1. Community Scourge The following slides represent a realistic public health crisis event and you are charged with developing first messages for the public.

2. Setting the Stage Brookfield is a city of 100,000 in a large semi-rural farming region. Brookfield is the regions healthcare, business, transportation and communications hub. The community has a trauma hospital, several four-year colleges, and an airport.

3. Setting the Stage Methamphetamine abuse is a problem in the Brookfield area. About ten people each year are admitted to the hospital with symptoms of Methamphetamine overdose. There are hundreds of users in the community and many people are jailed each year for using and making Methamphetamine.

4. DAY 1: Saturday - 12:45 a.m. Brookfield Hospital Three 20 year olds are brought to Brookfield Hospital ER by ambulance with symptoms of drug overdose. One person was given CPR in the field and has been put on a ventilator. The other two collapse in the ER. All three people die by 3:00 a.m. Blood tests show evidence of Methamphetamine intoxication.

5. DAY 3: Monday - 2:00 p.m. Childrens Corner Childcare Center Emergency Response Services respond to a childcare center to evaluate 5 toddlers with apparent respiratory problems. Children were spontaneously wheezing and coughing. No odors or harsh cleaning products were detected. The childcare center has good air circulation. The children recovered and were not transported to the hospital.

6. DAY 3: Monday – 6:00 p.m. Brookfield Hospital Four young adults are brought to Brookfield Hospital ER with Methamphetamine overdose, including elevated blood pressure, high body temperature and profuse sweating. All four are being monitored in the hospital. Two are on ventilators and the others are very ill as well.

7. DAY 5: Wednesday – 11:30 a.m. Childrens Corner Childcare Center Emergency Response Services are called back to the childcare center, where 8 children in the infant and toddler rooms are exhibiting respiratory problems. Two children are transported to the hospital. Routine toxics screens show that the blood of one 3 year old child tests positive for Methamphetamine. The other childs test is negative, but is having breathing problems, probably from inhaling a strong caustic.

8. DAY 5: Wednesday – 2:00 p.m. Childrens Corner Childcare Center Childrens Corner staff request that the Brookfield Public Health Department assess the indoor air quality of the childcare center. The Public Health inspector notes signs of a Methamphetamine lab in the house next door to the childcare center. (Lots of trash bags, chemical bottles, tanks, and blacked out windows.) The inspector reports the house to the police.

9. Review the Facts What is currently known by Public Health? –Paramedics have responded twice in three days to a daycare to evaluate a total of 13 toddlers with apparent respiratory problems. –2 children are transported to the hospital. –One 3 year old tests positive for Methamphetamine. –Methamphetamine production and use are a problem in the community. –A potential Methamphetamine lab has been identified. –Police have been notified.

10. Review the Facts What is currently known by others? (Public Health may or may not be aware of the following facts because Methamphetamine overdose is not reported to Public Health by hospitals or law enforcement.) –7 people have shown up at the hospital over the last 5 days for Methamphetamine use. –3 people have died and 4 are still hospitalized and are seriously ill. –The ER normally sees about 10 people a year for Methamphetamine.

11. Review the Facts What is currently unknown? –Whether the apparent increase in hospitalizations is coincidence or evidence of a bad batch of Methamphetamine?

12. Additional Information Methamphetamine oil becomes airborne and saturates carpets, walls and other surfaces. Anyone living where Methamphetamine is cooked will get it in their blood from environmental contamination. Risks to the people living in the house where Methamphetamine is being cooked include injury from explosion, skin and lung irritation, respiratory distress, neurological symptoms, mucus membrane irritation, and effects from toxicity of the drug itself.

13. Additional Information Methamphetamine takes only a few hours to cook, and the process is relatively simple (but dangerous) to carry out. Methamphetamine cooking materials are extremely flammable and many labs are discovered when there is a fire or explosion. For every pound of Methamphetamine manufactured, 5-6 pounds of toxic waste are produced. Environmental contamination to drinking water and soil is possible when materials are disposed of improperly.

14. DAY 5: Wednesday – 5:00 p.m. Childrens Corner Childcare Center Public Health inspectors do an initial assessment of the suspected Methamphetamine lab, and post a Do Not Enter sign on the house. The childcare operator tells parents about the hospital visits and the suspected Methamphetamine lab.

15. DAY 6: Thursday – 10:00 a.m. Investigation A police/public health investigation reveals a Methamphetamine lab operation next door to the childcare center. Anhydrous ammonia, used in Methamphetamine cooking, probably wafted in the air, sickening the children. The 3 year old Methamphetamine positive boy lived in the home and attended the childcare center.

16. Could the Word Get Out? Although you have not made any public announcements, could the word get out? –Yes! How could the word get out? –Emergency response service workers –Childrens Corner staff –Childrens Corner neighbors –Parents of children that attend Childrens Corner

17. DAY 6: Thursday – 12:00 p.m. Investigation Continues There is evidence that the abandoned well in the backyard of the house was used as a dump for the toxic Methamphetamine cooking chemicals. The homes in the neighborhood are on private or community wells. It is possible that drinking water in the neighborhood may have been contaminated.

18. DAY 6: Thursday – 12:00 p.m. Brookfield Health Department Reporters from the television stations and local newspapers begin calling to ask what is going on. They are demanding to know if the water is safe to drink. Neighbors state they detect the taste of solvents in their water. Promotional news spots feature hysterical neighbors with their children.

19. Communicating With the Media What is the best way to handle the media during a crisis? Do you … a)respond to reporters on a one-on-one, first- come-first-served basis OR, b)issue a news release OR, c)hold a news conference?

20. Communicating With the Media The best way to handle the media during this crisis is to … c)Hold a news conference. –This is fast-breaking news, the public will want to know whats happening and whos in charge. –Talking to reporters individually could lead to inconsistency of information given to the public. –After the news conference, send a news release to your full media list with all of the same information that was presented at the news conference.

21. What Are You Going to Say? Break into groups of 4 to 6 people, develop your first messages using the six proven steps.

22. Deliver An Effective First Message 1.Express empathy. 2.Share what you know – only confirmed facts. 3.State what you dont know. 4.Describe the process and plans to fill in knowledge gaps. 5.State your agencys commitment to helping people through the crisis. 6.Guide people to where they can get more information.

23. Sharing Your First Messages Report to the large group the first messages your group developed.

24. Sharing Your Group Results Sample First Message:

25. Now … Anticipate the Questions In your groups of 4 to 6 people, develop a list of questions you would expect the media and the public to ask.

26. Anticipate the Questions What are the questions that are likely to be asked as a crisis unfolds? –Anticipate questions from the people that are directly impacted by the crisis. –Anticipate questions from the general public. –Anticipate questions from the media.

27. Share Your Group Results Sample questions: Will there be delayed effects on the children? What will be done to clean up the lab? What can we expect next? How did this happen?

28. Community Scourge Continues Lab results from neighborhood drinking water wells come back positive for Methamphetamine. At least 5 homes have been affected by contamination and people in the homes have been drinking water contaminated by solvents and other chemicals. Police and Public Health officials continue to respond.

29. Next Steps