Sandman On Flu Risks For Seniors

 

# 4235

 

 

“This next week, or beginning this weekend, we're going to kick off the national influenza vaccination week. This is a concerted effort that the CDC, health and human services and all of our partners to encourage vaccination.

 

It includes a focus on people at high risk for complications, adults with emphysema, pregnant women, seniors, children, really encouraging vaccination for anyone who hasn't yet been vaccinated and wants to be.” – Dr. Anne Schuchat, CDC News conference Jan 8th, 2010

 

 

Yesterday, the CDC basically stated that it was time for seniors to get in line for the novel H1N1 vaccine.   Until now, with vaccine in short supply, the focus has been on vaccinating children, teenagers, and adults under the age of 64.

 

While this change was anticipated, many seniors – after hearing for months that they are at low risk of catching the virus – may not be very quick to embrace the vaccine.   And that is something that Dr. Peter Sandman worries will backfire on public health officials.

 

Dr. Peter Sandman is an expert on effective crisis communications, and he along with his wife and colleague  Dr. Jody Lanard produce a wealth of invaluable risk management advice on their website:

 

 

I’ve highlighted their work on numerous occasions, including:

 

Peter Sandman: Swine Flu For Grownups

Experts: `Mild’ Is A Misleading Term For This Pandemic

Peter Sandman On Pandemic Risk Communication

 

Yesterday Newsweek ran a story entitled Why Seniors Really Should Fear Swine Flu which was based largely on an analysis created by Dr. Sandman back in December, looking at the relative risks that various age groups face with the H1N1 swine flu.

 

Dr. Sandman used data from CDC Estimates of 2009 H1N1 Influenza Cases, Hospitalizations and Deaths in the United States, April – November 14, 2009  which is pretty much summarized in the chart below.

 

 

 

First we’ll look at the opening paragraphs of the Newsweek article, then we’ll go to the original analysis by Dr. Sandman, and end with a few brief comments of my own.

 

 

Why Seniors Really Should Fear Swine Flu

The CDC's vaccination advice for the over-65 set has been misleading.

By Sharon Begley 

Jan 8, 2010

In the federal government's explanations of swine flu, through its Web site and public-service announcements, one message has come through loud and clear: seniors can rest easy. Children face a much greater risk from this disease, and they are dying from it in numbers never seen with regular, seasonal flu. Maybe seniors even have some special immunity to H1N1.

 

There's only one problem: according to a new analysis, the CDC's own numbers show clearly and unequivocally that H1N1 is more than twice as deadly to seniors as to children. As a result, "many older adults undoubtedly underestimate their own risk and the importance of getting vaccinated," says Peter Sandman, a longtime scholar of risk communication. "Older adults have been told they don't have to worry, and that's not true. If the virus comes back, people will die."

 

Sandman's analysis of the latest estimates of cases, hospitalizations, and deaths by the U.S. Centers for Disease Control and Prevention is here, but let me summarize the basics. Children 0 to 17 are likeliest to catch swine flu. But adults (18 to 64) and seniors (65 and older) are much more likely to die of the disease. Kids are least likely to die if they catch swine flu.

 

(Continue . . .)

 

 

The analysis from the Sandman website follows.  You’ll want to follow the links to read this in its entirety.

 

 

What the CDC Is Saying about Swine Flu Severity

• How deadly is the pandemic so far?
• What age groups is it hitting hardest?
• What age groups does the government say it is hitting hardest?

by Peter M. Sandman

This update draws some inescapable tentative conclusions from the most recent (December 10) tentative estimates of U.S. pandemic flu cases, hospitalizations, and deaths provided by the U.S. Centers for Disease Control and Prevention (CDC).

 

The update also contrasts the CDC’s estimates with CDC communication about them, and with the Department of Health and Human Services’ new H1N1 vaccination campaign, “Together we can all fight the flu,” launched on December 7.

 

I don’t have any opinion on whether the estimates the CDC reported on December 10 are reliable, valid, and useful. But I am certain that the arithmetic I have performed on those estimates to show what they mean is solid. And I am certain that what the CDC’s estimates mean diverges significantly from what the U.S. government is telling people about the pandemic.

(Continue . . . )

 

 

It is important to note that  Dr. Sandman is not criticizing the CDC’s decision to target children, teenagers, and younger adults for vaccination.  That is, as he points out, not his field of expertise.

 

He cautions, however, that the messaging from the CDC needs to accurately convey the facts, and not just support their policy decisions.  Something he feels hasn’t always happened with their vaccine messaging.

 

Otherwise, he warns, they risk losing credibility.

 

Last summer, when the Advisory Committee On Immunization Practices decided to target children, teenagers and young adults (see The ACIP Committee Recommendations) for vaccination, the data was showing mostly children and teenagers being hit by this virus.

 

The downsizing of the estimated volume of vaccine to be available by mid-October, from 120 million doses to about 45 million (a target that was not met), further complicated matters.

 

Between the early demographic data, and the scarcity of vaccine supplies, one can understand the focus by the CDC on vaccinating pregnant women, children and teenagers.  

 

Since kids are walking Petri dishes, targeting them first appeared to provide the most bang for the buck. 

 

Although it was only 3 weeks ago that I was able to get the H1N1 vaccine (I’m 55 and not in a risk group), we now find ourselves awash in vaccine.  To the point where there is talk of giving away millions of doses lest they go unused.

 

Admittedly, all of this has been a precarious balancing act for the CDC, with shifting demographics and vaccine supplies. Trying to convey a simple `sound byte’ message about vaccination, without it becoming too convoluted, has been a challenge.

 

And perhaps, that’s the problem.   Trying to deal in `sound bytes’.

 

Designing an information campaign that relies on 10 second, or even 30 second PSAs, is the equivalent of my giving up this blog and only posting 140 character `microblogs’ on Twitter.  

 

It makes it difficult to `flesh out’ a message.

 

I’m not an expert on crisis communications, but following the ACIP recommendations, a better message early on might have been:

 

“Pandemic flu is a risk to everyone, although some in our older population may be lucky enough to have developed limited immunity to this virus.

 

Eventually we hope to see everyone vaccinated against H1N1, as vaccination is our best protection against influenza.

 

Right now, however, vaccine supplies are limited. More is on the way.

 

But for now we need to target those who are the biggest spreaders of the flu – children and young adults – and those we currently believe to be at highest risk – pregnant women and those with chronic health problems.

 

We ask for your patience.  When more vaccine becomes available, we will expand coverage to all ages.”

 

Too complicated?    I don’t think so.

 

But it requires more than 10 seconds. 

 

And it requires trusting the public to understand that there are physical limits as to what the government can do.   Something that  many in government are loath to admit.

 

As we face an increasingly complicated world, with threats that are not always well defined and solutions that are not always clear cut, we should be moving towards better risk communication . . .not shorter risk communication.

 

And for that, I can think of no better resource than the Sandman website.   Something that should be required reading for anyone charged with communicating with the public.

Sandman & Lanard On The Cochrane Tamiflu Report

 

# 8550

 

Somehow, with all of the MERS news coming out of the Middle East, I managed to miss a terrific piece of analysis by our favorite Risk Communications experts, Dr. Peter Sandman and Dr. Jody Lanard,  published last week on the The Peter M. Sandman Risk Communication Website.

 

Their website is 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.

 

Their latest analysis centers on the  recent release of (and media hype surrounding) a recent Cochrane group analysis that found insufficient evidence to show whether Oseltamivir (Tamiflu ®)  and other NAI antivirals reduces influenza complications and transmission. 

 

I wrote about  this report earlier this month in  Revisiting Tamiflu Efficacy (Again) & The CDC Responds To The Cochrane Tamiflu Study, where I posited the preponderance of evidence supports the use of NAI antivirals for severe influenza.

 

Early last week Declan Butler, writing for the Journal Nature, wrote a piece called Tamiflu report comes under fire, for which Sandman & Lanard have supplied some quotes. Building on their emailed comments to Butler, they penned and posted a longer analysis on their website the following day.

 

Since it would do an injustice to the authors to try to excerpt highlights, I would simply suggest you follow the link below to read it in its entirety. 

 

Overstated Attack Hiding Behind Scientific Assessment: An April 2014 Cochrane Review Trashes the Usefulness of Influenza Antiviral Drugs

by Peter M. Sandman and Jody Lanard

(an April 15, 2014 email responding to Declan Butler of Nature)

Declan Butler’s April 22, 2014 article drew from this email.

Introductory Note

In early April 2014, the Cochrane Collective published two journal articles and a news release that went out of their way to understate the value of Tamiflu and Relenza, the two antiviral drugs used against influenza. When Nature reporter Declan Butler asked for our comment, we quickly sent back the short email posted below.

 

(Continue . . . )

 

The Sandman site is a treasure trove of risk communications information, and you could literally spend days just hitting the highlights. 

 

Highly recommended.

Peter Sandman On Pandemic Risk Communication

 

# 3231

 

 

 

Peter Sandman is a risk communications expert, and makes his living advising companies, agencies, and governments on how to handle media relations during a crisis.

 

Risk communications can deal with everything from a terrorist attack or a pandemic to a CEO’s indiscretion or a product recall. 

 

Depending on the circumstances, getting it right can salvage a company, resurrect a career, and even save lives.

 

The Peter M. Sandman Risk Communication Website combines the expertise of Dr. Sandman, along with his wife Jody Lanard M.D., and is is a veritable treasure trove of risk communications information.  

 

Since the Sandman website has so much information, a good place to start is the Crisis Communication (High Hazard, High Outrage) page.  Here you will find a number of articles on risk communication during events such as pandemics, hurricanes, and other disasters.

 

Today Dr. Sandman has a commentary that appears in Nature, which delves into the things that – from a risk communications perspective – the CDC has gotten right, and the things they have gotten wrong over the first few weeks of the H1N1 Swine flu outbreak.

 

By all means, read it in its entirety. 

 

And then, when you are done, make plans to visit Dr. Sandman’s website.

 

But fair warning, pack a lunch.  There is a lot to see and absorb.

 

 

 

Pandemics: good hygiene is not enough

Peter M. Sandman¹

1. Peter M. Sandman is a risk-communication consultant, 59 Ridgeview Road, Princeton, New Jersey 08540-7601, USA.
   Email: peter@psandman.com

 

Abstract

The US government is doing well to communicate uncertainty over swine flu. It must also help the public to visualize what a bad pandemic might be like, says Peter M. Sandman.

R. LARSEN/THE GRAND RAPIDS PRESS/AP

 

Hygiene is useful, but getting ready for a pandemic also requires stocking up on key supplies.

 

By the time you read this, the outbreak of H1N1 'swine flu' may no longer seem to be a worldwide threat and the disease may have receded from the headlines. As the initial fuss dies down, public-health experts will remain on high alert, but the media and public will move on to something else, muttering about fear-mongering.

 

And whatever the situation is like now, it won't be the end of the story. A mutated virus (more virulent or transmissible or resistant to drugs) could appear a few months later.

 

As a risk-communication professional, I have been watching the US government walk a tightrope between over-reassurance and over-alarm about a swine-flu outbreak that could easily turn out to be devastating, relatively mild or anywhere in between. The United States hasn't issued false reassurances that they will keep the pandemic from 'our' shores — a temptation to which dozens of governments have succumbed. Here I will show what else I think the country is doing right — and wrong.

 

The US Centers for Disease Control and Prevention (CDC) is doing a superb job of explaining the current situation and how uncertain it is. The reiteration of uncertainty and what that means — advice may change; local strategies may differ — has been unprecedentedly good.

 

The CDC's biggest failure is in not doing enough to help people visualize what a bad pandemic might be like so they can understand and start preparing for the worst.

 

(Continue . . . )

Peter Sandman: Swine Flu For Grownups

 

 

# 3550

 

 

Peter Sandman is a risk communications expert, and makes his living advising companies, agencies, and governments on how to handle media relations during a crisis.

 

Risk communications can deal with everything from a terrorist attack or a pandemic to a CEO’s indiscretion or a product recall. 

 

Depending on the circumstances, getting it right can salvage a company, resurrect a career, and even save lives.

 

The Peter M. Sandman Risk Communication Website combines the expertise of Dr. Sandman, along with his wife Jody Lanard M.D., and is is a veritable treasure trove of risk communications information.  

 

Since the Sandman website has so much information, a good place to start is the Crisis Communication (High Hazard, High Outrage) page.  Here you will find a number of articles on risk communication during events such as pandemics, hurricanes, and other disasters.

 

Today we get an editorial from Dr. Sandman that is being widely syndicated in newspapers around the world, entitled  Swine Flu For Grownups. 

Swine Flu for Grownups

Jul 27th, 2009

by Peter M Sandman
- Peter M. Sandman is a risk communication consultant based in Princeton, NJ, USA. Further advice can be found on his website, www.psandman.com.

PRINCETON – No one knows how the swine flu (H1N1) pandemic will evolve. Will it keep spreading, or will it fizzle? Will it retreat during the northern hemisphere’s summer and return in the fall? Will it stay mild or turn more severe? Flu experts just don’t know.

 

What is certain is that health officials risk mishandling how they explain this new and potentially alarming threat to the public. Although they know a lot about virology and public health, they often know next to nothing about how to talk (and listen!) to people about risks.

 

So here’s a primer on the swine flu pandemic risk communication, framed in terms of what health officials shouldn’t do when they’re telling you about this new disease.

 

 

1. Don’t feign confidence. Nobody likes uncertainty; we all wish the experts knew exactly what will happen. But we cope better with candidly acknowledged uncertainty than with false confidence. When health officials tell us confidently that X is going to happen, and then Y happens instead, we lose trust in their leadership. Smart officials are planning for various swine flu pandemic scenarios, and expecting surprises that will force them to change their plans. They should tell us so.

 

2. Don’t over-reassure. So far, this pandemic is mild. But even a mild influenza virus kills a lot of people, especially those with other medical problems. And experts worry that the novel H1N1 virus could mutate into a more severe strain. Yet officials endlessly insist that there is, as a Scottish health official put it, “absolutely no need for the public to be concerned.” This is false and it could backfire. Even before a situation deteriorates (if it does), people sense when they are being “calmed” rather than informed. Not trusting that officials will be candid about alarming information, we rely more on rumors. Not trusting official over-reassurances, we become even more alarmed.

(Continue . . . )

 

There are 7 more important points in this editorial, well worth reading in its entirety.

 

Dr. Sandman’s writings have been mentioned in this space an number of times, most recently in Experts: `Mild’ Is A Misleading Term For This Pandemic, but also here, here, here, and here.

 

If you haven’t already, you shoud make plans to visit Dr. Sandman’s website.

 

But fair warning, pack a lunch.  There is a lot to see and absorb.

Referral: Ian Mackay's Guest Blog By Peter Sandman & Jody Lanard

#14,926


When it comes to  risk communications, Dr. Peter Sandman & Dr. Jody Lanard are the A-Team – which is why their services are sought by corporations, organizations, and agencies around the globe – often in the midst of a crisis.

Their website is an invaluable repository of risk management advice, that quite frankly, should be second home for anyone involved in public relations or risk communications.

I’ve featured their writings many times over the past decade, and when they see something amiss, they are never hesitant to point it out.  A few examples over the years:

CIDRAP Commentary: Sandman & Lanard On Ebola Crisis Communications Lessons

Sandman & Lanard On Ebola & Failures Of Imagination

Sandman & Lanard: WHO, Pandemic Phases & Public Preparedness

Sandman: A Tale Of Two CDCs

Lanard: China’s Risk Communication On H7N9

Referral: Sandman On The H5N1 Moratorium.

As you might guess, I'm quite a fan. They talk straight, and they expect no less from our public officials. 

Flublogia's resident virologist  Dr. Ian Mackay asked for - and received - Sandman and Lanard's take on using the `P' word (for `pandemic' and `preparedness') when talking about COVID-19.  

Follow the link below to read their response in full on Virology Down Under.

Past Time to Tell the Public: “It Will Probably Go Pandemic, and We Should All Prepare Now”Posted on

February 23, 2020AuthorIan M Mackay, PhD (EIC)3 Commentsby Jody Lanard and Peter M. Sandman

And when you're done, forward it to a friend. 

Referral: Sandman On The H5N1 Moratorium

 

 

# 6839

 

My thanks to Crof at Crofsblog for picking up a thoughtful piece by Dr. Peter Sandman, on the H5N1 research moratorium which has been in place for nearly a year.

 

For those unfamiliar with Dr. Sandman, he is a world renown expert on crisis communications, who along with his wife and colleague Dr. Jody Lanard, provide consulting services to individuals, organizations, and companies – often during their worst public relations nightmares.

 

Together they also produce a wealth of invaluable risk management advice on their website, which quite frankly should be second home for anyone involved in public relations or risk communications.

 

 

I’ve highlighted Peter and Jody’s work often in the past, including:

 

Peter Sandman On the CCIVI Vaccine Report

Peter Sandman: Swine Flu For Grownups

Experts: `Mild’ Is A Misleading Term For This Pandemic

Peter Sandman On Pandemic Risk Communication

 

 

Dr. Sandman’s latest piece was published yesterday on their website, and rather than trying to excerpt from it, I’ll simply provide you the link and invite you to read it in its entirety.

 

 

The Moratorium on H5N1 Bioengineering Research:What Was It For? What Did It Accomplish?

by Peter M. Sandman

(December 26, 2012 email to David Malakoff of Science)
David Malakoff's January 4, 2013 Science article drew from this email.

 

Highly recommended.

 

Peter Sandman On H5N1 Research Risk Communications

 

 

# 6162

 

 

I’m a bit chagrinned to admit that I hadn’t checked Peter Sandman’s terrific risk communications website over the weekend in the wake of last Friday’s decision from the Technical consultation on H5N1  held in Geneva.

 

Had I, I would have found a long and thoughtful essay on the need for respectful dialog . . . not `education’ or one sided advocacy in ongoing H5N1 discussions.

 

While not experts in virology, or influenza, Dr. Peter Sandman and his wife and colleague  Dr. Jody Lanard, are often consulted on pandemic communication issues and are internationally recognized experts in all manner of risk communications.

 

Their website, quite frankly,  should be required reading for anyone who’s job it is to deal with the public during a crisis.

 

The Peter M. Sandman Risk Communication Website

 

Last Friday Dr. Sandman sent Lisa Schnirring of CIDRAP news  a long email with his thoughts on the press releases coming out of the Geneva meeting (see WHO News Release On Geneva H5N1 Technical Meeting).

 

Lisa subsequently incorporated some of his comments in her article on the meeting Friday night (see WHO H5N1 study group extends moratorium, calls for full publication).

 

Rather than delay further, I’ll simply invite you to visit Dr. Sandman’s site to read:

 

The H5N1 Debate Needs Respectful Dialogue, Not  “Education” or One-Sided Advocacy

by Peter M. Sandman

(a February 17, 2012 email to Lisa Schnirring of CIDRAP News )

 

 

Highly recommended.

Sandman & Lanard On China’s H7N9 Risk Communications

Credit FAO

 

 

# 8278

 

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:

 

Forgoing Trust, China’s Poultry Industry Lobbies for an H7N9 Cover-Up

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.

(Continue . . . )

 

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.

 

Sandman & Lanard On Zika Risk Communications

#10,979

When it comes to designing effective risk communications, Dr. Peter Sandman & Dr. Jody Lanard are about as good as it gets – which is why their services have been used by corporations, organizations, and agencies around the globe – often in the midst of a crisis.

Their website is an invaluable repository of risk management advice, that quite frankly, should be second home for anyone involved in public relations or risk communications.

I’ve featured their writings more than a dozen times over the past decade, and when they see something amiss, they are never hesitant to point it out.  A few examples over the years:

CIDRAP Commentary: Sandman & Lanard On Ebola Crisis Communications Lessons

Sandman & Lanard On Ebola & Failures Of Imagination

NPR: Jody Lanard On Addressing Ebola Fears

Sandman & Lanard: Ebola Risk Communications

As seems to be happening with increasingly frequency in this 21st century, the world is faced with another new, highly uncertain, public health threat in the Zika virus. Its future course, like that of a CAT 5 hurricane lumbering far out to sea, teeters somewhere between fizzling out and making a devastating landfall.

No one - not the CDC, not the WHO, and certainly not this humble blogger - knows how this latest EID threat will play out. 

And like cadets taking the Kobayashi Maru test of Star Trek lore, public health agencies tasked with warning the public and preparing for Zika's arrival and impact are faced with a virtual no-win scenario.

Already, even before the full extent of Zika's impact is known, there are conflicting views over whether the CDC & WHO have oversold, or undersold, the threat.

Weighing in on all of this today are Peter Sandman and Jody Lanard in a long form essay that answers questions regarding the messaging from public health agencies on Zika's threat. While they find much to praise, they warn on some potential stumbling blocks ahead.


Follow the link for an illuminating read:

Zika Risk Communication: WHO and CDC Are Doing a Mostly Excellent Job So Far

by Peter M. Sandman and Jody Lanard

(a January 31, 2016 email in response to a query
from Faye Flam of Bloomberg View)
Faye Flam’s February 1 article drew from this email.

Question from Faye Flam: In the case of Ebola, some public health officials expressed great certainty about the likely spread of the virus, though there were considerable unknowns. With Zika, again, are there unknowns that have been glossed over? Could the public health community be more straightforward with the press about the unknowns and the uncertainties?

Top U.S. public health officials have been extremely straightforward about Zika unknowns and uncertainties, calibrating their statements to convey their own levels of uncertainty to the public without overstatement or understatement, and without overconfidence.

CDC is doing spectacularly good uncertainty risk communication. The goal should be to create the same level of uncertainty in the audience as in the source. CDC’s Anne Schuchat and Lyle Petersen and NIAID Director Anthony Fauci are carefully conveying their own levels of uncertainty, neither overstating nor understating what is known and unknown about Zika.

And mainstream science reporters seem to be capturing that uncertainty pretty well in how they are quoting and paraphrasing these expert officials.  

(Continue . . .)

Sandman: A Tale Of Two CDCs

 

 

# 7203

 

 

Regular readers (and anyone familiar with the world of risk communication issues) already know of Dr. Peter Sandman, and his wife and colleague Dr. Jody Lanard, who together run The Peter M. Sandman Risk Communication Website.

 

 

Over the years they’ve provided many corporations, agencies, and governments invaluable assistance on handling media relations during a crisis. I’ve highlighted Peter and Jody’s work often in the past, including:

 

Peter Sandman On the CCIVI Vaccine Report

Peter Sandman: Swine Flu For Grownups

Experts: `Mild’ Is A Misleading Term For This Pandemic

Peter Sandman On Pandemic Risk Communication

Today they have a lengthy analysis on the messaging and communication strategies being employed by China’s CDC and our own CDC on the emerging H7N9 virus that builds upon an earlier post I linked to on Saturday (see Lanard: China’s Risk Communication On H7N9).

 

The post (wherein Peter very kindly mentions this blog), is called:

 

Posted: April 8, 2013

H7N9: A Tale of Two CDCs

 

This post, along with the rest of their website, is a treasure trove of great advice and information of interest to anyone who is, or may someday become, a spokesperson during a crisis.

Highly recommended.

Sandman On H7N9 Risk Communications: Candor, but No Push to Prepare

A CDC scientist uses a pipette to transfer H7N9 virus into vials for sharing with partner laboratories for public health research purposes.

 

 

# 7283

 

Dr. Peter Sandman, and his wife and colleague Dr. Jody Lanard, together run The Peter M. Sandman Risk Communication Website. They provide consulting services to individuals, organizations, companies, and even governments – often during their worst public relations nightmares.

 

Their website contains a wealth of invaluable risk management advice, which quite frankly should be second home for anyone involved in public relations or risk communications.

 

 

I’ve highlighted their work often in the past, most recently in Sandman: A Tale Of Two CDCs, Lanard: China’s Risk Communication On H7N9, and Referral: Sandman On The H5N1 Moratorium.

 

Today Peter takes a long, and detailed look at the messaging coming out of the CDC and the World Health Organization on the emerging H7N9 virus (and MERS-CoV).  

 

While he finds their candor over the threat posed by these emerging pathogens praiseworthy, he finds their preparedness messaging to the public to be seriously lacking. 

 

There is simply too much good stuff here to even begin to excerpt it here. Instead, I will strongly urge you to read this exceptional opinion piece in its entirety.

 

When you return, I’ll have a bit more.

 

H7N9 Risk Communication: Candor but No Push to Prepare

by Peter M. Sandman

 

 

The lack of individual (or even corporate) preparedness messaging coming from the CDC and FEMA on these potential pandemic threats is a mystery to me, although I suspect it has much to do with the hammering they took after the worst case scenarios failed to materialize with the 2009 pandemic.

 

Many pundits and critics, most with the benefit of perfect hindsight, accused them of `crying wolf’.

 

But as any epidemiologist will tell you.  If you’ve seen one flu pandemic . . . you’ve seen one flu pandemic.

 

There’s simply no way to know, in advance, how severe any influenza (or MERS) pandemic might be. In many respects, the world got off very easy the last time.

 

Later today I’ll be posting a follow up blog on pandemic preparedness resources.

CIDRAP Commentary: Sandman & Lanard On Ebola Crisis Communications Lessons

Credit CDC PHIL

 

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When it comes to clear-eyed, coherent risk communications, Dr. Peter Sandman & Dr. Jody Lanard are about as good as it gets – which is why their services have been used by corporations, organizations, and agencies around the globe – often in the midst of a crisis.

I’ve quite happily featured their writings several times since the Ebola crisis began, including:

Sandman & Lanard On Ebola & Failures Of Imagination

NPR: Jody Lanard On Addressing Ebola Fears

Sandman & Lanard: Ebola Risk Communications

 

Today they’ve written a long, and valuable commentary for CIDRAP on the communications lessons (hopefully) learned from America’s brush with Ebola this fall – and lessons that could be applied the next time a `scary’ public health event takes place. 

 

Without further ado, I invite you to follow the link below to read:

 

COMMENTARY: When the next shoe drops — Ebola crisis communication lessons from October

Peter M. Sandman, PhD, and Jody Lanard, MD

Dec 09, 2014

Lessons learned this fall: (1) don't over-reassure, (2) acknowledge uncertainty, (3) don't overemphasize panic, and (4) don't ridicule overreactions.

(Continue . . .)

 

 

For further reading, the Peter Sandman Risk Communications website is an invaluable repository of risk management advice, that quite frankly, should be second home for anyone involved in public relations or risk communications.

Sandman And Lanard On Pandemic Credibility and Communication

 

 

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My thanks and a big hat tip to Crof at Crofsblog  for posting a link to what he rightfully calls the ` absolute must read’ of the day; an in-depth analysis of the World Health Organization’s pandemic communications and the charges of a `fake pandemic’.

 

The “Fake Pandemic” Charge Goes Mainstream and WHO’s Credibility Nosedives

by Peter M. Sandman and Jody Lanard

The extremely long assessment that follows advances an argument we can summarize in a single sentence:

The absurd charge that the World Health Organization (WHO) hyped a fake pandemic in order to enrich Big Pharma has gained undeserved mainstream credibility mostly because WHO has badly mishandled its risk communication about three issues: (a) the mildness of the pandemic (so far); (b) the debatable meaning of the term “influenza pandemic”; and (c) the inevitable – but not culpable – structural conflicts of interest of WHO advisors.

 

(Continue reading . . . )

 

Dr. Peter Sandman is an internationally recognized expert on effective crisis communications, and he along with his wife and colleague  Dr. Jody Lanard produce a wealth of invaluable risk management advice on their website:

 

I’ve highlighted their work on numerous occasions, including:

 

Referral: Risk Communication and Disasters

Peter Sandman: Swine Flu For Grownups

Experts: `Mild’ Is A Misleading Term For This Pandemic

Peter Sandman On Pandemic Risk Communication

Two Referrals In One

 

 

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One of the nicest things about being a flu blogger is quality of the company I get to keep.    I not only read, and enjoy, the other bloggers - I've become friends with many of them as well.

 

And one of the perks of having a blog is the ability to give a `hat tip' to a colleague when they've done something particularly well, or have found something of interest that you'd  like to mention in your own blog.

 

Today, I get to do a double hat tip to SophiaZoe, and another to Drs. Sandman and Lanard.  

 

 

 

SophiaZoe, my cyber-twin and editor of A Pandemic Chronicle, after a work-related absence, is blogging furiously again.  And we're glad to have her back.     

 

I'll call you attention to two of her recent blogs.  

 

First, this one from yesterday where she highlights two of my favorite writers, Drs.  Peter M.  Sandman and Jody Lanard,  latest work on a very topical subject: Healthcare worker vaccinations.

 

 

 

Influenza vaccine messaging

by SophiaZoe on January 11, 2009

Drs. Sandman and Lanard have published a new article that is worth a read even if one is not a healthcare worker. Unfortunately, many of the general public also hold the beliefs and misconceptions addressed.

Convincing Health Care Workers to Get a Flu Shot … Without the Hype

 

Susan Keady, an infection control practitioner in Alaska, recently sent the following comment to this website’s Guestbook:

My hospital is struggling, as we do every year, trying to get hospital employees to accept influenza immunization. There seem to be two issues here.

First, people say “I don’t need a vaccine because the flu is no big deal” or “because I never get the flu.” It’s a high-hazard, low-outrage risk. Of course, most of the hazard is to our patients.

Second, employees tell us that the flu vaccine is dangerous, has serious side effects, and may have unrecognized adverse effects on health. Vaccination is low-hazard, high-outrage.

Any suggestions on preparing messages to deal with both these issues? We are not finding that education or evidence work!

 

 

The Peter M. Sandman Risk Communication Website is a veritable treasure trove of excellent risk-communications information.  

 

Anyone whose job it will be to communicate during a crisis would do well to visit the website of Dr. Peter Sandman, who is an expert in risk communication, and who has written about pandemic communications on several occasions.

 

Since the Sandman website has so much information, a good place to start is the Crisis Communication (High Hazard, High Outrage) page.  Here you will find a number of articles on risk communication during events such as pandemics, hurricanes, and other disasters.

 

Highly Recommended.

 

 

 

Over the weekend, I was dragged kicking and screaming (well, not quite that traumatically) into the world of twitter by one of my blogging buddies. 

 

I was already a little intrigued with the idea after reading another blog by SophiaZoe, outlining FEMA's upcoming Twitter Media Conference, scheduled for later today.  

 

 

 

FEMA and Twitter

by SophiaZoe on January 9, 2009

There is going to be an interesting “New Media” event on Monday January 12.

 

FEMAINFOCUS Twitter Media Conference

FEMA Administrator David Paulison will be available from 3 -3:30 pm Monday, Jan 12, 2009, to give a message and reply to questions using the agency’s Twitter account, femainfocus. The agency’s top official will discuss where FEMA was, where it is now, and where he sees it going.

All related documents will be posted or linked from this page so please use this page to bookmark or link to.

 

Readers of this blog may have noted that I am a participant on Twitter, and FEMA [Federal Emergency Management Agency, US] is one of my Twitter “friends”, which simply means I receive their posts meant for those that have “friended” them.

 

(Continue )

Sandman & Lanard: WHO, Pandemic Phases & Public Preparedness

The current WHO phase of pandemic alert for avian influenza A(H5N1) is: ALERT

 

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Last May the internationally known, and highly regarded risk communications team of Dr. Peter Sandman and Dr. Jody Lanard wrote about the CDC’s  messaging on the H7N9 virus threat (see Sandman On H7N9 Risk Communications: Candor, but No Push to Prepare).

 

The Peter M. Sandman Risk Communication Website contains a wealth of invaluable risk management advice, which quite frankly should be second home for anyone involved in public relations or risk communications.

 

Yesterday they posted a letter from pandemic preparedness expert Eric S. Starbuck, DrPH, MPH, (see Paper: Are We Prepared For A Pandemic In Low Resource Communities?) asking (among other things) about the absence of any definitive pandemic phasing information on MERS-CoV and the H7N9 virus on the World Health Organization’s website.

 

As you can see by the graphic at the top of this blog, the H5N1 falls clearly in the `Alert Phase’, but a similar graphic for MERS-CoV or H7N9 are not currently posted on the WHO website.  

 

The closest thing I’ve found is this twitter  statement by Gregory Hartl – spokesperson for WHO – on the H7N9 virus back in April.

 

 

In response Peter & Jody take a detailed look at the World Health Organization’s new (Interim) Guidance on Pandemic Influenza Risk Management (see WHO Unveils New Pandemic Guidance) and how it presumably relates to MERS-CoV and H7N9, and their overall pandemic preparedness messaging.

 

I won’t even attempt to excerpt from this thoughtful 5000+ word analysis, and will instead simply make my strongest possible recommendation that you follow the link below and read it in its entirety.

 

Pandemic preparedness and pandemic stages re H5N1, H7N9, and MERS

 

 

Pandemic preparedness messaging is something I struggle with nearly every day in this blog, and so I know how difficult it can be to find the right `tone’; one that informs without turning people off to the message.

Agencies and organizations like WHO, CDC, ECDC and others also face the inevitable hyping of anything they say by the `tabloid press’. Then, if the worst doesn’t happen (and on the media’s time table), they can expect public excoriation.

 

It may not be `fair’, but it does sell papers. 

 

So their reluctance to come out too strongly before there is evidence of a clear and present danger is understandable. 

 

The suggestion by Sandman and Lanard that `other sorts of agencies – national security agencies, public works agencies, disaster response agencies, etc.’ – who are more used to dealing with the public and disaster response - get involved in the pandemic preparedness messaging makes sense to me.

 

Although you have to dig to find it (and already know it exists), you can find some pandemic preparedness information provided by FEMA, Ready.gov, and Flu.gov.

 

http://www.ready.gov/pandemic

http://www.flu.gov/pandemic/#

 

But I’ve seen no discernable push by either of these websites since the emergence of H7N9 or MERS-CoV to promote enhanced pandemic preparedness for the public.

 

The proactive pandemic preparedness messaging from federal agencies that we saw prior to the 2009 H1N1 pandemic has largely disappeared.

 

I suspect that the prolonged economic downturn has something to do with this, but I fear this may turn out to be penny wise and pound foolish.

 

For my part, I’ll continue to promote pandemic and `all hazards’ preparedness in this blog. 

 

Not because I’m convinced that a pandemic is on the horizon, but because I know that bad things (tornadoes, floods, hurricanes, earthquakes,  and yes . . . pandemics) will happen, often with little warning.

 

And the advantage always goes to those who are best prepared.

 

 

 

And finally, my thanks to Peter & Jody for the very kind mention of this blog in their comment.

Businesses Urged To Avoid Pandemic Pitfalls

 

 

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From Lisa Schnirring at CIDRAP (Center for Infectious Disease Research & Policy) News,  we get an overview of this week's webinar held by CIDRAP's Dr. Michael Osterholm and risk communications expert Dr. Peter Sandman on pandemic preparations for businesses.

 

 

I'll just post the opening couple of paragraphs.  Be assured there is plenty of good information in this article, and it is well worth following the link to read it in its entirety.

 

 

 

Businesses urged to avoid pandemic planning pitfalls

 

Lisa Schnirring Staff Writer

 

Oct 9, 2008 (CIDRAP News) – The current financial crisis may be pulling time and resources away from business pandemic planning, but two experts on the topic today told corporate leaders they can improve their firms' survivability during a global health emergency by avoiding specific mistakes.

 

The two—infectious disease expert Michael T. Osterholm, PhD, MPH, and risk communications expert Peter Sandman, PhD—spoke at a webinar today that was sponsored by the Center for Infectious Disease Research and Policy (CIDRAP) Business Source, an online infectious-disease preparedness resource for business. Osterholm directs CIDRAP, based at the University of Minnesota in Minneapolis, and Sandman is a risk communication consultant from Princeton, N.J. About 326 people from 83 sites took part in the webinar.

 

Osterholm and Sandman told the group that business pandemic planners face tough challenges, not only in managing problems caused by the financial markets, but also in keeping the preparedness momentum going amid "pandemic planning fatigue."

 

(Continue reading . . .)

 

 

You'd be hard pressed to find two people who would be more knowledgeable in their respective fields than Dr. Osterholm and Dr. Sandman.    Together, they present 7 important pandemic planning pitfalls to avoid.

 

CIDRAP is one of the best infectious disease resources on the Internet.   Not only for avian flu, but for many other emerging threats. 

 

The caliber of science reporting from CIDRAP Editor Robert Roos, news reporter Lisa Schnirring, and contributing writer Maryn McKenna are second to none.

 

Peter Sandman's website is also a wonderful resource on the issues of risk communications.   Businesses pay big bucks for his counsel, but you can glean much of his wisdom from the scores of articles and essays on his site.

Both are highly recommended.

Peter Sandman: Outrage On Both Sides

 

 

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Dr. Peter Sandman is a world renown expert on crisis communications, and along with his wife and colleague Dr. Jody Lanard, provide consulting services to individuals, organizations, and companies – often during their worst public relations nightmares.

Together they also produce a wealth of invaluable risk management advice on their website, which quite frankly should be second home for anyone involved in public relations or risk communications.

 

 

I’ve highlighted Peter and Jody’s work often in the past, including:

 

Peter Sandman: Swine Flu For Grownups

Experts: `Mild’ Is A Misleading Term For This Pandemic

Peter Sandman On Pandemic Risk Communication

 

 

When you think about `risk communications’ and `flu’, very little comes close to the often unseemly debate of the past few months over the publication of the Kawaoka and Fouchier H5N1 transmissibility papers.

 

 

For those that need a refresher:

 

Last September, Ron Fouchier from the Netherlands (and almost simultaneously Professor Yoshihiro Kawaoka from Wisconsin) announced success in creating enhanced strains of the H5N1 avian flu virus in the laboratory that can transmit efficiently among ferrets, which quickly sparked biosecurity concerns.

 

For some background, see Katherine Harmon’s Sci-Am article , New Scientist: Five Easy Mutations, & NPR: Bio-Terrorism Concerns Over Bird Flu Research.

 

 

The fate of these two papers has now been decided; Kawaoka’s was published earlier this month (see Nature Publishes The Kawaoka H5N1 Study), and a revised version of Fouchier’s paper is due out anytime.

 

While the original focus of this debate has been settled, we are left with nagging questions regarding the way this debate was handled, and concerns over what happens when this sort of situation inevitably occurs again.

 

Which brings us to a long, detailed, and very informative analysis of the risk communication missteps made by both sides of this debate, posted by Dr. Sandman on his website in response to a reader’s comment.

 

It is called:

 

Risk communication aspects of the debate over H5N1 transmission studies

 

 

I’ll not try to summarize this well reasoned and detailed examination of the events of the past few months, as to do so would be a disservice.

 

This article deserves to be read in its entirety. 

 

Highly recommended.