Risk communication during an infectious disease event - pandemics and public health.


Published on

Keynote address delivered to the Sheela Basrur Symposium at the start of the Ontario Public Health Convention, 3 April 2013. See here for the storify http://storify.com/TOPHCtweets/the-sheela-basrur-symposium This presentation was a joint effort with Julie Leask and Claire Hooker. Other contributions are on the Acknowledgements slide.

  • Be the first to comment

  • Be the first to like this

No Downloads
Total views
On SlideShare
From Embeds
Number of Embeds
Embeds 0
No embeds

No notes for slide

Risk communication during an infectious disease event - pandemics and public health.

  1. 1. SYDNEY MEDICAL SCHOOLwww.ncirs.usyd.edu.auEffective communication strategies duringan infectious disease eventSheela Basrur Symposium, Toronto, 3 April 2013A/Prof Julie LeaskSchool of Public HealthJulie.Leask@sydney.edu.au@JulieLeaskDr Claire HookerCentre for Values, Ethics and theLaw in Medicine
  2. 2. Acknowledgements›  Sheela Basrur›  Claire Hooker, Centre for Values, Ethicsand the Law in Medicine, University ofSydney›  Catherine King, May Chiew, Alexis PilsburyNational Centre for Immunisation Research& Surveillance›  Peter Massey, Hunter New England LocalHealth District, NSW
  3. 3. H1N1Source:www.crikey.com.au
  4. 4. Outline›  Understanding public responses›  Key challenges›  Working with the media›  Changing media landscape›  Practical risk communication suggestions
  5. 5. Understanding public responses to risk“If we want to be prepared for a major flu epidemic we mustunderstand not only the virus and how it spreads but alsocities and how they function, organizations and how theyoperate, communities and how they relate, and individualsand how they make choices.”Kickbusch and Sakallarides 2006
  6. 6. THE RECIPIENT›  Availability heuristic›  Anticipatory regret›  Ambiguity aversionSome particularly relevantcognitive heuristics and biases
  7. 7. Perception of the hazardFRIGHT FACTORS›  dreaded outcome›  affects ‘vulnerable’›  identifiable victims›  poorly understood byscience›  contradictorystatements fromsources›  involuntary
  8. 8. The goals in risk communication depend on the levelsof outrage and hazardFrom: Peter Sandman
  9. 9. Competence, objectivity, fairness, consistency, empathy(Renn and Levine in Communicating Risks to the Public 1991)
  10. 10. What is the strongest form of communication?
  11. 11. The challenges“One serious effect resulting from the restrictions above mentioned was thatthe general public was led to regard the disease as a very fearsome thing,and the application of regulations dealing with contacts strengthened theirbelief in the matter, with the result that so soon as the number of people fellill they were in very many instances left to do the best they could forthemselves because of the fear which the neighbours had of themselvescontracting the disease.In some towns yellow flags and other symbols were displayed to warn thepublic from entering the invaded premises, and this was cruelly insisted on insome districts where, unfortunately, the local authorities had made no effortsto provide proper help for the stricken inhabitants.”Report on the Influenza Epidemic in New South Wales in 1919;172
  12. 12. Uncertainty› The public and the mass mediahave poor tolerance for uncertainty› Uncertainty was communicatedreasonably well during the H1N1pandemic
  13. 13. Defining the risks› Illness and death› Impacts of trade and travelrestrictions› Psychosocial impact of restrictions› Excessive healthcare usage› Stockpiling medicines› Reputation risks
  14. 14. Media Challenges›  Traditional mass media remainsprime›  Limitations-  Tendency to amplify high outragerisks-  Tendency to reproduce error-  Lack of capacity to presentcomplexity-  Potential for stigmatisation
  15. 15. Working with journalists› Study: how journalistsapproached reporting avianinfluenza stories in 2007
  16. 16. Working within constraintsTyranny of deadlines“On one axis you have maximum accuracy, integrity, detail - all of thosewonderful things. And then on the other one youve got time. Your job isto do the best you can within that parameter.”(Newspaper medical reporter)Need for imagesHuman angle
  17. 17. Access to experts and transparency valuedGood ‘talent’•  Trusted•  Knowledgeable•  Communicate clearly andcompellingly•  Accessible“Just make sure your talent is always available – becausenothing annoys media more than if they cant get someone,that is when things go pear shaped, because no-one isthere to answer their questions”.Newspaper reporter
  18. 18. Journalists balance ethical tensions“We dont want to panic people, but at the same time we dowant them to watch our news. There will be headlines,promos saying tonight Pandemic kills x many people – butwe just have to make sure we give an accurate report of whathappens. But we always try to give advice. We want toreassure people what to do to protect themselves.”(TV news producer)
  19. 19. Specialist Medical Reporters› Better knowledge› Access to a wider range of sources› Gatekeepers and advocates› Cooperative but critical“The media is not the public relations wing of the healthdepartment. We are not there simply to report what theywant to tell the public - though we will usually do that also.But our role is to ask challenging, independentquestions.”(Newspaper medical reporter)
  20. 20. A changing media landscape
  21. 21. Slide courtesy of Carolyn Der Vartanian
  22. 22. Slide courtesy of Carolyn Der VartanianSocial Media: A group of Internet-basedapplications that … allow the exchange ofuser-generated content. (Kaplan 2010)
  23. 23. The pitfalls….
  24. 24. … and the opportunitiesInformation:"Train services are resuming in parts of Brisbane. Stopwalking on the tracks #TheBigWet #qldfloods""No homes can be reconnected to electricity until they havebeen certified as safe by an electrician #qldfloods#TheBigWet“MythbustingWivenhoe Dam is NOT about to collapse! #thebigwet#qldfloods"There is currently NO fuel shortage in Brisbane. #qldfloods#thebigwetThe lighter sideWere building an ArkHelp! Ive lost my GoldfishSource: http://www.brightlabs.com.au
  25. 25. Signorini A, Segre AM, Polgreen PM (2011) The Use of Twitter to Track Levels of Disease Activity andPublic Concern in the U.S. during the Influenza A H1N1 Pandemic. PLoS ONE 6(5): e19467. doi:10.1371/journal.pone.0019467 http://www.plosone.org/article/info:doi/10.1371/journal.pone.0019467Estimate disease activity in real time
  26. 26. Consider thisHow could you and your organization use social media?
  27. 27. Effective communication duringan infectious disease event
  28. 28. Being Prepared›  WHO do you need to communicate with?›  HOW are you going to communicate with them?›  WHAT do they need to know?Source:http://www.sti.risk-technologies.com/AnnouncementPreview.aspx?eid=4845
  29. 29. Pre-event•  PrepareEvent•  Media is ally•  Be available•  Work with specialist reporters•  Appeal to ethical commitments to reduce stigmatization•  Focus on action•  Use social mediaPost-event•  Media’s reflective and critical phase•  Acknowledge shortcomings•  Address non-medical costs•  EvaluatePreserve trustWorking with the media
  30. 30. General advice› Use trusted spokespersons› Be honest, frank and transparent› Err on the side of disclosurePreserve trust
  31. 31. Not  usually  a  helpful  concept  “Officials routinely expect the public to panic if toldalarming things, and misdiagnose orderly efforts toprepare as panic.”Peter Sandman Nature;2009‘Panic’ is not usually a helpful concept in outbreaks
  32. 32. Talking about probability›  Define the risks›  Qualitative & quantitative estimates›  Framing-  Loss frame “If you don’t wear PPE….-  Gain frame “If you wear PPE….”From http://www.chiin.ca/decisionaid.html
  33. 33. Communication tips›  Acknowledge uncertainty›  Be dedicated to good technicalinformation›  Explain rationale›  Acknowledge emotional aspects›  Communicate with allstakeholders-  Preparing channels before theevent-  Have mechanisms for listening›  Prioritise special risk groupsGood communication requires supportive leadership
  34. 34. Prioritise special risk groups› listen then share with communities theinformation needed› localise, personalise and humourise› avoid paternalism, tokenism and‘Aboriginalising’An example… The pandemic project with Aboriginal and TorresStrait Islander communitiesFrom: Massey PM et al Health Policy 2011;103:184-90 Australian Aboriginaland Torres Strait Islander communities and the development of pandemicinfluenza containment strategies: community voices and community control.
  35. 35. Social investmentMinistry of Health Report, October 1920Retrospective assessment of whatwas needed in 1918-19
  36. 36. Conclusions› Social and infrastructure investment› Action is a form of communication› Work with the traditional media› Evaluate efforts› Social media brings some risks but many opportunities“The smart city builds these long before a crisis”Kickbusch and Sakallarides. Flu City—Smart City: applying health promotionprinciples to a pandemic threat. Health Promotion International 2006
  37. 37. THANK YOU