Posted: March 15, 2007
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Article SummaryIf and when a serious pandemic arrives, messaging will shift from precaution advocacy (high-hazard, low-outrage) to crisis communication (high-hazard, high-outrage). There will be a transition period between the two, when the pandemic looks imminent and outrage is rising fast. This very long column – split into four parts – identifies 25 “standby messages” for that transition period. It elaborates both the messages and their risk communication rationales. Jody Lanard and I wrote the column with two goals in mind: to help officials prepare their communications for the early days of a pandemic, and to help them decide to be more candid (and thus more alarming) in their pre-pandemic communications now in order to make those early days less of a shock.

What to Say When a
Pandemic Looks Imminent:
Messaging for WHO
Phases Four and Five

(Page 4 of 4 – Return to page 1 link up to index)

Two Key Recommendations

We want to end this long column about “Pandemic Imminent” messaging with two key recommendations.

Focus on metamessaging.

link up to indexIt is impossible to know in advance exactly what some future crisis is going to be like. We don’t know where or how H5N1 or some other new animal flu virus will start spreading efficiently from human to human. We don’t know what scientists will learn between now and then about what works and what doesn’t in ameliorating the effects of a pandemic.

Most important, we don’t know how prepared the world will be when the pandemic starts: what antiviral stockpiles will look like, how vaccine manufacturing capacity will have changed, whether corporations will have developed more robust supply chains, whether the public will have learned the difference between pandemic flu and bird flu, and so forth.

Some of the messages in this column, in short, will turn out to be unnecessary or off-target. And some will be flat-out wrong.

So why did we fill page after page writing out messages in advance? To try to get the metamessaging right. Metamessaging is also the thrust of the commentary appended to each message.

Here’s what Peter wrote about metamessaging in an April 2004 column on “Crisis Communication”:

This jargony word is the best I can come up with to describe all the content of crisis communications other than information content: how reassuring to be, how confident to sound, how to address emotion, etc. As a rule, crisis planners do not consider these questions explicitly; instead they rely on instinct. And their instinct tends to be systematically wrong: over-reassuring, overconfident, inhumanly unemotional and intolerant of the emotions of others.

I believe the lowest-hanging fruit in crisis communication is improving our metamessaging. The key strategies here are counterintuitive and uncomfortable, individually and organizationally. But they are learnable.

When we’re in a hurry, we sometimes use the word “tone” as a synonym for metamessaging. Certainly metamessaging includes tone. It also includes nonverbal communication, things like posture and gesture; some experts think nonverbal communication is as important as verbal communication in determining how audiences respond in crisis situations.

But when we talk about metamessaging, the main thing we have in mind is real content.

It’s not factual content about the crisis itself; that’s your messaging. Metamessaging is content about your audience and content about yourself – especially your thoughts and attitudes and feelings about each other and about the crisis you are facing together.

  • Whether you see people as passive potential victims or as active potential pandemic-fighters is metamessaging.
  • Whether you tell them to trust you or invite them to monitor you and help you is metamessaging.
  • Whether you validate fearfulness as an appropriate way to respond to the situation or order people to “Stay calm!” is metamessaging.

Most pandemic communication planners tend to focus on messaging – on preparing to tell people facts. And yet what goes wrong in crisis after crisis isn’t the messaging. The facts are usually communicated about as well as can be expected. What goes wrong is the metamessaging … which the communicators never planned at all!

Even when it’s messaging that goes wrong, metamessaging is usually the source of the problem. Scary information gets suppressed because communicators are mistakenly committed to the metamessage that the public shouldn’t be afraid. Information about changes in policy get suppressed because communicators are mistakenly committed to the metamessage that the authorities aren’t making any mistakes.

We won’t go so far as to say that if you get the metamessaging right the messaging will take care of itself. It’s not easy to get the facts right; messaging takes hard work too. But we will say this: If you get the metamessaging wrong, even the best messaging won’t have the impact you wanted it to have. And unlike a lot of messaging, metamessaging really can be planned and debated in advance.

So as you think through your Communication Phase 4 messages about an imminent pandemic, focus on metamessaging.

Rethink your pre-pandemic messages.

link up to indexWhenever we are asked to run a pandemic communication planning exercise, we try to talk the client into dividing the time in half:

  • Half on pre-pandemic communication (what to say now about a possible future pandemic).
  • And half on pandemic communication (what to say when it looks imminent and when it arrives).

And then we do the pandemic half first, and save the pre-pandemic half for later in the workshop.

That order usually surprises the client and the group; it’s more intuitive to work on pre-crisis communication before crisis communication. But we have learned that groups that start out focusing on what to say about a possible future pandemic produce pretty wimpy messages – over-reassuring, emotionally empty, for-the-record messages. But groups that start out grappling with what they’ll need to say when the virus hits the fan turn later to the pre-pandemic communication task with a vastly different attitude. “What can we tell people way in advance,” they ask themselves, “that might help prepare them for the horrific things we’ll have to tell them if and when a pandemic actually happens?”

The best way to make your pre-crisis communications more candid, more alarming, and more realistic is to spend some time planning your crisis communications. Then go back and ask yourself what changes in your pre-crisis messaging would pay dividends if the crisis were ever to materialize.

In terms of our pandemic communication phases, preparing for Communication Phase 4 (“Pandemic Imminent”) can help you revise your thinking about what to say in Communication Phases 2 and 3 (“Pre-Pandemic Warm” and “Pre-Pandemic Hot”) – that is, what to say right now.

Or in terms of the WHO phases, working on your standby messages for WHO Phases 4 and 5 can help you decide to get more aggressive now, during WHO Phase 3.

Preparing for the “Pandemic Imminent” phase is important in its own right, too. If and when WHO ratchets up to Phase 4 or 5 and a pandemic looks imminent, you won’t have a lot of time to think through what to say. You will have a small window of opportunity to mobilize as much last-minute preparedness as possible. You need standby messages in the can, ready for you to plug in the details of the actual situation.

And once you’ve got some standby messages in the can, go back and see what you think of the messages you’re already putting out.

Many of the 25 Communication Phase 4 messages on this list are useful Phase 2 (“Pre-Pandemic Warm”) and Phase 3 (“Pre-Pandemic Hot”) messages too. Why would you want to “save” any of this to surprise people with when the pandemic looks imminent? In an ideal world, you would have said it all in advance. In a really ideal world, people would have paid attention in advance, too, and all you’d need to add is: “It’s coming. Now. Mobilize your pandemic crisis plan.”

We don’t live in an ideal world. Even if you include all 25 of our messages in your current pre-pandemic communications, lots of people won’t be listening yet. You’ll have to say it all again when the pandemic is imminent and just about everybody is listening.

More to the point, it’s extremely difficult to persuade governments and corporations to say all we want them to say now, when they don’t absolutely have to do so yet, and it’s not clear yet whether they will ever have to do so. We hope working on standby messaging for Communication Phase 4 will help you convince yourself that there is more you ought to be saying now.

If working on Communication Phase 4 (“Pandemic Imminent”) messaging doesn’t make you want to shake up your current pre-pandemic communications, spend some time imagining yourself in Communication Phase 6 – in the middle of a pandemic, right here, right now. Assume it’s a pretty severe one, a replay of 1918 or worse, rather than 1968:

  • Imagine your daily messages about each day’s death toll. (Imagine feeling like you’re writing dispatches from Iraq.)
  • Imagine explaining how bodies are being buried now that we’ve run out of coffins and embalming fluid.
  • Imagine expressing compassion for the families of diabetics and cancer victims who have died because insulin and chemotherapy drugs can no longer be manufactured or delivered.
  • Imagine putting out the call for volunteers who have recovered from the flu and are willing to deliver food and other essentials to the homes of the sick (who are home because the hospitals can do nothing for them).

Then look again at your pre-pandemic messages about hand-washing and cough etiquette and see if you want to add or change anything.

When we participate in other people’s pandemic tabletop exercises, one communication pattern keeps repeating itself. The scenario is always a severe pandemic. (Nobody ever drills for a mild pandemic or a false alarm – but that’s another matter.) Even though the participants usually know enough to expect the scenario will be a severe pandemic, they respond to the early rounds as they think they would in real life. That is, they under-react and over-reassure: They are slow to open their emergency management centers, slow to close the schools, and slow to warn the public. At each stage, as new developments are “injected,” they decide what to do and what to say, and at each stage their response is milder – less alarmed and less alarming – than the next inject will show it should have been.

We’re not sure this is always as clear to the participants as it is to us, even in hindsight. These days, nearly every pandemic tabletop exercise has at least a few veterans of past exercises. But we never hear anyone say in an early round: “We’re under-reacting! This is probably going to get worse, and we’ll end up wishing we’d told people X and Y now!” And we never hear anyone say, “Boy, I wish we’d told people a lot of this years ago!”

In fairness, pre-pandemic messaging has become much less over-reassuring than it was two years ago. (Maybe pandemic tabletops have helped.) In December 2004, when we wrote “Pandemic Influenza Risk Communication: The Teachable Moment,” the CDC and WHO were both using “2-7.4 million” as their estimate of pandemic deaths, without mentioning that these numbers were extrapolations from the mild 1957 and 1968 pandemics. Now both are clear that the “2-7.4 million” estimate is a best-case scenario, and a severe pandemic would be many times worse.

In December 2004, many national governments were reluctant to say much about pandemics at all, except to assert that they were taking all appropriate precautions and their countries were prepared. Now most western governments, at least, are fairly candid that there’s not a lot they can do for people during the early part of a pandemic, and that their countries are far from adequately prepared.

In December 2004 few corporations or local governments even had pandemic preparedness on their radar screens. Now many are busy figuring out how to prepare, and some are beginning to alert their employees or their citizens to the risk.

Despite the progress, pre-pandemic communication still has a long way to go. What we hear government and corporate planners say to each other in meetings about what may happen some day, and what we hear tabletop exercise participants say to each other in mid-scenario (shaking in their boots), and what we hear well-informed pandemic “preppers” saying to each other on the internet are all still much scarier than what most officials are saying to the public.

Right now, in mid-March 2007, we’re in a trough. The media have temporarily lost interest in pandemic preparedness, seeing it as “old news” even though the vast majority of the public has yet to take it onboard. We don’t know what’s going to happen to arouse the media’s interest again – a nearby H5N1 outbreak in birds, perhaps, or a new human-to-human cluster. Whatever the next teachable moment turns out to be – and we pray it’s not the pandemic itself – government and corporate communicators will need to use it more wisely, more emphatically, than they have used its predecessors.

The inadequacies of current pre-pandemic communications may be one of the reasons why governments and corporations are not focusing as much as they should on standby messaging for when the pandemic is imminent. It would be difficult for an organization to write hard-hitting, enormously upsetting standby messages for Communication Phase 4 (when a pandemic is imminent) and still put keep putting out wimpy messages during Communication Phases 2 and 3 (now). Insofar as a communicator is reluctant to sound the alarm now, he or she might understandably shy away from getting ready to sound the alarm later, when it will be almost too late. For such a communicator, failing to warn the public to prepare thus gets in the way of preparing to warn the public.

So let’s turn the logic around. Instead of ignoring standby messaging for an imminent pandemic because it might make us feel worse about the inadequacies of our current messages, let’s focus on standby messaging … and then revise our current messages to match.

Copyright © 2007 by Peter M. Sandman and Jody Lanard

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