After Katrina, The U.S. CDC convened a multidisciplinary "After-Action Report Workgroup." The group issued an analysis of its performance in support of Hurricane Katrina victims, and some of the results, it says, will help prepare the US CDC for pandemic influenza. It grouped its lessons learned into five categories. Several of these categories will be of interest to readers of this site.

• Mission objectives and deployment assignment
• Organization structure and Incident Command System
• Information Flow and Management
• Public Health Practice
• Training and Exercises

In addition to the obvious category -- Training and Exercises -- those responsible for health emergency preparedness will note that strategy ("Deployment Assignment") and ICS were seen as areas for improvement. For example, the CDC found that, while it had staff willing to volunteer "in record numbers," it did not have in place programs to get volunteers up to speed where needs were greatest. According to the report, "CDC is now making an unprecedented investment in training staff through its Corporate University, web-0based training modules, exercises and simulations."

For Pandemic Simulation, similar questions must be addressed:

• Does the simulation allow for various strategies for staff utilization?
• Does the simulation address lead time and other logistics aspects of training volunteers?
• Will the simulation demonstrate what happens when inadequate, or less usable equipment and supplies have been stockpiled?
• Will the simulation allow for adequate testing of various surge-capacity plans?
• Will the simulation adequately test whether appropriate support staff are available to support highly specialized staff, and to demonstrate likely consequences of support staff shortages?
  
• Will the simulation show what happens if resources such as the US CDC are overwhelmed and must provide dramatically curtailed support, or different kinds of support, to health facilities?