What do innovative emergency management, disaster wargaming, board games, AR scenario training, tabletop exercises, Grey Rhino, stress resilience, health science data, PGx and chemical exposure have in common? A LOT!

They are ALL closely connected to ensure optimal protection for our many everyday heroes — whether firefighters, police officers, military personnel, emergency and disaster managers, healthcare professionals and many more.

For our strategic planning and conceptualization in emergency, crisis and risk management, we should always take the time for a 360-degree perspective to protect the health and lives of our everyday heroes. To truly act with future security in mind, this is not merely an option, it should become the standard practice.

It is not always the sudden disasters that challenge us. More often, it is the obvious, large-scale risks that we ignore for far too long — until they inevitably escalate.

How often do we hear about the Black Swan, yet who truly considers and integrates the many Grey Rhinos into their planning and preparedness strategies?

Wake-up call

Dear community of global emergency, crisis, risk and disaster managers,

The often-forgotten "Grey Rhino" confronts us EVERY single day in its many forms and facets.

We are all aware of the alarming figures that highlight just how urgent and necessary innovative approaches in crisis and emergency management truly are.

Worldwide, an estimated 400 million people are struggling with the long-term effects of Long Covid and ME/CFS, with projections exceeding 1 billion cases by 2033. Most Long Covid / ME/CFS patients belong to the economically active age groups, making the economic impact staggering and posing a massive challenge (cf. Domke, 2024). But what about our first responders and everyday heroes on the front lines? Have we considered that many affected individuals may have lost their sense of smell, suffer from muscle weakness, experience vision problems or deal with severe orthostatic hypotension?
Diseases and fatalities resulting from non-optimized pharmacotherapy in the United States (2016) already amounted to $528.4 billion per year, accounting for 16% of total healthcare expenditures (cf. Buschman, 2018).
The drug crisis, which claimed over 105,000 lives in the United States in 2023, is closely linked to the alarming global increase in neurological diseases such as Alzheimer’s and dementia. In 2021 alone, more than 3.4 billion people suffered from a neurological disorder, including dementia, migraines or strokes (cf. afp/aerzteblatt, 2024).
In 2021, approximately 529 million people worldwide were affected by diabetes, with 96% suffering from type 2 diabetes, which is largely preventable. Factors such as high BMI, poor nutrition, environmental and occupational risks, alcohol consumption, smoking and lack of physical activity contribute significantly to the disease. By 2050, the number of cases is expected to double to around 1.3 billion (cf. Ong, 2023).
According to a recent study, nearsightedness in children is reaching alarming proportions. It is expected that the global incidence of myopia will exceed 740 million cases by 2050.
According to the International Agency for Research on Cancer (IARC), the number of cancer cases is rising rapidly worldwide. In 2022 alone, 20 million new cancer diagnoses were reported. Based on IARC projections, the number of annual cancer diagnoses is expected to increase by 77%, reaching 35 million cases per year by 2050.
In addition, there are the many toxic substances caused by chemicals and pesticides.
The weather and climate disasters that caused damage of 182.7 billion dollars and 568 deaths in the USA in 2024 alone, as well as the enormous psychological and physical strain on our many everyday heroes, be they our firefighters, police officers, soldiers, doctors/paramedics/nurses or emergency managers. We must succeed in keeping cities, regions and countries safe and stable in terms of health and the economy. Let's take a quick look at “past” figures in Berlin: in the police force, each employee was ill for an average of 50.3 days per year. In the fire department, 52.1 days/year (cf. Kopietz, 2023).
In some countries, allergy rates of up to 40% have already been reached and the European Academy's forecast predicts that around 50% of the population will be affected by allergies by 2050.
Pandemics
Economic and trade conflicts
Military disputes and conflicts
Sick leave/shortage of doctors/emergency medicine/abuse of medication/burden on healthcare systems
AI / cyber security
migration issues
Divided societies / chronically ill societies
Radicalization / Fake News
“Loss” of cognitive abilities

However, knowledge of these “gray rhinos” also offers us great opportunities in the field of emergency, risk and crisis management. With a combination of modern wargaming, AR scenario training, board games, table-top exercises, health science data and holistic 360-degree approaches, we can make these threats truly visible, tackle them proactively and also transform them in many other areas.

Create your own resilience strategy system with a 360-degree perspective as an optimized framework for the future

Wargaming as a method has of course long been known and proven to simulate conflicts and test corresponding decisions.

BUT I still see a lot of potential and room for improvement here. In my opinion, there are several opportunities and starting points for closing the gaps that still exist.

We should ask ourselves ...

- Are there still gaps in the area of integration or are our own technical capabilities currently still too limited?

- Can our positive training results really stand up to the real complexity in the real world? Are we really already focusing on 360-degree approaches and a holistic 360° resilience perspective? What about our urban and infrastructure resilience?

- Have “all” gray rhinos really been sufficiently identified and comprehensively included in our strategic planning?

- Have all the “real” challenges (chronically ill societies / divided societies and much more) been sufficiently addressed and considered or are we not yet sufficiently aware of them? Do we already have sufficient interdisciplinary links between medicine, psychology and technology?

- Is our adaptive response capacity and sustainable resilience already optimal?

- Is there still skepticism about “wargaming strategies” and if so, why? In my opinion, they are not only valuable and useful for military approaches, but also valuable “strategic gold” in the hands of EVERY emergency and crisis manager, as well as in civilian operations.

To ensure an even wider acceptance and more sustainable use of “Disaster Wargaming” (regardless of which variant you prefer), innovative enhancements are still needed. We must succeed in creating and training many more realistic simulations and scenarios (whether in AR scenario training, board games or tabletop exercises) combined with valuable (unfortunately currently completely underestimated and hardly considered) health approaches such as stress measurements, pharmacogenetic tests, consideration of cervical rhythm / sleep hygiene, lifestyle factors, mental training, breathing techniques, consideration of chemical exposure and, of course, the resilience factor).

We will not be able to avoid looking at these expanded approaches and implementing them consistently if we really want to strengthen the resilience and health of our everyday heroes and our societies in order to achieve real added value for safety and effectiveness in emergency and disaster management.

As a certified disaster manager (WAW) and my particular preference for a love of detail in strategies and concepts with 360-degree approaches, I would like to take you into my scenario world.

Let's work together to strengthen our overall social resilience and protect lives - the lives of our community and, above all, those of our everyday heroes.

Sources:

https://www.healthdata.org/research-analysis/library/burden-neurological-disorders-across-us-1990-2017
https://www.climate.gov/news-features/blogs/beyond-data/2024-active-year-us-billion-dollar-weather-and-climate-disasters
Wenn die Natur rebelliert: Klimawandel und der Anstieg von Allergien sowie Asthma, 8. April 2024, Interview mit: Univ.-Prof.in Dr.in Erika Jensen-Jarolim, Ursprünglich erschienen: UIM 02|2024
Ziyad Al-Aly, 2024, Ziyad Al-Aly ist Leiter der Forschungs- und Entwicklungsabteilung des VA St. Louis Health Care System und klinischer Epidemiologe an der Washington University in St. Louis, CBS News, https://www.cbsnews.com/news/long-covid-what-scientists-now-know/ (Website access: 10.04.2025
Pam Belluck, 9.8.2024, The New York Times, https://www.nytimes.com/2024/08/09/health/long-covid-world.html (Website access: 10.04.2025)
Britta Domke, 16.05.2024, Manager Magazin, https://www.manager-magazin.de/lifestyle/long-covid-konferenz-wir-muessen-uns-endlich-eingestehen-wie-gewaltig-dieses-problem-ist-a-4389644b-1795-4acf-bccf-759d6dce1982 (Website access: 10.04.2025)
Dr Kanyin Liane Ong, Institute for Health Metrics and Evaluation, University of Washington, Lancet 2023; 402: 203–34, Published Online June 22, 2023 https://doi.org/10.1016/ S0140-6736(23)01301-6
Heather Buschman, 02.04.2018, https://today.ucsd.edu/story/when_drugs_are_wrong_skipped_or_make_you_sick_the_cost_of_non_optimized_med (Website access: 10.04.2025)
Krü, Welt am Sonntag 07.09.2003, https://www.welt.de/print-wams/article100194/58-000-Tote-durch-falsche-Medikamente.html (Website access: 10.04.2025)
Andreas Kopietz, Berliner Zeitung 27.09.2023, https://www.berliner-zeitung.de/mensch-metropole/50-fehltage-im-jahr-so-krank-sind-berlins-polizisten-und-feuerwehrleute-li.435325 (Website access: 10.04.2025)

https://makula-netzhaut-myopie.center/blog/kurzsichtigkeit-myopie-bei-kindern-steigt-laut-studie-weltweit-an (Website access: 10.04.2025))