1. Port In Peril 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 Newell is a small coastal city with a thriving port and strong trucking industry. Newell is a major hub for transporting goods domestically and internationally. Within the past several months, all port cities have been on high alert for possible terrorist threats.

3. DAY 1: Tuesday – 3:00 p.m. Newell Hospital An Emergency Room physician sees a man in his early 30’s with sudden onset of severe headache, fatigue, muscle and chest pains, cough and fever. The physician orders a chest X-ray, blood draw and sputum culture.

4. DAY 1: Tuesday – 3:00 p.m. Newell Hospital The X-ray indicates the patient has pneumonia. It will be several days before the results of the sputum culture are returned. He receives antibiotics and is admitted to the hospital for respiratory support.

5. DAY 1: Tuesday – 4:30 p.m. Newell Hospital The same Emergency Room physician sees a 23 year-old man with similar symptoms. The X-ray results also indicate pneumonia. The physician orders tests and treats the second patient with antibiotics. The second patient is not admitted but asked to remain at the hospital for additional questioning.

6. DAY 1: Tuesday – 5:30 p.m. Newell Hospital The physician is suspicious of the coincidence that two otherwise healthy people with identical flu-like symptoms tested positive for pneumonia on the same day in the middle of summer. The physician instructs a nurse to conduct immediate follow-up questioning of both patients.

7. DAY 1: Tuesday – 6:30 p.m. Newell Hospital The nurse determines: Both men were truck drivers who work in the food industry. They routinely carry containers of food to public school cafeterias. Three days earlier, they each had transported containers from Newell Port to the same nearby warehouse.

8. DAY 1: Tuesday – 6:45 p.m. Newell Hospital The ER physician contacts the Newell Public Health Department to report the similarity between the two pneumonia cases.

9. DAY 3: Thursday – 8:30 a.m. Public Health Department The Newell Public Health Department contacts both patients for additional information. Public Health learns that the first patient’s 35 year-old girlfriend had gone to a walk-in clinic with similar symptoms on Tuesday and was released. The girlfriend died early this morning.

10. Review the Facts What is currently known? –Two otherwise healthy young men were seen at the same hospital ER within a short period of time with flu-like symptoms. –Chest X-rays of both young men indicated they had pneumonia. –Both men are truck drivers and picked up containers at the port and transported them to a nearby warehouse.

11. Review the Facts What is currently known? –One of the men was hospitalized, and the other was released. –The girlfriend of the first patient has died.

12. Review the Facts What is currently unknown? –What they may be infected with. –How contagious this might be. –If this is an act of bioterrorism.

13. 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? –Hospital staff –Victim’s family members –Dock workers and truck drivers

14. DAY 3: Thursday – 8:50 a.m. Public Health Department The girlfriend’s brother calls the Newell Public Health Department to find out what is known about the disease that killed his sister and made her boyfriend ill. The girlfriend’s brother calls a “tip line” for a local news station and reports a possible chemical release.

15. DAY 3: Thursday – 11:00 a.m. Newell Hospital Another 8 patients are seen in the ER with the same flu-like symptoms and pneumonia diagnoses. All either worked at the distribution warehouse or had close contact with one of the first two patients. More blood and sputum samples are sent to the state public health laboratory.

16. DAY 3: Thursday – 4:00 p.m. Newell Port Rumors spread among dockworkers about the existence of a mysterious contagious disease. Dockworkers and truck drivers plan to call in “sick” to avoid exposure.

17. DAY 3: Thursday – 4:30 p.m. Public Health Department The media begins calling and asking, “Is this some kind of plague or deliberate contamination?”

18. 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?

19. 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 what’s happening and who’s 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.

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

21. Deliver An Effective First Message 1.Express empathy. 2.Share what you know – only confirmed facts. 3.State what you don’t know. 4.Describe the process and plans to fill in knowledge gaps. 5.State your agency’s commitment to helping people through the crisis. 6.Guide people to where they can get more information.

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

23. Sharing Your Group Results Sample First Message:

24. 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.

25. 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.

26. Share Your Group Results Sample questions: –What is making people sick? –Should the port be closed? –Is this bioterrorism? –Who is at risk? –Should we wear masks?

27. Port in Peril Persists The state lab confirms that the illness for each patient is pneumonic plague, which is caused by the bacterium Yersinia pestis. This type of plague can spread from person to person through the air. Naturally occurring pneumonic plague is rare, and authorities suspect an act of bioterrorism.

28. Next Steps