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

2. Month 1: January Setting the Stage in Asia In Southeast Asia: The Avian Influenza H5N1 outbreak shows signs of persistent human-to-human transmission. All age groups are impacted. 230 patients have been hospitalized. 138 people have died.

3. Month 1: January Setting the Stage in the US In the United States: Public Health authorities have notified healthcare facilities to be alert for patients with severe respiratory illness and a history of travel to Asia. Isolates of the flu strain are sent to the Centers for Disease Control & Prevention (CDC), Federal Drug Administration (FDA) and the World Health Organization (WHO) laboratories so vaccine production can begin. Influenza vaccine manufacturers are on alert.

4. Month 2: February Pandemic Influenza Confirmed World Health Organization Confirms efficient human-to-human spread with outbreaks in more than one Asian country. Severe morbidity and mortality among Asian residents.

5. Month 2: February World-Wide Precautions in Effect Mandatory, enforced isolation of symptomatic patients. Flu wards activated and managed by government entities. Large facilities such as hotels and schools commandeered to serve as flu wards.

6. Month 2: February World-Wide Precautions in Effect Mandatory medical screening of all passengers entering and leaving air and seaports. Passengers suspected of being symptomatic or exposed to flu are either refused entry or immediately detained and isolated. Mandatory, enforced use of surgical masks by all citizens in public areas.

7. Month 2: February United States Response State and local agencies intensify influenza surveillance. International travel to the U.S. has not yet been curtailed by federal officials. Federal officials are considering closing U.S. airports.

8. Review the Facts What is currently known? –The World Health Organization has confirmed human-to-human transmission and the onset of a pandemic. –All age groups are affected; 230 patients have been hospitalized; 138 people have died. –U.S. Public Health and the healthcare system are on alert. –International travel to the U.S. is not curtailed. –Precautions are in effect outside the U.S. –U.S. officials are considering closing U.S. airports.

9. Review the Facts What is currently unknown? –When flu will arrive in U.S. –How severe the flu will be.

10. Month 3: March Local Facts 12 people in their early twenties have been admitted to local hospitals with high fever, difficulty breathing and severe pneumonia. All were airline passengers arriving from Hong Kong and Tokyo. Area hospitals have sent specimens to the state laboratory to determine if patients are infected with the virus responsible for the illnesses in Asia. The results will be available in 12-24 hours. No deaths have been reported locally.

11. 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? –Airline staff –Hospital staff –Victim’s family members

12. Month 3: March Rumors Reach the U.S. Media “Is the killer flu stalking our community? We've learned of a disturbing development in the spread of a virulent flu that's already caused hundreds of deaths in Asia. And now, within the past several hours an unknown number of college students returning from an exchange program in Asia have been admitted to local hospitals with ominous flu-like symptoms.”

13. 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?

14. 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.

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

16. 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.

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

18. Sharing Your Group Results Sample First Message:

19. 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.

20. 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.

21. Share Your Group Results Sample questions: Are my family and I safe? What can I do to protect us? Who (what) caused the flu? What is being done to stop the spread? Is it controllable? Is there catastrophic potential?

22. Traveling Fever Arrives A member of an Emergency Medical Services team that transported one of the ill returning travelers to the local hospital is also hospitalized with flu-like symptoms. Another passenger who was on a flight with the students is also admitted. A pandemic in the U.S. is now underway and Emergency Operation Centers deploy across the country.

23. Next Steps