In nearly all exercises, we also identified a number of strengths within participating health departments. However, there was far less commonality in these strengths than we observed with the areas for improvement. Universally, we observed public health leaders and staff who were committed and struggling to 'do the right thing.' The most commonly observed strengths were strong relationships between epidemiologists and hospital infection control practitioners and between public health workers and other emergency coordinators. In some instances, prior experience with emergency planning or response, such as involvement of health departments and emergency service agencies in coastal areas in preparing for or responding to hurricanes, was associated with stronger and more facile interactions between health department officials and partner agencies.