FORT KNOX, Ky. — More than 13 years before the COVID-19 pandemic swept across the globe, a group of about 100 area organizations gathered at Fort Knox to work on plans to combat it, or something similar.Nobody knew about the coronavirus back then. In fact, they weren’t even focused on the next big pandemic coming from a family of viruses that includes the common cold. Their one-day tabletop exercise pondered how they would respond if the next big influenza outbreak hit the area.“Back then, we were planning for an avian flu pandemic, which turned out to be not so big of a deal,” said Joel Tiotuico, plans officer for the Plans and Operations Division at Fort Knox Directorate of Plans, Training, Mobilization and Security. “The planning for that pandemic was basically because we thought it was going to turn out like COVID-19 has.”Tiotuico was charged with leading Fort Knox’s efforts back in mid-May 2007. He and Sara Jo Best, director of Lincoln Trail District Health Department, gathered together about 100 people from local, county, state and federal organizations for the exercise, including several from each of 10 counties that surround Fort Knox.“We had a really good turnout that year,” said Best, who mentioned that she had been promoted to oversee the preparedness department at the organization about three years prior. “We were tasked with developing emergency response plans, getting people trained to be able to respond; developing a community coalition to plan for emergency disasters. All that included Fort Knox.”The exercise, which was featured as a three-part series in the post’s Turret newspaper, made as its starting point the 1918 flu pandemic, which killed about half a million Americans.Tiotuico said the 2007 exercise was likely the first event that emphasized coordination and cooperation among so many different organizations to discuss how best to deal with a pandemic from a medical capacity.“Emergencies like fires, tornados, and ice storms — those are immediate action events. Whereas a pandemic similar to COVID-19 kind of starts slowly, and you’re reacting to something you don’t see, or don’t know it’s happening at first; you’re trying to prevent it from happening,” said Tiotuico. “In that tabletop exercise, we found out the best way to fight it was to try and prevent it.”Some of the preventive measures that surfaced from the 2007 exercise included the wearing of facial coverings, regular sanitizing of surfaces and social distancing by such means as teleworking.“Most of our guidance on this plan, up to now, was from the [Centers for Disease Control and Prevention],” said Tiotuico. “We had decision points, when to get people on telework, when to close stores and schools — it was all in the plan.”Tiotuico and Best said they remember the threats posed by the H5N1 bird flu scare of 2006, though other strains of that particular influenza had been around since at least 1997. According to news reports, the 2006 strain was predicted by health experts to reach unprecedented numbers of deaths if not mitigated. By May of 2007, Department of Defense officials released a guidebook from which to start planning for a possible flu pandemic.The 2007 Fort Knox exercise formed as a result of these concerns, said Tiotuico. The results were then placed into a document that could be tweaked over the years to fit whatever scenarios installation officials would face.He elicited the help of a preventive medicine doctor, who produced an 800-page clinical paper, from which Tiotuico honed to about 150 pages.“It’s pretty lengthy because everybody plays a part in it, from logistics to family welfare departments, to the schools and emergency management; even the commander himself,” said Tiotuico.Fast-forward to March 2020, Tiotuico said leaders had voiced concerns about what measures needed to be taken when COVID-19 hit the United States. They approached him.“When we started COVID, all I did was dust off our old plan and shape it to the operations order that we have now,” said Tiotuico. “The order I published in March is a by-product of the operational plan that we had for the pandemic.”Tiotuico said the key to effective planning comes from having a flexible document that allows leaders to quickly adjust and make informed decisions when disasters hit: disasters like the 2009 ice storm and this year’s pandemic.“This is the second time in my career since I’ve been here that I’ve written a plan for something, and it got executed,” said Tiotuico. “I just hope another disaster doesn’t happen while I’m here.”Tiotuico said he plans to retire in November.