1. Pandemic and Outbreak Communication PAHO/WHO
Module 1: IHR Risk Communication Capacity: Transparency and first announcement of a real or potential risk
Pandemic and Outbreak Communication PAHO/WHO

2. Effective Outbreak Management
Early
Detection
Rapid
Response
Control
Opportunity
CASES
DAY
Pandemic and Outbreak Communication PAHO/WHO

3. Effective Outbreak Communication
Proactive announcement of real or potential risk:
Increases surveillance
Protective behaviours
Reduces confusion
Gather scarce resources
CASES
DAY
Pandemic and Outbreak Communication PAHO/WHO

4. First Announcement -- the most important communication
Pandemic and Outbreak Communication PAHO/WHO

5. Transparency – the case against
"The Unknowns"
Lack of information will raise anxiety/panic
Media will sensationalize information gaps
Uninformed "experts" will speculate
Say nothing, hope nothing happens
Needless economic harm
Loss of control
Pandemic and Outbreak Communication PAHO/WHO

6. Transparency -- the case for
Rumours will fill information vacuum
If media announce: undermines trust
Withheld information more frightening
Public accept uncertainty and changing risk assessment
Encourages protective behaviors/surveillance
Describe the situation before others do
Emergencies can't be hidden
Transparency increases control
Pandemic and Outbreak Communication PAHO/WHO

7. Nuclear accident: Chernobyl, Ukraine
April 26 1:23 am: reactor explosion and fire
- Fire and emergency workers not informed of risk
April 26 5:00 am: M Gorbachev is briefed
Kremlin asks for more detailed analysis
April 27 14:00 pm: evacuation of Pripyat
116,000 residents told it would be for 3 days
April 28: After other countries report radioactivity in atmosphere, USSR acknowledges accident
Mid-May: Gorbachev statement
In the early hours of April 26, 1986 one of four nuclear reactors in Chernobyl exploded. Fire broke out in the reactor as a result and emergency crews rushed to the scene.
Although the technical experts on site recognised the seriousness of the situation, fire and emergency crews were not told that the fire was in the reactor and that there may be a risk of contamination.
Later that morning the head of the USSR at the time Mikhail Gorbachev was brief of the situation. There was not at the time a recognition of how serious the situation was.
The first reporting of the event came not from Soviet authorities but from other nearby countries who had detected radioactivity in the atmosphere and feared that their own facilities were the source.
The next day, 36 hours after the explosion, the nearby town of Pripyat was evacuated. The 116,000 people were reassured that it would only be for a couple of days.
Finally, two days after the event the Government news agency Tass acknowledged there had been an explosion in a brief article. The lack of detail and tone of the report suggested that the situation had been addressed.
Mikhail Gorbachev did not speak to the issue publicly for close to three weeks.
Pandemic and Outbreak Communication PAHO/WHO

8. Nuclear accident: Chernobyl, Ukraine
Worst nuclear reactor accident recorded
4000 predicted attributable deaths
emergency workers, evacuees, population
4000 attributable cases of thyroid cancer
mostly children: milk from contaminated cows
Ongoing public health crisis across region
Government information not trusted
M. Gorbachev: "We were afraid of panic"
Of course, the original assessments in Moscow downplaying the situation proved tragically wrong. The event was the worst ever recorded nuclear reactor accident.
According to the report of the Chernobyl Forum 4000 deaths which have occurred or are predicted are directly attributable to the accident.
Notably, the emergency responders who were not warned of the risk, and the people living nearby who were not told of the problem, are those affected.
4000 cases of thyroid cancer are linked to Chernobyl, mostly in children. Many of these victims would have drank milk from cows who had eaten contaminated grass – there were no clear warnings on what foods might be dangerous.
The Forum report identifies an ongoing public health crisis across the region which, they argue, is a result of the continued lack of understanding of risk prevention measures and the true nature of the health risks. The almost total lack of trust which persists in the region – twenty years later -- is a significant contributor to the problem and efforts to try and address it.
The decision to withhold information, to reluctantly acknowledge a problem and the associated risks, had deadly results. Speaking several years later Mikhail Gorbachev explained the mentality in the Government at the time:
"I confess that we were afraid of panic…"
Discussion: Was this fear justified?
Pandemic and Outbreak Communication PAHO/WHO

9. Transparency in practice
How do you decide whether or not information should be released publicly?
Will the release of this information:
help the affected community protect itself?
impact an economic sector?
stigmatize a population?
make the Government "look bad"?
introduce potential legal liability?
Pandemic and Outbreak Communication PAHO/WHO

10. Transparency in practice
IHR Risk Communication Capacity:
Transparency and effective information dissemination
Establish a decision making approach for public communication during emergency
Enshrine that approach in a guideline, policy or law
Ensure it is part of emergency management system through training, exercises, leadership endorsement
Pandemic and Outbreak Communication PAHO/WHO