© Unconventional Concepts, Inc. 2003 1 Principles for Risk and Crisis Communication with the Public Michael J. Hopmeier, MSME Chief, Innovative and Unconventional

© Unconventional Concepts, Inc. 2003 1

Principles for Risk and Crisis Communication with the Public

Michael J. Hopmeier, MSMEChief, Innovative and Unconventional Concepts

Unconventional Concepts, Inc.

Hellenic Center for Infectious Diseases Control (KEEL) 10-11-12 December 2003

Athens, Greece



This Lecture• Only 40 minutes• Will hit some key issues• NOT COMPREHENSIVE!• Just a start• Comments refer generally to both public,

and your own organizations• Refer to many other sources of

information– See me afterwards if you’d like reference

documents and model plans



Evacuations

September 11, 2001 Vs.

New York City Power Outage 2003


Uncontrolled Chaos on the streets of New York

SEPT 11, 2001


“Controlled chaos” on the streets of New York

From Greg BotelhoCNNMonday, August 18, 2003 Posted: 8:06 AM EDT (1206 GMT)

NEW YORK (CNN) -- Thursday's massive blackout left thousands of New York City residents, commuters and tourists flooding the streets of Manhattan just as the afternoon rush hour was getting under way. The exodus was massive, but New Yorkers weathered the day's events in a spirit of controlled chaos.

Thousands clogged the Brooklyn Bridge on their way out of Manhattan, calmly sharing lanes with cars and taxis in 90 degree heat. Many climbed over the barrier to use the bridge's walkway…


What is a Crisis/Disaster Situation?

An external situation which presents a threat to a person or his/her relatives.It may interrupt the functional, cognitive and historic continuity among individuals, families, groups, and the community.

• Israeli Homefront Command


First…do no harm

• Crisis situations are volatile• Poor/misleading communication about

the event can exacerbate the public’s fears and increase panic

• Orson Wells’ 1938 radio broadcast “War of the Worlds” resulted in pandemonium and paranoia

• Recent 9/11 terrorist attacks highlighted potential of media to cause psychological trauma


Two Key Issues

• Instill Confidence– Prevent panic!– Calm and make the public feel comfortable

and self assured

• Provide information to Public– Educate public in advance, if possible– Provide necessary information– Do Not Confuse Them!


Bottom Line

• We want to have the public respond, en mass, in a logical, predictable manner designed to ensure the greatest good to the greatest number


New York Times, October 28, 2001


Anthrax- Psychological effects more widespread than agent

• Negative psychological effects– Fear and paranoia are more damaging than anthrax

• In April 1997, 17 employees at the B'nai Brith National Headquarters went to D.C. area hospitals after feeling ill

– tests later proved the substance they encountered was not anthrax

• In fall 2001, 35 people in a Maryland subway reported nausea, sore throat and headache after exposure to hoax “liquid anthrax”

– window cleaning fluid.

– “But in my opinion we need to protect the Americans not from anthrax, but from the feeling of fear. ... I'm serious. ... Panic is even worse than the disease."

– Benjamin Cherkassky, a senior scientist at Moscow's Central Institute of Epidemiology


Anthrax- Lessons Learned• Needed to make decisions rapidly in the absence of data

• Access to subject matter experts was limited

• No “textbook” experience to guide response

• Understanding of “risk” evolved as outbreak unfolded

• Exaggerated or ambiguous risk assessment creates elevated fear and establishes a sense of distrust among public for future warnings

• Advising public NOT to panic induces opposite response

• Need coherent, rapid process for addressing scientific issues in the midst of a crisis


Communicating with the Public

• As a medical professional, the public has a high degree of trust in what you say– A recent poll in the US by the National

Center for Disaster Preparedness at Columbia University indicated that the United States Surgeon General was the most preferred and trusted figure to deliver news on a terrorist attack

• Planning ahead is key


Some Recent Examples

• SARS

• West Nile Virus

• Vitamin B1 deficiency in baby food

• Anthrax

• Various enteric disease outbreaks

• Smallpox vaccination

• Multiple terrorist incidents


How Do We Communicate?


Myths(Chess et al. 1988)

• Myth: – We don't have enough time and resources

to have a risk communication program.

• Action: – Train all your staff to communicate more

effectively. – Plan projects to include time to involve the

public.



• Myth: – Telling the public about a risk is more

likely to unduly alarm people than keeping quiet.

• Action: – Decrease potential for alarm by giving

people a chance to express their concerns.



• Myth: – Communication is less important than

education. – If people knew the true risks, they would

refuse to accept them.

• Action: – Pay as much attention to your process

for dealing with people as you do to explaining the data.



• Myth: – We shouldn't go to the public until we have

solutions to environmental health problems.

• Action: – Release and discuss information about

risk management options and involve communities in strategies in which they have a stake.



• Myth: – These issues are too difficult for the public

to understand.

• Action: – Separate public disagreement with your

policies from misunderstanding of the highly technical issues.



• Myth: – Technical decisions should be left in the

hands of technical people.

• Action: – Provide the public with information. – Listen to community concerns. – Involve staff with diverse backgrounds in

developing policy.



• Myth: – Risk communication is not my job.

• Action: – As a public servant, you have a

responsibility to the public. – Learn to integrate communication into

your job and help others do the same.



• Myth: – If we give them an inch, they'll take a mile.

• Action: – If you listen to people when they are

asking for inches, they are less likely to demand miles.

– Avoid the battleground. – Involve people early and often.



• Myth: – If we listen to the public, we will devote

scarce resources to issues that are not a great threat to public health.

• Action: – Listen early to avoid controversy and the

potential for disproportionate attention to lesser issues.



• Myth: – Activist groups are responsible for stirring

up unwarranted concerns.

• Action: – Activists help to focus public anger. – Many environmental groups are

reasonable and responsible. – Work with groups rather than against

them.


Develop a Plan

• Anticipate potential questions

• Prepare accurate, understandable, and consistent messages

• PRACTICE, PRACTICE, PRACTICE




Goal #1: Ease concern to necessary levels

• Saying “don’t panic” will not allay fears: you must provide clear indication of why they shouldn’t worry– Example: “The risk is low” or “the disease

is treatable”

• If threat is real and action is required, don’t encourage complacency


Goal # 2: Give guidance

• Give clear instructions on what precautions to take

• Provide a list of symptoms to look for in themselves and others

• Suggest when to call a physician• Giving ACTION items to public

provides comfort and detracts from focus on panic– EXAMPLE: US Duct tape Campaign


Proper Body Language is Essential

• Maintain good eye contact• Do not cross your arms

– otherwise you could appear defensive or uninterested

• Resting your head in your hands makes you look tired or bored

• Watch your tone of voice– a loud or high pitch voice can suggest

hostility or nervousness


Seven Cardinal Rules of Risk Communication(Covello and Allen, 1988)

• Accept and involve the public as a partner

• Plan carefully and evaluate your efforts• Listen to the Public’s specific concerns• Be honest, frank, and open• Work with other credible sources• Meet the needs of the media• Speak clearly and with compassion


Avoid Pitfalls


Avoid Pitfalls• Pitfall: Jargon

– Do: Define all technical terms and acronyms.

– Don't: Use language that may not be understood by even a portion of your audience.

• Pitfall: Humor – Do: If used, direct it at yourself

– Don't: Use it in relation to safety, health, or environmental issues.


Avoid Pitfalls

• Pitfall: Negative Allegations – Do: Refute the allegation without

repeating it.

– Don't: Repeat or refer to them.

• Pitfall: Negative Words and Phrases – Do: Use positive or neutral terms.

– Don't: Refer to national problems, i.e., "This is not Chernobyl."


Avoid Pitfalls

• Pitfall: Reliance on Words – Do: Use visuals to emphasize key points.– Don't: Rely entirely on words.

• Pitfall: Temper – Do: Remain calm. Use a question or

allegation as a springboard to say something positive.

– Don't: Let your feelings interfere with your ability to communicate positively.


Avoid Pitfalls

• Pitfall: Clarity – Do: Ask whether you have made yourself

clear.– Don't: Assume you have been understood.

• Pitfall: Abstractions – Do: Use examples, stories, and analogies

to establish a common understanding.– Don’t: Sound too aloof, detached or

academic


Avoid Pitfalls

• Pitfall: Nonverbal Messages – Do: Be sensitive to nonverbal messages

you are communicating. Make them consistent with what you are saying.

– Don't: Allow your body language, your position in the room, or your dress to be inconsistent with your message.

• Pitfall: Attacks – Do: Attack the issue.– Don't: Attack the person or organization.


Avoid Pitfalls

• Pitfall: Promises – Do: Promise only what you can deliver. Set

and follow strict orders.– Don't: Make promises you can't keep or fail

to follow up.

• Pitfall: Guarantees – Do: Emphasize achievements made and

ongoing efforts.– Don't: Say there are no guarantees.


Avoid Pitfalls• Pitfall: Speculation

– Do: Provide information on what is being done.– Don't: Speculate about worst cases.

• Pitfall: Money – Do: Refer to the importance you attach to

health, safety, and environmental issues; your moral obligation to public health outweighs financial considerations.

– Don't: Refer to the amount of money spent as a representation of your concern.


Avoid Pitfalls

• Pitfall: Organizational Identity – Do: Use personal pronouns ("I," "we").– Don't: Take on the identity of a large

organization.

• Pitfall: Blame – Do: Take responsibility for your share of

the problem.– Don't: Try to shift blame or responsibility

to others.


Avoid Pitfalls

• Pitfall: "Off the Record" – Do: Assume everything you say and do is

part of the public record.– Don't: Make side comments or

"confidential" remarks.

• Pitfall: Risk/Benefit/Cost Comparisons – Do: Discuss risks and benefits in separate

communications.– Don't: Discuss your costs along with risk

levels.


Avoid Pitfalls

• Pitfall: Risk Comparison – Do: Use them to help put risks in

perspective.– Don't: Compare unrelated risks.

• Pitfall: Health Risk Numbers – Do: Stress that true risk is between zero and

the worst-case estimate. Base actions on federal and state standards rather than risk numbers.

– Don't: State absolutes or expect the lay public to understand risk numbers.


Avoid Pitfalls

• Pitfall: Numbers – Do: Emphasize performance, trends, and

achievements.– Don't: Mention or repeat large negative

numbers.

• Pitfall: Technical Details and Debates – Do: Focus your remarks on empathy,

competence, honesty, and dedication.– Don't: Provide too much detail or take part

in protracted technical debates.


Avoid Pitfalls

• Pitfall: Length of Presentations – Do: Limit presentations to 15 minutes.

– Don't: Ramble or fail to plan the time well.

And Finally• Pitfall: “Who is in charge?”

– Do: Have a strong, clear, consistent, concise and single message and voice

– Don’t: Have multiple “leaders” saying different things


The Terrorism Factor

• Intentional acts often create a sense of outrage in the public– can lead to desire for retribution

• The threat is unfamiliar– creating a sense of vulnerability and fear

of unknown• Avoid placing blame on alleged perpetrators

or injecting “politics” into your message– as physicians your primary role is treating

and preventing illness


• Use the media as your ally

• Provide key statistics and information to the media in written form

• Anticipate questions and be prepared

• They will often ask you to speculate so be careful– instead indicate that more information is

needed

Communicating with the Media


SummarySummary

• Crisis communication does NOT begin with the Crisis!– sometimes it may end there, however

• The purpose is to both inform and calm the public

• Make sure YOU are informed, calm, and confident

• YOU are the government to the public; be consistent, compassionate, and in control

Documents

© Unconventional Concepts, Inc. 2003 1 Principles for Risk and Crisis Communication with the Public Michael J. Hopmeier, MSME Chief, Innovative and Unconventional