Micerc a guide for Developing Crisis Communication Plans Office of Public Health Preparedness

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Public Education Campaigns

The activities mentioned above are vital components of a public education campaign. They use informal means to educate the public of where to turn for information and increase community awareness about urgent public health events and what to do. The next step in pre-event planning involves using formal mediums to communicate these messages, including television, radio, print, web sites, billboards, buses, and flyers. The following list is a sampling of pro-active steps that can be taken:

  • Connect to the media by soliciting news coverage of an event or offer ideas for feature stories.

  • Invite the public to respond to a short survey in the newspaper about where they go to get health information.

  • Write a press release to notify reporters of an upcoming preparedness event.

  • Develop public service announcements for radio and TV.

  • Disseminate health information packets to the media containing vital information about a variety of public health threats.

Section Five

Strategic National Stockpile

Communications for the Strategic National Stockpile (SNS)

During a large-scale emergency, public fear and anxiety may frustrate your ability to distribute and dispense prophylaxis to those who really need it. Dread of disease and fear of contagion are estranging forces. But keep in mind that there is no evidence to support the Hollywood inspired images of hysterical mobs driven by the single-minded goal of self-preservation, at the expense to others. An effective health communications plan acknowledges peoples sense of fear and asks them to bear the risks and work toward solution.

Action oriented communicators can help the public determine the danger and take practical steps to reduce the chance of illness. SNS communication materials should offer understandable explanations of why a strategy is or is not recommended and warn the public to expect conflicting answers while the best solution is being identified. When writing communication messages for your SNS plan, be sure they contain accurate and comprehensive information about the threat, dispensing efforts to protect the potentially exposed, and treatment efforts to care for the sick. Threat-specific messages tell people specific information about the protective drug regimens that the state or local government will provide to protect them, and the routine that they should expect when they go to the dispensing site.

An effective health communications plan will have messages and information materials prepared before an emergency so that authorities can quickly add incident specific data at the onset of an emergency. The number of dispensing and treatment locations, for instance, will depend upon the scale and type of threat. A large-scale threat will require more dispensing sites, but if contagion is a concern, the number of treatment centers may be limited, and therefore may be quite large. Public information officers will need to know where the active dispensing and treatment locations are before they can effectively inform the public.

When completed, your health communications plan should include the following:

  • Multi-language (languages commonly spoken in your area) text of all documents used to inform the public during an emergency. These include TV and radio public information announcements and the informational materials, forms, scripts, and videos that dispensing sites use when issuing prophylaxis to the public

  • Storage location of all informational materials (including electronic versions)

  • Methods for reproducing and disseminating informational materials during an emergency, and

  • Specific communication channels, partnerships and staffing pools that support public information release, reproduction and dissemination. The last should include volunteers or contractual professionals to

      • Serve as on-site interpreters for people who do not speak English, are hearing impaired, and

      • Assist with public information campaigns, printing needs and on-site public information assistance

Tips for Public Health Leaders:

From ‘Dilemmas of Governance’ ppt briefing, Johns Hopkins Center for Civilian Biodefense Strategies www.hopkins-biodefense.org

Respect the publics need to know. People need to be fully and honestly informed in order to trust leadership. The more government tries to hide the more suspect people become. “The federal government has to have the cooperation from the American people. There is no federal force out there that can require 300,000,000 people to take steps they don’t want to take.” Sam Nunn, playing the President, Dark Winter bioterrorist exercise, June 2001.

Respondents to a national poll said they believed that if it were not possible to vaccinate everyone quickly, wealthy and influential people would get the vaccine first. Leaders are in the unfortunate position of having to prove inequities will not prevail. Plans should take income disparities into account. Be sure your disease controls to do not appear arbitrary, the public may judge health leaders undeserving of the populations cooperation if there are inequities in access to resources. You might want to consider setting up mass vaccination clinics in locations accessible for people without transportation, and informing the public that the emergency treatment is free.

When tragic choices like distributing scarce, life-saving medical resources arise, such public decisions require full disclosure, with clearly stated facts and rationale on the table, and due diligence given to distributing benefits and burdens justly. Provide evidence that access is based on need, not money or favored state. One preventative measure for members of the public feeling as if eligibility criteria have been arbitrarily imposed is to provide meaningful opportunities for them to comment upon policy options under consideration.

Active engagement of the public in relief efforts may counter the terrorizing effects of an attack, while assuring that authorities have sufficient personnel to carry out critical functions. The SNS mass dispensing sites are ideal opportunities to facilitate positive action by individuals, organized volunteers and civic organizations.

Pre-Event SNS Activities for Public Health and Hospitals

Work closely with your SNS Planner as you develop materials for SNS communication needs. SNS Planners and local emergency planning groups are working hard to make decisions and answer questions that need to be incorporated into the SNS communication documents.

SNS Message Template

The following SNS message template may be a helpful tool as you begin to create threat specific messages. As much procedural information as possible needs to be determined before an incident occurs, such as, dispensing/treatment site locations and what identification information the public needs to bring with them to the dispensing sites. Each local planning group needs to coordinate their SNS plans with regional partners. Keep in mind that the size and type of incident will determine which sites are used. The addresses of your dispensing sites should not be advertised to the public before an incident occurs, for security reasons and to avoid confusing the public.

The SNS template below outlines the vital information that can be compiled for most biological and chemical agents ahead of time.

Specific information about the disease:

Is the agent contagious?

Who should be concerned about exposure? (e.g., during the tularemia exercise we provided assurances to the public that if they were not directly exposed they were not at risk.)
Who should seek preventive treatment at dispensing sites?
Who should seek symptomatic treatment at treatment centers?

Who should be referred for medical treatment?

Where are the dispensing sites and treatment centers? (e.g., addresses, directions, best street access to each site, parking instructions)
When will the dispensing operations start? (e.g., dates, hours, special instructions about when to show up, such as alphabetically or by zip code)

Routine at the dispensing sites:
What forms of identification are needed for adults? (e.g., health information, drug allergies, current medications, drivers license or state identification, social security number)

What information must someone have in order to pick up medications for family members? (e.g., children’s weight, age, health information, drug allergies, current medications, birth certificate, children’s social security number)

Health and treatment recommendations:

What drug regimens have been recommended for adults and children?

Within what time frames?
Your message needs to include statements reminding the public of the importance of taking the medication as prescribed. For example:

For the medicine to effectively prevent illness, you must take the medication as prescribed. Keep taking the medicine, until it is gone, even if you feel okay, unless your doctor tells you to stop. If you stop taking this medicine too soon, you may become ill, or your illness may come back. DO NOT share your medication with anyone else.

Dispensing Site Videos

Dispensing site videos can be scripted ahead of time. The videos can be shown at the entrance to help you manage clinic movement. The information provided in the first video may help you weed out those who were not exposed and do not need to stay in line for treatment. At registration you may want to highlight information about the health effects of the etiological or chemical agent and provide instructions about dispensing site procedures. At the dispensing station you may want to talk about the importance of taking the medication as prescribed and not sharing medications. The videos can be continuous play to save rewinding time. A sample tularemia script written for the SNS exercise in June 2003 is included in the appendix.

Joint Press Release

An incident large enough to require dispensing sites implies the activation of state and local EOCs, including activation of Joint Information Centers. This is an opportunity to develop joint press releases between state and local organizations. This helps ensure that the messages going out will be consistent. Common talking points may be developed and distributed to public information officers (PIO) and spokespersons on all levels of government. The public information officer and/or spokesperson from your department needs to work closely with the PIOs at your local and state EOCs. This is difficult to coordinate during an event. It is important to develop joint information center procedures ahead of time and practice them during exercises.

Media Information Packet

The fact sheets, FAQs, News Releases, health recommendations, risk communication statements etc. developed jointly should be assembled and distributed to media organizations during press conferences. This sort of pro-active step helps ensure consistent messages are going out at all levels.

Signs and Posters

Signs or posters for your dispensing sites can be made ahead of time. Keep in mind the signs needed may vary based on the incident and site layout. Examples: Welcome, SNS Site, Entrance, Registration, Pre-Screening, Intake, First Aid Station, Distribution, Dispensing, Outtake, Medical Review, Communications, Data Collection, Education/Video, Triage, Alternate Services, Mental Health Services, Clinic Treatment Area, Medical/Pharmacy Consultation, Inventory Control and Clinic Exit.

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