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The H1N1 Outbreak of 2009Robert Chandler, PhDDirector Nicholson School of CommunicationDirector, Nicholson School of CommunicationUniversity of Central Florida

About Everbridge

• Leader in incident notification systems

• Fast-growing global company with more than 1,000 clients in more than 100 countries

S th Gl b l 2000 h lth• Serve the Global 2000, healthcare systems, state and local government, federal government, military, financial services firms, and universities

• 100% focused on incident notification solutions that merge technology and expertise

• Several years experience delivering message mappings solutions for pandemic communications

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AgendaAgendaPart 1: Presentation • Pros and cons to the global response• Combating hysteria and misinformation• Applying lessons learned to other emergencies

Part 2: Q&A

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Q&ANote: slides are currently available to everyone onQ&A available to everyone on blog.everbridge.com

Use the Q&A function to submit your questionsquestions.

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The H1N1 Outbreak of 2009:of 2009: Did Officials Cry Wolf?

Robert C. Chandler, PhDUniversity of Central FloridaUniversity of Central Florida

Path of the outbreak – H1N1 2009

April 26 July 24 Nov 16pU.S. Government declares H1N1 a public health emergency

yReporting of individual probable and confirmed novel cases is discontinued

Five vaccines approved by the FDA

2 0 0 9 : ……………………………………………………………………………………..…… ….……..…………….

A il 15 J 11

discontinued

O t 24 Jan 3

2 0 1 0 :

April 15First U.S. patient is confirmed

June 11WHO raises worldwide pandemic level to phase 6

Oct 24President Obama signs emergency declaration

Jan 3CDC reports more than 200 countries have reported p plaboratory confirmed cases

CDC estimates from 2009 H1N1 - USApril to December 2009April to December 2009

Note that the following statistics are CDC estimated, since a small number of people were tested and sought care for H1N1 2009.people were tested and sought care for H1N1 2009.

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The least lethal modern pandemic?

• H1N1 2009 seems unlikely at this point to reach the lower end of the mortality and contagion states projected last August

p

y g p j g

• 1 out of every 2,000 people who were infected died

• By comparison…the 1918 pandemic killed about 50 for every 2,000 infected; the 1957 and 1968 pandemics killed about 4 in every 2,000 casesp y ,

• Would we consider this pandemic:Mild? Moderate? Severe?• Mild? • Moderate? • Severe?

• How did media coverage figure into perception of H1N1?

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The wolf howling? (US edition)g ( )

• CBS News investigation alleges that the abrupt cancellation of testing and countingabrupt cancellation of testing and counting contributed to misdiagnosis of the flu.

• Due to uncertainties, the CDC advised that even those who were told they had H1N1 previously (and should be immune) should get vaccinated. The small amount of people who truly had H1N1 would be getting the vaccine unnecessarily, exposing them to

t ti l id ff tpotential side effects.

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The wolf howling? (international edition)

• With lower incidences than anticipated in England, Wolfgang Wodarg head of health at the Council of

g ( )

Wolfgang Wodarg, head of health at the Council of Europe, accused the makers of flu drugs and vaccines of influencing the WHO decision to declare a pandemic.

• The union minister of health in India has questioned the role of the World Health Organization in overreacting to the H1N1 Swine flu scare and declaring it to be athe H1N1 Swine flu scare and declaring it to be a dangerous pandemic.

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Positive communication during the pandemic• HHS Press Conference April 29, 2009

by Secretary Kathleen Sebelius

g p

• Detailed that 50 million courses of Tamiflu and Relenza had already begun shipping

• Development of vaccines and concerns about ensuring their safety mentioned

• Actionable advice cited – “Cover your mouth and nose when coughing or sneezing, and don’t go to work or school if you feel ill. Don’t send your child to daycare don’t send your child to school if you have flu likechild to daycare, don t send your child to school if you have flu-like symptoms. That will help contain the spread of this disease.”

CDC d WHO h ldi kl f• CDC and WHO holding weekly news conferences, taking phone questions

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Positive communication during the pandemic• President Obama’s Weekly Address (May 1, 2009) (and White

House blog)announces that H1N1 information will be available b f i l di it (F b k M S T itt

g p

on a number of social media sites (Facebook, MySpace, Twitter, YouTube, iTunes and more)

• An email phishing scam was reported , purported to be from CDC requiring recipients to create a personal H1N1 profile. The CDC quickly reacted, reporting the issue and providing

ti i t ticautionary instructions

• Health education worked – a majority of people sought the j y p p gvaccine, yet a strong minority group of Americans (35%) refused the vaccine – important data for the next pandemic

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Controversy during the pandemic

• On Nov 2, 2009 BusinessWeek reported that while hospitals and other organizations faced shortages of the H1N1 vaccine, Citigroup,

y g p

g g , g p,Goldman Sachs and other large New York companies were already receiving small amounts of the vaccine.• Cries for an investigation ensued, particularly by hospital/healthcare

frepresentatives who were in the midst of shortage.

• Government prediction of 160 million doses of the vaccine, t ll t d t t b d120 illi 1/3 f th di t deventually, turned out to be around120 million. 1/3 of the predicted

dosage was adequate, tripling the amount we had on hand. Rumors and fear were common in discussion of available vaccine.

• Voluntary non-safety recalls of nose spray and vaccines fueled additional fear.

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System weaknesses exposed

• Old, slow vaccine technology

y p

• Too great of US reliance on foreign vaccine production

• Health care surge pushed many medical care providers to their capacity limits during a relatively mild pandemic - which should be a cause of great alarm

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Audience pollpWere the numbers reported by Dr. Chandler of cases and deaths higher or lower than you expected at the beginning of the epidemic?

О HigherО Lower

H tt l d H1N1 fl h t ?Have you gotten your seasonal and H1N1 flu shots?О Yes, I’ve gotten both shots.О Yes, I’ve gotten my seasonal flu shot.О Yes, I’ve gotten my H1N1 shot.О No, I have not gotten either shot.

If h t tt H1N1 h t h ?If you have not gotten an H1N1 shots, why?О The vaccine was never available to me.О The vaccine was only available after the danger had passed.О I don’t trust the vaccine/feel it’s a safety risk.

Responding to rumors and inaccuraciesp g

Three steps to rumor control:1. Determine what rumors

are circulating.

2. Determine which rumors are true and which are false.

3. Correct inaccurate rumors and replace them with reliable informationwith reliable information.

Major pandemic rumorsj p

• 1000’s died in Mexico • The H1N1 flu shot had killed a Washington Redskins

• H1N1 had circulated in the mid-west for decades

a Washington Redskins Cheerleader (and a follow-up email rumor that the same cheerleader was cured by chelation therapy by a doctor

• H1N1 had escaped from a government laboratory

chelation therapy by a doctor associated with the antivaccine movement

• Tamiflu resistance was widespread

• Mutant killer H1N1 strains were circulating in Argentina or Ukraine or North Carolina p

Responding to rumors and inaccuraciesp g

• Move quickly to correct. • If a rumor is confined to a small audience—correct it

• Keep the level of response appropriate to the level of the problem.

small audience correct it within that group, don’t create a major public event.

po Overreacting to an isolated mistake

will attract attention to the problem you are trying to correct.

Under reacting to widely reported

• If a rumor is widely known and spreading—move aggressively and publicly to correct it.

o Under-reacting to widely reported information that is not correct will compound the error.

B f l th t t

• When squelching a rumor, anticipate how the rumor might evolve in response to your ff t B th h• Be careful that your comments

don’t leave the wrong impression and that they are not open to interpretation.

efforts. Be as thorough as you can in closing off avenues for future rumors.

Lessons for the next emergencyg y

• Preparation for incidents includes the need for flexible plansfor flexible plans

• Have communication plans for the pre, pandemic alert and pandemic acute phases.p p p

• Account for changes to common communication channels due to quarantine, ill d th d i ff tillness, and other pandemic effects.

• Have policies in place before an incident happens (examples: travel and telework)happens (examples: travel and telework)

Lessons for the next emergencyg y

• Create and send authoritative, accurate, forthright messages. Do not downplay risks or threats. g p yCorrect misinformation swiftly.

• Define/elaborate on information broadcasted ( l f i f WHO d i l t h )(example: confusion of WHO pandemic alert phases)

• Incidents with constant policy changes require a time sensitive communication mechanismtime-sensitive communication mechanism

• Ability to get information to those out of close range of your organization is also vitalof your organization is also vital

Audience resultsWere the numbers reported by Dr. Chandler of cases and deaths higher or lower than you expected at the beginning of the epidemic?

О HigherО Lower

Have you gotten your seasonal and H1N1 flu shots?Have you gotten your seasonal and H1N1 flu shots?О Yes, I’ve gotten both shots.О Yes, I’ve gotten my seasonal flu shot.

Y I’ tt H1N1 h tО Yes, I’ve gotten my H1N1 shot.О No, I have not gotten either shot.

If o ha e not gotten an H1N1 shots h ?If you have not gotten an H1N1 shots, why?О The vaccine was never available to me.О The vaccine was only available after the danger had passed.

’ /f ’ fО I don’t trust the vaccine/feel it’s a safety risk.

Audience results COMPAREResponse from Everbridge Webinar: H1N1 Live Q&A, 11/17/09

Incident Notification for H1N1

Marc LadinVP of Marketing, Everbridge

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How Everbridge clients used notification to combat H1N1combat H1N1

• H1N1 i ti d i• H1N1 vaccination drives• Volunteer coordination• Communicating best practices for hygiene – social distancingg p yg g• Rumor control (3P = 1N)• Coordinating distribution of strategic national stockpile of vaccine

E ti it ti l d t• Executive situational updates• Creating a hotline for employees to call• Using confirmation capability to sign up to actually receive vaccineg p y g p y

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Lessons learned by Everbridge during this pandemicduring this pandemic

• G t i ti i d l i• Government organizations requires more advance planning

• Clients needed more proactive communicationp

• Issues with contradictory messages sent within an organization

• Be aware of message readability (i.e. 3-3-30)

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The Everbridge difference

t h l + ti ttechnology + expertise = empowerment

technology + expertise = confidence

technology + expertise = your success

technology + expertise = solution

gy p y

Everbridge, the world’s recognized leader in incident notification t t h l ith i d t ti t h lsystems, merges technology with industry expertise to help

millions of people communicate in a crisis, manage operational incidents, and connect on a daily basis., y

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Q&ANote: slides are currently available to everyone onavailable to everyone on blog.everbridge.com

Use the Q&A function to submit your questionsquestions.

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Item Number (Schedule II): 26.1Activity Group: A1 Point for each webinar

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1 Point for each webinar

Contact information Communication resources

Marc Ladinmarc.ladin@everbridge.com1-818-230-9700

Pandemic Tooleverbridge.com/pandemic-tool

H1N1 Communication Kitgo everbridge com/H1N1Com

Robert C. Chandler, PhDrcchandl@mail.ucf.edu

go.everbridge.com/H1N1CommunicationKit.html

Everbridge for H1N1 everbridge.com/H1N1flu

1-407-823-2683White papers, case studies, literatureeverbridge.com/resources

H t ff thHot off the presses…Get Dr. Chandler’s new book – Surviving the PandemicAvailable at Outskirtspress.com or Amazon.com

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