Managing Panic in a Pandemic
Journalists play a key role helping government manage fear in the general population during a disaster, says epidemiologist Dori Reissman, a commander with the United States Public Health Service. In this section, Reissman explains how the government uses insights from behavioral and social science research to maintain public trust and get messages across in a crisis; how an expert panel came up with the concept of “psychological first aid”; and why she hopes that journalists will infuse their stories with the five elements of psychological first aid—safety, calming, connection, efficacy and hope—should a severe pandemic arrive.
Dori Reissman, Commander, United States Public Health Service, and Senior Medical Advisor, National Institute for Occupational Safety and Health:
I challenge you, as journalists, to figure out how you can help us to manage fear in the public. I hope you haven't reached the point at which you either want to stick your head in the sand or run around and say the sky is falling.
I hear the word "panic" all the time, and most of the time people don't panic.
Panic really is about a loss of social order, a loss of internal order. Most of the time people are running around doing what they believe is self-protective. It's not panic, but it might not be social order.
Let's be careful with our language and what we evoke because that creates an image for people. When you say "panic," it evokes a feeling of being out of control. Is that what we want to evoke? Or do we want to give the message of how we can reel it in?
Public trust is a big issue
When we're thinking of behavioral health and emotional readiness in the context of panic, we don't have a ready-made framework of measures and countermeasures that are understood.
That has created some of the problems that we have had in trying to disseminate our message. When we reach out to the different audiences, we find public trust is a big issue. If you don't have the trust, people aren't going to follow what you say to do.
The idea behind the public trust is this: If people are concerned about something and you don't address those concerns, they really can't hear your message.
In government, we focus on determining the right messages for what we anticipate the issues will be.
That's called push technology. We push out that message. But what if that message is out of sync with what the concerns are? What if the message has no receiver? Think about this as a football analogy. How do you get the receiver to catch the ball if you haven't shown that person how to do it?
And what are the behaviors that you want to increase and what are the other behaviors you want to decrease in order to reduce risk? It’s shaping behavior; it's not the government walking in and trying to control people. Instead, it's gaining a sense of how people take personal accountability for their own safety in the context of the community's safety.
The other part of the slippery slope is about people not coping well and making poor choices. There's a social and emotional deterioration, and with that comes dysfunction, and with that also comes a cascade of economic problems.
We don’t deal with what we house in our minds
We don't deal with what we house in our minds, yet we really need to pay attention to it. I don't know how to obtain that kind of attention, but I know that you, as journalists, are a vector of it. You have a lot of impact, so I want to continue to challenge you.
In terms of trying to reduce risky behavior, we aren't very good about following directions. We don't listen to our mothers. We don't listen to our doctors. So why should we listen to the government?
Good things happen if you do them
We've had different sets of experts get together and discuss the empirical evidence to support the notion that good things will happen if you do them. That's what I'm going to call psychological first aid
, and it has certain underpinnings—safety, calming, connection, efficacy and hope.
Questions Journalists Can Ask
||Safety is about removing people from a threat.
||Calming happens when you want to lower the state of arousal so people can function, concentrate and take concrete steps towards what they need to do to protect themselves.
||Connection: People's basic need to connect with others and not be isolated needs to be attended to.
||Efficacy occurs when someone is capable of taking action on their own. When they do so as a member of a group, that's collective efficacy.
||Hope: The idea that the world is predicable and we will get through it, that's hope.
If journalists could take these five ideas and infuse them in their messages, I'd be very happy. Absent this, we don't have leadership set up to handle grief. Continuity of operations goes way beyond business. It's continuity of life as we know it.
||How do we manage massive grief and loss?
||How do we perform ceremonies when we can't attend them?
||How do we support people who have lost a lot when we can't touch them?
Editor’s note: The content of this page was originally generated during discussions at the December 2006 Nieman Conference “The Next Big Health Crisis—And How to Cover It,” made possible with the generous support of the Dart Foundation. The transcripts have been edited to make the material accessible in this online guide.