Transcript Outbreak communication

Outbreak communication
Preben Aavitsland
Your role
• National, regional or local public health
office
• Responsible for outbreak response
Challenges in outbreak investigations
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Great urgency
Start without hypothesis
Few cases
Pressure to conclude
Bias caused by media reports
Legal and financial pressure
Many agencies and persons involved
Background
• Many communication failures
– delayed outbreak control
– undermined public trust and compliance
– prolonged economic, social and political turmoil
• WHO after SARS:
– ”Communication expertise has become as essential to
outbreak control as epidemiological training and
laboratory analysis.”
– Literature review + international conference 
guidelines
Key elements of outbreak communication
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Trust
Announcing early
Transparency
The public
Planning
Trust
• Communicate in ways that build, maintain or
restore trust
• Trust is hard to win and easy to lose
• No trust  fear and lack of compliance
• Trust the public's ability to tolerate incomplete
and sometimes alarming information
• Accountability, involvement and transparency are
key factors to build trust
A trust triangle in your institute
Policy makers
Technical staff
(epidemiologists…)
Communicators
• Build the trianlge before it is needed
Announcing early
• The first announcement is critical!
• Outbreaks cannot be hidden  Announce as
early as possible
– Avoid rumours and misinformation
– Avoid loss of trust when someone else reveals the
situation (”Governement cover-up”)
• The longer you wait, the more frightening the
information will seem when it is revealed
– And the media will ask: ”What do you know, and when
did you know it?”
• You do not decide what the media will be
interested in
But be careful
• Make sure to inform your partners first
– Establish contact with them in advance
• Make reservations for incomplete
information
– State clearly: ”This is what we know at the
moment. Information may change the
investigation continues.”
Transparency
• Transparency = candid, easily understood,
complete and factually accurate
information
• Let the public "view" the informationgathering, risk-assessing and decisionmaking processes
• Explain the limits, for instance patient
privacy
Barriers to transparency
• Fear of economic loss
– Tourists will be afraid
– Trade may stop
• Bad planning and preparation
– Forgot to prepare a message
– Forgot to prepare answers tolikely questions
• No training in delivering bad news or discussing
uncertainty
• Fear of revealing weaknesses in infrastructure
Seek culture change in outbreak preparation!
The public
• Understand the public’s beliefs, opinions and
knowledge
– ”Communications surveillance”
– Include representatives of the public in the planning
• Explicitly address pre-existing beliefs
• Take the publicly held view seriously
– Acknowledge and correct
– Do not ignore, patronise or ridicule
• Always tell the public what they can do to reduce
risk
• The mass media ”represent” the public
Planning
• Everything you do is communication!
– Sometimes actions speak louder than words
• Include risk communication in plans
• Include communicators in the team from
the start