Photo: DFID-UK Department for International Development via Wikimedia
It can seem next to impossible to prepare for a threat you know will come without knowing what it will be, where it comes from, how it will travel, how bad it will be and where it will go. Yet that’s what thousands of public health officials and health care providers do on an ongoing basis in order to be ready for whatever infectious disease next threatens to become a pandemic.
During Health Journalism 2018, Bara Vaida, AHCJ’s core topic leader on infectious diseases, moderated a panel discussing what’s necessary to be ready for pandemics. That includes the barriers to being fully prepared, many facets related to an outbreak (including the health and safety of responders on the front line) and the challenge this presents for journalists covering public health.
“The media is a megaphone for correct information to battle misinformation,” said panelist Cyrus Shahpar, M.D., director of preventing epidemics for Resolve to Save Lives. “If you’re writing a story, you can help save people’s lives. Telling people to stay home when they have the flu – these things can save lives.”
But good coverage is more than just providing accurate information: reporters need to consider precision and context as well, said independent journalist and panelist Maryn McKenna.
“As reporters, we are a small slice of the media, but when it comes to outbreaks or the threat of outbreaks, we have a responsibility for not just truthfulness but also precision in reporting,” McKenna said.
This admittedly is difficult in a media ecosystem that now rewards journalists for eyeballs and clicks. “I don’t know how to solve that, but I think it is something we all have to face in our role in a social media-driven media environment,” McKenna said.
She recommended that journalists recognize the impact of outbreaks on the sectors behind clinical care, such as business and the larger health care infrastructure. Reporters would have known the crisis of personal protective equipment (PPE) shortage was coming during the Ebola epidemic if they had spoken to the one remaining PPE manufacturer left in the United States, McKenna said.
“We have missed stories that we could have found earlier,” she said. “I would urge us to think broadly and horizontally that what are all the things that affect the delivery of health and who are the people in those industries we should be talking to.”
The best way to be prepared for covering such emergencies is to be prepared before they arrive, just as public health officials and health care providers must be. Reporters need to develop strong relationships with sources, including the CDC, local and state health departments, medical organizations, local hospitals, researchers and epidemiologists, so they are ready when an outbreak occurs.
Thinking ahead also helps reporters discover where preparedness gaps might exist, said panelist Saskia Popescu, M.P.H. An epidemiologist at Phoenix Children’s Hospital and a biosecurity fellow at the Johns Hopkins Center for Security Emerging Leaders Initiative, Popescu said one challenges for hospitals is that infection control is not a revenue generator: it’s a cost sink, and facilities are apt to only invest in infection control procedures to the extent that they can get reimbursement. As public health budgets have dropped at all levels over the past two decades, hospitals can be left with undertrained staff, inadequate policies and often poorly prepared centers.
“We throw money at the fire that’s happening not right now,” Popescu said. Perhaps journalists can draw attention to those gaps before the fire starts, especially since those gaps put health care providers at high risk themselves.
“We know from the literature and from experience that many health care providers are not willing to engage in their duty to care for others because of concerns for their own health and transmitting any illness or disease to their family,” said panelist David H. Beyda, M.D., chairman and professor of the Department of Bioethics and Medical Humanism at the University of Arizona College of Medicine.
Health care providers are expected to take measures to protect the public, but little to no accountability exists for ensuring providers themselves are protected or cared for if they become ill from an outbreak.
“A lifeguard is expected to save the life of a drowning person, but if there’s a shark fin in the water, he’s not going to go,” Beyda said. “Firemen are expected to enter a burning building to save a person, but if the building is about to collapse, the fire chief will say ‘don’t go in.’”
Health care workers often don’t have those same protections and it’s a problem our society has not reckoned with, even though it is an essential part of preparedness, he said.
The panelists also addressed one tricky aspect of risk perception: the more knowledge and familiarity people have with a hazard, the lower their perception of risk tends to be. Conversely, knowing very little – as the public did with Ebola – can lead to exaggeration and paranoia.
“The more information we give to the public regarding the particulars of the illness in the pandemic, that would help and would really mitigate their fear with the perception of risk,” Beyda said.
One note: scheduled panelist Michael T. Osterholm, Ph.D., M.P.H., director of the Center for Infectious Disease Research and Policy at the University of Minnesota, was unable to attend because of weather, and would be a good resource on this topic.
To see discussion of the panel on Twitter, check out #AHCJpandemic.