SPRING EXERCISE. They’ve been hearing about it ever since they arrived at the Kennedy School. At the end of their first year, MPPs must take part in what has become a rite of passage. For two weeks, routines are suspended and students become aides to top state and federal officials. Many graduates consider it one of the most useful activities they take part in as students. In the following pages, the Bulletin follows MPP student Paula Castillo as she makes her way through the two-week exercise.

WEEK 1 THE GROUND RULES

Sounds of surprise ripple through Belfer’s Land Hall when Spring Exercise cochair Sheila Burke MPA 1982 announces that the students’ task will be to prepare Massachusetts for the bird flu pandemic. Castillo and her fellow MPPs are to prepare individual memos and, in groups, develop 25-to-30-page written briefs and carry out 30-minute briefings with the Massachusetts governor. In the next several days, they will hear from experts most likely to be called upon if the avian flu epidemic were to become a reality. Former Massachusetts Commissioner of Public Health Howard Koh and Harvard School of Public Health (HSPH) Dean Barry Bloom provide an overview of issues to consider in preparing for an influenza pandemic. “Remember all preparedness is local,” says Koh, who now heads the Division of Public Health Practice at HSPH and is a member of the Spring Exercise design team. They also hear from state and local health officials and get insider advice from Kennedy School faculty on what makes for successful memos and effective briefings.

WEEK 2 IT'S ALL ABOUT TEAMWORK

At the end of the first week, as Castillo finishes her memo outlining resource allocation for pandemic preparation to the commissioner of public health, she is assigned to the group she will be working with for the rest of the exercise. Castillo is excited, but nervous. Many of her classmates are her friends, she says, and she’s heard it can get pretty tense. They must rely on one another to pull their weight, since grades are based primarily on work done together. For the next six days, Castillo and her teammates meet in one of the many carrels tucked away off Taubman’s spiraling main staircase. Their job is to propose a decision framework for social distancing measures and a triage protocol for dispensing ventilators. With teammates, Castillo identifies “trigger points” for deciding when residents should be isolated and crunches numbers to figure out how many more ventilators will be needed. As time for their practice briefing nears, Castillo notes, “I can’t wait to get this over. It seems we’re progressing, but slowly.”

DRESS REHEARSAL GETTING FEEDBACK

The dry run briefing — occurring just two days before the briefing to the “governor” —
helps Castillo and her teammates know if they are on the right track. Days of listening to scientists, communications and polling experts, and public health officials has come down to this moment.

Teammate Colleen Gross has volunteered to present their briefing. She has barely begun describing past epidemics when Kennedy School Lecturer in Public Policy Jack Donahue MPP 1982, PhD 1988, cochair of Spring Exercise and the team’s faculty advisor, stops her. “We’re familiar with what’s on the screen, go on,” he says.

Shifting gears, Gross moves to the team’s trigger point recommendations: point one, human to human transmission; point two, an outbreak somewhere in the world; and point three, an outbreak somewhere in North America. At point three, the team recommends voluntary social distancing. Trigger point four — an outbreak in Boston — the team recommends shutting down public buildings, transportation, and enforcing social isolation.

“So there are two flavors,” asks Donahue, “limited and full scale?” Juliette Kayyem, Kennedy School lecturer and the team’s other faculty advisor, wants to know what constitutes an outbreak — “14 people or 114 people?” “Could we narrow the range of uncertainty between too early and too late with further study?” asks Donahue.

The 30 minutes up, Donahue offers some trade advice.“To Gross: It was pretty much impossible to look at you and the screen at the same time. You don’t want to have the governor shifting back and forth like that.”

“The group dynamics are interesting,” adds Kayyem. Looking at the team, “You folks are part of this. You need to be engaged, even if you’re
not the presenter. You’re not back benchers.”

“This is why we have the dry run,” adds Donahue. The team smiles for the first time.

30 MINUTES WITH THE GOVERNOR TEAM COMES TOGETHER

Friday 11:30 a.m. In response to Wednesday’s feedback, Gross now places herself close to the screen, a little off to the side. Her teammates sit at the conference table on either side of her. She doesn’t waste time, quickly introducing her teammates and outlining what will be covered in the next half-hour.

When Gross explains the importance of not responding too soon to a potential disaster, as in the swine flu epidemic, or too late, as in Katrina, John Haigh MPP 1982, acting as governor (in real life the Kennedy School’s executive dean), interrupts. “What’s your best guess for when an outbreak will occur?” “History shows that pandemics come in cycles of 38 years,” says Gross. “And in any given year, the probability is 4 percent,” adds Castillo. Minutes later, as teammate David Lanier outlines the state’s plan for social distancing, Haigh asks, “What’s the magnitude of the risk?” When Lanier responds that the number is flexible depending upon severity of the strain, Haigh quickly asks, “What’s your best guess?” “We’re talking about 5 percent of the population infected,” Lanier shoots back.

Finally, Haigh offers advice: “Be clear up front on what you are trying to accomplish. First, articulate the issues and provide the salient facts to provide context and an understanding of the problem. Second, outline alternatives, along with a recommended approach. They’ll be very adept at making decisions as long as you frame the issue for them in a clear way.”

RELIEF TAKE A DEEP BREATH

The presentation over, the group relaxes. In the hall, they wish the team about to enter good luck. “I will miss you guys,” says Castillo, soon after leaving the briefing room. They will hear sometime in the next two weeks how they did. For now, they decide to head out across the street for lunch at Charlie’s Kitchen. Later they attend the celebration party in the Taubman rotunda, where Dean David Ellwood congratulates the more than 200 MPPs taking part in the exercise. Later, Castillo looks back on the two weeks. The hardest part was coming up with the numbers: how many infected, how many deaths, the number of ventilators. The best part was learning what makes a good team, she says, noting that her fears about hurt feelings were never realized. All five of the teammates had something important to offer, she said. “Everybody pulled their weight on this team,” says Castillo. She also has a much greater understanding of how to conduct a briefing. As a result of this exercise, she says, she has changed a final presentation she will be making for one of her classes. In summing up the last two weeks, Castillo has one last comment: “I’m thrilled with all I’ve learned.”