On October 18, 2019 — fourteen weeks before SARS-CoV-2 was identified — the Gates Foundation, Johns Hopkins Center for Health Security, and the World Economic Forum jointly hosted Event 201, a high-level tabletop pandemic simulation exercise in New York. The exercise modelled a fictional coronavirus pandemic originating in pigs and spreading globally, and highlighted critical gaps in public-private co-ordination, health communication, and medical countermeasure supply chains. Event 201's recommendations — published in November 2019 — closely anticipated the actual challenges that emerged during COVID-19 in early 2020.