What kind of risk communication does pandemic preparedness require?

When the virus hits the fan, it'll be crisis communication. But what it is now depends on your opinions and your audience.

The most fundamental truth about risk communication is the very low correlation between how dangerous a risk is and how upsetting it is. If you know something is really dangerous (or really safe), that tells you almost nothing about how much it will upset or bore people. If you know something really upsets (or bores) people, that tells you almost nothing about how dangerous or safe it is. If you graph the technical seriousness of a risk (hazard) against its emotional seriousness (outrage and fear), the chart at right is what you get.

You need three different skill sets to manage these three kinds of risk communication, which have very little in common:

  • Precaution advocacy is alerting insufficiently concerned people to serious hazards. The goal is to increase people's concern (yes, their outrage and fear) to motivate them to take precautions.
  • Outrage management is reassuring excessively concerned people about small hazards. The aim is to decrease people's concern in order to reduce their impulse to take (or demand) precautions you consider unnecessary.
  • Crisis communication is guiding appropriately concerned people through serious hazards. The key task is helping people bear the situation and act wisely in the face of overwhelming emotions.

Where on this map does an influenza pandemic fall? The answer depends on how serious you think the risk is (the hazard, in my terminology) and how concerned you think your audience is (the outrage and fear).

Crisis communication

If and when a severe pandemic happens, the job will be crisis communication. Every business and every government needs a standby pandemic crisis communication plan. That's fundamental. If and when a severe pandemic arrives, you will have a great deal to say to your employees and other stakeholders, and you need to be as ready as possible when the time comes.

The job is crisis communication already if you are talking to appropriately outraged and frightened Asian poultry farmers who face a devastating economic crisis because their flocks are about to be culled. And it's crisis communication if you're talking to the small but growing network of pandemic "preppers"—fellow citizens who already share your view that we face a serious pandemic risk that deserves our serious attention.

Outrage management

Outrage management also plays a role in pandemic communication. Every time an H5N1-positive bird is found in a country that hasn't had this deadly strain of one avian flu in birds before, some consumers become excessively alarmed that they might die from eating poultry. While such alarm is a temporary "adjustment reaction" that doesn't last long, it's a teachable moment—a chance to sound the alarm about pandemic preparedness. But it's not wrong to want to reassure people about food safety as well, a job that calls for outrage management skills (skills most poultry industry and government spokespeople unfortunately lack).

A subset of the prepper community has gone beyond worrying about a possible future pandemic that could be severe to believing an outbreak is imminent and virtually certain to be catastrophic. This group suspects that the World Health Organization (WHO) and the US Centers for Disease Control and Prevention are covering up the real facts. When you talk to these people, you're doing outrage management. (When they talk to you, they're doing precaution advocacy.)

And here's another opportunity for pandemic outrage management. Imagine spending the next few years getting everybody ready for a severe pandemic. Then the WHO goes to phase 6, we all trigger our pandemic plans, stock markets crumble, stores run out of everything—and the pandemic turns out mild. Or imagine that the WHO goes to phase 6 tomorrow while we're mostly unprepared. The pandemic turns out devastatingly severe, millions die, and, after it's over, the Congressional investigations begin into why we weren't more ready. What kind of risk communication will predominate in these two possible futures? Outrage management.

Of course, some people think all pandemic risk communication should be outrage management. Commentators like Marc Siegel, MD, an associate professor at the New York University School of Medicine, and Michael Fumento, a writer based in Washington, D.C., have made a mini-industry out of claiming that pandemic fears are overblown. I don't mean to sound snide. After all, I've made a mini-industry out of claiming that people aren't worried enough. Advocates on all sides of the pandemic preparedness controversy say what they believe is right.

Precaution advocacy

If you're on the same side I'm on, the main kind of pandemic risk communication you need to be doing right now is precaution advocacy.

Just as every company needs a pandemic crisis communication plan, every company needs a pandemic precaution advocacy plan. And while your pandemic crisis communication plan is a standby plan, your pandemic precaution advocacy plan should be implemented ASAP.

The principal goal of such a plan is to arouse sufficient concern—even fear—to motivate your key stakeholders to prepare. You want them to prepare logistically, to get ready to cope with what may be coming. You also want them to prepare emotionally, to have the inevitable shocked adjustment reaction now, get over it, and be ready to roll when the time comes. (If they don't experience some shock when they learn what a severe pandemic might be like, you haven't explained it right.)

I understand people like Siegel and Fumento, who keep saying what they genuinely believe—that it's a mistake to worry much about pandemic preparedness. But I don't understand people who believe that pandemic preparedness is crucial, but are reluctant to say so for fear of alarming their audience. I devoted two earlier columns to "fear of fear" ("Scaring people is scary" and "Get your slice of the 'fearfulness' pie"), and I won't repeat myself here. Suffice it to say that if pandemic preparedness is important, then scaring people into preparing is important, too.

I'm especially frustrated by organizations and people who do sound the pandemic alarm until it seems to be working, at which point they switch from precaution advocacy to outrage management. The government of the United Kingdom (UK), for example, has been reasonably candid about its pandemic fears. Then came the February 2007 Bernard Matthews turkey outbreak. Suddenly the UK public was actually interested in bird flu. And the UK authorities squandered the teachable moment. In their determination to over-reassure the public about the genuinely small foodborne risk, they said nothing about the much larger pandemic risk. (See "How not to conduct crisis communication.)

I'm not saying they were wrong to tell people it was pretty safe to eat poultry, though they were surely wrong to make categorical statements about the source of the infection that later had to be withdrawn. But where was the other half of the equation? "We're not that worried about the risk of eating poultry. What we're really worried about is . . ."

From now until just before the pandemic actually hits, the essence of corporate pandemic communication should be precaution advocacy. And it needs to be audible. As my wife and colleague Jody Lanard likes to tell her audiences, Paul Revere shouted, "The British are coming! The British are coming!" He didn't murmur, "Excuse me, I don't want to upset you, but I think the British are coming."

Choosing your tool kit

Whenever you do any kind of risk communication, the first task is to figure out which kind to do. Decide how great you believe the hazard is (or will soon be). Decide how great you believe the outrage is (or will soon be). Then deduce whether you need your precaution advocacy tool kit, your outrage management tool kit, or your crisis communication tool kit.

To alert your stakeholders to the pandemic risk, you need your precaution advocacy tool kit right now. To guide them through the pandemic that may be coming, sooner or later you will need your crisis communication tool kit as well.

An internationally renowned expert in risk communication and crisis communication, Peter Sandman speaks and consults widely on communication aspects of pandemic preparedness. Dr. Sandman, Deputy Editor, contributes an original column to CIDRAP Source Weekly Briefing every other week. Most of his risk communication writing is available without charge at the Peter Sandman Risk Communication Web Site, which includes an index of pandemic-related writing on the site.

Newsletter Sign-up

Get CIDRAP news and other free newsletters.

Sign up now»


Unrestricted financial support provided by

Bentson Foundation 3M Gilead 
Grant support for ASP provided by

  Become an underwriter»