The report uses prior disasters as case studies. Analysis of those case studies provide lessons learned and provided indicators based on previous events.

 Historical patterns are used as a baseline for building responses. The single hypothetical scenario offers a timeline and discusses the impact of a pandemic. The CDC is relied upon for warning and this report discusses the second and third order effects of a pandemic. Multiple scenario generation is used. This is done for the purpose of creating a standardized response. Structured reasoning is discussed in detail so each scenario can be used to generate a broadly applicable response that can be easily adapted to specific issues. Warnings are not explicitly discussed but the report highlights shortcomings in preparations and lists considerations. Specific to a pandemic, the report details areas that are likely to be impacted and problems that will likely occur. 

The SARS outbreak in 2002 gave the U.S. a glimpse of what could occur during a modern pandemic and would serve as a warning that the next one could be worse. Information leading up to 2020 indicated a pandemic would be disastrous and existing planning was not appropriate. Various government and civilian agencies raised awareness, and some offered solutions and disaster recovery plans. Over time, conceptual scenarios turned into vulnerability warnings making it clear that a pandemic was a question of “when” not “if”.  

In our after action or current action review (Coronavirus has not been eradicated) a consistent timeline was drawn from the first NIE in January 2000 through the current period.

How clearly were likelihood and implications communicated?

Many sources stated the likelihood in a clear manner. The implications were consistently determined to be serious. A pandemic was deemed to be likely and high impact.  There were numerous examples across all of the sources as to the potential for a global pandemic and referenced the 1918, 1956, 1968 pandemics as well as the more recent MERS-CoV, Ebola, and SARS outbreaks.  A common theme throughout the sources were the dynamic and rapid evolution of a threat.

How timely? Did policymakers theoretically have time to take appropriate actions?

A pandemic response playbook for the Executive Office of the President was created in 2016. Most recent warnings were mentioned in 2019, with enough warning to create a plan, prepare supplies, and begin looking for indicators.  In fact as far back at 2000 with the NIE in January of 2000 disseminated key issues and implications for an impending pandemic.

What were the key challenges the analysts faced?

Some sources state political issues caused challenges for the analysts. They produced a product that was not used appropriately.  Also, intelligence fusion and integration across the interagency was not consistent as other near-term and current operations competed for policymakers' priorities.

How accurate?

The specific location of an outbreak and specific disease were topics of debate, but the result of an outbreak were similar across most sources. Broadly speaking, there was to be mass disruption across the globe with all elements of daily life disrupted.  Our research indicates many previous pandemics have initiated in the eastern regions of the World however due to changes in climate, migration, and global transportation, no confirmed place of origin could be definitely established.

*Document                                Team member*
2000-NIE                                   Braswell
2003-NIC Report SARS            Saucedo
2016-WHO Report                      -
2016 - Pandemic Playbook      Hap
2016- Ebola Memo                    Girod
2017-USNORTHCOM                Braswell
Branch Plan
2017-G'town Global Health      Hoffman
2018- WHO R&D Blueprint       Girod
2019- Preparedness Index      Hoffman
2019- Statement for the           Girod and Yitzhak
Record US IC
2019- FEMA Assessment         Green
2019- Crimson Contagion        Girod
2019- Congressional                 Follett
Testimony 

Summary written by Braswell, Hap, Green, and Saucedo 

This is a National Intelligence Estimate so at the strategic level. It represents input and analysis from the IC.  It examines the most lethal diseases globally and by region; develops alternative scenarios about their future course; examines national and international capacities to dealwith them; and assesses their national and global social, economic, political, and security impact. It then assesses the infectious disease threat from international sources to the United States; to US military personnel overseas and to regions in which the United States has or may develop significant equities.c.  The methodology incorporated data analysis in developing a typology used to analyze impact regionally.d. Does it communicate strategic, operational, or tactical warning? The NIE is strategic in nature.e. What are the types and the quality of the intelligence used? DIA/AFMIC (Armed Forces Medical Intelligence Center) analysis incorporated f. Is the argument based on observation, analogy, historical patters, or a combination? A combination of historical patterns and observation are used.   Three potential scenarios. 1. Stead progress 2. progress stymied, and 3. deterioration, the limited improvement.  Factors affecting growth and changes in human behavior are considered key drivers.i.  The NIE presents the probability of a bioterrorist attack against US civilian and military personnel overseas or in the United States also is likely to grow as more states and groups develop a biological warfare capability. It suggests the development of a global surveillance and response system to identify outbreaks and coordinating action without overtly calling it a recommendation.  Alternative Futures Analysis method was used to which included examining three plausible scenarios for the course of the infectious disease threat over the next 20 years (2000-2020).  The scenarios were influenced by three sets of variables. The first is the relationship between increasing microbial resistance and scientific efforts to develop new antibiotics and vaccines. The second is the trajectory of developing and transitional economies, especially concerning the basic quality of life of the poorest groups in these countries. The third is the degree of success of global and national efforts to create effective systems of surveillance and response. The interplay of these drivers will determine the overall outlook.  “New, and reemerging infectious diseases will pose a rising global health threat and will complicate US and global security over the next 20 years.  These diseases will endanger US citizens at home and abroad, threaten US armed forces deployed overseas, and exacerbate social and political instability in key countries and regions in which the United States has significant interests.”  As this NIE is at the strategic level, trends and regions and areas are discussed versus specific instances of potential threat.

This NIE is useful as a strategic warning piece on the breadth of impact a pandemic would have and I found the SAT well developed through the scenario based analysis. I think unless a policymaker had a completed understanding of the problem set this may not reach a wide audience. Note. the impact beyond health and on the economic and security of the U.S. informative.

This report "specifically identified coronaviruses as a potential threat" and the lack of preparedness that would exacerbate a potential infectious disease pandemic.

The report does not however provide an alternative of analysis on how a foreign actor could or may try to use a pandemic to threaten the strategic interests of the US or allies.

This branch plan serves as an operational level warning and plan to identify key drivers that may contribute to an outbreak and coordinate response to a pandemic. The level of imagination is fairly limited given the intent of this product. A more effective document may be the intelligence assessment itself of the threat coronavirus and warning tripwires that would inform a policymaker.

b.      What kind of product is it? What is its purpose? (as a product type) This is an Executive Branch Playbook. The purpose is to guide domestic and international decision-making in the event of a pandemic either at home or abroad. It is a decision-making tool that identifies what questions to ask, whom to consult, and the critical decisions which may require deliberation through the National Security Council. 

c.       What does it say about the analytical process involved in reaching the judgments? Notably, this is a playbook designed to assist complex national-level decision-making on complex and emerging threats. Per the module 12 lecture, emerging threats are within the six-month time frame. The playbook enables targeted subject matter input from relevant agencies within this emerging threat timeline. 

d.      Does it communicate strategic, operational, or tactical warning? This product is designed to help national-level decision-makers digest intelligence and make strategic-level decisions. It specifically highlights that the DOD’s Armed Forces Health Surveillance Center and National Center for Medical Intelligence (in conjunction with the Department of Homeland Security) have the ability to answer questions from decision-makers regarding epidemiology and country-dependent questions (Department of State would assist in the event of a pandemic originating overseas). The document states that the NCMI would “provide assessments of foreign health threats, including pandemic warning, to prevent strategic surprise across the broad threat spectrum.”

e.      What are the types and the quality of the intelligence used? The Executive Branch would use All Source intelligence from across the IC and US Government. It cites past examples of epidemics and pandemics such as the February 2003, Severe Acute Respiratory Syndrome pandemic which spread across 20 countries before being contained. It also cites the 2014 Ebola outbreak as well as the MERS-CoV and the Zika outbreaks as a sources of information.  

f.        Is the argument based on observation, analogy, historical patterns, or a combination? In the event the playbook is implemented, the intelligence would be based on a combination of observation and historical patterns due to pulling intelligence from multiple agencies and sources. For example, the CDC would dispatch officers to the field which would generate field reporting, similarly, the Department of State would receive reporting from Host Nations if the pandemic was abroad. 

g.      Does it identify scenarios or multiple hypotheses, drivers, etc? The playbook has example exercises that explore multiple health crisis scenarios (e.g. domestic, foreign, natural, and man-made). It also cites specific viruses that have caused crises in the past such as Bacillus anthracis, hantavirus, West Nile Virus, the Ebola Virus, and most importantly for our purposes “novel coronaviruses.”

h.      Does it refer to indications and indicators? The playbook specifically states that Epidemic Intelligence Service officers working in CDC health departments would be dispatched to investigate epidemics due to both natural and man-made causes. It specifically mentions the ability to be treated through pharmaceutical interventions, whether the pathogen is known scientifically, its mode of transmission, the ability to sterilize surfaces the pathogen comes in contact with, clinical severity, and degree of transmissibility as possible indicators of a potential future health crisis. 

i.        Is it objective? Is the analysis imaginative (in the intelligence sense)? The playbook itself is an objective policy document and decision-making tool, informed by past intelligence reporting and Executive operations planning tools. 

j.        Does it employ structured reasoning techniques? (SATs or other) Not directly.

k.      Are assumptions and limitations clearly stated? The document contains a significant number of assumptions for the Decision-Making Rubric for Assessment and Response. Assumptions are clearly stated in both foreign and domestic health crisis situations. Of specific interest to intelligence analysts, is the section covering indicators specifically what the document describes as the four areas of risk “ epidemiological indicators, humanitarian/developmental/public health impact indicators, security and political stability indicators, and its [the pathogen’s] transmission/outbreak/potential for public concern in the United States.”

l.        Is the warning clear and explicit? N/A for this document however in the scenarios warnings and threat levels are clearly articulated. 

m.    How detailed is the warning and justification? N/A

Overall, the document, while not exactly an intelligence report, adds to the body of USG literature that predicts a future pandemic of national concern. The report specifically highlights novel coronaviruses as a “pathogen of heightened concern.” While the likeliness of a pandemic is not explicitly stated within the text the assumption is that it is nearly inevitable. Moreover, the document implies that a pandemic would be an event with great national security and international security implications. The report itself was designed to be used by the highest levels of the US government and it clearly articulates the threat of epidemics and pandemics.

Reference:
https://stacks.stanford.edu/file/druid:hy459js4845/Pandemic-Playbook.pdf