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Pandemics: what the public demands to raise trust in authority


BRUSSELS – When the H1N1 pandemic, or “Swine Flu”, made headlines in 2009 it generated a wave of fear throughout Western countries. Although the European Centre for Disease Prevention and Control estimates that more than 2300 people died from the flu in the EU alone, its consequences were less serious than some experts predicted.

One of the consequences of H1N1 saw the public’s confidence in health authorities plummet, social media participants calling into question official statements on the pandemic’s potential impact. One of the key remedies, argues an EU-funded initiative, is for decision-makers to maintain a “front and centre” Web presence during a crisis.

Managing public perception when a real pandemic hits is a vital task for emergency health responders and was among the main research topics explained at the 8th meeting of the European Commission’s Community of Users (CoU) on Safe, Secure and Resilient Societies.

Held here on 13 September, officials from the International Emergency Management Society spoke about their ongoing EU-funded initiative on pandemic response known as the “Action plan on Science in Society related issues in Epidemics and Total pandemics”, (ASSET). Thomas Robertson, the society’s regional director for North America, showcased the project’s findings which could, in a pandemic, maintain public confidence in national health authorities and thus encourage people to protect themselves effectively.

“For Europe to better respond to public health emergencies, an open dialogue needs to be established between policymakers and the public,” Robertson said. To help do this, ASSET created a forum to gather input from European health decision makers and link the latter to European publics.

Consisting of public health policymakers from 12 countries (Bulgaria, Denmark, Greece, France, Ireland, Israel, Italy, Luxembourg, Norway, Romania, Sweden, and United Kingdom), the forum held meetings in 2015, 2016, and 2017 – supplemented by an online equivalent – to define the fundamental challenges of pandemic response, namely: participatory governance, ethical issues and public hesitancy over vaccination.

ASSET then consulted 425 individuals across six European countries, plus Norway Switzerland in autumn 2016. The project used so-called “deliberative polling”, a method that informs its subjects about the background of an issue before asking questions to solicit the best possible responses on pandemic preparedness and response. Drawing on the results, ASSET’s report cited the following conclusions:

  • Risk communication: Respondents said that developing honest, clear and transparent communications would restore and increase the public’s trust — no matter how bad the situation is. They said it is their right to know and understand public health crises.
  • Trustable sources: General practitioners and health professionals should be trained to adapt to a changing society, and decision makers should be urged to be visible and present on the web, as the internet’s use is increasing exponentially.
  • Ethics: In pandemic situations, the general public health interest should take precedence over individual freedom.
  • Vaccination: Informational materials for vaccination needs to be updated, clarified and standardised, especially for high-risk target groups such as pregnant women and the elderly.
  • Participation: Public health authorities should devote more resources to collecting citizen input on policies for epidemic preparedness and response.

According to ASSET, 94 percent of respondents would be willing to provide input again, suggesting that the public wants participatory governance in the realm of public health policy. Indeed, per Robertson ASSET is a “proof of concept for citizenship participation in public health policy and pandemic preparedness.”

He said the next step would be finding ways to integrate participatory governance into national and EU frameworks of pandemic response and public health policy.

     THE UPSHOT: While ASSET’s work shows the public wants to be engaged with these decisions, a substantial amount of information and research generated in the public health field seem to be “floating above the public.” In other words, it’s not just about engaging with the public but providing the latter with sufficient information to be properly engaged.
     However, one suspects too that in the event of a truly major and widespread public health threat, the best-laid plans will surely dissolve. No number of appeals to calm, no amount or public information or awareness-raising effort will overcome the basic human instinct to panic vis-à-vis a deadly epidemic’s silent, lethal impact.
     And social media would amplify the threat perception and rumour mill beyond public authorities’ control. Writ large, that could easily lead to panic buying, riots, destruction of property and lives and, in the worst case, structural break down of society and the political order.
     While the risk of public health threats of such catastrophic effect are, one continues to hope, low, they are nonetheless the nightmare scenario that no public health official – and certainly no politician anywhere – ever wants to publicly address or acknowledge.
     The public is not as naïve or unthinking as many elites assume. Could official refusals to address such an obvious issue partly explain the public’s mistrust toward authorities in our new googled century of pseudo-transparency?
     One will probably never find out because authorities will never research that one – or if they do, you’ll never hear about it.


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