George Town, Cayman Islands. August 10, 2026. The Caribbean Public Health Agency (CARPHA), in collaboration with the Ministry of Health, Environment and Sustainability (MHES) of the Cayman Islands, delivered a country-specific simulation exercise and targeted capacity building initiatives to advance outbreak preparedness and response at the national level. The live simulation exercise provided a structured, scenario-based platform to test coordination, decision-making, and operational response across sectors. It emphasised high-risk and context-specific settings relevant to the Cayman Islands, including the tourism sector (both hotel-based & cruise ship health events), mass gathering, and the local community.

This initiative supported the Cayman Islands in strengthening its national preparedness and response systems, while contributing to broader regional resilience by embedding a culture of continuous rehearsal and learning to strengthen public health emergency management. This four-day mission in the Cayman Islands, from August 3-6, 2026, was conducted by a five-member CARPHA delegation led by Dr. Lisa Indar, CARPHA Executive Director (ED), together with Mr. Mohamed Elsherbiny, Senior Technical Advisor, in the

Office of the ED, Mr. Keston Daniel, Coordinator, Regional Tourism and Health Program (THP), Ms. Tamara Barnard, Coordinator, Foodborne Diseases and Zoonoses (One Health) and Ms. Samantha Llanos, Epidemiologist, Visitor Based Surveillance, of the THP.

The exercise brought together 25 representatives from public health, clinical services, laboratory services, infection prevention and control, emergency management, communications and other key sectors to assess how effectively the national system could detect, investigate and respond to multiple concurrent infectious disease events. While CARPHA typically conducts Tingua, a tabletop exercise based on a fictional Caribbean country, the Cayman Islands opted for a live, country-specific simulation. This approach allowed the exercise to be tailored to the country’s health system, operational arrangements and priority settings, providing a practical assessment of national systems under realistic conditions. Both approaches are designed to bridge the gap between emergency response plans and their implementation while building the capacity of relevant public health practitioners.

The scenario simulated multiple cases involving several infectious diseases across different exposure settings, including hotels, the community and a cruise ship. The exercise was designed to test participants’ ability to distinguish between concurrent and unrelated public health events, rapidly assess risks, and coordinate appropriate response measures. This was a simulation exercise only. There was no actual outbreak associated with the exercise scenario.

Following the exercise, CARPHA convened an after-action review to reflect on the response and identify areas for improvement. In opening the after-action review, Chief Medical Officer, Dr. Hilary Wolf emphasised the importance of strengthening national capacity for outbreak preparedness and response, noting that initiatives such as this are critical to protecting both residents and visitors. She stated “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 practise 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”.

Reflecting the Government’s commitment to strengthening national preparedness and protecting the health and well-being of residents and visitors, the Honourable Katherine Ebanks-Wilks, Minister for Health, Environment and Sustainability, highlighted the importance of continued collaboration with CARPHA, noting “The health and safety of our residents and visitors is fundamental 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. This collaboration with CARPHA provides an important opportunity to strengthen our national systems, test our readiness and translate the lessons learned into meaningful improvements. We are committed to continued partnership and investment in preparedness so that the Cayman Islands remains resilient in the face of emerging health threats”.

The mission concluded with a national outbreak response training, which covered the core components of outbreak preparedness, detection, investigation, coordination and response, and provided an opportunity to contextualise these principles through the simulation exercise. The training included an in-depth sensitisation session on the CARPHA Travelers Health Programme (THP) early warning systems, including the Tourism and Health Information System (THiS), Mass Gathering Surveillance System (MGSS), and Caribbean Vessel Surveillance System (CVSS). The session highlighted the role of these systems in strengthening the Cayman Islands’ capacity to monitor, detect and respond to public health threats associated with tourism, mass gatherings events and cruise travel.

The exercise highlighted the importance of strong, connected systems for early detection, rapid investigation and coordinated response to public health threats. Through the simulation exercise, technical training and engagement with national stakeholders, the mission provided practical opportunities to identify strengths, address gaps and strengthen collaboration across the health and wider government sectors. The CARPHA team also developed a series of recommendations to strengthen surveillance, early warning and outbreak detection, investigation, coordination and response mechanisms across the Cayman Islands. These recommendations provide a practical basis for translating the lessons identified during the mission into tangible improvements in national preparedness and response capacity. CARPHA remains committed to working alongside the Cayman Islands to support implementation of these priorities and contribute to a safer and more resilient Cayman Islands for both residents and visitors.

About CARPHA-THP

CARPHA’s THP is a multifaceted programme that pioneers work for improving sustainable Caribbean tourism and health security, whilst engaging and collaborating with CARPHA Member States. The THP adopts a multisectoral approach for improving the resilience of the tourism industry and, by extension, the health sector of each participating country through surveillance, response, guidelines, capacity building, standards, policy, advocacy and partnerships, and a travellers’ health award and app. The THP strengthens regional and national health systems and enhances the health of visitor and resident populations by seeking to address the health, safety, and environmental sanitation threats to tourism. The programme has built capacity and equipped countries with regional tools that supports preparedness and response to public health threats.

https://carpha.org/THP/Background  

 Photo Captions:

Photo Caption: (L-R) Mr. Keston Daniel, Mr. Mohamed Elsherbiny, Dr. Hilary Wolf, Chief Medical Officer – Ministry of Health, Environment and Sustainability (MHES) of the Cayman Islands; Dr. Lisa Indar, Executive Director - CARPHA, Minister of Health, the Honourable Katherine Ebanks-Wilks and Ms. Tamara Banks, Deputy Chief Medical Officer; Dr. Mark Paramlall, Ms. Samantha Llanos and Ms. Tamara Barnard.

Photo Caption: Urgent Care Physician and Nurses of the Cayman Islands are joined by CARPHA’s mission team following the preparedness and response exercise.

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