Speak First

1. Speak First Communicating Effectively in Times of Crisis and Uncertainty

2. Getting Started • Presenter • (insert name and credentials) • Participants • Your name • Your organization • Your role

3. Presentation Objectives • Today you will learn: • Why communicating EARLY in a crisis is so important. • Core skills for communicating quickly and effectively during a crisis. • New ways of thinking about your role as a communicator.

4. Communication: Whose Job Is It? In the event of a public health crisis, who becomes a “spokesperson?” Public health professionals Government officials/representatives First responders Medical professionals Others? What is the likelihood that YOU will be a spokesperson during a time of crisis? It is likely.

5. Communication: Why Is It Critical? • Why is it critical to communicate with the public during times of crisis and uncertainty? Effective communication can limit injury, suffering and death.

6. Communication: How Is It Critical? • How does effective communication limit injury, suffering and death? • It builds public trust and cooperation. • It supports response and recovery efforts. • It informs response partners. • It reduces rumors and misinformation. • It discourages social stigmatization. • It aids the care of the sick. • It bolsters individuals and communities to rebound from traumatic events.

7. Learn By Example:A Killer Without A Name An Illustration of Communicating in Times of Crisis and Uncertainty

8. A Killer Without A Name • Where: In the Southwest region of the United States. • When: May through November 1993. • Who: Mostly healthy, young, rural Native American residents. • What: 48 cases of rapidly progressing respiratory disease causing 27 deaths. • Why and How: Currently unknown.

9. A Killer Without A Name • What did those who were sick have in common? • Healthy • Young • Rural residents • Native American • Which commonality do you think received the most attention? • Native American

10. A Killer Without A Name • An investigation was launched. • Information about the 27 deaths began to spread across the region. • A well-coordinated crisis communications effort got off to a late start, allowing for a number of negative public responses.

11. A Killer Without A Name • Public Response: • A medical center reports an increase of 800 patients a day of “worried well.” • Native American men and women are perceived as “carriers of death.” • Native American owned businesses are boycotted by Native Americans and others.

12. A Killer Without A Name • Public Response: • Rumors multiply that the government is spreading a biological killer to “wipe out undesirables” causing additional mistrust of government. • Reporters hound Native American individuals, asking intrusive and intimate questions while disregarding patient confidentiality. • Native American beliefs against speaking the names of the dead and conducting autopsies are ignored and haunt the living.

13. A Killer Without A Name • WHY and HOW were people getting sick and dying? • Hantavirus. • Caused by an unusual increase in the population of deer mice and the increased contact of the mice with humans. This information was taken from the book: Virus Hunter: Thirty Years of Battling Hot Viruses Around the World by C.J. Peters, 1997.

14. A Killer Without A Name • How could local health officials have reduced fear and cultural insensitivity by what they did before and during the event? • Before: Built relationships with tribal leaders and members. • Before: Built relationships with media. • During: Spoke earlier rather than later, delivering first, then frequent messages through news conferences.

15. How can you speak FIRST, and speak effectively, in your own time of crisis and uncertainty?

16. Speak First –Speak Well • Understand that crisis communication is a process. • Understand that FIRST MESSAGE DELIVERY is a critical point in that process. • Understand that there are right ways and wrong ways to deliver first messages. • Understand that the right message at the right time can save lives and limit suffering.

17. Crisis Communications is a Process

18. When Crisis Occurs • What happens in a crisis? • Crisis events can happen instantly. • Crises can also creep slowly into communities. • Crisis events create a demand for information before all facts are known. • During a crisis, people take in, process, and act on information differently.

19. Health Crises Are Different • What makes health crises challenging and especially scary to the public? • Diseases and contamination may be silent and invisible. • Illnesses are discovered over time (while the public continues to be exposed). • There are many uncertainties, investigations and delays before a solution is found. • Experts may disagree on disease control efforts.

20. So, how will first messages help, and how will you get them right?

21. First Messages Matter • Why is it so important that you speak early during a time of a health crisis? • The public judges YOUR emergency preparedness by how quickly you release information. • The public takes action and makes choices based on the first messages they hear. • You demonstrate that someone is in charge and taking action. • It buys time for interagency coordination to take place.

22. First Messages Matter • In other words, Speed Equals Authority • Someone is in charge. • A system is in place. • A response is underway.

23. What if We Speak Late? • What are the consequences of communicating late? • It allows time for bystanders and unofficial professionals to characterize the emergency and offer unofficial opinion. • It forces the media to report rumors and inaccuracies. • It creates public confusion and anxiety.

24. Why Do Some Organizations Hold Back? • Most commonly, organizations withhold information for fear that people will panic. • The reality is that most people cope creatively with crisis and DO NOT engage in extreme behavior, especially if they believe they are being told the truth. • Be sure not to confuse fear and anxiety with panic. • Know that there will always be “fighters and fleers” who take unnecessary actions.

25. Why Do Some Public Health Organizations Hold Back? • It is a natural response for public health agencies to: • Want ALL the information before talking with the public. • Have coordinated with ALL response partners before offering a statement. • Since 9/11, the CDC recommends communicating with the public right away to show that a response is underway.

26. First Messages Matter Remember, developing and communicating first messages DOES NOT mean having all the answers. It DOES mean showing that someone is in charge, and that a response is underway.

27. How to Speak First and Speak Effectively in a Crisis

28. What Are People Looking For? • Why do people want information quickly in a crisis? • To help them make more informed decisions about their well-being. • To know how to protect themselves and their loved ones. • To help them preserve or recover their well-being and normalcy. • To get involved in emergency response efforts (for some people).

29. So, Be First to Speak • The goals of delivering first messages: • To provide a caring and compassionate response. • To spread credible information rapidly. • To reduce or manage personal risk. • To set reasonable public expectations. • To emphasize the need to comply with public health measures for containing the spread of the disease.

30. Where Do You Start? Implement the Six Proven Steps to Delivering Effective First Messages

31. Six Steps to Delivering First Messages • Express empathy. • Show your ability to understand what another person is feeling. People are better able to listen to difficult information from a caring person. • Provide an expression of empathy in the first 30 seconds. • Example: “I know you are concerned and I know you want as much information as possible.”

32. Six Steps to Delivering First Messages • Share what you know – only the confirmed facts. • Who, what, when, where, why and how. • It is not necessary to have every answer to move ahead with delivering your first message. • Example: “This situation is developing. I want to tell you what we can confirm right now. At (time), a (brief description of what happened).”

33. Six Steps to Delivering First Messages • State what you don’t know. • Acknowledge that there are unanswered questions. • Example: “At this point, we do not know the number of (persons ill or exposed, injured, deaths, etc.) but we will tell you when we know.”

34. Six Steps to Delivering First Messages • Describe the process and plans to fill in knowledge gaps. • Explain the first steps being taken to respond to the crisis. • Describe what people can expect next. • Example: “We are working with local health care providers and emergency response partners to care for the victims.”

35. Six Steps to Delivering First Messages • State your agency’s commitment to helping people through the crisis. • Let people know that your agency is there for the long haul. • State when they will be hearing from you again. • Example: “We are committed to keeping you informed and will be back with a statement in two hours” (Be sure to follow through).

36. Six Steps to Delivering First Messages • Guide people to where they can get more information. • Provide a website address and a hotline or resource number. • Again, state when you will be back in touch with them. • Example: “Please check our hotline number and website for up-to-date information. The hotline number is 555.555.5555 and our Web site is www.healthdept.com”

37. Recap: Six Proven Steps to Delivering Effective First Messages • Express empathy. • Share what you know – only confirmed facts. • State what you don’t know. • Describe the process and plans to fill in knowledge gaps. • State your agency’s commitment to helping people through the crisis. • Guide people to where they can get more information.

38. Keep This in Mind • What is important to remember when developing first messages? • During a crisis, a person’s ability to listen to and understand information goes down. • Use simple words and phrases. • People forget 80% or more of the information they hear. • People remember the first and last things that you say.

39. What’s Next? Anticipating the Questions

40. Anticipating the Questions • Why is it critical to anticipate the questions AFTER first messages are delivered? • Speeds up the process of communicating with the public. • Allows the response to be proactive, not reactive. • Helps focus the incident commander and response partners on the public’s concerns. • Prepares you and your partners to deliver consistent key messages to the public. • Media reporters will be doing the same thing.

41. Anticipating the Questions • What are the questions that are likely to be asked as a crisis unfolds? • Anticipate questions from the people that are directly affected by the crisis. • Anticipate questions from the general public. • Anticipate questions from the media.

42. Anticipating the Questions • Are my family and I safe? • What have you found that will affect us? • What can I do to protect us? • Who (what) caused this problem? • What is being done to help the victims? • What can I do to help? • Is it controllable? • Is there catastrophic potential? • Is the affect or outcome uncertain?

43. Learn By Example Start Practice Scenario

44. Muddy Waters The following slides represent a realistic public health crisis event and you are charged with developing first messages for the public.

45. Setting the Stage • Middletown Utility Services serves a community of 10,000 people in a suburban town that is 20 miles from a city of 500,000 people. • Middletown Utility Services receives its water from two sources. • The first water source is surface water supplied by North County Utility, a purveyor that sells water to dozens of local utility companies throughout its service area. • The second water source comes from its own wells.

46. Setting the Stage • The water is chlorinated and fluoride is added before it is pumped to several water tanks. • All tanks are protected with chain link fences and monitored by video camera. • Both the surface water and the well water are considered to be excellent quality. • Water metals are well within permitted levels.

47. Setting the Stage • Every few years, bacteria counts are measured above standards, requiring notification of customers. • No pathogenic bacteria have ever been found upon confirmation testing.

48. DAY 1: Monday – 7:33 a.m.Middletown Utility Services • A Middletown Utility Services worker makes a routine inspection of Water Tank number three and notices that the locks on the chain link fence have been broken. • The worker also notices tire tracks in the mud track leading up to the gate. • The utility worker immediately calls his supervisor, who in turn calls 9-1-1.

49. DAY 1: Monday – 7:53 a.m.Middletown Utility Services • The police arrive and an investigation begins. • A heavy vehicle entered the area inside the chain link fence. • The cables to the video camera were cut. • An impression of a large, heavy, round container, approximately two feet in diameter is on the ground beside the tank.

50. DAY 1: Monday – 7:58 a.m.Middletown Utility Services • The police investigation continues. • Brown glass is scattered around the area. • At the top of the ladder, the cover lock is also broken. • Water in the 100,000 gallon tank appears to be off-color. • The police notify the FBI.