The Caribbean Public Health Agency (CARPHA) and the Cayman Islands Ministry of Health, Environment and Sustainability have carried out a simulation exercise to strengthen preparedness and response to multiple infectious disease outbreaks.

The scenario simulated several infectious diseases across different exposure settings, including hotels, the community and a cruise ship. It was intended to test whether participants could distinguish between unrelated and concurrent public health events, assess risk quickly and coordinate an appropriate response. CARPHA said the exercise was a simulation only and no actual outbreak was linked to it.

The four-day drill, from August 3 to 6, 2026, brought together 25 representatives from public health, clinical services, laboratory services, infection prevention and control, emergency management, communications and other key sectors to test how the national system would detect, investigate and react.

Live exercise tested national readiness

A five-member CARPHA delegation led by Dr. Lisa Indar, opted for a live, country-specific simulation rather than CARPHA's usual Tingua tabletop exercise. Tingua is normally based on a fictional Caribbean country. In this case, the exercise was tailored to the Cayman Islands' health system, operational arrangements and priorities.

That approach was meant to give teams a realistic insight into how the system might function under pressure.

Review identified strengths and gaps

After the exercise, CARPHA held an after-action review to reflect on the response and identify areas for improvement. The review assessed how effectively the national system could detect, investigate and respond to multiple concurrent infectious disease events, and produces recommendations to strengthen surveillance, early warning and outbreak response mechanisms.

Chief Medical Officer Dr. Hilary Wolf said: "Strengthening outbreak preparedness requires more than having plans in place; it requires testing those plans in realistic situations and identifying where systems, coordination and communication can be strengthened. This simulation provided an important opportunity for our teams and partners to practice responding to multiple public health events across different settings and to identify practical areas for improvement. Continued collaboration with CARPHA will help us build on these lessons and further strengthen our capacity to protect the health of both residents and visitors.”

Health Minister Katherine Ebanks-Wilks MP also pointed to the need for continued partnership.

"The health and safety of our residents and visitors are central to the resilience of the Cayman Islands. As a destination with a significant tourism sector and a highly connected population, we must remain prepared to detect and respond quickly to public health threats.”

Training covered detection, investigation and response

The mission ended with a national outbreak response training session. It covered the core steps of outbreak preparedness, detection, investigation, coordination and response, and used the simulation as a practical example to show how those steps worked in real time.

The training also included a sensitisation session on CARPHA's Traveller Health Programme early warning systems. These included the Tourism and Health Information System, known as THiS, the Mass Gathering Surveillance System and the Caribbean Vessel Surveillance System.

CARPHA said those systems were important for monitoring and responding to public health threats linked to tourism, mass gatherings and cruise travel.

Regional upgrades to its tourism and vessel surveillance systems generated more than 4,100 health reports, with 92% of outbreak responses taking place within 24 hours, according to a 2025 Pandemic Fund progress report. Its mass-gathering surveillance system was also used during major events including the 2024 ICC Men's T20 Cricket World Cup.

The CARPHA team has developed a series of recommendations to strengthen surveillance, early warning, investigation, coordination and response across the Cayman Islands. CARPHA said it remained committed to working with the territory to support the implementation of those priorities.

The agency said the mission helped connect emergency response plans with how they were carried out on the ground. It also aimed to build a culture of continuous rehearsal and learning among public health practitioners and partner agencies.

CARPHA's Tourism and Health Programme has long focused on strengthening health security across the Caribbean through surveillance, response, guidelines, capacity building, standards, policy, advocacy and partnerships.