Table A1 Detailed injects and... | Emerald Publishing

Table A1

Detailed injects and capabilities tested during the tabletop exercise

Inject	Time frame	Type of hazards	Disaster phase	Scenario	Objectives/ Task
1	60 min	Multihazards	Mitigation	Participants receive a map and a fictional facility profile outlining their roles in the disaster scenario	To identify hazards that may impact pharmaceutical supply during disasters To identify relevant plans, guidelines and reference materials To identify risks, bottlenecks and limitations in supply operations To develop mitigation strategies for the identified risks, bottlenecks and limitations in supply operations
2	30 min	Pandemic	Preparedness	A novel virus outbreak in a neighbouring country has triggered a pandemic alert, though no domestic cases have been reported yet	To develop a preparedness plan To develop a communication and coordination plan To gather and manage relevant information
3	45 min	Pandemic	Response	Four weeks into a local outbreak of a novel virus, the healthcare system is under severe strain. Hospitals are overwhelmed, ICU bed capacity is critically low, and approximately one-third of healthcare personnel are absent due to infection or quarantine. The demand for pharmaceuticals has surged dramatically, yet no clinically proven treatment or vaccine is currently available	To develop response measures To identify key medications expected to experience increased demand To establish essential monitoring components for managing the evolving situation To develop strategies for addressing significant workforce shortages
4	45 min	Pandemic	Response	Although conclusive evidence remains limited, emerging clinical findings indicate that a specific antiviral may be effective against the novel virus. While the drug is registered with the national regulatory authority and is available on the market, it is not currently listed in the drug formulary. Nevertheless, clinicians have begun prescribing it off-label, resulting in a sharp increase in demand and critically low stock levels	To develop strategies to improve access to the antiviral To forecast the required quantity of the antiviral and identify key factors influencing demand To create a sourcing plan for the antiviral
5	30 min	Pandemic	Response	The use of antivirals has risen sharply. However, manufacturers have reported supply constraints due to export restrictions imposed by their respective governments, prioritising domestic needs. In addition, the delivery of other essential medicines has been delayed, primarily due to port clearance issues associated with Movement Control Orders and driver shortages resulting from infections with the novel virus	To develop a strategy for managing supply disruptions To develop a communication and coordination plan with other parties
6	45 min	Pandemic	Recovery	Following successful containment efforts, the outbreak has been brought under control, and the government has officially declared the end of the pandemic. The situation has now entered the recovery phase, with a surplus of remaining antiviral supplies	To conduct logistics recovery activities To carry out an after-action review To develop and implement a communication plan
7	30 min	Floods	Preparedness	The Meteorological Department has issued an alert warning of potential heavy rainfall and flooding linked to the monsoon transition phase	To develop a preparedness plan To identify key stakeholders and create a communication plan To determine the essential medicines that need to be stockpiled
8	45 min	Floods	Response	Prolonged heavy rainfall has caused widespread flooding, disrupting communication infrastructure and road access in several areas. While your facility remains operational, mass evacuations have led to the establishment of nearby Temporary Evacuation Centres, where health teams have been directed to set up static clinics, including pharmacy services. At the same time, a sudden surge in demand has resulted in shortages of several essential medicines at your facility, creating an urgent need for additional supplies. In response, private entities and NGOs have offered to donate pharmaceutical products	To develop a plan for establishing pharmacy services at Temporary Evacuation Centres To develop strategies for managing increased medication demand during flood-related logistical challenges To manage in-kind donations
9	30 min	CBRN	Response	Rising floodwaters inundated an industrial area, damaging the electrical systems controlling chemical storage temperatures and triggering a major explosion at a factory housing various chemicals. The blast released hazardous gases into the air, leading to the evacuation of nearby residents due to the risk of toxic exposure. Affected individuals reported symptoms including shortness of breath, dizziness, eye irritation, nausea, vomiting and sore throat	To conduct needs assessments To develop a plan for sourcing critical supplies
10	15 min	CBRN	Response	Within 24 h of the explosion, an investigation report by the HAZMAT unit of the Fire and Rescue Department confirmed the presence of eight major chemicals detected at above-normal levels near the factory. These substances were identified as the probable causes of the symptoms reported by individuals exposed to them	To identify the required medications based on the chemical substances detected during the chemical incident
11	30 min	CBRN	Response	Three hours after receiving the HAZMAT team’s report, medical specialists requested an antidote to treat patients affected by the chemical incident. However, the antidote is not registered with the Drug Control Authority and is unavailable on the local market	To plan the necessary steps for obtaining the required antidote at multiple levels in response to the chemical incident To develop a plan for the distribution and supply of critical supplies
12	30 min	Floods	Response	Continuous heavy rainfall has further worsened flooding in several areas. Due to the high risk of severe impact, the Fire and Rescue Department has issued an evacuation order. Rising water levels have led to flooding across all facilities, resulting in a disruption to the power supply	To develop an evacuation plan To identify key stakeholders or agencies for coordination during evacuation
13	30 min	Floods	Recovery	Four days after the major flooding, the water levels have begun to recede and the situation is stabilising. Temporary evacuation centres have been closed, and the air pollution from the chemical factory explosion has been successfully controlled	To coordinate logistics recovery operations To manage reverse logistics To conduct an After-Action Review to evaluate response and recovery efforts

Inject	Time frame	Type of hazards	Disaster phase	Scenario	Objectives/ Task
1	60 min	Multihazards	Mitigation	Participants receive a map and a fictional facility profile outlining their roles in the disaster scenario	To identify hazards that may impact pharmaceutical supply during disasters To identify relevant plans, guidelines and reference materials To identify risks, bottlenecks and limitations in supply operations To develop mitigation strategies for the identified risks, bottlenecks and limitations in supply operations
2	30 min	Pandemic	Preparedness	A novel virus outbreak in a neighbouring country has triggered a pandemic alert, though no domestic cases have been reported yet	To develop a preparedness plan To develop a communication and coordination plan To gather and manage relevant information
3	45 min	Pandemic	Response	Four weeks into a local outbreak of a novel virus, the healthcare system is under severe strain. Hospitals are overwhelmed, ICU bed capacity is critically low, and approximately one-third of healthcare personnel are absent due to infection or quarantine. The demand for pharmaceuticals has surged dramatically, yet no clinically proven treatment or vaccine is currently available	To develop response measures To identify key medications expected to experience increased demand To establish essential monitoring components for managing the evolving situation To develop strategies for addressing significant workforce shortages
4	45 min	Pandemic	Response	Although conclusive evidence remains limited, emerging clinical findings indicate that a specific antiviral may be effective against the novel virus. While the drug is registered with the national regulatory authority and is available on the market, it is not currently listed in the drug formulary. Nevertheless, clinicians have begun prescribing it off-label, resulting in a sharp increase in demand and critically low stock levels	To develop strategies to improve access to the antiviral To forecast the required quantity of the antiviral and identify key factors influencing demand To create a sourcing plan for the antiviral
5	30 min	Pandemic	Response	The use of antivirals has risen sharply. However, manufacturers have reported supply constraints due to export restrictions imposed by their respective governments, prioritising domestic needs. In addition, the delivery of other essential medicines has been delayed, primarily due to port clearance issues associated with Movement Control Orders and driver shortages resulting from infections with the novel virus	To develop a strategy for managing supply disruptions To develop a communication and coordination plan with other parties
6	45 min	Pandemic	Recovery	Following successful containment efforts, the outbreak has been brought under control, and the government has officially declared the end of the pandemic. The situation has now entered the recovery phase, with a surplus of remaining antiviral supplies	To conduct logistics recovery activities To carry out an after-action review To develop and implement a communication plan
7	30 min	Floods	Preparedness	The Meteorological Department has issued an alert warning of potential heavy rainfall and flooding linked to the monsoon transition phase	To develop a preparedness plan To identify key stakeholders and create a communication plan To determine the essential medicines that need to be stockpiled
8	45 min	Floods	Response	Prolonged heavy rainfall has caused widespread flooding, disrupting communication infrastructure and road access in several areas. While your facility remains operational, mass evacuations have led to the establishment of nearby Temporary Evacuation Centres, where health teams have been directed to set up static clinics, including pharmacy services. At the same time, a sudden surge in demand has resulted in shortages of several essential medicines at your facility, creating an urgent need for additional supplies. In response, private entities and NGOs have offered to donate pharmaceutical products	To develop a plan for establishing pharmacy services at Temporary Evacuation Centres To develop strategies for managing increased medication demand during flood-related logistical challenges To manage in-kind donations
9	30 min	CBRN	Response	Rising floodwaters inundated an industrial area, damaging the electrical systems controlling chemical storage temperatures and triggering a major explosion at a factory housing various chemicals. The blast released hazardous gases into the air, leading to the evacuation of nearby residents due to the risk of toxic exposure. Affected individuals reported symptoms including shortness of breath, dizziness, eye irritation, nausea, vomiting and sore throat	To conduct needs assessments To develop a plan for sourcing critical supplies
10	15 min	CBRN	Response	Within 24 h of the explosion, an investigation report by the HAZMAT unit of the Fire and Rescue Department confirmed the presence of eight major chemicals detected at above-normal levels near the factory. These substances were identified as the probable causes of the symptoms reported by individuals exposed to them	To identify the required medications based on the chemical substances detected during the chemical incident
11	30 min	CBRN	Response	Three hours after receiving the HAZMAT team’s report, medical specialists requested an antidote to treat patients affected by the chemical incident. However, the antidote is not registered with the Drug Control Authority and is unavailable on the local market	To plan the necessary steps for obtaining the required antidote at multiple levels in response to the chemical incident To develop a plan for the distribution and supply of critical supplies
12	30 min	Floods	Response	Continuous heavy rainfall has further worsened flooding in several areas. Due to the high risk of severe impact, the Fire and Rescue Department has issued an evacuation order. Rising water levels have led to flooding across all facilities, resulting in a disruption to the power supply	To develop an evacuation plan To identify key stakeholders or agencies for coordination during evacuation
13	30 min	Floods	Recovery	Four days after the major flooding, the water levels have begun to recede and the situation is stabilising. Temporary evacuation centres have been closed, and the air pollution from the chemical factory explosion has been successfully controlled	To coordinate logistics recovery operations To manage reverse logistics To conduct an After-Action Review to evaluate response and recovery efforts

Source(s): Authors’ own work