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H1N1 Flu Response Shows Government Needs To Improve Social Media Public Communications For Future Emergencies

May 4th, 2009 · 7 Comments

In his weekly radio/video address, President Obama addressed the government’s response to the H1N1 flu outbreak. One new topic he raised was the role of social media in communicating with the citizenry. As the President said: “The White House has launched pages on Facebook, MySpace and Twitter to support the ongoing efforts by the CDC to update the public as quickly and effectively as possible.” The Administration’s use of these social networking applications for the H1N1 makes sense; the more distribution channels for information the better. Yet, there are still significant limitations in government — federal, state and local — social media abilities which should be addressed for the next major emergencies (potentially even a strong reoccurrence of H1N1 in the Fall). To do so, I would suggest that governmental agencies bring together experts and the various stakeholders to help develop a social media capability and strategy for the future.

I wrote on the blog this past week that the communications from governmental officials during the H1N1 situation had been very good so far, but I was concerned about the ability of federal, state and local authorities to inform the public if the flu became more serious, particularly in the area of social media. I also suggested that while there was a lot of uninformed ‘noise’ on Twitter and other social media, users by and large could find reliable information on the situation relatively easily. However, Robin Parker, from the Oregon Trail Red Cross chapter’s Cross Blog which has one of the most useful and creative web operations on emergency preparedness, commented on my post Friday with some suggestions for governmental entities:

I think you’re right that twitter is pretty self-correcting. I do think, though, that the CDC (and other official info sources) could be doing a better job with their tweets. They’ve been posting links to PDFs, but many people can’t click the links if they’re reading twitter from their mobile devices (or even some computers). If the CDC were to pull out the main points from those PDFs and tweet them it would be much more useful (and then people could easily retweet the info to correct misconceptions). I’d also like to see them offering more concrete tips. (Like my favorites: “sing a full round of happy birthday while washing your hands to make sure you’ve washed long enough” or “try sneezing into your elbow, not your hand if you don’t have a tissue handy”) … Little things, yes. But they make it easier for a worried public to take action and feel like they’re making a difference.

Robin is right. Government agencies have not taken enough advantage of social media in their H1N1 response. The good news is that so far the outbreak has not been as serious as once feared so those limitations have been as problematic as they could have been. 

Video of President Obama’s Weekly Address Focusing on H1N1 Flu Response and Announcing New White House Social Media Initiatives.

David Stephenson, an expert in disaster social media, has been regularly tweeting throughout last week with his frustration over the social media response of government at all levels. (Some samples: WHO site still absurd,designed 4 800pixel display? 1/2 of copy is boilerplate…IMHO site NOT updated frequently enough, doesn’t show understanding of 24/7 news cycle, real-time data…as of 10:40, CDC site still doesn’t have report of boy’s death. I refreshed to be certain, but says last update was 3:30 AM! BAD!)

In a Tech President opinion piece, “H1N1 Health Agencies Still Don’t Grasp Full Power of Web-Based Communication Strategies,” Stephenson criticizes: 

the official sites’ failure to realize we live in a 24/7 world, especially in a situation where the virus, as I understand it, is not limited to 9-5, local-time in terms of its spread. Both sites have gone 5-6 hours or even longer (especially the WHO site) without updates. Astounding! WE NEED 24/7 UPDATES, EVEN IF THE UPDATE FOR A GIVEN HOUR SIMPLY SAYS “NO CHANGES FROM THE PREVIOUS HOUR…given the array of Web 2.0 tools available to them, I don’t think it’s enough, More important than any specific tool is that they must adopt this 24/7 public information model, or convince the virus to adopt normal working hours for its spread.”

The CDC’s Preparedness division’s Twitter feed, CDCEmergency, offers solid if only periodic information; the  CDC’s and HHS’s H1N1 sites are clear and relatively complete. The CDC also has a Social Media page with “tools for consumers and partners.” And, the President’s announcement this weekend that the White House would be distributing H1N1 info through its social media outlets is constructive, because it adds more information distribution. But the distribution methods are only as good and as plentiful as the content created. 

My concern is that the current governmental social media capability – nationally and particularly locally – is not robust enough to handle a major decentralized emergency (such as if H1N1 had become more serious). To date, the important information for the public (H1N1 numbers, general instructions) has been relatively centralized and limited. But if the flu spread widely Americans would be going to social media applications like Twitter looking for more detailed information (as well as offering their own reports) on a community basis which would severely test local government sites. These new ways of communications — which empower the citizen — offer both a challenge and an opportunity for officials. 

In a major emergency, there will be rumors and misinformation along with good information. There will be a need to deal with all of it. As the H1N1 outbreak showed, in a crisis we will likely rely on data and guidance from national as well as state and local officials — and in this case even international. There will be a wide range of opinions that the public (and the media) will need to reconcile — for example, last week World Health Organization Director-General Margaret Chan described the situation as “it really is all of humanity that is under threat.” while New York Mayor Mike Bloomberg called it “a relatively minor annoyance” and added that “New Yorkers tend to get on with it as opposed to other places.”

There is also a need for a new media rapid response operation that can distribute important information, put other information into context and rebut misinformation. The CDC has a “What’s New” section of their H1N1 website with updates every several hours. However, in this new media age, “What’s New” is really now second-by-second as every new tweet hits Twitter. For example, a Harvard School of Public Health survey released Friday and a CDC public webcast conducted the day before indicated that there is a need for some more explicit guidance to the public and local communities to address questions that they still have about how to deal with the H1N1 situation. The Harvard survey indicated that 59% of Americans are taking the advice of officials and are washing their hands or using hand sanitizer more frequently. However, a quarter are avoiding places where many people are gathered, like sporting events, malls or public transportation (25%); one in five are avoiding people who they thought may have recently traveled to Mexico; and 17% are avoiding Mexican restaurants or stores.

I thought officials should have addressed some of the findings of this survey through social media to correct any misapprehensions that the public (even a minority) might have. i know that avoiding crowds, public transportation and Mexican restaurants is not behavior being recommended by authorities. And I’m pretty sure that staying away from people who have been in Mexico recently is being over cautious. But as a good deal of Americans are apparently doing so according to the survey, it would seem to make sense for officials to address it explicitly. In fact, when I asked Harvard’s Dr. Robert Blendon, who headed the survey team, about this during a teleconference on Friday, he said that based on the findings he believes that there is indeed a “need for authorities to explain to the public” which behaviors were “high risk” and which were not.

At the public webcast held by CDC Thursday, citizens were able to submit questions to acting Director Richard Besser along with DHS Secretary Napolitano and HHS Secretary Sebelius. If I was to characterize the theme of much of the questioning from the audience it would be ‘if we’re in for a dime, why shouldn’t we be in for a dollar’? That is, many of the questioners wanted to know why the government isn’t taking and recommending more active precautionary measures. For example, some of the questions included: *why aren’t we closing borders with Mexico? *why aren’t we closing schools? *should people be avoiding planes and trains as well as mass transit? *should I cancel an upcoming family reunion? *should I be wearing a mask when I travel? But these are questions that should be answered in real time and could be with all the new social media applications.

At the CDC webcast, I emailed in a question: “In a pandemic, there will be a lot of information being transmitted through the web from citizens via social media applications. Do you think that the federal, state and local governments throughout the nation have the social media capacity to keep on top of that to ensure timely and correct information is being transmitted to the public?” They didn’t get to it in the webcast. It looks like thankfully we will not get to that point with this current outbreak, but I do believe it a question that needs to be answered sooner rather than later. 

In fact, I would suggest that in the weeks to come lead emergency agencies like CDC, HHS and DHS focus on how they would handle new media for the next major emergency. I would recommend they bring together social media and technology experts, various stakeholders, bloggers and the news media to determine how best to serve the public’s information needs in an emergency nationally and locally. One of the interesting challenges (and paradoxes) of disaster response and social media is that while they are both usually best conducted in a grass-roots, bottom-up, localized manner, they also rely on some top-down, centralized efforts as well — ie. while information about one’s community is the most important to citizens, there needs to be a link to state, national and even international information as well. That is, the question is how do you best combine top-down and bottom-up approaches in responding to the disaster with social media.

During this outbreak, there have been private sector entities, non-profit agencies and individuals who were cranking out information on 24/7 time to augment the government’s effort. Some examples include the Twitter feeds of Veratect , a private company that tracks disease globally which has been offering almost minute-to-minute H1N1 diagnoses from around the world, and H1N1Info. Other good sources have been the feeds of Robin Parker’s Oregon Trail Red Cross chapter (tweeted mostly by its Communications Director Lise Harwin),  as well as individuals like Greg Dworkin, co-founder of the FluWiki, and David Stephenson. I think ultimately it is a role of the lead emergency agencies to bring things together for the public on the web. But in the interim it has fallen to others. (e.g. During hurricanes Gustav and Ike last summer, it took social media expert, Andy Carvin, to create the Hurricane Information Center which brought together information and resources.)

Hopefully, the governmental learning curve on social media will be quick. Robin Parker sent me an email this morning to say that things are improving: “The good news is that CDC started posting *slightly* better tweets this weekend – putting the numbers in context by letting people know that 36,000 people die each year of regular-old-flu, and giving a few specific tips. I have a feeling that they’ll get better as time goes on. (Fingers crossed.)”

Cover your nose with a tissue when you sneeze. Visit for more information.
A Print PSA from the CDC for the H1N1 Flu Outbreak

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