Posted: May 10, 2009
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Article SummaryJamaica Observer columnist Clare Forrester is the former Media and Communication Advisor of the Office of Caribbean Program Coordination of the Pan American Health Organization, where she worked with my wife and colleague Jody Lanard. This is a thoughtful and level-headed column arguing that the swine flu threat is still serious, that officials need to be candid rather than over-reassuring, and that the real danger isn’t panic but apathy – and loss of trust if officials over-reassure and then things get bad. She interviewed Jody and looked at my website to get some additional quotes, but she had it right to start with.

H1N1 flu – are we preparing for
the worst or hoping for a break?

Jamaica Observer, May 9, 2009

The initiatives being taken to cope with the threat of the HIN1 influenza pandemic are commendable. While I suspect that all the planning elements were not, on the whole, in place when evidence emerged leading to the high alert health status declared globally by the World Health Organisation, the respective ministries, notably Health and Agriculture, and the Office of Disaster Preparedness were not caught napping.

Serious steps appear to be in place to secure our ports of entry, surveillance initiatives have been heightened and there is a far-reaching public education programme, enhanced by a cooperative international drive led by the WHO.

So far, Jamaica and the rest of the English-speaking Caribbean have been spared. While we are still not out of the woods, there are indications that this particular strain of the virus is not as deadly as initially feared.

Much of what has been achieved so far, however, could be negated if the situation deteriorates. One reason for this would be precisely because our leaders seem inclined to make reassuring statements in what may be a misguided effort to calm fears.

“Our primary aim right now is to ensure that nothing happens,” said Health Minister Ruddy Spencer when news broke of the flu. Senior Medical Officer Dr Marion Bullock-Ducasse expressed similar sentiments when she told the media that “there is no need to worry.” The Minister and the doctor are in good company. US President Obama in one of his earliest statements on the epidemic, affirmed that while there was cause for some concern, “there is no need for alarm.” Since none of these people are emissaries of the Almighty, I don’t see how they can provide such comforting assurances.

The past experiences of several countries provide sobering evidence that this calming approach most likely leads to a breakdown in public confidence when events really go bad and the public conclude, as they will, that they have been “blindsided”. They will then be truly outraged. That is a risk that leaders face in determining what is in the best interest of the public; holding back or releasing information that could stir fears of a backlash. For many on the front line the choice usually is to hold back the bad news and hope for the best.

In the early stage of the 2003 SARS outbreak, the health minister of Hong Kong assured the public that “Hong Kong is absolutely safe and no different from any other big cities in the world. Hong Kong does not have an outbreak.” Sadly, that situation went from bad to worse. The mayor’s early response was a classic case of “how not to” in writings on the subject of risk communication. What he might have added in his early comments was that even the best prepared countries are usually under-prepared when in the throes of a pandemic.

The credibility of many political leaders over the years has taken a beating because they choose what seem at the time to be the safe way out. Rather than prepare their country for coping with a possible “life and death“ situation, the tendency is to choose the option they perceive counters panic.

I asked risk and crisis communication specialist, Jody Lanard, who is engaged in related international communication surveillance, whether concerns about panic warranted some reassurance, when there were no confirmed cases in evidence at the time of writing. “Quite the contrary,” was her quick response. Lanard and her husband Peter Sandman, also an internationally renowned crisis communication specialist, are unswerving in their belief that any dilemma presented in times of crisis ought to be shared with the public. What if, given the media focus on the pandemic, public “outrage level” may be so elevated that the reassuring tone of leaders like Obama and Spencer is justifiable? “Never,” was her response. “I can hardly get any of my friends to stockpile food, make a business plan at work, get advance refills on their routine meds. And they’re panicking? No, they’re upset and trying to figure out what’s going on, and how bad it could get. And the government isn’t helping them visualise it.”

Sandman agrees in an essay on the subject. He writes: “Panic is relatively rare. People may feel relatively panicky in a crisis, but they usually act in calm and orderly ways.” He recommends that those in the vanguard of the response effort should not try to “allay” panic by “blindsiding” or reassuring people. These strategies, he explained, paradoxically may even promote panic.

Lanard, in consultation with the Pan American Health Organisation, is one of the specialists who worked with public education and communication practitioners in our region over the past three years in preparation for a possible pandemic. Representatives of the respective planning sectors in every Caribbean country and beyond have been trained in coping strategies including surveillance and risk and crisis communication skills. Hence, there has been much training, planning and strategising in anticipation of a global crisis brought on by the next flu pandemic.

All the preparation could come to naught, however, if countries ignore the evidence of history in terms of building trust and ensuring that responses initiated on behalf of the public are undertaken transparently. These are universally accepted as the two guiding principles in communicating with the public when faced with actual or potential crisis such as the present situation that grips the world.

Obviously, there is enormous uncertainty about what will happen, especially in our region, and how fast it will happen. Most crisis communicators agree that there are times when some reassurance may be necessary and useful. But this should not be emphasised, and especially never at the onset of the crisis.

While we are in a state of “high alert,” as declared by the WHO, let’s engage the public by being candid, keeping them informed of what’s happening and what they can do to minimise the risks should, heaven forbid, the situation assume truly disastrous proportions in our country and region as seemed to have been the case in Mexico, the epicentre of the pandemic. But in the event the worst does come to our shores, let’s share all the important information with our people at all levels. That will best help them to deal with the adversities experienced. There is no question that this may be one of those “sink or swim” situations and, given the alternative, how and what we do now may well determine whether we all survive by swimming together.

Clare Forrester is a journalist and social communication consultant.

Copyright © 2009 by Jamaica Observer

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