Sandra Mullin
New York City Dept. of Health and Mental Hygiene
In the United States, food-borne pathogens cause an estimated
76 million illnesses
325,000 hospitalizations
5,000 deaths annually
Germs lurk in every step of the production process.
Waco, Oregon 1984-5
751 people sickened from deliberate Salmonella contamination of salad bars
Occurred before the 24 hour news cycle, media competition, breaking news tickers
(photo of Trade Center towers burning)
We are sending this broadcast alert in response to the tragic terrorist attack at the World Trade Center this morning. We want to alert you to the following issues:
There is Currently No Evidence of a Biologic, Radiologic or Chemical Attack: The NYC Department of Health (DOH) has received no information suggesting that a biologic, chemical or radiologic terrorist attack has occurred in New York City. There is currently NO evidence that there were any chemical or biologic agents on the planes.
However, we do request that you be especially alert to ANY unusual disease issues over the next three weeks.
Anthrax Comes to New York City
(graphic - cartoon by Mike Peters. Family around TV set. Caption: Attention: "We interrupt this emergency breaking news bulletin with an even scarier emergency breaking news bulletin.")
EXPECT THE UNEXPECTED
NYC is deservedly described as one of the most prepared cities in the nation
But we weren’t looking for illness in the right places
It's the doctor's office (not hospitals) stupid!
Preparedness is a journey not a destination
(photo - skin disease or injury to a patient's arm)
(photo - the anthrax letter mailed to news anchor Tom Brokaw)
No. of letters: 2
No. of cases: 8
No. of deaths: 1
No. of case reports: 600
No. of persons on antibiotics: 1700
No. of powder events: 3,000
No. of anxious New Yorkers: 8 million
(photo - headline on the New York Post during the anthrax crisis: "Anthrax This: Stricken NY Post Girl's Message to the Terrorists")
While there were so few cases, there was so much to do: labs, p.o.d.s, hotlines, media inquiries
Recognize that even though the risk may be small, people worry!
Consider mental health needs of a terrified population and plan for them
(photo - Cover of U.S. News and World Report. Headline, "Death by Mail.")
24/7 public hotline/website updates
Daily Mayoral/Health Commissioner media briefings
Regular contact with electeds/community orgs/hospitals P.I.O’s
Intra-agency communication critical
Difficult issue for public health even in the absence of a crisis:
People smoke
Have unprotected sex
Eat fatty foods
Don’t wear seat belts
Don’t exercise
We choose these risks but some risks are seen as:
Outside our control
Exotic/Unfamiliar
Involuntary/Imposed
People are more afraid of the things that don’t kill them than the things that do (Sandman)
During uncertain times, what you communicate and how you communicate it are both critical
During a crisis, or when an issue is highly controversial, don’t expect a dissertation that compares one risk to another to work in your favor
People are likely to feel patronized or cornered
Data do not impress when people are upset
Practice: the introduction of West Nile virus into NYC in 1999
Mayor Giuliani’s and the Health Department’s credibility was high
After 9/11 we were already in emergency and crisis communications mode
If intentional contamination of food with botulism or salmonella were to occur, what are the recommendations?
Should consumers take antibiotics for protection against contaminated food?
Need to fine tune public health messages now.
Unlike an explosion or chemical release, a bioterrorist attack is likely to be covert, and time-consuming to detect.
Symptoms might not occur among victims for days or weeks
Those initially presenting themselves to physicians and clinics might be geographically dispersed.
Contaminated food may still be available to other persons besides the patient.
Variables include incubation period, duration of illness, symptoms, means of transmission, treatment and prognosis
Build trust before a crisis
Empathize with public
Don’t use reassurance to minimize concern
Model being able to bear fear and uncertainty
Talk straight and this will reassure!
We're trying to make ourselves feel better!
Use subordinate clauses – It appears we’re seeing fewer cases but until a hard frost, we may still see more illnesses from West Nile…
Let people be afraid!
Our job is to give information – say what we know, what we don’t know
I don
Better irritate by not knowing now than lose credibility for incorrect speculation later on (Sandman)
Resist the urge to use the words "isolated, " or "panic," as in don't!
Food-borne illnesses - difficult to track in normal circumstances
In an intentional contamination incident, expect information to unfold slowly
Be honest, credible
(headline from New York Times: "The Truth Hurts: Efforts to Calm the Nation's Fears Spin Out of Control")
Two-way communication: Share plans for preparation and information with the public now
Improve agency communication skills
Prepare likely spokesperson(s) and share information with all staff
Meet with stakeholders, eg: citizen’s groups, unions, environmental groups, elected officials, etc.
Help public to be more informed and involved in disaster planning and communications response
Public must have more control over risk reduction
The best time to dissuade people from using gas masks is not during a BT event. (Share info now!)
(graphic - advertisement for gas masks)
(graphic - Poster on Identifying Suspicious Mail)
Q. What is the Food and Drug Administration (FDA) doing to protect the food supply against terrorism?
A. Over the last few years, FDA
has worked with food safety agencies at federal,
state and local levels to significantly strengthen
the Nation's food safety system across the entire
distribution chain -- from the farm to the table.
The main results of this cooperation -- more
effective prevention ……
Since the September 11 attack, FDA has increased
its emergency response capability …..
Media Lists
Update phone numbers/email list serves/two way radios
Fact sheets/what ifs/q's and a's/
Hotline contracts
Cross-train staff for crisis activities
Whenever people are ambivalent, they resolve their ambivalence by favoring the side neglected in the communication environment.
The public will take the other seat of the seesaw if they are ambivalent. Don’t preempt the seat you’d like the public to take.
(cartoon - Man being interviewed at television news desk answers, "I don't know." Crewman offstage says, "Finally, a pundit who knows what he's talking about.")
Thank You
Sandra Mullin
Associate Commissioner,
Communications
NYC Dept. Of Health and Mental
Hygiene
Smullin@health.nyc.gov