Communication and medical disaster planning in the age of COVID-19

We now live in a world wherein information dissemination has been widely influenced by advancements in both hardware and software technologies. These tools provide a profound opportunity to harness the importance of communication in disaster response planning, as well as disaster prevention. Indeed, communication is the thread that connects all the phases of a disaster response plan (mitigation, preparedness, response, and recovery) and therefore requires that we evaluate how it has been implemented over the course of the pandemic and how we can continue making strides to inform the public with facts so that individuals can make well-informed decisions (Seba, 2018; Lindsay, 2012).

While disaster response planning usually entails implementing learnings from historical events, a fair share relies on human ingenuity to speculate potential disaster scenarios that have not occurred, and what a response to such disaster would look like. A recent example of such disaster response planning scenario can be seen in the “high-level pandemic exercise” (Event 201) hosted in 2019 in New York by the World Economic Forum, Bill and Melinda Gates Foundation and the Johns Hopkins Center for Health Security (Johns Hopkins Center for Health Security, n.d.). The goal of this exercise was to assess the preparedness levels to a pandemic, and potential response strategies. It is worth noting that the ‘experts’ who partook in the exercise vehemently expressed our unpreparedness for such an event (Pearce, 2019).

Not all disasters are alike but communication should be consistent

Despite a firm stance that Event 201 was not a prediction of the soon to occur COVID-19 pandemic, certain disasters – like hurricanes, can be predicted (Johns Hopkins Center for Health Security, 2020; Samost, n.d.). Unsurprisingly, the earlier the prediction of a hurricane, the larger the error in miles (i.e., the trajectory of the storm). Communicating to residents and implementing evacuation orders about an impending hurricane is critical to saving lives, as can be vindicated by the history of hurricane Katrina (Eisenman, 2007). Nevertheless, there is a myriad of reasons why residents might not hearken to evacuation orders including but not limited to?will?and?ability. In fact, despite states prone to hurricanes having laws in place that require services be provided to facilitate the adherence of evacuation orders, individuals can still choose to ignore them and cannot be forcibly removed from their homes. One argument is that the person non-compliant with an evacuation order is putting only themself in danger, and “coercive and quasi-coercive” methods which include fines and civil liability for rescue costs could be implemented to increase compliance (Fairchild, 2006).

Then comes the disaster caused by a pandemic such as COVID-19, to which methodologies used to save lives include quarantines, mask-wearing, and vaccinations. Of note is the fact that pandemics cannot be predicted with the atypical accuracy of hurricanes (aside from its seasonality), much less so far in advance, and the novelty of the infectious agent only adds layers of complexity to the health communication strategy needed to inform the public about what needs to be done to protect themselves. As noted in the Lancet editorial about COVID-19, providing verifiable information is the best way to protect against the “disease of panic,” which can end up costing more lives and an economic downturn than intended (Lancet, 2020). The question now becomes what constitutes verifiable information when there is uncertainty about the?modus operandi?of a novel viral or bacterial outbreak? The phrase ‘follow the science’ has been widely adopted during times of such uncertainty to establish communication channels that leaves ample room for backtracking on statements made earlier, ‘because we now know better.’ As such, this alone should provide valid reason for skeptics (including those who may be not scientists), to voice their opinion and allow for individuals to take decisions as they see fit for their health and wellbeing.?

As summarized by Viana (2021), a pandemic like COVID-19 can be overcome with mass vaccinations yet fining anyone for not taking a vaccine would seem more far-fetched than fining an individual who refuses to vacate an area about to be under siege to a natural disaster even though in the former, the likelihood of harm done to anyone other than the unvaccinated individual is higher. This argument, as sound as it is, falls short of acknowledging that should there be broad availability of vaccines, those vaccinated should theoretically and practically be safe from severe disease caused by infection irrespective of whom they get it from (vaccinated or not). It could even be argued that vaccination entails expectance of future infection. As such, we can also surmise that any unvaccinated person is therefore putting only themselves at risk of severe disease and even death from an infection. While this view is admittedly a simplification of our society and all its nuances, there are ethical and legal ramifications to decisions that are communicated during disasters which ultimately warrants critical assessment of how it impacts not only society-at-large, but the units it is made up of – families and individuals.

Conclusion

Academic disciplines are fond of research operations that seek to further knowledge in their field. Often, various schools of thought arise, challenging the?status quo?and daring to step out of conformity. The knowledge or lack thereof (deemed misinformation), is posited to be a great influence on how those who consume it are affected, and evermore important is how this plays a role in the handling of disasters wherein the emotion of fear leads to speculation and mistrust of the communicated information. In 1955, the polio vaccine was deemed “safe, potent, and effective,” yet, unfolding manufacturing mishaps led to contaminated vaccines that literally crippled some recipients, requiring government intervention. This regulatory oversight was thereon repeated in 1976 with the outbreak of the swine flu which led to a hurried attempt to vaccinate the US population, with some recipients having adverse events that have since culminated in antivaccine movements (Trogen, 2020). The message from these events could not be any clearer especially when we now live in a world wherein the fast-tracked COVID-19 vaccines are being mandated in various jurisdictions around the world. Vaccines have been shown to provide tremendous benefit in times of pandemics, but how they are ‘sold’ to the public need revamping, and this could be as easy as letting individuals make the choice for themselves whether to use it as a means of protection. Communicating this message of choice while clearly expressing the benefits and risks to vaccinations will go a long way to rebuild trust in the public health sector.?

References

Eisenman, D., Cordasco, K., Asch, S., Goldon, J., & Glik, D. (2007). Disaster planning and risk?communication with vulnerable communities: Lessons from Hurricane Katrina.?American Journal of Public Health, 97(Suppl 1), S109-S115.?https://dx.doi.org/10.2105%2FAJPH.2005.084335

Fairchild, A., Colgroves, J., Jones, M., Redlener, I., & Bayer, R. (2006). Ethical and legal?challenges posed by mandatory hurricane evacuation: Duties and limits.?National Center for Disaster Preparedness, Mailman School of Public Health, Columbia University. https://doi.org/10.7916/D8183FW8

Johns Hopkins Center for Health Security. (2020).?Statement about nCoV and our pandemic?exercise.?Johns Hopkins Center for Health Security.?https://www.centerforhealthsecurity.org/news/center-news/2020/2020-01-24-Statement-of-Clarification-Event201.html

Johns Hopkins Center for Health Security. (n.d).?Event 201.?Johns Hopkins Center for Health?Security.?https://www.centerforhealthsecurity.org/event201/

Lancet. (2020). COVID-19: Fighting panic with information.?Lancet, 395(10224), 537.?https://dx.doi.org/10.1016%2FS0140-6736(20)30379-2

Lindsay, B. (2012).?Federal emergency management: A brief introduction.?Congressional?Research Services.?https://sgp.fas.org/crs/homesec/R42845.pdf

Pearce, K. (2019).?Pandemic simulation exercise spotlights massive preparedness gap.?Johns?Hopkins University.?https://hub.jhu.edu/2019/11/06/event-201-health-security/

Samost, A. (n.d.).?Predicting hurricanes. MIT.?https://web.mit.edu/12.000/www/m2010/teams/neworleans1/predicting%20hurricanes.htm

Seba, A., Nouali-Taboudjemat, N., Badache, N., & Seba, H. (2018). A review on security challenges of wireless communications in disaster emergency response and crisis management situations.?Journal of Network and Computer Applications, 126, 150-161.?https://doi.org/10.1016/j.jnca.2018.11.010

Trogen, B., Oshinsky, D., & Chaplan, A. (2020). Adverse consequences of rushing a SARS-CoV-2?vaccine.?JAMA, 323(24), 2460-2461.?https://jamanetwork.com/article.aspx?doi=10.1001/jama.2020.8917

Viana, J., Dorp, C., Nunes, A., Gomes, M., Boven, M., Kretzschmar, M., Veldhoen, M., & Rozhnova, G. (2021). Controlling the pandemic during the SARS-CoV-2 vaccination rollout.?Nature Communications, 12(3674).?https://doi.org/10.1038/s41467-021-23938-8