Saturday, October 04, 2014

Ebola Risk Communications




# 9046


The debate over what is meant by Ebola not being `airborne and what constitutes `direct contact’  continues, with a growing chorus of discontent in the media, and online, as to how the CDC describes the risks of transmission to the general public. 


Last night, a clearly frustrated Dr. Ian Mackay wrote What words would you use to separate influenza spread from Ebola virus disease spread?    Thoughtful and Highly recommended.

Let me be clear here. Like Dr. Mackay (and most scientists out there), I firmly believe that Ebola is not an airborne virus.  If it were, we’d be digging mass graves all over the world right now.  But there is some risk from large droplet transmission, which can travel a short distance (1 meter or so) through the air. 


And therein lies the difficulty.  How to explain the difference to the public.


Admittedly, finding a simple, coherent, and accurate way to convey risks to the public – particularly when the topic is likely to alarm – has always been a challenge. The tendency of officials  has generally been to carefully parse these messages in order to deliver a 10 second sound bite that is A) defendably true and B) as non-inflammatory as possible.


The problem being, the public knows that you can’t possibly explain a complex set of risks in a 10-second sound byte, and so any attempt to do so is doomed from the beginning.


The CDC’s oft repeated message that -  `You can’t get Ebola through air’ -  while technically true, fails to account for the potential for large-droplet-close-quarters transmission.  What I’ve dubbed as being within `spittle range’ from a cough or sneeze. (Note: CDC Interim guidance does acknowledge this possibility).



This glaring omission has led to hundreds – if not thousands – of `media voices’ (yes, I use that term very loosely) on TV, in newspapers, on Youtube, Facebook & Twitter to openly question the validity of both the message and the messenger. Add in the growing distrust of governments in general, and any gaps or inconsistencies in the message just add more blood to the water.


The public messaging tactics that worked when we had three TV networks, and no internet, are as dead today as film photography.  With Google, all facts are checkable.


Which makes both the accuracy and completeness of the messaging coming from the CDC, HHS, WHO, and others on the Ebola outbreak paramount.  A half answer – no matter how true or well intentioned it may be – comes off as being evasive . . .or worse.


As it is, with an increasingly skeptical mainstream press and the proliferation of conspiracy sites online, the CDC and the HHS are in serious danger of losing the battle for the hearts and minds of the American public on this Ebola threat – and whatever comes down the pike next. 


And while that would be bad for those agencies, it would be even worse for the people they are trying so hard to protect.


If I could be bold enough to offer some advice to the CDC, it would be to take a page from the press briefings provided by Dr  Anne Schuchat - director of the National Center for Immunization and Respiratory Diseases, and Assistant Surgeon General of the United States – whom many regarded as being the best communicator at the CDC during the 2009 pandemic.


She managed to calmly convey rapidly changing and unscripted information clearly and concisely – while acknowledging the things about the virus that were still unknown – in almost daily briefings during the opening  months of the outbreak.

By ditching the all-too-obvious `talking points’, by being willing to deviate from the `script’  when needed, and by trusting that the vast majority of the American public can handle a certain degree of uncertainty - even when talking about something as scary as Ebola - you can engender far more confidence in your agencies, defuse the critics, and vastly improve the way your messages are received.

And that is the sort of gravitas your agencies are going to need if they are going to deal successfully with Ebola, and whatever else comes next.

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