After the debacle of the SARS cover up in 2002-2003, and a decade of less-than-forthcoming admissions regarding their H5N1 problems, Chinese health officials have earned a good deal of rare, but well-deserved praise for their apparent openness on the emerging H7N9 virus.
Over the past week, however, we’ve seen disturbing reports that the Chinese MOA (Ministry of Agriculture) and poultry industry leaders – tired of the stigma and declining poultry sales – are down playing the dangers (see China’s MOA Disputes Poultry As Source Of H7N9 Infections) and are seeking to curb public disclosure of cases, while demanding a name change from `bird flu’ to simply `flu’.
Over the past 24 hours China’s official news agency – Xinhua - has also begun publishing a series of reassuring `forward-looking’ articles heralding the creation of an H7N9 vaccine, without mentioning the long road still ahead to test, produce, and (perhaps someday) distribute the vaccine in any useful quantity.
H7N9 vaccine to undergo clinical testing Xinhuanet 2014-02-09 18:39
H7N9 vaccine proves effective on lab mice Xinhuanet 2014-02-09 10:05
Vaccine development progresses as China reports more H7N9 ca... Xinhuanet 2014-02-08 22:50
Vaccine developed as China reports more H7N9 cases Xinhuanet 2014-02-08 20:42
While we continue to see case reports coming out of affected provinces – with this apparent move to try to downplay the threat – one has to wonder just how accurate these daily counts are going to be going forward. China’s MOA carries great sway, perhaps even more than the Ministry of Health, and as we’ve discussed in the past (see Food Insecurity, Economics, And The Control Of H7N9), their agendas don’t always mesh.
All of which serves as prelude to a brilliant piece by our favorite Risk Communications experts, Dr. Peter Sandman and Dr. Jody Lanard, published on the The Peter M. Sandman Risk Communication Website, a repository of invaluable risk management advice, that quite frankly should be second home for anyone involved in public relations or risk communications.
I’ve highlighted their work often in the past,including Sandman & Lanard: WHO, Pandemic Phases & Public Preparedness, Sandman: A Tale Of Two CDCs, Lanard: China’s Risk Communication On H7N9, and Referral: Sandman On The H5N1 Moratorium.
Follow the link below to read:
by Jody Lanard and Peter M. Sandman
(a February 6, 2014 email to Lisa Schnirring of CIDRAP News)
Lisa Schnirring’s February 6, 2014 article drew from this email.
According to the South China Morning Post and other sources, China’s poultry industry wants China’s public health agencies to stop reporting individual cases of H7N9, to “avoid excessively detailed reports” of H7N9 infections, and to call this novel bird flu virus “H7N9 flu” or “H7N9 virus” rather than “H7N9 bird flu.” The industry’s goal is to reduce consumer concern about shopping for, purchasing, cooking, and eating poultry.
This has two main problems.
First, the industry’s goal is inappropriate. Consumer concern is justified, at least about contact with live poultry, and particularly about environmental exposure at live animal markets. (There isn’t any evidence that eating well-cooked or even poorly-cooked poultry is dangerous; the H7N9 virus is mostly found in the respiratory tract of infected poultry, unlike the more systemic distribution of the H5N1 virus in infected poultry.) The number of human cases of H7N9 in China, though not huge, is growing faster than last year and far faster than H5N1. And the available evidence strongly suggests that most victims are catching the virus from poultry or poultry environments (such as live animal markets), and at most only occasionally from other people. The U.S. government, among others, advises visitors to China to avoid contact with live poultry and live animal markets. It is not foolish for Chinese consumers to try to be as cautious as their food-purchasing and food-consumption patterns permit. This is especially true in the face of massive expert uncertainty about how this new virus behaves.
More importantly, the industry’s recommendations are bound to backfire. It is a fundamental principle of risk communication that mistrust arouses outrage. In other words, people become much more concerned about a health risk when they discover that they are not being told the whole truth about that risk. When sources cannot be trusted, small risks look big and big risks look bigger.
As long as the information coming out of China has been perceived as being reasonably reliable, it has been fairly easy to accept their assurances that there are no signs of sustained human-to-human transmission of the virus.
Should that flow of information stop (or appear manipulated) – due to political or economic interests trumping those of public health – those assurances will quickly ring hollow, regardless of the actual situation on the ground.