Can Good Communications Help Combat Swine Flu?

“Media-based communication is vitally necessary, but not sufficient, in meeting the multiple information needs of disaster risk reduction and disaster management. Other forms of participatory, non-media communications are needed to create communities that are better prepared and more disaster resilient.” from Communicating Disasters: An Asia Pacific Handbook, 2007.

In this article on health communication for pandemic influenza, Nalaka Gunawardene discusses the preparation and use of media messages for the swine flu virus, in light of lessons from the avian flu, Severe Acute Respiratory Syndrome (SARS) outbreaks, and disasters and humanitarian crises of the Indian Ocean Tsunami, Hurricane Katrina, and the Kashmir earthquake.

The author begins with the healthcare warning system of the World Health Organization (WHO) for information on the global spread and prevention possibilities of influenza, originally honed for use in the avian influenza pandemic, now applied to the form of swine flu virus that infects humans, A(H1N1). He describes the dilemma that public health officials face when taking on the role of crisis managers: they need the wide reach and quick access of the "myriad media outlets to inform, update and, where necessary, reassure the worried public. But they also realise the fine line between educating people and frightening them". Because media's need for constant "saturation coverage demands new twists and turns at regular intervals… [e]ven a virulent virus cannot mutate fast enough, it seems, for some news-gatherers and their gate-keepers..." who may sensationalise the information made available to the public.

The ability for communication to reinforce public health measures - such as flu shots, quarantine measures, and hospital care - through rapid, technology-based outreach is now possible. As stated here, "[m]ore than four billion mobile phones are in use, a majority of them in the developing world. Nearly a quarter of the world population (over 1.5 billion people) have access to the web, even if at varying levels of bandwidth. Thousands of radio and TV channels saturate the airwaves - these still are the primary source of news and information for billions. Authentic information and analysis are constantly coming out of trusted sources like the WHO and the Centers for Disease Control and Prevention (CDC) in the US [United States]. What we need is clarity and simplicity of messages, credible messengers and sustained delivery."

Beyond infusing the information channels with messages, there is a need to take into account cultural, political, and institutional factors. The lack of coordination, for example, in a warning system for the Indian Ocean tsunami points to gaps in existing hazard warning systems that need close analysis.

The SARS prevention work done by media teamed with governments and experts is evidence of the use of radio and television as "educator, entertainer and, in some countries, even nanny." [Click here for Gunawardene's blog 'TV playing nanny'.] Singapore - recognised for "the methods, style, tone, timing and breadth of its communicated messages" in a study by Dr. Stewart Auyash, called 'Communications as a Treatment for SARS in Singapore' - is described as an example. "Singapore’s SARS containment policy assigned a major role for news media institutions, who promoted ‘positive participation’ by all citizens to stall or disrupt virus transmission. Citizens who followed the WHO’s preventive guidelines were hailed as community heroes. Those violating quarantine were named and shamed. Top government officials, including cabinet ministers, were shown submitting to the same mandatory preventive procedures as everyone else."

Maintaining public trust is cited as a fundamental strategy. Singapore officials in the SARS epidemic, as reported here, gave clear and immediate answers when they had them. According to the author, Asian governments and others that do not respond effectively to a health crisis suffer "from a credibility gap in managing information about emergencies. For example, the initially slow and guarded media reporting on SARS allowed the virus to spread quickly in China, with devastating results. We cannot afford to repeat these mistakes with the latest flu pandemic."