Crimson Contagion was a joint exercise conducted from January to August 2019, in which numerous national, state and local, private and public organizations in the US participated, in order to test the capacity of the federal government and twelve states to respond to a severe pandemic of influenza originating in China.
The simulation, which was conducted months prior to the start of the COVID-19 pandemic, involves a scenario in which tourists returning from China spread a respiratory virus in the United States, beginning in Chicago. In less than two months the virus had infected 110 million Americans, killing more than half a million. The report issued at the conclusion of the exercise outlines the government's limited capacity to respond to a pandemic, with federal agencies lacking the funds, coordination, and resources to facilitate an effective response to the virus.
Between January and August 2019, Trump’s Department of Health and Human Services (HHS), headed by Alex Azar, runs a simulation—code-named "Crimson Contagion". In this "Functional Exercise", participated the National Security Council, United States Department of Health and Human Services, United States Department of Agriculture, United States Department of Commerce, United States Department of Defense, United States Department of Energy, United States Department of Homeland Security, United States Department of Housing and Urban Development, United States Department of Interior, United States Department of Justice, United States Department of Labor, United States Department of State, United States Department of Transportation, United States Department of Treasury, between others State and Local organizations, public and private.
During the simulation, several tourists fall ill with a "respiratory virus [that] began in China . . . [and] quickly spread around the world by air travelers . . . [with] high fevers." The virus spreads quickly throughout the world with the first detection in the United States occurring in Chicago (the host city for the exercise). The simulated virus was dubbed "H7N9 Influenza". Conduct of Crimson Contagion begins at a point 47 days after the first case is discovered in the United States. According to the results of the coordinating draft report, dated October 2019, the Crimson Contagion simulation registers 110 million infected Americans, 7.7 million hospitalizations, and 586,000 fatalities. 
- Federal government lacks sufficient funding to respond to a severe influenza pandemic.
- Exercise participants lacked clarity on the roles of different federal agencies, and what information was important to pass on to federal partners.
- HHS had issues providing accurate and relevant information to hospitals and other public health organizations.
- Confusion between HHS, FEMA, and the Department of Homeland Security on which federal agency would take the lead in the crisis.
- The United States lacks the production capacity to meet the demands for protective equipment and medical devices such as masks and ventilators imposed by a pandemic.
- States were unable to efficiently request resources due to the lack of a standardized request process.
- "Coronavirus Outbreak: A Cascade of Warnings, Heard but Unheeded". The New York Times. 2020-03-19. Retrieved 2020-03-25.
- Stracqualursi, Veronica (2020-03-19). "New York Times: HHS' pandemic simulation showed how US was ill prepared for coronavirus". CNN. Retrieved 2020-03-25.
- Moseley, Carol Marin & Don (2020-03-24). "'Crimson Contagion 2019' Simulation Warned of Pandemic Implications in US". NBC Chicago. Retrieved 2020-03-25.
- Crimson Contagion 2019 US Department of Health and Human Services Office of the Assistant Secretary for Preparedness and Response