Outbreak and Crisis Communication. Training for Trainers Workshop Washington D.C. 18-20 July 2006 Gathering information

1. Outbreak and Crisis Communication. Training for Trainers Workshop Washington D.C. 18-20 July 2006 Gathering information Cristiana Salvi Information Outreach WHO Regional Office for Europe

2. Gathering information • Gathering information in an outbreak can be very confusing. • Nevertheless we have to talk during this confusing period. • How do we gather the most reliable information and make statements while it is still uncertain?

3. The experience in the field Turkey Jan 06 Azerbaijan Mar 06 Romania May 06

4. Dealing with limited data: • Information gaps:be aware that information gaps often cause public rumours, concerns and lack of collaboration • Rumors:keep up and deal with press rumours as they immerge • Changing scenarios:report as much as possible all pieces of information, but with the necessary caution to be prepared in case of change of epidemiological scenario to adjust the message without undermining trust.

5. Uncertainty and public trust • Refrain from waiting for confirmed information to inform the public (Azerbaijan) • Express uncertainty, it is more credible than being overly reassuring (Turkey) • Balance the need to speak with one voice with early reporting (Romania)

6. Case studies • Azerbaijan: waiting for H5N1 London confirmation • Lack of release of preliminary confirmed H5 cases, lead to a delayed first announcement. • Turkey: uncertainty • After first confirmation of H5N1 from WHO London CC, the results from the national laboratory where considered final. This narrowed the ground for possible change of scenario. • Romania: speaking with different voices • Animal health experts not referring to AI as cause of the outbreak / Human health alerting for AI. This contributed to a drop of trust.

7. Effective risk communication requires you to • Fill the information gap • Keep up with rumors • Deal with a changing scenario … BUT… where do you get the necessary information to do that?

8. Who are your sources of information? • Internal: • your technical people • (your political people) • External: • PAHO/WHO • recognized laboratories • other partners • the media • the public

9. Internal source of information: your technical people Closeness with technical side is paramount in crisis response. Outbreak communication is critical feature of crisis response and fully embedded into risk management as vital to the outbreak control as epidemiology • Advocate for this concept with technical managers • Be in close contact with the team leader/ officer in charge of the outbreak control to gather information • Agree the information to release and timeliness • Trigger daily briefings • Provide support to spokespersons

10. External source of information: • PAHO/WHO: consistency and simultaneity of release • data sharing – PAHO/WHO to comment government’s response; • agreed information release - consistency of voices which triggers trust; • common statements - governments’ and UNs’ credibility. • Laboratories: the source of first information • recommend technical people to be in close contact with laboratories and be too through them

11. The other sectors • Animal health experts • Ensure close coordination with animal health experts to deliver comprehensive consistent messages. • Other partners • Identify all partners and set up coordination • i.e. the education sector

12. Case studies Romania • MoA identifying the outbreak as Newcastle disease • MoH calling in WHO experts to support control of AI outbreak Turkey • FAO’s “animal” statement on the endemicity of the virus in birds in Turkey. • MoH/WHO press conference: WHO’s “human” message not to worry. • Media’s understanding between animal and human health is often not clear. • The human health sector should take the leadership and coordinate other sectors.

13. The media Media are an exceptional source of information as they are always at the centre of events (what you cannot be) and can get first hand information. • Use media as an opportunity, not as a threat: you can get first hand information from reporters who ask you to comment a piece of news. • Develop relations and possibly partnership • Acknowledgment of uncertainty does not diminish your credibility, but instead makes you be perceived as professional, in wanting to have official confirmation, before commenting.

14. The public The public is a major source of information as people’s judgments are influenced by many factors other than just data. Failing to consider them can lead to poor communication outcomes. • Visit the field: visiting hospital, households and working in the crisis room provides you a real insight of facts and empathy with people • Gather risk perception through directly talking to the public • Partnership with social mobilization people to get the public’s perception from them Use risk perception to shape your messages accordingly

15. Case studies • Azerbaijan: • Due to late first announcement the public did not believe deaths were caused by AI and did not collaborate for outbreak control. • What we did: • recommend to the government to announce the AI outbreak soon • provide clear information to the people on the nature of the outbreak, asking for their help to avoid further spread • Romania: • Due to contradictory messages from animal and human health sectors, people were sceptical about the nature and size of the outbreak. • Culling was not perceived as a measure necessary for human health protection and this reduced people’s collaboration with the authorities • What we did: • try and coordinate the two sectors for consistent message delivery • focus on human health protection as reason behind culling operations and behavioural change

16. Outbreak and Crisis Communication. Training for Trainers Workshop Washington D.C. 18-20 July 2006 Thank you Cristiana Salvi Information Outreach WHO Regional Office for Europe csa@ecr.euro.who.int Ph. 0039 06 4877543