Right Steps & Poui Trees

But Won’t They Panic If We Tell Them?- Communication re #ZikaVirus & other health emergencies

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I found myself nodding in agreement frequently as I watched a presentation given by Dr Barbara Reynolds at the US Centers for Disease Control & Prevention’s (CDC) Zika Action Plan Summit which was held in Atlanta, GA on April 1. The title of Dr Reynolds’ talk was “Crisis and Emergency Risk Communication: What the public needs when risks are uncertain”. (Scroll down for link to presentations.)

As I watched the live stream of the presentation, I kept thinking back to a number of public health situations in the past couple of years when the Jamaican public would have benefited from better communication by Government agencies:

  • the chikungunya/ChikV epidemic in 2014
  • the Riverton dump fire in 2015
  • the problems in health facilities & deaths of premature babies in 2015.

And although the current situations with Zika virus and H1N1 influenza virus are being handled significantly better, there are still some ways in which communication can be improved.

Dr Barbara Reynolds’ Presentation

Dr Reynolds defined crisis and risk communication as “the kind of communication that leaders will do, along with their experts, to help people and communities make the best possible decisions when the information is imperfect and we’re under impossible time constraints.”  Early in her presentation, she made a very important statement:

cdc barbara reynolds

“And it may be actually surprising to learn that people can accept bad news more easily than they can accept uncertainty.”

 

I didn’t actually find this surprising, as from experience I know it is true. With bad news, you know more clearly where you stand and what actions you need to take; with uncertainty, you don’t know where you stand and decisions about what actions to take are that much more difficult. Dr Reynolds emphasized that during such times the public need to have the facts and need to be empowered by having not just the how of what to do, but also the why.CDC zika Reynolds slide for blog 1

 

In discussing common communication failures, she noted that “a poor operational response cannot be saved by good communication….[and] a good operational response can be spoiled by poor communication.” cdc zika Reynolds slide for blog 2Numbers 2 and 3 on this list  – late release of information & paternalistic attitudes – certainly were among the problems with the communication responses we experienced during the three health crises I mentioned earlier.

 

Dr Reynolds  said she had seen over the years that:

“people often talk about changing messages based on the fear that people will panic. Panic behaviour is actually very rare, but if it does happen the research tells us it happens when there’s no credible authority  and all options seem equal. So what we should be working towards is being as credible as possible at every stage along this response.”

She discussed six principles of Crisis and Risk Communication, which were a useful framework for developing messages.

cdc zika Reynolds slide for blog A4cdc zika Reynolds slide for blog 4

The issue of credibility and trust was raised repeatedly, and the need for these qualities in leaders and spokespersons communicating with the public. Dr Reynolds stated that:

“Condescension is the number one failure in good communication in a response.” 

cdc zika Reynolds slide for blog 5

She shared a number of communication lessons particularly relevant to the developing situation with Zika, where there is a lot still not known about the virus and knowledge is being added to almost on a daily basis.

cdc zika Reynolds slide for blog 6

Dr Reynolds began with and ended with the following message:

cdc zika Reynolds slide for blog 7

Jamaica’s Communication Responses

I believe lives were lost because of both the poor operational response and communication response to the ChikV epidemic. Despite prior warning years before, the Jamaican Government failed to prepare adequately for the possibility of an epidemic. And the poor communication response failed to inform the public adequately about the risks. The initial messages downplayed the risks, which was particularly dangerous for those with pre-existing medical conditions and vulnerable groups such as the elderly. There was also a failure initially to inform the public about the possible medium and long term effects ChikV could have on a percentage of people.

That experience has had an impact on the response to Zika virus to date, not solely because of the toll it took on the lives and health of Jamaicans, but also because of the political fallout. As continues to be shown , the full impact of Zika is not yet known to the scientists and medical practitioners, the public health authorities and political leaders or the public. In this situation, with more possible impacts being discovered and discussed on an ongoing basis, it is essential that the public is kept informed and updated.

Public health spokespersons have been far more visible and accessible, both regarding Zika and the H1N1 flu virus since the start of 2016. It is good to see and hear from the Ministry of Health’s current Chief Medical Officer Dr Winston De La Haye and other Ministry spokespersons on radio and TV and in the print media. Both the current Minister of Health Christopher Tufton and his predecessor Horace Dalley learned lessons from the experience of Dr Fenton Ferguson, whose handling of the ChikV crisis was devastating. I know that Jamaica has experts with the skills and experience to handle communication during public health emergencies, and we must benefit fully from this expertise.

One way in which we need to improve is in making information accessible in more permanent and official ways. For example, although Dr De La Haye and other Ministry of Health representatives give updates about numbers of confirmed cases, number of samples tested, etc, this data is not routinely made available on the Ministry’s website. So if you miss the update in the media, there isn’t a clear place to go to to retrieve it. It is also important that the public aren’t left to guess when the next update will be. More information is also needed regarding Jamaica’s state of readiness to deal with a possible increase in cases of microcephaly, Guillain-Barre Syndrome and other neurological disorders being associated with Zika virus outbreaks.

Zika virus is being increasingly regarded as a puzzling and complex virus, with possible severe effects, despite its relatively mild symptoms. Effective communication with the public is essential, though challenging.

Links to CDC Presentations

cdc zap reynolds

Dr Reynolds’ presentation is available here.

cdc zap you tube reynolds Video recording of Dr Reynolds’ presentation available here. (Starts at 3:54)

cdc zap web page Link to CDC Zika Action Plan Summit page with presentations & other resources

 

 

 

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Author: rightpouitree

Navigating the real and virtual worlds and sometimes writing about what I observe...

7 thoughts on “But Won’t They Panic If We Tell Them?- Communication re #ZikaVirus & other health emergencies

  1. It shouldn’t be hard to understand that bad news is better than uncertainty. People are better able to deal with known (likely) outcomes, so being told the ‘worst’ means moving from expecting (at most), the ‘best’. It’s like being at a cross road and making a choice between right or left, is easier than not knowing where to turn, which is a first step to a sort of paralysis. Financial markets (and economists) understand this: market often price in expected bad or good news, and when events happen, often have little or no reaction, but react badly to increased uncertainties/no decisions/actions.

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    • So true, isn’t it? Uncertainty is really difficult to deal with, so it is incumbent on govt officials/agents not to add to the uncertainty, if possible.

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      • But many political people are especially trapped by ‘knowledge is power’, and fear or even loathe transparency and sharing information. So, think public ignorance (which = uncertainty) is better for their retaining power/control. It’s like not realizing that you must let go of balls to juggle well.

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  2. Reblogged this on Petchary's Blog and commented:
    My fellow blogger Susan Goffe continues to follow news and information regarding mosquito-borne diseases (currently the Zika Virus). This is an excellent post that I feel I must share with you. During my years in Public Affairs I can only agree with all these comments on how to communicate properly in a time of crisis. The Chikungunya Virus (Chik-V) outbreak in Jamaica was a real disaster in terms of what NOT to do in public relations. I hope this will be of interest – and particularly to the Ministry of Health and its spokesmen. Zika is a particularly tough virus to handle, as we are beginning to realize. And with the ongoing rains, the mosquitoes who were dormant during our recent dry period are making their presence felt again. Great thanks to Susan for this very important post.

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    • Thanks for reblogging! I think that we are so aware of the need for effective communication in part because we experienced the ChikV debacle. I think some lessons have been learned, but Zika is really a challenge, given all that is being learned on a daily basis.

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  3. Reblogged this on Jamaican Journal and commented:
    Fellow blogger Susan Goffe has written a great post about the government’s response to the Zika virus. I have not been keeping up with it as much as I had ChikV because of my girl, so thank you to Susan for so diligently monitoring the situation. Fingers crossed that Zika will not be as disastrous as ChikV.

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    • Thanks for reblogging, Kate! You did indeed monitor and write about the 2014 ChikV epidemic, which really took a toll. We won’t be taken so unaware by Zika, but how we will cope if there is a large outbreak remains to be seen. It’s interesting that the spread of Zika seems to be a lot slower than with ChikV, but if 75-80% of cases show no symptoms, far more people may have had it that is known!

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