For example, one set of exercises we designed focused on pandemic influenza preparedness in local health departments. Because it was infeasible to exercise the entire pandemic plan around a single scenario and in a single exercise, we developed the scenario and then the exercise by first meeting with local stakeholders to decide on the issue areas that would be covered in the exercise. These issue areas included disease surveillance, medical surge capacity, non-pharmacological disease control, and the use of antiviral medications. The scenario was then customized to unfold to deal with each of these issue areas.