Two years ago, the College of Physicians of Philadelphia embarked on a research project. The goal was to investigate and make recommendations concerning the state of preparedness and capabilities for an optimal response by the City of Philadelphia to a high-consequence infectious disease (HCID). HCIDs include known infectious diseases like Ebola and SARS as well as emerging or novel ones such as COVID-19. Although infectious disease experts globally had established that the next pandemic was no longer a question of if but when, scant attention had been focused on pandemic preparedness. Ready or not, we are now overwhelmed by a pandemic, so we know the “when”, but do we know the plan of action?
The United States is no stranger to infectious diseases and/or outbreaks, and neither is Philadelphia. In 1918, Philadelphia like most of the world was plagued by what is commonly known as the Spanish flu, this pandemic was then followed by legionnaire’s disease outbreak in 1976 and HIV/AIDS in 1981. In recent times, the current opioid epidemic in the City, has also given rise to Hepatitis A and HIV infections. These outbreaks occur in addition to the seasonal flu which afflicts the City almost annually. All these diseases now have some form of effective treatment and/or prevention, yet the number of deaths continue to rise. For example, in the 2017/2018 flu season, CDC’s estimated flu-related deaths in adults reached a high of 79,000 nationally. These numbers indicate that vaccination is necessary but insufficient to combat an outbreak let alone a pandemic. This is where communication – effective communication- becomes a matter of life and death.
Effective communication, or the lack thereof is almost always among the most glaring lessons in the aftermath of an outbreak. In 1918, health officials underplayed the magnitude of the flu, despite mortality records indicating otherwise. This dismissal of facts encouraged a false sense of security among the general public. In Philadelphia, health concerns were upstaged by the liberty bond parade which provided the political platform to dispel fear and panic. This parade, coupled with intentional disinformation, inadvertently incited gross mistrust in health officials as it resulted in the avoidable death of over 12,000 Philadelphians within a matter of weeks. What then constitutes effective communication?
Effective communication must be credible and timely. During an outbreak, dissemination of information essential to the response and containment of a disease is extremely relevant. Factual timely information could increase the level of awareness and compliance of the general public which potentially reduces the propagation of disease. In the absence of facts, an infodemic – an over-abundance of information, both accurate and inaccurate – occurs. Ideally, preventative measures should be communicated and readily accessible as part of emergency preparedness. These communications should address directly the concerns of the public and be made available across all populations. Reaching diverse populations mandate utilization of all available platforms including social media, webpages and media outlets. These actions, if executed appropriately results in an informed citizenry – an asset to mitigation efforts.
The COVID-19 pandemic is not the last the world will face; however, it presents a stark reminder to practice effective communication. In the presence or absence of a vaccine, effective communication can decrease social and economic disruption and deliver life-saving guidance if governments communicate well between both themselves and with the public.
“In the next … pandemic … the single most important weapon against the disease will be a vaccine. The second most important will be communication…” – John M. Barry