H1N1… an example of how not to do effective health communications

As someone who spent a quarter century in the health communications and social marketing field, I am flabbergasted on how ineffective the communications coming out of health authorities is on H1N1 /Swine flu.

One thing seems clear and that is the compelling need for reliable information, to understand the risks this virus presents, what to do about it and who to go to for help and advice.

Yes there is the WHO, many levels of government and others who are providing news and information via many channels: television, radio, toll-free phone numbers, the web, printed material, etc. Much of that information, though, is contradictory, inconsistent, and hard to understand and, in some cases unreliable. There are so many sources you don’t know who to believe. For example today I heard a news clip that many health professionals will not be taking the vaccine. What message does this send to the public? If health workers won’t take the vaccine … why should I?

Marguerite Wente in her article yesterday in the Globe and Mail states “swine flu overkill (SFO) is a serious illness caused by saturation media coverage and repetition of the word “pandemic.” I’m not one to minimize the horrors of the H1N1 virus, which can be unpleasant and even fatal. But please, people. Can’t we get a grip? The CBC has been covering swine flu as if it were the biggest natural disaster since Hurricane Katrina. The newspapers have been full of drama about whether there will be enough vaccine, whether it’s arriving fast enough, and if not, who’s to blame. Ordinary citizens are feverishly researching the ins and outs of adjuvants, and wondering if they should drive to the next town so their kids can be vaccinated right away. Meantime, a lot of people have said the hell with it. It’s hard to blame them. Ever since the spring, when the World Health Organization declared swine flu to be a “pandemic” – after just 144 deaths – SFO has been running rampant. Ordinary pandemics kill at least a million people worldwide. Swine flu has killed around 5,000 people, including 86 in Canada. Worldwide, ordinary seasonal flu kills 700 to 1,400 people a day.”(According to the World Health Organization, fewer than 5,000 people have died around the globe from this variant of swine flu. In any normal year, influenza causes between 250,000 and 500,000 deaths worldwide.)

In the Southern Hemisphere, the winter flu season is now over. In spite of dire predictions, only 185 people died from swine flu in Australia – considerably fewer than the roughly 3,000 who succumb to seasonal influenza in that country each year. And no, it wasn’t because the population was immunized. Australia’s vaccination campaign against swine flu took off last month. Last week, U.S. President Barack Obama declared swine flu a national emergency after about 1,000 Americans died. Yet according to the Centers for Disease Control, roughly 50,000 Americans die every year from seasonal flu – without any politician paying much attention.

So, is this an example of overkill? Is it a case of “the boy crying wolf”. When a  real pandemic hits, which could happen, will people listen? Is the SFO responsible for half of our population saying they won’t take the vaccine? Sometimes “over-communications” can work against the health communicators who day after day are “hammering out” the message. And the more they hammer the less confidence people have towards the vaccine. Is this effective “crisis or risk communications?

As Wente states “everybody loves a good health scare. Remember BSE? Infected cows were going to turn our brains to mush. Then came SARS. In 2003, one widely quoted British expert predicted that it could turn out to be more lethal than AIDS. The final death toll from SARS was 774 – about one day’s worth of flu victims. Then came deadly birds. In 2006, David Nabarro, a top WHO official, warned that avian flu could kill 150 million people. The White House’s avian flu response plan projected that as many as two million Americans might die and one leading influenza researcher warned that a pandemic might kill half the human population. To date, the worldwide death toll from avian flu is 262 ( Wente dd not mention West Nile Virus and the Ebola-virus.)

Are we blowing the H1N1 out of proportion? I also wonder if the health authorities have a Marketing and Communications plan that comprehends the need not to over communicate and ensure that everyone in the health field is on the same page and that we get consistent messages that don’t contradict each other. Where is the coordination between federal province/state and municipal/regional governments not to mention others in the health field? Ironically, the more the public hears about how important it is to get the shot, the more skeptical it gets. According to sources, in the U.S., only half the population plans to get it, according to surveys, and a third oppose it for their kids. In Canada, 51 per cent of us are saying we won’t bother – up from 38 per cent in July.

Wente points out that “all these health crisis  have a lot in common: a legitimate concern that’s blown wildly out of proportion by various interest groups, including scientists and public-health agencies, whose warnings are then amplified by the media. Politicians have no choice but to respond in kind, just in case. This outbreak has followed the usual course. The President’s Council of Advisors on Science and Technology recently predicted that there might be 30,000 to 90,000 U.S. deaths from swine flu, peaking in mid-October. (That would be a week ago.) To date the U.S. death toll has barely reached a thousand, but the President has declared a national emergency anyway.”

Our organization is presently involved in working on an Immunization program where we are trying to convince parents to immunize their children. You wouldn’t believe, all the anti-vaccinationists, including a former Playboy bunny, who are trying to convince parents not to immunize their children.   – People who believe that vaccines cause autism or brain poisoning. The H1N1 epidemic of coverage also feeds a growing sense that the risks are overblown and these anti-vaccinationists are coming out of the woodwork and spouting their nonsense to a gullible audience who does not know who to believe.

Also have you tried going to a website from a health authority to download credible information on H1N1 flu. Good Luck.

As Wente states in her article: “As for me, despite my SFO, I’m definitely going to get the shot. Although I’m in a low-risk group, the last thing I want to do is wind up in hospital, where MSRA, C. difficile, and other hospital-acquired infections kill around 8,000 Canadians a year. My advice is that whatever you do, stay out of the hospital – or you might get really sick.”

If you are a health communicator or marketer, I would love to hear from you. Oh yes I will get the flu shot, something I have done for the past 5 years.


2 Replies to “H1N1… an example of how not to do effective health communications”

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