Citizens elect leaders to make policies. To carry out those policies, these leaders appoint public administrators. Public administrators use their experience and knowledge to accomplish the work of the government, often behind the scenes.
When a public health crisis arises, the work of public administrators comes to the forefront. To do their jobs, it is vital for public administrators to be able to communicate with the public to promote understanding, urge actions, and relieve fears.
This guide provides resources and relevant information on the essential elements of an effective public health crisis communication plan.
Creating a Public Health Crisis Communication Plan
In scenarios where public health is at risk, as in the COVID-19 pandemic, public administrators develop public health crisis communication plans to protect the health and safety of citizens. An effective communication plan has a clearly defined audience. For the COVID-19 crisis, the audience is everyone. Still, many different people must be reached — populations of different ages and racial backgrounds, for example. An effective public health crisis communication plan will anticipate the reactions of diverse groups of stakeholders.
Sources such as Resources for Emergency Health Professionals can help public health administrators predict and respond to potential crises. In its Crisis and Emergency Risk Communication (CERC) manual, the Centers for Disease Control and Prevention (CDC) provides guidance for health communicators, first responders, and leaders of organizations. Professionals who are developing public health crisis communication plans must understand legal and healthcare policies, plan for crises, and properly budget enough money.
Understanding Legal and Healthcare Policies
Not all information gathered during a health crisis, such as a pandemic, may be available to the media or public. Even during a public health crisis, the defense of the government is of paramount importance, and sensitive information must not be disseminated. This concept is known as “need to know.”
However, transparency is a central component of an effective public health crisis communication plan. How can a public administrator balance the need between informing the public and meeting legal requirements surrounding access to information, privacy and public health powers?
The answer is clear. Public administrators can better equip themselves to make timely decisions about sharing information by being informed about legal and healthcare policies. In its CERC manual, the CDC discusses laws that are essential for compliant public health crisis communications. These include:
- Freedom of speech and the press
- Laws of defamation
- Copyright law
- The public’s right to know
- Freedom of Information Act (FOIA)
- Health Insurance Portability and Accountability Act privacy regulations
- Public health laws
- Public health powers and liabilities
- State public health emergency powers
By following the relevant laws and understanding how to apply them, public administrators position themselves for better decision-making amid the crisis. The following resources provide additional information on legal matters related to public health:
- Public Health Professionals Gateway, CDC
- CERC: Media and Public Health Law, CDC
- Topic Collection: Healthcare-Related Disaster Legal/ Regulatory/ Federal Policy, HHS.gov
- Health Law By Countries, World Health Organization (WHO)
- The Public Health System & the 10 Essential Public Health Services, CDC
Planning for Crises
The famous Benjamin Franklin quote, “By failing to prepare, you are preparing to fail,” speaks to the importance of preparing for difficult times ahead. Preparation is essential for public administrators, because they can never know about the severity of a crisis until it arrives.
Every crisis is unique, so even the best plans may have gaps. However, public administrators can effectively anticipate and respond to problems by understanding the patterns of most crises and collaborating with others to establish preventive measures.
Dividing the public health crisis communications plan into phases can help in achieving key aims. According to the CDC’s CERC guidelines, these phases include:
- Pre-crisis: The most critical planning work takes place in this phase
- Initial: Intense media and public interest on the rise; incomplete facts may be reported
- Maintenance: Helping the public understand risks, listening to audience feedback, staying on top of information flows, and correcting misinformation
- Resolution: As the crisis winds down, reinforce public messages, promote risk avoidance and mitigation education, and address mishaps in the response efforts
- Evaluation: Assess communications plan performance, record lessons learned, and determine actions to improve future planning
The WHO provides a crisis communications plan template. Similarly, the Pan American Health Organization offers a checklist for planning a national risk communication strategy.
How much does implementing a public health crisis communication plan cost? Such plans support around-the-clock operations, so it’s essential to consider what is needed to ensure 24/7 availability of resources when determining a budget.
Public officials must assess the government’s state of preparedness to determine the finances necessary to run a public health crisis communication plan. Key cost factors include the human capital and equipment resources needed to get the message out. Determining the funding requirements for a public health crisis communication plan also requires knowing the cost of space, technology, and essential media. Examples of necessary media can include hosting new websites, designing infographics, and creating informative videos. Due to the evolving nature of pandemics, even the best-conceived budget may need to be supplemented. A contingency or emergency budget can help mitigate this challenge.
What to Do When a Crisis Begins
Upon identifying the crisis, key critical first steps include the following:
- Verifying that the data about the crisis is scientifically sound and validated by the medical community
- Notifying leaders of the situation, giving them the first assessment of the crisis, and offering them perspectives and informed insights on critical next steps
- Coordinating with local, state and federal governments to centralize communications, including identifying a spokesperson and reaching out to communications staff
- Informing the media about the emergency through an official statement, providing facts and credible information, then immediately monitoring the media for misinformation
- Sharing the information with the public directly with pre-cleared facts and letting them know about the resources in place in response to the crisis
- Engaging with partners in the public and private sectors to let them know about response efforts and ask for their support in communicating the right messages
- Conducting a public health crisis risk assessment and establishing a locale for centralized operations
While this list is highly detailed, it is not comprehensive. The CDC provides resources for what to do when a crisis begins, including its 48 Hours Checklist and Crisis Emergency Risk Communication Plan Checklist. Below are examples of other essential steps when responding to a crisis:
Identify Who Will Serve as a Spokesperson Regarding the Crisis
Designating a spokesperson for a public health crisis is a critical step in controlling the messaging that goes out to the public and the media. In addition to the primary spokesperson, designated backup spokespersons should be pre-screened and trained, according to Bernstein Crisis Management.
A person’s position should not be the only factor in choosing a spokesperson. Their public communication skills, demeanor, trustworthiness and availability all matter for the critical role of spokesperson.
“Different types of infectious diseases prompt the need for communication in different ways,” according to a recent study by Public Relations Review. This report shows that the integration of traditional, social and online media is essential for infectious disease communications. A spokesperson should have a general knowledge of how to communicate across various media, including print, online, broadcast and social media.
A spokesperson should also have an understanding of scientific and medical complexities, along with best practices for crisis communication. Most importantly, a spokesperson must be able to deliver informative, accurate messages without provoking fright or alarm.
Further guidance for individuals selected as spokespersons during a public health crisis can be found at these sites:
- Communicating During an Outbreak or Public Health Investigation, CDC
- COVID-19: Guidelines for Communicating About Coronavirus Disease 2019, Pan American Health Organization
Train Other Public Officials to Communicate Effectively About the Crisis
Relevant public officials should know how to answer questions and provide clear, accurate information about a public health crisis. These individuals can be local elected leaders, community leaders, influential people in minority groups, religious leaders, municipal authorities and healthcare workers. They should receive training in key principles of risk communication. Preparing them to face journalists through training sessions and simulations can help them be ready for tough questions.
Ease Public Panic
Public health crises disrupt people’s lives. By their nature, crises can provoke a feeling of having no control over a situation. To help ease panic, public administrators must provide clear and simple-to-understand information on the potential risks of a pandemic, as well as steps people can take to help protect themselves.
When communications go awry, public panic could soon follow. Easing the fear does not mean providing only optimistic messages; it means being transparent. If the public perceives that public officials may be withholding facts, then trust can erode. Public administrators must demonstrate that they can adapt to rapidly changing situations and that they understand public concern.
Help Set the Tone for How People Will React
In a public health crisis, people can feel vulnerable and stressed. These feelings can create uncertainty and anxiety. Setting the tone for how people will react requires respectfully acknowledging their feelings without dismissing their fears or concerns. For example, in the COVID-19 pandemic response, the CDC said, “Being quarantined can be disruptive, frustrating, and feel scary. Especially when the reason for quarantine is exposure to a new disease for which there may be limited information.” If people believe their public officials are speaking knowledgeably and honestly, then they will likely listen more actively.
Maintain Consistent Communication During a Crisis
Communication during a public health crisis must be consistent, clear, timely, and accurate. The information shared must be credible. Messaging — whether from a podium in a press conference or a social media post — must be empathetic, instructive, and clear.
Public administrators use resources from entities such as the World Health Organization and the CDC to learn how to ensure consistent communications and correct misinformation. Guidance from the CDC’s principles of public health crisis communication includes being first, right and credible. This means public administrators must ensure they promptly share accurate, science-based information, including communicating what is known and unknown. This approach can help stop the spread of disease while establishing credibility with the public.
Questions inevitably will arise from the public and the media, and public administrators must ensure their answers are consistent and based on scientific data. Frequently asked questions in the case of the outbreak of disease may include the following:
What is the illness?
Public administrators should provide the name of the disease and explain how it is transmitted.
What are its symptoms?
Let people know about common symptoms and signs of severe cases so they can assess their condition and determine what their next steps should be.
Is there an antidote, vaccine, or treatment?
If there are no treatments or vaccines available, let the public know. For prevention, inform the public on how and where to get accurate information. Inform the public about the safety and health measures they can take to minimize the spread of the disease. Reliable sources of information include the World Health Organization and the CDC.
Can you put complex scientific and technical terms into common language?
Public administrators help serve as liaisons between medical professionals and the public. In that role, they must ensure the language used is understandable, clear, and simple to understand. A simple, short, and easy message work best: “cover your cough,” for example.
When should individuals seek medical attention?
Emphasis on detailing the most severe symptoms should be clear, as well as instructions for when to seek medical attention. If specific populations are susceptible to the disease, this should be communicated so they are aware.
The CDC provides a worksheet of commonly asked questions during public health crises.
Working with Media to Effectively Communicate
Intense media and public interest quickly rise in the first phases of a crisis announcement. The media serves a useful purpose in the crisis communications processes, with its representatives playing a pivotal role in amplifying messages. The public administrator must compile accurate information and work with the media to separate facts from fiction. Helpful strategies for public administrators include:
- Making final reports, information, and recommendations fully and readily available
- Openly and honestly relaying accurate information, including health and prevention messages based on scientifically valid data
- Communicating health messages that are sensitive to language and cultural differences and community norms.
Working effectively with the media requires establishing an efficient flow of information. This process consists of several key components:
- Defining clear communication channels by establishing a media list and updating media databases and contact information
- Building out the processes for collaboration with the media and distributing press materials
- Preparing key messaging aligned with the findings from medical and public health authorities
- Developing educational content to keep the public informed
- Selecting communication channels to reach large numbers of people: email, radio, internet, television, social media and more
Preparing answers to frequently asked questions can also help address misinformation. The Illinois Department of Public Health offers an example of an online Q&A resource. As another example, the WHO maintained a resource dedicated to addressing common myths about COVID-19.
Helping the Public Recover After a Crisis
As a crisis winds down, public administrators remain on the front lines to help people recover both physically and emotionally. During this phase, they work to reinforce important messages, promote risk avoidance and disease mitigation, and address any mishaps in the response efforts.
Public administrators meet with public officials and policymakers to review the crisis and establish policies that can help prevent similar disasters in the future. By assessing the performance of a public health crisis communications plan and recording lessons learned, public administrators can determine actions to improve future planning — and better serve the public when it is needed most.
Centers for Disease Control and Prevention, “Be Prepared by Staying Informed About COVID-19”
Centers for Disease Control and Prevention, Crisis & Emergency Risk Communication (CERC)
Centers for Disease Control and Prevention, Emergency Preparedness and Response
Health Security, “When the Next Disease Strikes: How To Communicate (and How Not To)”
Life Sciences, Society and Policy, “Crisis Communication in Public Health Emergencies: The Limits of ‘Legal Control’ and the Risks for Harmful Outcomes in a Digital Age”
National Academy of Medicine, “Health Literacy Insights for Health Crises”
National Association of County and City Health Officials, Communicating in a Crisis: Risk Communication Guidelines for Public Officials
Ohio University, “Public Policy vs. Public Administration: How Do Public Organizations Get Things Done?”
World Health Organization, Coronavirus Disease (COVID-2019) Press Briefings