Outbreak communication

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Outbreak communication

• Preben Aavitsland

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Your role

• National, regional or local public health office
• Responsible for outbreak response

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Challenges in outbreak investigations

• Great urgency
• Start without hypothesis
• Few cases
• Pressure to conclude
• Bias caused by media reports
• Legal and financial pressure
• Many agencies and persons involved

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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

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Key elements of outbreak communication

• Trust
• Announcing early
• Transparency
• The public
• Planning

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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

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A trust triangle in your institute
Policy makers
Technical staff (epidemiologists)
Communicators

• Build the trianlge before it is needed

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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

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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.

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Transparency

• Transparency candid, easily understood,
  complete and factually accurate information
• Let the public "view" the information-gathering,
  risk-assessing and decision-making processes
• Explain the limits, for instance patient privacy

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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!

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The public

• Understand the publics 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

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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