaks.

Read the whole study:

The SPARS Pandemic 2025-2028_ A Futuristic Scenario to Facilitate
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