risk and crisis communication for disasters manila, philippines, february 12-15, 2007 jody lanard...

Risk and Crisis Communication

For Disasters

Manila, Philippines, February 12-15, 2007

Jody Lanard M.D.

Please feel free to adapt and use these slides, with proper credit to the source:

“From material developed by Peter Sandman and Jody Lanard for the U.S. CDC, the World Health Organization, Health Canada, the Government of Singapore, the American Hygiene Association, and others.”

titletitle

Risk Communication ParadigmsRisk Communication Paradigms

Watch out!! Watch out!! (precaution advocacy)(precaution advocacy)

Calm down!! Calm down!! (outrage and fear management)(outrage and fear management)

We’ll get through this together. We’ll get through this together. (crisis communication)(crisis communication)

One definition of risk One definition of risk communication:communication:

"The interactive process of exchanging "The interactive process of exchanging information and opinion among individuals, information and opinion among individuals, groups, and institutions involving multiple groups, and institutions involving multiple messages about the nature of risk...“*messages about the nature of risk...“*

-- The National Research Council-- The National Research Council*(Note the emphasis on multi-directional communication!)*(Note the emphasis on multi-directional communication!)

What “risk communication” is not:What “risk communication” is not:

“ “Educating the public”Educating the public”

One-way communicationOne-way communication

Talking to people who have no Talking to people who have no

pre-existing viewspre-existing views

Information you give out after you Information you give out after you

have made all your plans.have made all your plans.

Who Outbreak Communication Who Outbreak Communication GuidelinesGuidelines

TrustTrust Announcing earlyAnnouncing early TransparencyTransparency The publicThe public PlanningPlanning

Risk: a traditional definitionRisk: a traditional definition(one among many)(one among many)

The multiplication ofThe multiplication of

Magnitude x Probability.Magnitude x Probability.

How likely to happen?How likely to happen?

How bad if it happens?How bad if it happens?

Outrage FactorsOutrage Factors(How normal people estimate most hazards)(How normal people estimate most hazards)

““safe”safe” “risky”“risky”

VoluntaryVoluntary InvoluntaryInvoluntaryControlled by selfControlled by self Controlled by othersControlled by othersTrustworthy sourcesTrustworthy sources Untrustworthy sourcesUntrustworthy sourcesResponsive processResponsive process Unresponsive processUnresponsive processFamiliarFamiliar UnfamiliarUnfamiliarNot memorableNot memorable MemorableMemorableNo moral relevanceNo moral relevance Moral relevanceMoral relevanceNot dreadedNot dreaded DreadedDreadedChronicChronic CatastrophicCatastrophic

Peter Sandman 1987, 2006 (Based on the risk perception work of Paul Slovic)©

A new definition of risk:A new definition of risk:(for the purpose of communication planning)(for the purpose of communication planning)

RiskRisk

A new definition of risk:A new definition of risk:

RiskRisk

HazardHazard

A new definition of risk:A new definition of risk:RiskRisk

HazardHazardOutrageOutrage

(Please note: “outrage” can also stand for fear; shame; loss of (Please note: “outrage” can also stand for fear; shame; loss of face. It has different implications and expressions between face. It has different implications and expressions between and within different cultures. The concept we call and within different cultures. The concept we call “outrage” does not always mean the direct feeling and “outrage” does not always mean the direct feeling and expression of indignation. It would be useful to find the expression of indignation. It would be useful to find the right word to describe the part of the public’s perception of right word to describe the part of the public’s perception of “risk” that does not relate to the technical hazard.)“risk” that does not relate to the technical hazard.)

A new “definition” of risk:A new “definition” of risk:

Risk =Risk =Hazard + OutrageHazard + Outrage

(Peter Sandman’s formula!)(Peter Sandman’s formula!)

For technical people:For technical people:

Risk = f( H, O )Risk = f( H, O )

Four Kinds of Risk Communication

HAZARD

OUTRAGE*

Copyright 2003 Peter Sandman

First communication planning task:First communication planning task: Diagnose which “communication Diagnose which “communication

environments” are relevant.environments” are relevant.


HAZARD

OUTRAGE


PUBLIC RELATIONS

HEALTH & SAFETY EDUCATION

ACTIVISM

Four kinds of risk communicationFour kinds of risk communication 1. When people are ignoring a serious hazard1. When people are ignoring a serious hazard


HAZARD

OUTRAGE


“Precaution Advocacy”

1. When people are ignoring a serious hazard, contin.1. When people are ignoring a serious hazard, contin.


HAZARD

OUTRAGE



1. When people are ignoring a serious hazard, contin.1. When people are ignoring a serious hazard, contin.

Warning: next comes a concept that Warning: next comes a concept that generates enormous resistance:generates enormous resistance:


HAZARD

OUTRAGE

Or

FEAR



First, inform people – and mobilize their First, inform people – and mobilize their concern to a level of fear or worry concern to a level of fear or worry proportionate to the hazard. proportionate to the hazard.

(Officials hate the second half of this (Officials hate the second half of this recommendation!!)recommendation!!)


HAZARD

OUTRAGE

Or

FEAR



Fear Appeal Documentation Fear Appeal Documentation

Then, help them manage the Then, help them manage the hazardhazard (“things (“things they can do”), or else they will try to they can do”), or else they will try to manage their manage their fearfear (by way of denial, apathy, (by way of denial, apathy, scoffing).scoffing).


HAZARDCopyright 2003 Peter Sandman


Lower right hand circle, arrowLower right hand circle, arrow

In other words…In other words…

OUTRAGE

Or

FEAR


HAZARD

OUTRAGE MANAGEMENT


Copyright 2003 Peter Sandman Upper Left Hand CircleUpper Left Hand Circle

OUTRAGE

Or

FEAR


HAZARD

OUTRAGE MANAGEMENT


Your Job: Inform people Your Job: Inform people AND use outrage/fear AND use outrage/fear management strategies to management strategies to reduce their outrage or fear.reduce their outrage or fear.

OUTRAGE

Or

FEAR


HAZARD

O orUT FR EA AG RE

OUTRAGE MANAGEMENT


In other words...In other words...

Upper Left Hand Circle, ArrowUpper Left Hand Circle, Arrow


HAZARD

OUTRAGE

OUTRAGE MANAGEMENT


Copyright 2003 Peter Sandman Smiley FaceSmiley Face


HAZARD

OUTRAGE

OUTRAGE MANAGEMENT


Copyright 2003 Peter Sandman Two ArrowsTwo Arrows

HAZARD

OUTRAGE

CRISIS COMMUNICATION

OUTRAGE MANAGEMENT



Three circles (adds crisis)Three circles (adds crisis)


HAZARD

OUTRAGE


Crisis

Communication

Get through this togetherGet through this together

““We’ll get through this together”We’ll get through this together”

(No way to make a living in this corner…

… but do communication surveillance to look for undiagnosed concerns, fear, or outrage)

OutrageorFear

HazardPeter Sandman 2004 www.psandman.com

© Low Hazard Low OutrageLow Hazard Low Outrage


TrustTrust Announcing earlyAnnouncing early TransparencyTransparency

How bad is it? How sure are you?

1. Don't over-reassure.

9/11 dust chasing people9/11 dust chasing people

9/11 overview dust9/11 overview dust

Christie Todd is pleasedChristie Todd is pleased

Bad example: Premature overconfident over-reassurance:Bad example: Premature overconfident over-reassurance:

"We are very encouraged that the results from our monitoring "We are very encouraged that the results from our monitoring of air quality and drinking water conditions in both New of air quality and drinking water conditions in both New York and near the Pentagon show that the public in these York and near the Pentagon show that the public in these areas is not being exposed to excessive levels of asbestos or areas is not being exposed to excessive levels of asbestos or other harmful substances… I am glad to reassure the people other harmful substances… I am glad to reassure the people of New York and Washington, D.C. that their air is safe to of New York and Washington, D.C. that their air is safe to breath and their water is safe to drink" breath and their water is safe to drink"

– – U.S.Environmental U.S.Environmental Protection Protection Agency Director Agency Director Whitman,Whitman,

September 18, 2001September 18, 2001

Blasting Christie Todd WhitmanBlasting Christie Todd Whitman

Judge Blasts Ex-EPA Chief For Judge Blasts Ex-EPA Chief For 'Conscience-Shocking' Actions After 9/11'Conscience-Shocking' Actions After 9/11

““for reassuring Manhattan residents soon for reassuring Manhattan residents soon after the 2001 terrorist attacks that the after the 2001 terrorist attacks that the environment was safe to return to homes environment was safe to return to homes and offices while toxic dust was polluting and offices while toxic dust was polluting the neighborhood.” the neighborhood.”

----NBC News, February 2006NBC News, February 2006

Blasting Christie, continuedBlasting Christie, continued

““The EPA's Office of the Inspector General The EPA's Office of the Inspector General eventually criticized the agency's response, eventually criticized the agency's response, saying it did not have available data and saying it did not have available data and information to support the Sept. 18, 2001, information to support the Sept. 18, 2001, statement that the air was safe to breathe.statement that the air was safe to breathe.

““The EPA's internal watchdog found the The EPA's internal watchdog found the agency, at the urging of White House agency, at the urging of White House officials, gave misleading assurances there officials, gave misleading assurances there was no health risk from the dust in the air was no health risk from the dust in the air after the towers' collapse.”after the towers' collapse.”

Normal view of U.S. at night, Normal view of U.S. at night, from outer spacefrom outer space

BBllaacckkoouut t PPhhoottoo

9/11 jitters9/11 jitters New York Blackout, 2003New York Blackout, 2003

““Living close to the World Living close to the World Trade Center site and Trade Center site and still having the 9/11 still having the 9/11 jitters I thought the jitters I thought the worst…worst…

“ “The first radio reports The first radio reports reassured everyone that reassured everyone that it was not an act of it was not an act of terrorism.” terrorism.”

-- Leah Singer, blogger-- Leah Singer, blogger

““People are a little scared People are a little scared and seem on edge. I and seem on edge. I don't hear the word don't hear the word terrorism, but the air is terrorism, but the air is thick with the thought.”thick with the thought.”-- Jason Kottke, blogger-- Jason Kottke, blogger

Bloomberg example don’t over-reassureBloomberg example don’t over-reassure

Don’t over-reassure – bad example:Don’t over-reassure – bad example:

Mayor Bloomberg, early in the NY blackout of 2003Mayor Bloomberg, early in the NY blackout of 2003

““I can tell you 100 I can tell you 100 percent sure that there percent sure that there is no evidence as of is no evidence as of this moment this moment whatsoever of any whatsoever of any terrorism.”terrorism.”

NY Mayor Michael Bloomberg talking to CNN anchor NY Mayor Michael Bloomberg talking to CNN anchor Kyra Phillips, 7:41 p.m., August 14, 2003Kyra Phillips, 7:41 p.m., August 14, 2003

Bloomberg weasalBloomberg weasal wordswordsQuiz:Quiz:

What words “protect” him if he turns out What words “protect” him if he turns out wrong?wrong?

Bloomberg as of this moment Bloomberg as of this moment Answer:Answer:

“…“…as of this as of this moment…”moment…”

CNN crawl?CNN crawl?What words did CNN run as a What words did CNN run as a caption, while the Mayor spoke?caption, while the Mayor spoke?

““???????”???????”

100% sure100% sureFor about ten minutes, CNN ran For about ten minutes, CNN ran the words:the words:

““100% sure”100% sure”

See SawSee Saw

1. Don't over-reassure.2. Put reassuring information in subordinate clauses.

How bad is it? How sure are you?How bad is it? How sure are you?

Subordinate ClauseSubordinate Clause

Singapore “subordinates” the good news

When WHO said that the sars situation When WHO said that the sars situation seemed to be improving in Singapore, seemed to be improving in Singapore, the Minister of Health spokeswoman, the Minister of Health spokeswoman, Eunice Teo, passed on this Eunice Teo, passed on this encouraging information as follows: encouraging information as follows:

““The WHO said the peak is over in The WHO said the peak is over in Singapore, but our minister has said it Singapore, but our minister has said it is too early to tell."is too early to tell."

See Saw See Saw

Malaysia “subordinates” Malaysia “subordinates” the good news:the good news:

Veterinary Services DG Datuk Dr. Hawari Hussein: Veterinary Services DG Datuk Dr. Hawari Hussein: Malaysia was eligible to be declaredMalaysia was eligible to be declared "bird flu "bird flu free," free," after no new cases were detected for 21 after no new cases were detected for 21 days. days.

But he added: health authorities were doing extra But he added: health authorities were doing extra tests tests "to be absolutely sure... The threat is still "to be absolutely sure... The threat is still there, from neighbouring countries. The tests there, from neighbouring countries. The tests are part of our own initiative to be sure."are part of our own initiative to be sure."

(adapted from the Star on line, November 16 2004: Malaysia set to be declared (adapted from the Star on line, November 16 2004: Malaysia set to be declared

free of bird flu)free of bird flu)

U.S. CDC Director Julie Gerberding U.S. CDC Director Julie Gerberding “subordinates” the good news“subordinates” the good news

When asked if there was community When asked if there was community transmission of SARS, Dr. Gerberding said:transmission of SARS, Dr. Gerberding said:

"Even though there is no sign of "Even though there is no sign of community spread, we are continuing community spread, we are continuing intense surveillance and we're not out intense surveillance and we're not out of the woods yet."of the woods yet."


When asked if SARS could possibly be due to When asked if SARS could possibly be due to terrorism, Dr. Gerberding said:terrorism, Dr. Gerberding said:

““Although this virus appears to be of Although this virus appears to be of entirely natural origin, we are being entirely natural origin, we are being vigilant about all possibilities."vigilant about all possibilities."

One day, when there was very little One day, when there was very little important SARS news …important SARS news …

Photo from: Photo from: http://pardonbakarmisiniz.wordpress.com/files/2006/08/meteor-shower.jpghttp://pardonbakarmisiniz.wordpress.com/files/2006/08/meteor-shower.jpg

“Is SARS From Outer Space?” –CNN headline, May 23, 2003


"Even though there is no evidence "Even though there is no evidence that SARS comes from outer that SARS comes from outer space, we're keeping an open space, we're keeping an open mind.”mind.”

-- Dr. Julie Gerberding, U.S. CDC-- Dr. Julie Gerberding, U.S. CDCcopyright Peter Sandman and Jody Lanard 2006copyright Peter Sandman and Jody Lanard 2006


Announcing earlyAnnouncing early

1. Don't over-reassure.2. Put reassuring information in subordinate clauses. 3. Err on the alarming side.


Err Alarming SideErr Alarming Side

..

Early on in SARS, Dick Thompson errs on the alarming side.

“One might think we are overreacting to the cases. But when you do not know the cause, when it strikes hospital staff, ands it certainly is moving at the speed of a jet, we are taking this very seriously.”

– WHO’s Dick Thompson

--From the risk communication Good Example file. (Don't aim for zero fear; err on the alarming side; acknowledge people's "anchoring frames.“)

See Saw 3See Saw 3


TrustTrust Announcing earlyAnnouncing early TransparencyTransparency

4. Acknowledge uncertainty.


UncertaintyUncertainty

Warning people about uncertaintyWarning people about uncertainty

““We will learn things in the coming weeks We will learn things in the coming weeks that everyone will wish we had known that everyone will wish we had known when we started.”when we started.”

This became the U.S. CDC’s mantra after its This became the U.S. CDC’s mantra after its early communication mistakes during the early communication mistakes during the anthrax poisonings.anthrax poisonings.

4. Acknowledge uncertainty. 5 . Share dilemmas.


Share DilemmasShare Dilemmas

Minister Tony Abbott shares Minister Tony Abbott shares pandemic planning dilemmaspandemic planning dilemmas

““Of course, it’s impossible to say if, when and Of course, it’s impossible to say if, when and how a pandemic might develop. The next how a pandemic might develop. The next pandemic might be comparatively mild like pandemic might be comparatively mild like the flu outbreaks of the late 50s and 60s. the flu outbreaks of the late 50s and 60s. But it could also be a worldwide biological But it could also be a worldwide biological version of the Indian Ocean Tsunami. There version of the Indian Ocean Tsunami. There are obvious limits to how much are obvious limits to how much governments can invest in preparations for governments can invest in preparations for hypothetical events, however serious.”hypothetical events, however serious.”

--from a May 2005 speech by Australia Minister of Health Tony Abbott--from a May 2005 speech by Australia Minister of Health Tony Abbott

Minister Abbott’s Dilemma (and Minister Abbott’s Dilemma (and yours), continuedyours), continued

“ “ It’s hard to discuss potential disasters outside It’s hard to discuss potential disasters outside people’s ordinary experience without generating people’s ordinary experience without generating the sort of lurid headlines which make some scoff the sort of lurid headlines which make some scoff and others panic…and others panic…

“ “ If a deadly flu pandemic ever seems imminent, no If a deadly flu pandemic ever seems imminent, no preparations will be enough. But if the current bird preparations will be enough. But if the current bird flu outbreaks in Asia gradually subside, the flu outbreaks in Asia gradually subside, the Government’s investment in a stockpile likely to Government’s investment in a stockpile likely to be time-expired in five years will be the health be time-expired in five years will be the health equivalent of a redundant weapons system.”equivalent of a redundant weapons system.”

--from a May 2005 speech by Australia Minister of Health Tony Abbott--from a May 2005 speech by Australia Minister of Health Tony Abbott

4. Acknowledge uncertainty. 5 . Share dilemmas. 6 . Acknowledge opinion

diversity.


Opinion DiversityOpinion Diversity

SARS in Singapore: SARS in Singapore: To close the schools? Or not?To close the schools? Or not?

In the middle of the SARS crisis, the In the middle of the SARS crisis, the Singapore government told the public Singapore government told the public about internal disagreements about about internal disagreements about whether to close the schools…whether to close the schools…

4. Acknowledge uncertainty. 5 . Share dilemmas. 6 . Acknowledge opinion

diversity. 7 . Be willing to speculate –

responsibly.


SpeculateSpeculate

Philippines says “don’t speculate”Philippines says “don’t speculate”

13 February, 2007, Philippine Star-News:13 February, 2007, Philippine Star-News:

Investigating the cause of death of an egret, a Investigating the cause of death of an egret, a senior animal official said:senior animal official said:

““There are many causes of death and not There are many causes of death and not necessarily bird flu,” and that it would be necessarily bird flu,” and that it would be wrong to speculate until after the bird had wrong to speculate until after the bird had been examined and a report made.been examined and a report made.

Accuracy ofInformation

+ Speed of Release

Empathy+

Openness

Crisis and Emergency CommunicationCrisis and Emergency Communication

CredibilitySuccessful

+ = Communication

Trust

CredibilitySuccessful

+ = Communication

Trust


The publicThe public PlanningPlanning

8. Don't overdiagnose or overplan for panic.

Coping with the emotional side of the crisisCoping with the emotional side of the crisis

““Panic” in Boracay fire? Not.Panic” in Boracay fire? Not.

A couple months ago, there was a fire at a A couple months ago, there was a fire at a cottage resort at Boracay, a famous vacation cottage resort at Boracay, a famous vacation spot in the Philippines. spot in the Philippines.

People fled the fire. People fled the fire.

““Foreigners were seen helping mostly local Foreigners were seen helping mostly local tourists carry their baggages to safe tourists carry their baggages to safe spots.“spots.“

"no one was reported injured or killed.""no one was reported injured or killed."

““Panic” in Boracay fire? Not.Panic” in Boracay fire? Not.

""no one was reported injured or killedno one was reported injured or killed ,","

but the same reporter said the fire sent but the same reporter said the fire sent

"hundreds of tourists in panic.”"hundreds of tourists in panic.”

And said that the incident And said that the incident

""caused panic not only to the residentscaused panic not only to the residents…, …, but but especially to local and foreign tourists. People especially to local and foreign tourists. People flee in different directions looking for a place flee in different directions looking for a place where they will be safe."where they will be safe."

Panic in Baseco barangay fire?Panic in Baseco barangay fire?

"Residents were screaming and running "Residents were screaming and running in the streets in panic to save their lives in the streets in panic to save their lives and their families. The firefighters and their families. The firefighters arrived at the scene, but could not arrived at the scene, but could not immediately control the fire because of immediately control the fire because of the chaotic situation."the chaotic situation."


In the next sentence, the author notes In the next sentence, the author notes the huge amount of physical damage to the huge amount of physical damage to buildings housing 15,100 people, buildings housing 15,100 people, observing that there were also 49 observing that there were also 49 injuries but no fatalities.injuries but no fatalities.

49 injuries, no deaths – out of 15,100 !!49 injuries, no deaths – out of 15,100 !!


Almost by definition, the self-rescue was effective. Almost by definition, the self-rescue was effective.

The residents knew their way around the alleys The residents knew their way around the alleys better than the incoming firefighters, and got better than the incoming firefighters, and got everyone out with only a few injuries and no everyone out with only a few injuries and no deaths. deaths.

Undoubtedly it looked chaotic to the firefighters. Undoubtedly it looked chaotic to the firefighters. What is typical is the assumption on the part of the What is typical is the assumption on the part of the officials that the behaviour was panic – despite the officials that the behaviour was panic – despite the fact that it was part of an effective and successful fact that it was part of an effective and successful self-organized rescue operation.self-organized rescue operation.


9. Don't aim for zero fear.


Zero FearZero Fear

TERROR

FEAR

CONCERN

INTEREST

APATHY

PANIC DENIAL

What is the “right” level of fear?What is the “right” level of fear?

TERROR

FEAR

“HIGH CONCERN” ???

CONCERN

INTEREST

APATHY

PANIC DENIAL


TERROR

FEAR

CONCERN

INTEREST

APATHY

PANIC DENIAL


Sometimes, a degree of rational fear is appropriate!

WHO/PAHO Pan Flu Communication WHO/PAHO Pan Flu Communication example: draft versus final example: draft versus final

Final:“It is important to proactively address reports that will create misplaced fear or unrealistic expectations.”

Draft:Draft:““To respond to rumors and To respond to rumors and inaccuracies to minimize concern, inaccuracies to minimize concern, disruption and stigmatization.”disruption and stigmatization.”


9. Don't aim for zero fear.10. Don't forget other emotions

(besides fear).


Don’t forget other emotionsDon’t forget other emotions

1. Fear2. Empathy/Misery3. Anger4. Hurt5. Guilt6. Resilience!

Emotional Responses to Crisis

List other emotionsList other emotions

11. Don't ridicule the public's emotions.


Don’t ridicule emotionsDon’t ridicule emotions


12. Legitimize people's fears.


Legitimize FearsLegitimize Fears

SARS: Singapore’s Prime Minister validates SARS: Singapore’s Prime Minister validates fear – and couragefear – and courage

““Our health-care workers put their lives at risk every Our health-care workers put their lives at risk every day they went to work… 'They were frightened. day they went to work… 'They were frightened. But they conquered their fear with courage. But they conquered their fear with courage. Courage in tending to an infected patient. Courage Courage in tending to an infected patient. Courage in taking respiratory fluid samples from the throat. in taking respiratory fluid samples from the throat. Courage in cleaning the wards every night. Courage in cleaning the wards every night.

““We saw this courage in our doctors, nurses and We saw this courage in our doctors, nurses and other health-care professionals; in the attendants, other health-care professionals; in the attendants, security officers and cleaners in our hospitals.”security officers and cleaners in our hospitals.”

--Prime Minister Goh, at SARS Memorial Ceremony, July 23, 2003. Straits Times--Prime Minister Goh, at SARS Memorial Ceremony, July 23, 2003. Straits Times

Dr. Jeff Engel answers a reporter about Dr. Jeff Engel answers a reporter about whether he is stirring up too much fear.whether he is stirring up too much fear.

"We need to involve our community in all aspects of "We need to involve our community in all aspects of public health. Certainly a disease like SARS, so public health. Certainly a disease like SARS, so new, so frightening, should instill fear. Fear is an new, so frightening, should instill fear. Fear is an appropriate response ‹ for me as a public health appropriate response ‹ for me as a public health physician, for everyone in the community. physician, for everyone in the community.

We need to transfer that fear into positive energy, and We need to transfer that fear into positive energy, and keep the facts out in front of hysteria.... I think [the keep the facts out in front of hysteria.... I think [the media's] response is appropriate. This is a new media's] response is appropriate. This is a new disease, it spreads person to person, it can kill, it has disease, it spreads person to person, it can kill, it has a high case-fatality rate. That is newsworthy!"a high case-fatality rate. That is newsworthy!"

--June 2003, when North Carolina had its first confirmed SARS case.--June 2003, when North Carolina had its first confirmed SARS case.

Singapore PM Goh legitimizing others’ fearsSingapore PM Goh legitimizing others’ fearsduring SARS:during SARS:

When Australia and several Asian countries warned When Australia and several Asian countries warned against travel to Singapore, Mr Goh responded: against travel to Singapore, Mr Goh responded: 'We can understand that, because we also give 'We can understand that, because we also give travel advisories to Singaporeans not to go to travel advisories to Singaporeans not to go to [other] affected places. [other] affected places.

'So we must expect other countries to advise their 'So we must expect other countries to advise their travellers not to come to Singapore... If we are travellers not to come to Singapore... If we are open about it and all Singaporeans cooperate by open about it and all Singaporeans cooperate by being as careful as they can, we may be able to being as careful as they can, we may be able to break this cycle early and if we do, then of course break this cycle early and if we do, then of course people outside will have confidence in Singapore people outside will have confidence in Singapore and the way we manage the problem.' and the way we manage the problem.'

Goh involves the public and legitimizes fear:Goh involves the public and legitimizes fear:

Closing the schools during SARSClosing the schools during SARS

Open respectful expert disagreementOpen respectful expert disagreement

PM Goh and SARS fearPM Goh and SARS fear While acknowledging SARS fear - his own, as well as his While acknowledging SARS fear - his own, as well as his

citizens' - PM Goh nearly always pivoted from the subject citizens' - PM Goh nearly always pivoted from the subject of fear to action and courage. of fear to action and courage.

S-A-R-S =S-A-R-S =

"Schools Are Really Shut!" … "Single And Really Sexy!""Schools Are Really Shut!" … "Single And Really Sexy!"

““Singaporeans Are Really Scared”.Singaporeans Are Really Scared”. Yes, we were really Yes, we were really scared. Scared for our lives and our loved ones. Scared of scared. Scared for our lives and our loved ones. Scared of taking a taxi, scared of going to the hospital. Scared that taking a taxi, scared of going to the hospital. Scared that tourists and customers would not return, and we might lose tourists and customers would not return, and we might lose our jobs. For the first time in our history, all Singaporeans our jobs. For the first time in our history, all Singaporeans felt the same fear at the same time. But far from being felt the same fear at the same time. But far from being frozen by the fear, the entire nation sprang into action." frozen by the fear, the entire nation sprang into action."

Talking about mass casualties:Talking about mass casualties:a dilemmaa dilemma

Talking about it too soon?Talking about it too soon?

Waiting until inaccurate information Waiting until inaccurate information starts spreading, and then reacting?starts spreading, and then reacting?

Share the dilemma –Share the dilemma –to help set the agenda.to help set the agenda.

With compassionWith compassion With acknowledgement of the tabooWith acknowledgement of the taboo With apology for breaking the tabooWith apology for breaking the taboo


12. Legitimize people's fears.13. Tolerate early over-

reactions.


Tolerate Early ReactionsTolerate Early Reactions

Adjustment Reactions --Adjustment Reactions --

-- the Teachable Moment in crisis -- the Teachable Moment in crisis communications!communications!

You can harness and channel it,You can harness and channel it,

Or you can waste the opportunity!Or you can waste the opportunity!

Copyright Lanard and Sandman 2004Copyright Lanard and Sandman 2004

Tolerate Early Over-reactions:Use the “Teachable Moment”

Fear

or

Initial Reaction

Start of crisis

Time

Curve Adjustment ReactionCurve Adjustment Reaction

Acknowledge that culling is grossAcknowledge that culling is gross

Culling:Culling:

State agriculture officials staged photo oppsState agriculture officials staged photo oppsFrom http://birdflubook.com/a.php?id=79From http://birdflubook.com/a.php?id=79

Are we hungry yet?Are we hungry yet?

Nigeria validates the adjustment Nigeria validates the adjustment reaction, and tells people what to expect:reaction, and tells people what to expect:

"However, we have observed that in other countries "However, we have observed that in other countries experiencing their first human H5N1 cases, there experiencing their first human H5N1 cases, there has been widespread fear of poultry and poultry has been widespread fear of poultry and poultry products, with a concomitant drop in consumption products, with a concomitant drop in consumption and sales. For a short time, that may happen in and sales. For a short time, that may happen in Nigeria too. It is entirely understandable that the Nigeria too. It is entirely understandable that the population may be overtly worried about all population may be overtly worried about all chickens, not just sick chickens.”chickens, not just sick chickens.”

Nigeria Avian Influenza Crisis Management Center, Bulletin 29, early 2007Nigeria Avian Influenza Crisis Management Center, Bulletin 29, early 2007


TrustTrust

14. Establish your own humanity.


Establish HumanityEstablish Humanity

WHO's David Heymann shows his humanity, after issuing a global alert about SARS:

"[It] was a pretty radical decision, and I didn't sleep that night because I knew that what we were doing was going to have a lot of different repercussions.“

15. Tell people what to expect.

Involving the publicInvolving the public

Good example: Thai candor, and Good example: Thai candor, and telling people what to expecttelling people what to expect

Thailand tells people what to expect, Thailand tells people what to expect, and does not over-reassure:and does not over-reassure:

““We are now about 80% ready to deal with We are now about 80% ready to deal with a bird flu outbreak should it happen a bird flu outbreak should it happen todaytoday.”.”

--Thai Deputy Prime Minister Chaturon Chaisaeng, --Thai Deputy Prime Minister Chaturon Chaisaeng,

9 February, 2005, Bangkok Post9 February, 2005, Bangkok Post

Thailand tells people what to expect, does not Thailand tells people what to expect, does not over-reassure, and acknowledges uncertainty:over-reassure, and acknowledges uncertainty:

““The first wave of bird flu outbreakThe first wave of bird flu outbreak

has passed ... but we don’t know when thehas passed ... but we don’t know when the

second wave will come, and we don’t trustsecond wave will come, and we don’t trust

the situation.... So the Public Health Min-the situation.... So the Public Health Min-

istry is being as careful as possible.”istry is being as careful as possible.”

Bulgaria tell people what to expectBulgaria tell people what to expect

Bulgaria “tells people what to expect:”Bulgaria “tells people what to expect:”

Agriculture Minister Nihat Kabil said that… Agriculture Minister Nihat Kabil said that… he expected the latest Bulgarian samples to he expected the latest Bulgarian samples to test positive for this strain.test positive for this strain.

"We suppose, after all samples sent to "We suppose, after all samples sent to Weybridge from southeast Europe tested Weybridge from southeast Europe tested positive for H5N1, the other samples (from positive for H5N1, the other samples (from Bulgaria) that will be sent tomorrow will, Bulgaria) that will be sent tomorrow will, with very high probability, also test positive with very high probability, also test positive for H5N1.".for H5N1.".........

Bulgaria, continued:Bulgaria, continued:

Kabil said he feared it was only a matter of time Kabil said he feared it was only a matter of time before H5N1 appeared in domestic poultry.before H5N1 appeared in domestic poultry.

"It is not necessary to start culling domestic birds ... "It is not necessary to start culling domestic birds ... (but) we have to accept the thought that in the (but) we have to accept the thought that in the coming days we might have the first outbreak.coming days we might have the first outbreak.

The probability of that is very high and we have to be The probability of that is very high and we have to be ready for pictures of veterinarians going into those ready for pictures of veterinarians going into those areas with special suits to cull birds.“ (Reuters)areas with special suits to cull birds.“ (Reuters)

Selangor outbreak: Singapore tells its Selangor outbreak: Singapore tells its people that Malaysia can be trustedpeople that Malaysia can be trusted

HPAI in Selangor / Effectiveness of DFZsHPAI in Selangor / Effectiveness of DFZs

The Highly Pathogenic Avian Influenza (HPAI) or The Highly Pathogenic Avian Influenza (HPAI) or Bird Flu is currently the most threatening disease Bird Flu is currently the most threatening disease to our food supply.to our food supply.

Its worldwide spread and recent detection in Its worldwide spread and recent detection in Selangor have raised concerns in Singapore.Selangor have raised concerns in Singapore.

In accordance with protocols established between In accordance with protocols established between the veterinary authorities of Singapore and the veterinary authorities of Singapore and Malaysia, AVA suspended poultry and egg Malaysia, AVA suspended poultry and egg imports from Selangor. imports from Selangor.

From a speech by the Singapore Minister of State for National From a speech by the Singapore Minister of State for National Development, 6 March 2006Development, 6 March 2006

Singapore tells its people that Malaysia can Singapore tells its people that Malaysia can be trusted, continuedbe trusted, continued

Over the last two years, AVA has been working Over the last two years, AVA has been working with its Malaysian counterpart to establish Disease with its Malaysian counterpart to establish Disease Free Zones. Free Zones.

Poultry can be imported from these zones even if Poultry can be imported from these zones even if isolated cases of HPAI are detected in other areas.isolated cases of HPAI are detected in other areas.

We hence did not suspend all poultry imports We hence did not suspend all poultry imports from Malaysia, unlike the outbreak in Kelantan in from Malaysia, unlike the outbreak in Kelantan in 2004.2004.

The impact on our egg and poultry supply this The impact on our egg and poultry supply this time was negligible.time was negligible.

From a speech by the Singapore Minister of State for National From a speech by the Singapore Minister of State for National

Development, 6 March 2006Development, 6 March 2006

16 Offer people things to do.

Involving the publicInvolving the public

Offer people things to doOffer people things to do

16 Offer people things to do. 17. Let people choose their own

actions.

Involving the Involving the publicpublic

Let People ChooseLet People Choose

Dr. Balaji acknowledges uncertainty, and lets Dr. Balaji acknowledges uncertainty, and lets people choose their own actions: SARS maskspeople choose their own actions: SARS masks

During a television call-in show, Minister of During a television call-in show, Minister of State for Health Balaji Sadasivan was asked State for Health Balaji Sadasivan was asked by a caller about whether to wear masks in by a caller about whether to wear masks in public, and what kind to use. public, and what kind to use.

At this point, it seemed very likely, but not At this point, it seemed very likely, but not yet 100% definite, that SARS was mostly yet 100% definite, that SARS was mostly transmitted by close personal contact, transmitted by close personal contact, through droplets and touching contaminated through droplets and touching contaminated surfaces.surfaces.

Dr. Balaji acknowledges uncertainty, and lets Dr. Balaji acknowledges uncertainty, and lets people choose their own actions: SARS maskspeople choose their own actions: SARS masks

Dr. Balaji told the caller that there was no Dr. Balaji told the caller that there was no evidence that wearing a mask [in public] evidence that wearing a mask [in public] helps, and no evidence that it doesn't help, helps, and no evidence that it doesn't help, and that is why they hadn't given a definite and that is why they hadn't given a definite recommendation at that point. recommendation at that point.

But the MOH explained how to wear masks But the MOH explained how to wear masks properly, if people decided they wanted to properly, if people decided they wanted to wear them.wear them.

The SARS mask example showed:The SARS mask example showed:

Acknowledging uncertainty.Acknowledging uncertainty.

Legitimizing people’s fears.Legitimizing people’s fears.

Letting people choose their own actions Letting people choose their own actions (and helping them do it right).(and helping them do it right).

16 Offer people things to do. 17. Let people choose their own

actions. 18. Ask more of people.

Involving the Involving the publicpublic

Ask more of peopleAsk more of people

Adult resilient response?

Regressed dependent response?

Ask More of People: Ally with Our Adult Selves!

Emergency Ambivalence or

Ally with adult sideAlly with adult side

SingaporeSingapore shares emotions about SARSshares emotions about SARS

SARS commemoration ceremony, Singapore, Summer 2003 [The Straits Times]

““Heroes and Angels / Through Your Heroes and Angels / Through Your Eyes” – the SARS anthem, SingaporeEyes” – the SARS anthem, Singapore


Overwhelmed by emotion, a nurse sheds a tear as she watches a patient suffering from SARS.http://www.wpro.who.int/sites/whd/heroes/singapore/pic10.htm

19. Acknowledge errors,

deficiencies, and misbehaviors.

Acknowledge Errors, Misimpressions, Acknowledge Errors, Misimpressions, and Half-truthsand Half-truths

Canada protests WHO travel advisoryCanada protests WHO travel advisory

Canadian official: “We believe this decision was Canadian official: “We believe this decision was made without consulting the province – we made without consulting the province – we believe it was an over-reaction.” “The medical believe it was an over-reaction.” “The medical evidence does not support this advisory.”evidence does not support this advisory.”

WHO’s Dick Thompson: “There was a breakdown in WHO’s Dick Thompson: “There was a breakdown in communications. I think that we’re willing to communications. I think that we’re willing to acknowledge that there was some kind of mistake, acknowledge that there was some kind of mistake, that they didn’t receive the message. And I think that they didn’t receive the message. And I think we’re ready to accept some blame here.”we’re ready to accept some blame here.”

Singapore acknowledges error Singapore acknowledges error

In mid-May, 2003, there was an unexpected potential In mid-May, 2003, there was an unexpected potential new outbreak of SARS at a Singapore mental new outbreak of SARS at a Singapore mental hospital. Before this turned out to be a false alarm, hospital. Before this turned out to be a false alarm, the Singapore Straits Times wrote: "SARS the Singapore Straits Times wrote: "SARS Combat Unit Chief Khaw Boon Wan....admitted Combat Unit Chief Khaw Boon Wan....admitted that the fresh batch of possible cases at the that the fresh batch of possible cases at the Institute of Mental Health had caught him Institute of Mental Health had caught him unprepared. The chronic-care hospital 'was not on unprepared. The chronic-care hospital 'was not on my radar screen," [he] confessed, 'because we just my radar screen," [he] confessed, 'because we just didn't have the time to focus on it. It was a tactical didn't have the time to focus on it. It was a tactical error." error."

19. Acknowledge errors,

deficiencies, and misbehaviors. 20. Apologize often for errors, deficiencies, and misbehaviors.


Apologize for ErrorsApologize for Errors

21.Be explicit about "anchoring frames*.”

*what people already know and believe;

their “mental models.”


Anchoring FramesAnchoring Frames

You want parents to use child car seats.

You found out Hispanic parents are particularly resistant.

Why?

From Dr. Wm. Smith, Academy for Educational Development, slides on line at: http://www.izcoalitionsta.org/content.cfm?id=514

Suppose…

My child is always safest in my My child is always safest in my arms.arms.God decides when to take my God decides when to take my baby.baby.


Have a priest bless the car seats.Have a priest bless the car seats.


21. Be explicit about "anchoring frames."

22. Be explicit about changes in official opinion, prediction,

or policy.


Changes in PolicyChanges in Policy

FAO official acknowledges errorFAO official acknowledges errorre: best guess about AI spread, after re: best guess about AI spread, after over-emphasizing possible role of over-emphasizing possible role of migratory birds:migratory birds:

"Many of us at the outset underestimated "Many of us at the outset underestimated the role of trade.”the role of trade.”

-- FAO’s Sam Jutzi, director of Animal Production -- FAO’s Sam Jutzi, director of Animal Production and Health, February 12 2007and Health, February 12 2007

23. Don't lie, and don't tell half- truths.


Don’t Lie…Don’t Lie…


TrustTrust TransparencyTransparency

Singapore’s cholera outbreak, 2004Singapore’s cholera outbreak, 2004

Reported to the public immediately. Reported to the public immediately.

Updated the public often.Updated the public often.

When they said the outbreak was over, there was When they said the outbreak was over, there was no apparent skepticism.no apparent skepticism.

It made very little news, because it wasn't a It made very little news, because it wasn't a "cover-up" or "belated announcement" story. "cover-up" or "belated announcement" story.

Ministry Of Health Investigating a Cluster Of Ministry Of Health Investigating a Cluster Of Cholera Cases At Bedok 15 Oct 2004Cholera Cases At Bedok 15 Oct 2004

11 A cluster of eight local cholera cases has been A cluster of eight local cholera cases has been identified in Singapore, comprising two males identified in Singapore, comprising two males and six females aged between 20 to 84 years. and six females aged between 20 to 84 years.

22 The cases had acute onset of illness between 3 The cases had acute onset of illness between 3 and 10 Oct 2004 and were admitted to SGH, and 10 Oct 2004 and were admitted to SGH, CGH and CDC. Three have been discharged and CGH and CDC. Three have been discharged and the other five are recovering.the other five are recovering.

3 Investigations by the Ministry revealed that 3 Investigations by the Ministry revealed that

majority had patronised hawker stalls and eating majority had patronised hawker stalls and eating establishments in Bedok. A total of 115 food establishments in Bedok. A total of 115 food handlers and 25 home contacts have been referred handlers and 25 home contacts have been referred to CDC for medical screening. to CDC for medical screening.

Update on Cholera cases in Singapore Update on Cholera cases in Singapore 18 Oct 200418 Oct 2004

The Ministry had reported on 16 Oct 2004 a The Ministry had reported on 16 Oct 2004 a cluster of eight local cholera cases.... An cluster of eight local cholera cases.... An additional case has since been notified to the additional case has since been notified to the Ministry. Ministry.

The case is a 89-year-old Malay male…. The case is a 89-year-old Malay male….

Of the eight cases reported earlier, five are well Of the eight cases reported earlier, five are well and have been discharged. The other three are still and have been discharged. The other three are still in hospital: two at SGH and one at CDC. in hospital: two at SGH and one at CDC.

Thus far, all the cases had onset of illness between Thus far, all the cases had onset of illness between 3 and 10 Oct 20043 and 10 Oct 2004

Update on Cholera cases in Singapore Update on Cholera cases in Singapore 18 Oct 200418 Oct 2004

Singapore: No More Cholera Cases Singapore: No More Cholera Cases Reported, 27 Oct 2004Reported, 27 Oct 2004

There have been no further cases reported There have been no further cases reported since the last confirmed case of cholera since the last confirmed case of cholera with an onset of illness on 10 Oct 2004. with an onset of illness on 10 Oct 2004.

Investigations indicated that all the cases of Investigations indicated that all the cases of cholera had consumed seafood on or around cholera had consumed seafood on or around the week of 2 Oct 2004. the week of 2 Oct 2004.

The Ministry would like to highlight the The Ministry would like to highlight the importance of maintaining good personal importance of maintaining good personal and food hygiene practices at all times….and food hygiene practices at all times….

23. Don't lie, and don't tell half- truths.

24. Aim for total candor and transparency.


Aim for total…Aim for total…

25. Be careful with risk comparisons.


Risk ComparisonsRisk Comparisons

Scenario for an exercise:Scenario for an exercise:

Ten minutes in a taxi with your MinisterTen minutes in a taxi with your Minister The Minister has not been trained in risk The Minister has not been trained in risk

communication.communication. He or she is going to announce that a He or she is going to announce that a

gastroenteritis outbreak is actually cholera.gastroenteritis outbreak is actually cholera. The facts are: The Health Department confirmed The facts are: The Health Department confirmed

this two weeks ago, but did not tell the public until this two weeks ago, but did not tell the public until – ten minutes from now.– ten minutes from now.

Brief the Minister on the risk communication Brief the Minister on the risk communication strategies to help make this announcement.strategies to help make this announcement.

Announcing that it is choleraAnnouncing that it is choleraFor several weeks, officials have been For several weeks, officials have been

reporting increasing numbers of diarrheal reporting increasing numbers of diarrheal illnesses.illnesses.

These are in villages near a major These are in villages near a major international resort. Most of the workers at international resort. Most of the workers at this resort live in these villages.this resort live in these villages.

Increasing rumors suggest that the illnesses Increasing rumors suggest that the illnesses are really cholera. Today the Health are really cholera. Today the Health Minister is going to confirm this.Minister is going to confirm this.

Feel free to adapt any of these Feel free to adapt any of these slides for your own purposes!slides for your own purposes!

(with appropriate credit if it is due.)(with appropriate credit if it is due.)

For example ….For example …...

Crisis Communication: Guidelines for actionCrisis Communication: Guidelines for action,, a 64-page manual of handouts covering the a 64-page manual of handouts covering the material in this presentation is available for free, material in this presentation is available for free, on line, on The Peter Sandman Risk on line, on The Peter Sandman Risk Communication Website,Communication Website, www.psandman.com,,

at:at:

http://psandman.com/handouts/AIHA-DVD.htmhttp://psandman.com/handouts/AIHA-DVD.htm

Thank you!Thank you!

http://www.psandman.com/

Scenario: local outbreakScenario: local outbreak

Work on this in breakout groups.Work on this in breakout groups. Develop either a press statement, talking Develop either a press statement, talking

points to inform the public.points to inform the public. Optional: follow the issuance of the Optional: follow the issuance of the

statement with a role-play of a press statement with a role-play of a press conference.conference.

What you know:What you know:

4 patients, one family, flu-like symptoms a week 4 patients, one family, flu-like symptoms a week ago. Hospitalized. Two died.ago. Hospitalized. Two died.

Two care-givers at hospital sick with same Two care-givers at hospital sick with same symptoms.symptoms.

30 chickens died in family’s village 4 days before 30 chickens died in family’s village 4 days before victims got sick.victims got sick.

Samples have been taken. No results yet. Samples have been taken. No results yet.

Table Top Scenario for doing crisis Table Top Scenario for doing crisis and pre-crisis messagingand pre-crisis messaging

Trainer and groups: You can develop any scenario Trainer and groups: You can develop any scenario you wish. The one which follows is about the start you wish. The one which follows is about the start of an influenza pandemic.)of an influenza pandemic.)

The template for this exercise is not yet available The template for this exercise is not yet available on line, but is included in the CDROM from most on line, but is included in the CDROM from most WHO risk communication workshops conducted WHO risk communication workshops conducted by Jody Lanard. If you cannot obtain it, please by Jody Lanard. If you cannot obtain it, please email me, and I will send it to you.email me, and I will send it to you.

[email protected]@psandman.com

WHO announces Pandemic Phase 6WHO announces Pandemic Phase 6

At 11 a.m. today, WHO formally contacted all Member States to say:At 11 a.m. today, WHO formally contacted all Member States to say:

At noon today, we are announcing that an influenza pandemic has begun. It is At noon today, we are announcing that an influenza pandemic has begun. It is caused by a novel flu strain, H7N3. It appears to be a reassortment of an avian caused by a novel flu strain, H7N3. It appears to be a reassortment of an avian H7 and a human N3 strain. There have been no known outbreaks of unusual H7 and a human N3 strain. There have been no known outbreaks of unusual bird disease in the affected countries.bird disease in the affected countries.

There are large clusters of human to human transmitted cases in several border There are large clusters of human to human transmitted cases in several border towns in Texas and Mexico, plus several others in Argentina and Peru.towns in Texas and Mexico, plus several others in Argentina and Peru.

We do not know the attack rate or case fatality rate. There have been numerous We do not know the attack rate or case fatality rate. There have been numerous deaths. We do not have a case definition yet. It appears similar to descriptions deaths. We do not have a case definition yet. It appears similar to descriptions of the 1918 influenza, with rapid progression to pneumonia and death.of the 1918 influenza, with rapid progression to pneumonia and death.

At noon, WHO announced this to the public.At noon, WHO announced this to the public.

risk and crisis communication for disasters manila, philippines, february 12-15, 2007 jody lanard...

Documents

risk communication paradigms

crisis communication

nature of risk

communication environments

new definition of risk

title slide

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