Crisis & Emergency Risk Communication Barbara Reynolds, Ph.D.

Crisis & Emergency Risk Communication Barbara Reynolds, Ph.D.

Communicating in a crisis is different
In a serious crisis, all affected people . . . Take in information differently Process information differently Act on information differently In a catastrophic event: communication is different Be first, be right, be credible

The Risk of Disasters Is Increasing
Increased terrorism Population density Aging U.S. population International travel speed Emerging diseases

What the public seeks from your communication
5 public concerns. . . Gain wanted facts Empower decisionmaking Involved as a participant, not spectator Provide watchguard over resource allocation Recover or preserve well-being and normalcy

Crisis and Emergency Risk Communication impacts
5 organizational concerns -- you need to. . . Execute response and recovery efforts Decrease illness, injury, and deaths Avoid misallocation of limited resources Reduce rumors surrounding recovery Avoid wasting resources

Crisis Communication Lifecycle
Precrisis Prepare Foster alliances Develop consensus recommendations Test message Evaluate plans Initial Express empathy Provide simple risk explanations Establish credibility Recommend actions Commit to stakeholders Maintenance Further explain risk by population groups Provide more background Gain support for response Empower risk/benefit decisionmaking Capture feedback for analysis Resolution Educate a primed public for future crises Examine problems Gain support for policy and resources Promote your organization’s role Evaluation Capture lessons learned Develop an event SWOT Improve plan Return to precrisis planning

Precrisis Phase Prepare Foster alliances
Develop consensus recommendations Test message Evaluate plans

Initial Phase Express empathy Provide simple risk explanations
Establish credibility Recommend actions Commit to stakeholders

Maintenance Further explain risk by population groups
Provide more background Gain support for response Empower risk/benefit decisionmaking Capture feedback for analysis

Resolution Educate “primed” public for future crises Examine problems
Gain support for policy and resources Promote your organization’s role

Evaluation Capture lessons learned Develop an event SWOT Improve plan
Return to precrisis planning

5 communication failures that kill operational success
Mixed messages from multiple experts Information released late Paternalistic attitudes Not countering rumors and myths in real-time Public power struggles and confusion

5 communication steps that boost operational success
Execute a solid communication plan Be the first source for information Express empathy early Show competence and expertise Remain honest and open

Psychology of a Crisis

What Do People Feel Inside When a Disaster Looms or Occurs?
Psychological barriers: Denial Fear, anxiety, confusion, dread Hopelessness or helplessness Seldom panic Vicarious rehearsal Note to Instructor(s): This is a short four slide section on the learning objectives and purpose of the course. Run this slide and the next for 5 and 25 seconds respectively.

What Is Vicarious Rehearsal?
The communication age gives national audiences the experience of local crises. These “armchair victims” mentally rehearse recommended courses of actions. Recommendations are easier to reject the farther removed the audience is from real threat. Note to Instructor(s): This is a short four slide section on the learning objectives and purpose of the course. Run this slide and the next for 5 and 25 seconds respectively.

Individuals at risk—the cost?
Demands for unneeded treatment Dependence on special relationships (bribery) MUPS—Multiple Unexplained Physical Symptoms Self-destructive behaviors Stigmatization Negative Actions Misallocation of Treatment Needless Destruction Accusation of Preferential Treatment Unreasonable Travel/Trade Restrictions Fraud Stealing/Looting (Group Behavior) Rumor Spreading Doomsaying Bribery for Scarce Resources Self Destructive Behavior MUPS

Community at risk—the cost?
Disorganized group behavior (unreasonable demands, stealing) Rumors, hoaxes, fraud, stigmatization Trade/industry liabilities/losses Diplomacy Civil actions

Communicating in a Crisis Is Different
Public must feel empowered – reduce fear and victimization Mental preparation reduces anxiety Taking action reduces anxiety Uncertainty must be addressed

Decisionmaking in a Crisis Is Different
People simplify Cling to current beliefs We remember what we see or previously experience (first messages carry more weight) People limit intake of new information (3-7 bits)

How Do We Communicate About Risk in an Emergency?
All risks are not accepted equally Voluntary vs. involuntary Controlled personally vs. controlled by others Familiar vs. exotic Natural vs. manmade Reversible vs. permanent Statistical vs. anecdotal Fairly vs. unfairly distributed Affecting adults vs. affecting children

Be Careful With Risk Comparisons
Are they similarly accepted based on high/low hazard (scientific/technical measure) high/low outrage (emotional measure) A. High hazard B. High outrage C. Low hazard D. Low outrage Pandemic influenza—high hazard, low outrage Bioterrorism attack with plague—high hazard, high outrage Pertussis outbreak in elementary school—low hazard, low outrage Hepatitis A outbreak among children who consumed USDA school lunch program frozen strawberries illegally imported to the U.S.—low hazard, high outrage.

Risk Acceptance Examples
Dying by falling coconut or dying by shark Natural vs. manmade Fairly vs. unfairly distributed Familiar vs. exotic Controlled by self vs. outside control of self

Risk Communication Principles for Emergencies
Don’t overreassure Considered controversial by some. A high estimate of harm modified downward is much more acceptable to the public than a low estimate of harm modified upward.

When the news is good, state continued concern before stating reassuring updates “Although we’re not out of the woods yet, we have seen a declining number of cases each day this week.” “Although the fires could still be a threat, we have them 85% contained.”

Under promise and over deliver . . . Instead of making promises about outcomes, express the uncertainty of the situation and a confident belief in the “process” to fix the problem and address public safety concerns.

Give people things to do - Anxiety is reduced by action and a restored sense of control Symbolic behaviors Preparatory behaviors Contingent “if, then” behaviors 3-part action plan Must do X Should do Y Can do Z

Allow people the right to feel fear Don’t pretend they’re not afraid, and don’t tell them they shouldn’t be. Acknowledge the fear, and give contextual information.

Messages and Audiences

Judging the Message Speed counts – marker for preparedness
Facts – consistency is vital Trusted source – can’t fake these

Public Information Release
What to release When to release How to release Where to release Who to release Why release

Audience Relationship to Event

Match Audiences and Concerns
Victims and their families Politicians First responders Trade and industry Community far outside disaster Media Concerns Opportunity to express concern Personal safety Resources for response Loss of revenue/liability Speed of information flow Anticipatory guidance Family’s safety

5 Key Elements To Build Trust
Expressed empathy Competence Honesty Commitment Accountability

Emergency Information
Any information is empowering Benefit from substantive action steps Plain English Illustrations and color Source identification

What does the public want to know?
Can you tell me more about the attack “What caused it, why, what is the reason behind it?” “Will there be more attacks?” How long is the emergency “How long is the event going to last?” “How long is this ‘radiation’ going to last?”

Accuracy of Information
__________ Speed of Release CREDIBILITY Successful Communication = + Empathy + Openness TRUST

Initial Message Must Be short Be relevant Give positive action steps
Be repeated

Initial Message Must Not Use jargon Be judgmental
Make promises that can’t be kept Include humor

Sources of Social Pressure
What will I gain? What will it cost me? What do those important to me want me to do? Can I actually carry it out?

The STARCC Principle Simple Timely Accurate Relevant Credible
Your public messages in a crisis must be: Simple Timely Accurate Relevant Credible Consistent

Crisis Communication Plan

Elements of a Complete Crisis Communication Plan
Signed endorsement from director Designated staff responsibilities Information verification and clearance/release procedures Agreements on information release authorities Media contact list Procedures to coordinate with public health organization response teams Designated spokespersons Emergency response team after-hours contact numbers Emergency response information partner contact numbers Partner agreements (like joining the local EOC’s JIC) Procedures/plans on how to get resources you’ll need Pre-identified vehicles of information dissemination Note to Instructor(s): Time:

Nine Steps of Crisis Response
Organize assignments Conduct assessment (activate crisis plan) Prepare information and obtain approvals 3 4 Conduct notification 5 Release information to media, public, partners through arranged channels 2 6 Crisis Occurs Verify situation 1 Obtain feedback and conduct crisis evaluation 7 8 Conduct public education 9 Monitor events

Prepare Information and Obtain Approvals
Execute steps in communication plan Public information release for your agency: Top official Top communicator Top subject matter expert Look once, check twice, release it and move on Delegate what you can, prioritize what you can’t

First 48 Hours - Tools Critical first steps checklist
Message template for news release Press availability at site template Public call tracking sheet Media call triage sheet Risk assessment for communication

Stakeholder/ Partner Communication

Stakeholder/Partner Communication
Stakeholders have a special connection to you and your involvement in the emergency. They are interested in how the incident will impact them. Partners have a working relationship to you and collaborate in an official capacity on the emergency issue or other issues. They are interested in fulfilling their role in the incident and staying informed.

5 Mistakes With Stakeholders
Inadequate access Lack of clarity No energy for response Too little, too late Perception of arrogance

Stakeholders can be . . . Advocate–maintain loyalty
Adversary–discourage negative action Ambivalent–keep neutral or move to advocate

3 Reasons to expend energy on stakeholders during an emergency
They may . . . Know what you need to know Have points of view outside your organization’s Communicate your message for you

5 steps in stakeholder preplanning
Identify stakeholders Do an assessment Query stakeholders Prioritize by relationship to incident Determine level of “touch”

Community Relations! Why?
Community acceptance through community involvement Resource multiplier for volunteer “door to door” communication Involving stakeholders is a way to advance trust through transparency Our communities, our social capital, are a critical element of our nation's security

Dealing With Angry People
Anger arises when people. . . Have been hurt Feel threatened by risks out of their control Are not respected Have their fundamental beliefs challenged Sometimes, anger arises when . . . Media arrive Damages may be in play

High-Outrage Public Meetings
“Do’s” The best way to deal with criticism and outrage by an audience is to acknowledge that it exists. (Don’t say, “I know how you feel.”) Practice active listening and try to avoid interrupting. State the problem and then the recommendation.

High-Outrage Public Meetings
“Don’ts” Verbal abuse! Don’t blow your stack. Try to bring along a neutral third party who can step in and diffuse the situation. Don’t look for one answer that fits all. Don’t promise what you can’t deliver.

Don’t lecture at the Townhall
Easy but not effective Doesn’t change thoughts/behaviors Instead, ask questions Key: don’t give a solution, rather help audience discover solution

4 Questions to help people persuade themselves
Start with broad open-ended historical questions Ask questions about wants and needs Ask about specifics being faced now Ask in a way to encourage a statement of benefits

2 simple tips to gain acceptance
Accumulate “yeses” Don’t say “yes, but”—say “yes, and”

Six Principles of CERC Be First: If the information is yours to provide by organizational authority—do so as soon as possible. If you can’t—then explain how you are working to get it. Be Right: Give facts in increments. Tell people what you know when you know it, tell them what you don’t know, and tell them if you will know relevant information later. Be Credible: Tell the truth. Do not withhold to avoid embarrassment or the possible “panic” that seldom happens. Uncertainty is worse than not knowing—rumors are more damaging than hard truths.

Six Principles of CERC Express Empathy: Acknowledge in words what people are feeling—it builds trust. Promote Action: Give people things to do. It calms anxiety and helps restore order. Show Respect: Treat people the way you want to be treated—the way you want your loved ones treated—always—even when hard decisions must be communicated.

Terrorism and Bioterrorism Communication Challenges

What’s Different in a Terrorism Response?
Stronger reaction from the public Multiple events occur Incident location is a crime scene Detection is delayed Responders are at higher risk Response assets are targets

Terrorism and Risk Communication
Outside control of individual or community Unfairly distributed From untrusted source Man-made Exotic Catastrophic

Federal Response Plan FBI leads on information release in crisis management FEMA leads on information release in consequence management Transfer lead from the FBI to FEMA by Attorney General Core federal response: DOJ/FBI DOE FEMA DOD EPA HHS

Joint Information Center
FBI public information officer and staff FEMA public information officer and staff Other federal agencies’ PI staff State and local PIOs

Bioterrorism Is Different
Medical and public health systems are usually the first to detect bioterrorism. A delay is likely between the release of the agent and the knowledge that the occurrence is a bioterrorist act. A short window of opportunity exists between the first cases and the second wave.

Natural Emerging Infectious Disease or Bioterrorism?
Encephalitis Hemorrhagic mediastinitis Hemorrhagic fever Pneumonia with abnormal liver function Papulopustular rash (e.g., smallpox) Descending paralysis Nausea, vomiting, diarrhea

Media Are Sure To Ask: Is this bioterrorism?
Could this be bioterrorism? Are you investigating this situation as possible bioterrorism? Is the FBI involved in this investigation? When will you be able to tell us whether or not this situation is bioterrorism?

Is It an Emerging Disease or Undeclared Bioterrorism?
A possible response to media from public health officials is: “We’re all understandably concerned about the uncertainty surrounding this outbreak, and we wish we could easily answer that question today.” (continued on next slide)

“For the sake of those who are ill or may become ill, our medical epidemiologists (professional disease detectives) are going to first try to answer the following critical questions: (1) Who is becoming ill? (2) What organism is causing the illness? (3) How should it be treated? (4) How can it be controlled to stop the spread?” (continued on next slide)

“One question that disease investigators routinely ask is, “Could this outbreak have been caused intentionally?” “We [organization name] must keep an open mind as data in this investigation are collected and analyzed.” (continued on next slide)

“Any specific questions about the FBI’s involvement regarding this outbreak investigation should be referred to them. However, the FBI and [your organization] have a strong partnership regarding the investigation of unusual disease outbreaks and have worked comfortably together in the past in our parallel investigations.” (Note: Don’t forget to coordinate this answer with the FBI.)

Strategic National Stockpile (SNS)
12-hour Push Pack – 100 cargo containers Air or ground ship 50 tons of medicine, medical supplies, equipment Nerve agents, anthrax, plague, tularemia Treat thousands of symptomatic and protect hundreds of thousands

Tale of Two Cities: Smallpox
Milwaukee, Wisconsin, experienced a Smallpox outbreak in 1894 of fairly major proportions, and caused urban rioting for about a month in the city streets—why? New York City experienced the last Smallpox outbreak in this country in People stayed in line for hours, full days, and came back the next day in some cases with no unrest—why? Judith W. Leavitt, PhD, University of Wisconsin

SNS Communication Plan
Multi-language text Methods for reproducing materials Communication channels Volunteers Contractors On-site interpreters Not all SNS events the same SNS communication assessment checklist

Working With the Media

Disasters Are Media Events
We need the media to be there. Give important protective actions for the public. Know how to reach their audiences and what their audiences need.

Response Officials Should
Understand that their job is not the media’s job Know that they can’t dismiss media when they’re inconvenient Accept that the media will be involved in the response, and plan accordingly

Response Officials Should
Attempt to provide all media equal access Use technology to fairly distribute information Plan to precredential media for access to EOC/JOC or JIC Think consistent messages

Response Officials Should Not
Hold grudges Discount local media Tell the media what to do

How To Work With Reporters
Reporters want a front seat to the action and all information NOW. Preparation will save relationships. If you don’t have the facts, tell them the process. Reality Check: 70,000 media outlets in U.S. Media cover the news 24/7.

Media, Too, Are Affected by Crises
Verification Adversarial role National dominance Lack of scientific expertise

Media and Crisis Coverage
Evidence strongly suggests that coverage is more factual when reporters have more information. They become more interpretative when they have less information. What should we conclude?

Command Post Media will expect a command post. Official channels that work well will discourage reliance on nonofficial channels. Be media-friendly at the command post—prepare for them to be on site.

Media Beating on Your Door
Alternatives to “no comment” that give you breathing room: “We’ve just learned about this and are trying to get more information.” “I’m not the authority on this, let me have XXXX call you right back.” “We’re preparing a statement on that now. Can I fax it to you in about 2 hours?”

Media Availability or Press Conferences “In Person” Tips
Determine in advance who will answer questions about specific subject matters Keep answers short and focused—nothing longer than 2 minutes Assume that every mike is “alive” the entire time Sitting or standing?

Two press conference killers
Have “hangers on” from your organization circling the room Being visible to the media/public while waiting to begin the press conference

Television Interview Tips
Don’t look at yourself on the TV monitor. Look at the reporter, not the camera, unless directed otherwise. Do an earphone check. Ask what to do if it pops out of your ear.

Writing for the Media During a Crisis
The pressure will be tremendous from all quarters. It must be fast and accurate. It’s like cooking a turkey when people are starving. If information isn’t finalized, explain the process.

Emergency Press Releases
One page with attached factsheet (can clear quicker) Think of them as press updates, and prime media when to expect them Should answer 5Ws and H for the time it covers

Press Statements Are Not Press Releases
They are the official position. May be used to counter a contrary view. Not used for peer-review debate. Offer encouragement to the public and responders.

Spokesperson

What the Public Will Ask First
Are my family and I safe? What have you found that may affect me? What can I do to protect myself and my family? Who caused this? Can you fix it?

What the Media Will Ask First
What happened? Who is in charge? Has this been contained? Are victims being helped? What can we expect? What should we do? Why did this happen? Did you have forewarning?

Spokesperson Qualities
What makes a good spokesperson? What doesn’t make a good spokesperson?

Role of a Spokesperson in an Emergency
Take your organization from an “it” to a “we” Build trust and credibility for the organization Remove the psychological barriers within the audience Ultimately, reduce the incidence of illness, injury, and death by getting it right

Be your organization; then be yourself. What’s your organization’s identity?

It’s more than “acting natural.” Every organization has an identity. Try to embody that identity. Example: CDC has a history of going into harm’s way to help people. We humbly go where we are asked. We value our partners and won’t steal the show. Therefore, a spokesperson would express a desire to help, show courage, and express the value of partners. “Committed but not showy.”

Emergency Risk Communication Principles
Don’t overreassure Acknowledge that there is a process in place Express wishes Give people things to do Ask more of people

Emergency Risk Communication Principles
Consider the “what if” questions.

Spokesperson Recommendations
Stay within the scope of your responsibility Tell the truth Follow up on issues Expect criticism

Your Interview Rights Know who will do the interview
Know and limit the interview to agreed subjects Set limits on time and format Ask who else will be or has been interviewed Decline to be interviewed Decline to answer a question

You Do Not Have the Right To:
Embarrass or argue with a reporter Demand that your remarks not be edited Demand the opportunity to edit the piece Insist that an adversary not be interviewed Lie Demand that an answer you’ve given not be used State what you are about to say is “off the record” or not attributable to you

Sensational or Unrelated Questions
“Bridges” back to what you want to say: “What I think you are really asking is . . .” “The overall issue is . . .” “What’s important to remember is . . .” “It’s our policy to not discuss [topic], but what I can tell you . . .”

Watch Out For Machine gun questioning. Reporter fires rapid questions at you. You respond, “Please let me answer this question.” Feeding the mike and the pause. Seldom will dead air make scintillating viewing, unless you’re reacting nonverbally. Relax. Hot mike. It’s always on—always—including during “testing.”

Watch Out For Reporter asks a sensational question and gives you an A or B dilemma. Use positive words, correct the inaccuracies without repeating the negative, and reject A or B if neither is valid. (e.g., corn versus produce) Explain, “There’s actually another alternative you may not have considered,” and give your message point.

Watch Out For Surprise prop. The reporter attempts to hand you a report or supposedly contaminated item. If you take it, you own it. React by saying, “I’m familiar with that report and what I can say is” or “I’m not familiar with the report, but what is important” and then go to key message.

Effective Nonverbal Communication
Do maintain eye contact Do maintain an open posture Do not retreat behind physical barriers such as podiums or tables Do not frown or show anger or disbelief through facial expression Do not dress in a way that emphasizes the differences between you and your audience

Grief in context Circumstances of the death Nature of the relationship
Experienced loss before Any secondary losses

Communicating about loss
Ask clarifying questions When possible, use the words the person uses Say “you’re crying” instead of “you’re sad.” Short statements of condolences (e.g., “this is a sad time,” or “you’re in my prayers”) Use “death” or “dying,” not softer euphemisms like “expired,” or “heavenly reward”

Media and Public Health Law

Model Emergency Health Powers Act
Model public health law for states Protection of civil liberties balanced with need to stop transmission of disease Explain what law covers and why Laws address: quarantine, vaccination, property issues, access to medical records Model law draft – court order to quarantine someone, unless delay could pose an immediate threat

Protecting the Public from Infectious Diseases
Detention – temporary hold Isolation – separation from others for period of communicability Quarantine – restricts activities of well persons exposed

First Amendment “In the First Amendment the founding fathers gave the free press protection it must have to fulfill its essential role in our democracy. The press was to serve the governed, not the governors.” New York Times Co. v U.S., 403 U.S. 713 (1971)

Media’s right to acquire news
Press has right to acquire news from any source by any lawful means No Constitutional right to special access Information not available to the public: Crime scene Disasters Police station Hospital lab Other places

Access may be restricted
Interference with legitimate law enforcement action Law enforcement perimeter Crime scene Disaster scene

Right to acquire information
Available or open to the public Place or process historically open to the public: Hospitals? Jails? Courtrooms? Meeting/conference rooms?

Media’s right of publication
Once information is acquired Ability to restrict information; Severely limited Heavy burden to prevent or prohibit Minneapolis Star Tribune v. U.S., 713 F Supp (S. Minn, 1988)

Assisting the media Inviting media on search or arrest in private citizen’s home is not protected by 1st Amendment and may result in civil liability Violation of 4th Amendment Rights

Employees access to media
Freedom of speech may be Constitutionally protected: if public value outweighs detrimental impact May be required to follow chain of command Ability to choose spokesperson: Police officer has no 1st Amendment right to speak or act on behalf of department when not authorized to do so. Koch v. City of Portland, 766 P.2d 405 (Ore. App. 1988)

CDC’s principles of communication for public
Communication will be open, honest, and based on sound science, conveying accurate information Information will not be withheld solely to protect CDC or the government from criticism or embarrassment Information will be released consistent with the Freedom of Information Act

Freedom of Information Act
FOIA does not apply to state and local governments (most jurisdictions have a FOIA-like laws) Principle of democracy is that citizens be informed about their government. FOIA ensures that the federal government provides public maximum possible information

Federal Privacy Act of 1974 Federal employees matter of public record:
Name and title Grade and annual salary rate Position description Location of duty, room and phone number Name in case of accident after NOK notified Current city/state residence Hospitalization/confinement

Federal Privacy Act of 1974 Most circumstances, may not release:
Age, date of birth Marital status and dependents Street address or phone number Race, sex Legal proceedings Normally protects: medical records, pay records

Human Resources for Crisis Communication

Take off the superhero cape
Responders potential secondary victims Responders risk stretching beyond limits Exhaustion, frustration, anger, guilt are expected After more than 24 hours without sleep, perform as if you are legally drunk

Personal Coping Recognize emotions will be high Eat nutritious food
Take mental breaks Avoid lots of caffeine or alcohol Leave when your shift is over Exercise

Supervisor’s 7 Supports
Remind workers of value of their effort Insist they take meal breaks Make nutritious food and drink available Respond to timid requests for relief Encourage exercise Accept non-offensive “silliness” Insist workers take time to sleep

Executing the Crisis Communication Plan
Apply risk assessment tools Don’t want uninformed fresh crew—stagger hours Relief for leadership too Work 12 hour days, never more than 16 Require a day off after 10 days

Crisis & Emergency Risk Communication Barbara Reynolds, Ph.D.

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Crisis & Emergency Risk Communication Barbara Reynolds, Ph.D.

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