Transcript Slide 1

California’s Approach to Risk
Communication –
Diversity, Flexibility and
Model Program Development
Ken August –Office of Public Affairs
Terri Stratton -Emergency Preparedness Office
California Department of Health Services
Overall CDHS Emergency
Preparedness Goal
Ensure California is prepared for:
 Bioterrorism
(Biological/Chemical/Radiological)
 Other infectious disease outbreaks
 Natural disasters and other public health
threats and emergencies
 Where possible, take an “all hazards”
approach
Risk Communication
Principles and Approach
Crisis Communication Lifecycle
Precrisis
• Prepare
• Foster
alliances
• Develop
consensus
recommendati
ons
• Test message
• Evaluate plans
Initial
• Express
empathy
• Provide simple
risk
explanations
• Establish
credibility
• Recommend
actions
• Commit to
stakeholders
Maintenance
• Further explain
risk by
population
groups
• Provide more
background
• Gain support for
response
• Empower
risk/benefit
decisionmaking
• Capture feedback
for analysis
Resolution
• Educate a primed
public for future
crises
• Examine
problems
• Gain support for
policy and
resources
• Promote your
organization’s
role
Evaluation
• Capture lessons
learned
• Develop an event
SWOT
• Improve plan
• Return to precrisis
planning
5 Communication Failures that
Kill Operational Success
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Mixed messages from multiple experts
Information released late
Paternalistic attitudes
Not countering rumors and myths in realtime
Public power struggles and confusion
What Do People Feel Inside When
a Disaster Looms or Occurs?
Psychological barriers:
 Denial
 Fear, anxiety, confusion, dread
 Hopelessness or helplessness
 Seldom panic
 Vicarious rehearsal
Communicating in
a Crisis Is Different
Public must feel empowered – reduce fear
and victimization
 Mental preparation reduces anxiety
 Taking action reduces anxiety
 Uncertainty must be addressed
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Decision Making in
a Crisis Is Different
People simplify
 Cling to current beliefs
 We remember what we see or previously
experience (first messages carry more
weight)
 People limit intake of new information (3-7
bits)
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Risk Communication Principles
for Emergencies
Don’t over reassure - deal with
uncertainty
 When the news is good, state continued
concern before stating reassuring updates
 Under promise and over deliver
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Judging the Message
Speed counts – marker for preparedness
 Facts – consistency is vital
 Trusted source – can’t fake these. Consider
the importance of messenger
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California’s Risk
Communication Preparedness
Efforts
CDHS in partnership with Federal, State,
and Local Government in collaboration
with Red Cross, CBOs and Others
California Strategic Framework
for Risk Communication
Transparency
 Echo Strategy
 Primary Focus on communicating
during an event
 Partnerships and Collaborations
 Tools and training – CERC Tool Kit
 Multi-language focus
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Key Activities
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Emergency Plans
Fact sheets, key messages, press releases
Translation of materials
Website
Drills and exercises
Partner/Stakeholder Involvement
Special populations
Ethnic media roundtables
An Introduction to Seasonal, Avian,
and Pandemic Influenza
California Department of
Health Services
2007
Pandemic Influenza
 What You
Should Know
 How Should You Prepare
 How You Can Help Others
Influenza Terms
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Avian/Bird Flu in birds– is caused by influenza viruses that
occur naturally among wild birds. The H5N1 variant is deadly
to domestic fowl and can be transmitted from birds to humans
when close contact with infected birds exists.
Avian/Bird Flu in humans – Limited cases of human H5N1
with exposure to sick birds. Poultry is safe to eat when fully
cooked. There is no human immunity and no vaccine is
available.
Pandemic Flu – is a virulent human flu that causes a global
outbreak or pandemic, of serious illness. Because there is little
natural immunity, the disease can spread easily from person to
person. Currently, there is no pandemic flu.
Seasonal Flu – is a respiratory illness that can be transmitted
person to person. Most people have some immunity, and a
vaccine is available.
Definition of Influenza
A contagious disease caused by a virus
 Primarily affects the respiratory tract
 Can cause severe illness and lead to lifethreatening complications
 A global infectious disease threat
 An annual public health problem
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More About Seasonal Influenza or
the “Flu”
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Easily confused with other infections, such as
Colds
 Other viral infections
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Usually self-limited to about a week of illness
Complications can contribute to serious
secondary infections and may lead to
hospitalization and death
Usual Symptoms of Seasonal Flu
Fever
 Fatigue
 Body aches
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Headache
 Dry Cough
 Runny or stuffy
nose
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How Seasonal Influenza is Spread
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Primarily through respiratory droplets
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Coughing
Sneezing
Touching respiratory droplets on self,
another person, or an object, and then
touching mouth, nose, eyes without
washing hands
Seasonal Influenza Protections
Practice good personal hygiene
 Stay home if you are sick
 Get vaccinated
 Influenza viruses change more than other
respiratory viruses
 Minor changes occur constantly (drift)
• Cumulative
• Reason why vaccine is updated each
year
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Keep informed about influenza outbreaks: www.cdc.gov/flu
Impact of Seasonal Influenza
250,000 to 500,000 deaths globally/year
 36,000 deaths and more than 200,000
hospitalizations/year in United States
 $37.5 billion in economic costs/year in
United States related to influenza and
pneumonia
 Ever-present threat of pandemic influenza
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Seasonal Influenza vs. Pandemic
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Seasonal outbreaks
 Caused by subtypes of influenza viruses that
already circulate among people
Pandemic outbreaks
 Caused by
 New subtypes
 Subtypes that have never circulated among
people (H5N1 fits this criteria)
 Subtypes that have not circulated among
people for a long time
Influenza Viruses
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Naturally infect several animal species
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Birds and mammals, including people
People usually infected only by human viruses
Wild birds are main reservoir for influenza A
viruses
All known “A” subtypes circulate in wild birds
 Infect wild and domesticated birds
 Ultimate source for viruses (and virus genes)
infecting other animal species
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Avian Influenza Viruses
Human Influenza
A Viruses
H1 – H16
H1 – H3
Impact of Potential Pandemic
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Illness (estimated 30% attack rate):
 Moderate 9 million
 Severe 90 million
Hospitalization:
 Moderate 865,000
 Severe 9,900,000
Mechanical ventilation:
 Moderate 65,000
 Severe 750,000
Deaths:
 Moderate 209,000 (comparable to 1956-58)
 Severe 1,903,000 (comparable to 1918-19)
Current Influenza Vaccine
Production Timeline: 6-9 months
Stages of an Influenza Pandemic
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The World Health Organization defines the six
stages of a pandemic:
 Interpandemic period
 Phase 1: No new influenza virus subtypes
have been detected in humans.
 Phase 2: No new influenza virus subtypes
have been detected in humans. However,
a circulating animal influenza virus
subtype poses a substantial risk of human
disease.
Stages of an Influenza Pandemic
(continued)
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Pandemic alert period
 Phase 3: Human infection(s) but no human-tohuman spread, or at most, rare instances of
spread to a close contact.
 Phase 4: Small cluster(s) with limited human-tohuman transmission, but spread is highly
localized.
 Phase 5: Large cluster(s), but human-to-human
spread still localized, suggesting that the virus is
becoming increasingly better adapted to humans,
but may not yet be fully transmissible
(substantial pandemic risk).
Stages of an Influenza Pandemic
(continued)
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Pandemic period
 Phase 6: Pandemic: increased and
sustained transmission in general
population worldwide.
Currently…
H5N1 infection is widespread among
wild birds and domestic poultry
Reports of H5N1-infected humans
Limited human-to-human spread of virus
Preparation and Response
• Individuals and Families
• Businesses
• Communities
• Faith-based Organizations
• Health Care Providers
• Schools
• Governments
• International Organizations
Importance of Seasonal Flu Program to
Pandemic Preparedness
Everyone has a role:
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People learn and practice basic steps to stay
healthy.
Manufacturers strengthen resources to produce
and deliver influenza vaccines.
Collaborative planning helps ensure readiness in
communities, states, nationally and internationally.
What is Being Done on Your Behalf to
Prepare for an Influenza Pandemic?
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U.S. Government, including Health and Human
Services (HHS), CDC, the National Institutes of
Health, and other federal agencies
World Health Organization (WHO)
Governments and other organizations around the
world
National Strategy for Pandemic
Influenza
Preparedness and
Communication
 Surveillance and
Detection
 Response and
Containment
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Public Health’s Role in Preparation
and Response
Selected examples:
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Conducts and supports clinical and virological
influenza surveillance.
Coordinates pandemic response activities with
state, local and tribal public health agencies.
Coordinates antiviral and other drug delivery from
the Strategic National Stockpile.
What Individuals and Families Can
Do to Prepare for a Pandemic
Store a supply of water, food, medical,
health and emergency supplies.
 Talk with family members and loved ones
about how they would be cared for if they
got sick or what will be needed to care for
them in your home.
 Teach your children to wash hands
frequently with soap and water, and model
the correct behavior.
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What Individuals and Families Can
Do (continued)
Teach your children to cover coughs and
sneezes with tissues or sleeve (not hand),
and be sure to model that behavior.
 Teach your children to stay away from
others as much as possible if they are sick.
Stay home from work and school if sick.
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Complete pandemic influenza checklist for individuals and families:
www.pandemicflu.gov/planguide/checklist.html
What Businesses Can Do to Prepare
for a Pandemic
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Plan for the impact on your business
Plan for the impact on your employees and
customers
Establish policies to be implemented during a
pandemic
Allocate resources to protect your employees and
customers during a pandemic
Complete pandemic influenza checklist for businesses:
www.pandemicflu.gov/plan/businesschecklist.html
What Faith-based and Community
Organizations Can Do to Prepare for a
Pandemic
Plan the impact of a pandemic on your
organization and its mission.
 Communicate with and educate your staff
members and persons in the communities
that you serve.
 Plan for the impact of a pandemic on your
staff, members and the communities you
serve.
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What Faith-based and Community
Organizations Can Do (continued)
Communicate to and educate your
employees
 Coordinate with external organizations and
help your community
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Complete pandemic influenza checklist for faith-based and community
organizations:
www.pandemicflu.gov/plan/pdf/faithbasedCommunityChecklist.pdf
What Health Care Providers Can Do
to Prepare for a Pandemic
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Health care providers play an essential role
in the detection of an initial case of novel or
pandemic influenza in a community. Early
identification and isolation of cases may
help slow the spread of influenza within a
community.
Clinical guidelines: www.hhs.gov/pandemicflu/plan/sup5.html
What Schools Can Do to Prepare
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Have an emergency plan in place including basic
supplies and call down list.
Model proper hygiene and encourage students and
families to do the same.
Participate in local discussions regarding emergency
preparedness, response and criteria for school
closures.
Consider distance learning techniques and the internet
to communicate to families if there was school
closure.
Questions to anticipate
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Is poultry safe to eat?
Should I have my chickens tested and where?
Is it safe for children to play where birds have
been? What precautions should I take?
Will H5N1 arrive in CA and when?
When we have positive birds here does that mean
we have a pandemic?
Discussion Question
Please jot down three actions to take for
either personal or school preparedness that
you can begin working on this month.
 Briefly share these with your those sitting
near you.
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Summary
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Another pandemic is probably inevitable.
We are facing an unknown, but increased risk
of a pandemic.
H5N1 will likely persist/recur in Asia,
Europe, and Africa and may spread to other
parts of the world.
H5N1 is a “new” virus to humans and can
cause severe disease; person-to-person spread
has been very limited.
Summary (continued)
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No evidence now of sustained H5N1 transmission
among people
H5N1 is a leading pandemic candidate, but
 must continue to monitor other avian influenza
viruses.
 must push forward pandemic preparedness
actions BEFORE final warning signs are
detected.
Resources
www.cdc.gov/flu
 www.cdc.gov/flu/workplace
 www.cdc.gov/flu/school
 www.cdc.gov/flu/professionals/index.htm
 www.pandemicflu.gov
 www.dhs.ca.gov
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For More Information
Terri Stratton
(916) 650-6457
[email protected]
Ken August
(916) 650-6864
[email protected]
CA Department of Health Services