1. Outbreak communication Preben Aavitsland

2. Your role National, regional or local public health office Responsible for outbreak response

3. Challenges in outbreak investigations Great urgency Start without hypothesis Few cases Pressure to conclude Bias caused by media reports Legal and financial pressure Many agencies and persons involved

4. Background Many communication failures –delayed outbreak control –undermined public trust and compliance –prolonged economic, social and political turmoil WHO after SARS: –Communication expertise has become as essential to outbreak control as epidemiological training and laboratory analysis. –Literature review + international conference guidelines

6. Key elements of outbreak communication Trust Announcing early Transparency The public Planning

7. Trust Communicate in ways that build, maintain or restore trust Trust is hard to win and easy to lose No trust fear and lack of compliance Trust the public's ability to tolerate incomplete and sometimes alarming information Accountability, involvement and transparency are key factors to build trust

8. A trust triangle in your institute Build the trianlge before it is needed Policy makers Technical staff (epidemiologists…) Communicators

9. Announcing early The first announcement is critical! Outbreaks cannot be hidden Announce as early as possible –Avoid rumours and misinformation –Avoid loss of trust when someone else reveals the situation (Governement cover-up) The longer you wait, the more frightening the information will seem when it is revealed –And the media will ask: What do you know, and when did you know it? You do not decide what the media will be interested in

10. But be careful Make sure to inform your partners first –Establish contact with them in advance Make reservations for incomplete information –State clearly: This is what we know at the moment. Information may change the investigation continues.

11. Transparency Transparency = candid, easily understood, complete and factually accurate information Let the public "view" the information- gathering, risk-assessing and decision- making processes Explain the limits, for instance patient privacy

12. Barriers to transparency Fear of economic loss –Tourists will be afraid –Trade may stop Bad planning and preparation –Forgot to prepare a message –Forgot to prepare answers tolikely questions No training in delivering bad news or discussing uncertainty Fear of revealing weaknesses in infrastructure Seek culture change in outbreak preparation!

14. The public Understand the publics beliefs, opinions and knowledge –Communications surveillance –Include representatives of the public in the planning Explicitly address pre-existing beliefs Take the publicly held view seriously –Acknowledge and correct –Do not ignore, patronise or ridicule Always tell the public what they can do to reduce risk The mass media represent the public

15. Planning Everything you do is communication! –Sometimes actions speak louder than words Include risk communication in plans Include communicators in the team from the start