Tweet
On my recent visit to <st1:place w:st="on"><st1:city w:st="on">Washington</st1:city> <st1:state w:st="on">D.C.</st1:state></st1:place> to participate in a table-top exercise about pandemic influenza communication on behalf of the FluTrackers.com team, I had the pleasure to interview Stephanie Marshall, Director of Pandemic Communication for the U.S. Department of Health and Human Services. We spent quite awhile together. While I asked her many questions about communications, in general, she also asked me many questions.
<o:p></o:p>
She was very interested in how a large international site such as ours operates. She also wanted to know how we find the information we post and what editorial guidelines we employ. I emphasized our commitment to help lessen morbidity and mortality. I also explained how our news analysts gather news and how the editors and moderators monitor the site 24 hours a day, everyday. She was also very impressed with our ability to host meaningful discussions in a climate of respect and dignity for all participants and subjects. We discussed how FluTrackers.com is not only an information portal, but also a community of individuals. As a community, we have a standard of behavior that encourages all participants to exhibit the highest degree of compassion, understanding, and respect toward each other. Since Stephanie has many years experience in the public relations arena she appreciates this kind of environment for effective communication.
<o:p></o:p>
Her background is in public relations and communications for various health care concerns. She has worked for both commercial and non-profit entities. She has worked in her present position for 2 years. Previous to this she was the Deputy Director of External Affairs for the Centers for Medicare & Medicaid Services. With her involvement in the health field she knows well the challenge of trying to encourage people to change their behavior. And this is at the center of pandemic communication.
<o:p></o:p>
Just how do you prepare a nation for the threat of pandemic influenza? What is considered?
<o:p></o:p>
I had a few questions about this and Dr. William Raub, Science Advisor to Secretary Levitt at the U.S. Department of Health and Human Services, was kind enough to provide some clarification for me:
<o:p></o:p>
Given that the average case fatality rate of known H5N1 cases to date is 60%+, why is the U.S. government using the much lower case fatality rate experienced in the <st1:country-region w:st="on"><st1:place w:st="on">U.S.</st1:place></st1:country-region> in the 1918 influenza pandemic to form the development of its pandemic plan?
<o:p></o:p>
“The high case fatality rates observed for humans infected with H5N1 avian influenza virus clearly are of concern to public health officials. However, experience with influenza outbreaks of many different kinds in many different places over many years has not shown widespread human-to-human transmission of infection to be associated with such virulent viruses. This probably is because the resulting disease is so severe and disabling that it tends to limit the number and frequency of interpersonal contacts and thus tends to terminate chains of infection early. To extend this thought, concern would increase considerably if the case fatality rate for humans infected with H5N1 avian influenza began to fall significantly; for that could lead to more infected individuals experiencing longer periods of less severe illness, attempting to maintain some semblance of normal daily activities, and thereby having multiple occasions to infect others.”<o:p></o:p>
<o:p> </o:p>
As you know FluTrackers.com has advocated a 90 day personal stockpile of essential items for almost 2 years. Why is the <st1:country-region w:st="on"><st1:place w:st="on">U.S.</st1:place></st1:country-region> government only recommending 2 weeks of preparations for a personal pandemic stockpile?
<o:p></o:p>
“ U. S. Government officials believe that no right answer exists regarding the size of personal stockpiles of essential items in preparation for an influenza pandemic. We applaud those who take personal responsibility for preparedness to whatever extent their perspectives dictate and their means allow. We have focused on a 2-week supply as presenting not only a realistic goal for most people but also being a quantity sufficient for them to contribute significantly to the social distancing that will be necessary community-by-community to slow the progress of the local epidemic. We believe that a significant fraction of the potential adverse health and socioeconomic consequences could be prevented if every household were to maintain at least a 2-week personal stockpile of essential items and were to do so in concert with (a) other mitigation efforts led by community leaders (such as prohibitions of large-public gatherings and timely closing of schools) and (b) business-continuity initiatives to avoid significant degradations in supply chains for essential goods and services (which proper planning can make possible). Communities need to plan, test, and, when the time comes, implement a wide array of mitigation actions. No single one is likely to suffice.”<o:p></o:p>
<o:p></o:p>
What is the procedure to change this policy from 2 weeks to 90 days?
<o:p></o:p>
“None of our policies are immutable. We are prepared to revisit any and all as evidence merits. We have found that broad-based stakeholder consultations through various fora and media have been effective for various topics such as vaccination priorities, needs for various types and quantities of other medical countermeasures, and communication strategies. We are committed to improving our abilities to conduct such consultations and welcome recommendations.”<o:p></o:p>
<o:p> </o:p>
Stephanie answered the following questions:
<o:p></o:p>
What is next for the “pandemic message” from the HHS?
<o:p></o:p>
“HHS has conducted extensive audience research on the most effective methods for communicating with the public about pandemic influenza and the importance of individual preparedness. Research findings indicate that citizens want to hear about the importance of pandemic planning from leaders within their community, such as civic leaders, faith-based leaders, local employers, and local nurses and doctors.
<o:p></o:p>
To encourage local leaders to inform citizens about pandemic flu and the importance of individual preparedness we have developed a program called Take the Lead: Working Together to Prepare Now. We have partnered with such organizations as the Red Cross, International Association of Lions Clubs of America, the General Federation of Women’s Clubs, and the American Medical Association to encourage their local membership to get involved in pandemic planning. We’ve placed advertisements about the campaign in trade publications and we’ve created tools and resources community leaders can use to help educate their communities about the importance of individual preparedness.
<o:p></o:p>
We’re testing this approach in nine diverse communities, including <st1:city w:st="on">San Diego</st1:city>, <st1:city w:st="on">St. Louis</st1:city> and <st1:place w:st="on"><st1:city w:st="on">Burlington</st1:city>, <st1:state w:st="on">VT</st1:state></st1:place> among others. Findings from this pilot program will help us refine and improve the program.
<o:p></o:p>
Information about the Take the Lead program can be found at http://www.pandemicflu.gov/takethelead/
<o:p></o:p>
We’re in the process of developing materials that will be widely distributed during a pandemic. To support this effort, we’re currently working with service organizations that reach vulnerable populations to determine the best methods for reaching vulnerable individuals with information before, during, and after a pandemic. “<o:p></o:p>
<o:p> </o:p>
Why doesn’t the HHS release some of the public service announcements that have been prepared for a possible pandemic, and if some are inappropriate for use now, are there some pre-pandemic messages that can be released at this time?
<o:p></o:p>
“HHS released a series of television and radio public service announcements (PSAs) in February 2007. The “Know What to do About Pandemic Flu” PSAs can be viewed at http://www.pandemicflu.gov/news/ Over the last year, these spots have been played more than 6,000 times on all major networks and in Spanish on Univision and Telefutura networks. A majority of these airings occurred during the day and evening. The PSAs have also been provided to numerous state and local public health departments for use at community meetings and for local placement. “<o:p></o:p>
<o:p> </o:p>
I also asked Stephanie what she sees as the biggest challenge for pandemic communication at this time and she said that reaching the public via traditional channels is not enough. This is why HHS is reaching out to the online communities as part of the effort to increase the message through “ the influencers”. I also asked her if the online media has the same status with HHS as the main stream media and she said that we do and in fact we may be issued press passes in the future.
<o:p></o:p>
I appreciate the ability to contact, in a very direct way, someone at the top of our government to discuss and obtain vital information regarding the threat of pandemic influenza. While we do not agree on many issues it is important to maintain an open door for the flow of information. Thank you to both Ms. Marshall and Dr. Raub. I would also like to thank the following for helping me prepare ideas and questions for this interview: Jason Gale of Bloomberg.com, Lisa Schnirring of CIDRAP, Don McNeil of The New York Times.com, and of course, the entire team at FluTrackers.com.
© Sharon Sanders
Flutrackers.com <o:p></o:p>