Tuesday, July 24, 2007

Crisis Communication: The Asian Bird Flu 1997

Case Background:
It started as a one-off, but then raised fears of an epidemic reminiscent of the 1968 Hong Kong flu which killed 46,500 people worldwide. The first stage of the bird flu outbreak can be traced back to the spring of 1997. In April, an epidemic of the influenza A (H5N1) virus in Hong Kong wreaked havoc with the chicken population and resulted in the deaths of 6,800 chickens.

This strain of virus which had been previously known to infect only birds now crossed the species barrier and infected humans. By the end of 1997, the confirmed number of cases had reached 18, resulting in 6 deaths.

The first human case occurred in May when a three-year-old boy was admitted to Queen Elizabeth Hospital. He died five days later of severe pneumonia and multiple organ failure. However, it was not until August that the alarm bells began to ring and the revelation by health officials that what at first appeared to be a normal flu case was, in fact, far more sinister. For the first time anywhere, a human had become infected with a bird virus.

Investigations led to health officials dismissing it as an isolated case. However, on November 26, a 13-year-old girl was admitted to Prince of Wales Hospital suffering from the disease. Three days later, a 54-year-old man entered Queen Elizabeth Hospital infected with H5N1. Both died, the man on December 5 and the girl on December 21.

On December 28 the Hong Kong Government took the extreme step of ordering the immediate slaughter of 1.3 million chickens and an unknown number of ducks, geese and other birds in a desperate attempt to stamp out the deadly new virus. A 60-year-old woman had also died from H5N1 at United Christian Hospital on December 23, bringing the death toll to four.

By year's end, 14 people in all had been confirmed as having the disease, six of whom had recovered. Six others were suspected of having the flu, while nine people who were exposed to it developed immunity without falling sick.
Imports of mainland chickens - the source of 80 per cent of chickens consumed in Hong Kong - were temporarily suspended. On December 27, the Centres for Disease Control and the Health Department said there was still no conclusive evidence of human-to-human transmission.

But questions remained. Can humans get the virus from each other or just from birds, and is it airborne or spread by touching infected birds' blood or droppings? Why has the virus retained its avian characteristics and not mutated into a more human strain of influenza A, which would make it more efficient in attacking people?

It is the race to find these answers that preoccupied Hong Kong that fateful new year of 1997/98.

Warnings of a possible pandemic prompted a swift international response. The implications for Hong Kong were enormous as the Asian bird flu not only threatened the health and welfare of the people of Hong Kong, but also affected Hong Kong’s economy and reputation in terms of international tourism and trade.
In managing the Asian bird flu crisis, the Hong Kong Government was faced with several challenges: it needed to communicate the facts of the situation effectively, explain what actions it had taken to alleviate the situation, and also communicate to an increasingly hysterical public both locally and internationally.


What is avian influenza (bird flu)?
Avian influenza is an infection caused by avian (bird) influenza (flu) viruses. These flu viruses occur naturally among birds. Wild birds worldwide carry the viruses in their intestines, but usually do not get sick from them. However, avian influenza is very contagious among birds and can make some domesticated birds, including chickens, ducks, and turkeys, very sick and kill them. There are 15 varieties of bird flu. Each variety sustained itself in the wild aquatic bird populations of the world. These strains of bird flu in ducks and shorebirds showed little genetic change over time and were quite harmless to these natural hosts. When bird flu transferred to other species, such as chickens, however, they had the opportunity to multiply in huge numbers and to accumulate mutations, the variants of which could cause disease.

How do people become infected with avian influenza viruses?
Most cases of avian influenza infection in humans have resulted from direct or close contact with infected poultry (domesticated chicken, ducks, and turkeys) or surfaces contaminated with secretions and excretions from infected birds.

What are the symptoms of avian influenza in humans?
Symptoms of avian influenza in humans have ranged from typical human influenza-like symptoms (fever, cough, sore throat, and muscle aches) to eye infections, pneumonia, severe respiratory diseases (such as acute respiratory distress syndrome), and other severe and life-threatening complications. The symptoms of avian influenza may depend on which specific virus subtype and strain caused the infection.

Q1• How did the Government communicate the facts of the situation?
In a world with global media coverage and competition for sensational news, any hypothetical doomsday scenario that could capture the public imagination risks unleashing a media storm. The perception of risk is then easily distorted from the actual risk. The threat of a pandemic is particularly scary as there is a lack of control, which in turn leads into aimless activity added to this if people feel that the government is hiding facts from them or not revealing everything a furor is created and panic ensues and the situation escalates out of control

Anatomy of a crisis
Crises can happen anywhere, at any time, and often occur when they are least expected. When a crisis does occur, events usually unfold rapidly, leaving little time for planning. That is why preparation is essential. Aside from tangible damage, a crisis can also destroy an institution's or government’s reputation. The longer a crisis goes on, the more damage it can do to public support, people’s morale, and increase panic. Therefore, it is necessary to handle crises in a swift and organized manner.

The most challenging part of crisis communication management is reacting - with the right response - quickly. This is because behavior always precedes communication. Non-behavior or inappropriate behavior leads to spin, not communication. In emergencies, it's the non-action and the resulting spin that causes disruption.

Hong Kong Government
One of the most glaring flaws in the government’s handling of the Asian Bird Flu is lack of transparency and lack of PR skills. The people perceived the government handling of the bird flu as a saga miscommunication and the lack of preparedness, manpower and resources.
In their defense we have to remember that this virus was something totally new to people so perhaps some latitude can be allowed.

ARGUMENTS FOR & AGAINST

Argument AGAINST the Government
The entire 'bird flu' saga shows that the Hong Kong Government proved to be a rigid bureaucracy incapable of managing any crisis in society swiftly in an era when public health is a huge issue. The story of H5N1 bird flu began in April, and on August 20 the Department of Health announced the first fatality. Three more cases were announced between November 28 and December 6, and several more since.

Since April the Department of Health did not take the public into its confidence. It has concealed facts from the public rather than publicised its findings and opinions. This is hard to justify, even with the best of motives. The old attitude persisted and perhaps still persists. Can the Heath Department explain what it did with its findings and whether it instituted any preventive measures from August until December, when more H5N1-caused deaths occurred?

Lack of transparency was partly responsible for the endemic fear that spread faster than the bird flu virus itself. At the very least, the Health Department should have educated the public through the mass media on the symptoms of H5N1 virus and how to prevent common flu. What was even more disturbing than the department's failure to do so was to hear its chief, Margaret Chan claim publicly that she ate chickens every day. This was irresponsible behaviour in someone who should have calmed public concerns by disclosing what measures her department would adopt immediately to prevent the spread of the virus and how ordinary citizens could protect themselves.

Nothing breeds panic more than the suspicion of a cover-up. The best way of allaying such fears is to give the public all the facts as they become available, to present the implications in a balanced manner, and to assure people that the authorities are giving all their attention to the matter. The fact was that the leader doesn’t appear to give any reassurance to the public [at least the case doesn’t mention] his silence on the issue irresponsible behaviour. Although the media was blamed for exaggerating the incidence of bird flu it seems that, without pressure and exposure in the mass media, it is doubtful the Government would have reacted to the crisis much faster and more responsibly than ever before

Public fears were not calmed, nor any emergency meeting held to discuss the bird flu. Political parties seemed ill prepared for the crisis, just issuing statements in support of the Government's decision to ban the imports of chickens from the mainland. The Department of Health should have informed the public that the flu usually intensifies on the fourth day of infection, and that it is not always fatal. Because the institutional mechanisms, media excepted, were ineffective, public fear led to congestion of the public hospital emergency wards. One cannot actually blame these citizens who carried their children to the wards.

With the benefit of hindsight, Hong Kong during the transition period from 1984 to June 1997 wasted too much time in political disputes at the expense of paying sufficient attention to public health. In December 1997, the Department of Health asserted there was no evidence of human-to-human transmission, and that chicken was safe to eat. What happened then? Within days the media quoted scientific authorities as saying human-to-human transmission had become likely. A World Health Organisation spokesman said the vaccine would take at least six months to develop. Then the Department of Health advised that the virus had been found in chicken organs.

Surely this could not hope to engender public confidence. Is avoidance of 'unnecessary' public panic an excuse for withholding research results and factual background of cases? Who should be the best judge of what is 'unnecessary'?

What the health officials didn’t understand was that the lack of information creates suspicion which often leads to irrational conclusions and even panic. And, most importantly, who should be held responsible if people die due to misinformation?

In Government’s Defense

According to the Department of Health, they had adopted a very open and responsible approach in dealing with these two issues. [South China Morning Post]

In August the department made a public announcement of the detection in man for the first time of this new strain of influenza A virus and in view of the importance of this discovery, the World Health Organization was notified. A special team was set up to work closely with local and international experts and agencies and to assess its global health impact while department staff actively conducted a series of field investigations and laboratory tests with other organisations to trace the source of the infection. The Government set up an Inter-Departmental Coordinating Committee (ICC). The purpose of ICC was to co-ordinate the efforts of the various government departments. In the later phase of the bird flu crisis, the Department of Health set up a Special Information Unit (SIU) that was responsible for inter-departmental communication also.

The Special Information Unit [SIU] worked closely with the Hospital Authority to identify suspected cases and to confirm cases of bird flu. This enabled both agencies to arrive at a consensus in responding to media queries. Whenever the media raised issues, the SIU informed the departments and officers concerned before responding. This ensured that information released was standardized and communicated in a more convincing way, or expressed in a more readily understood manner.

Samples of the specimen were sent to the CDC in Atlanta, USA, and to Mill Hill in England and these laboratories played important roles in a global surveillance network for tracking down changes in flu viruses. Interviews were conducted and blood samples collected for further analysis. As this virus was new to man, the Centers for Disease Control and Prevention (CDC) in Atlanta had to develop an entirely new test for it. While awaiting the test results, the second and subsequent cases occurred in late November and early December.

According to the Department of Health since the outbreak of the second case, they had been very forthcoming with factual information to the public and the media. Organising press conferences and briefings and issuing press releases and giving updates on a regular basis.

From November 1997, the Government Information Service (GIS) maintained the Government Information Centre web page. It contained major government and quasi-government decisions and announcements, suggested preventive measures, provided government officials’ speeches, and outlined press conferences. In addition, updated information on confirmed and suspected cases of bird flu was regularly published. The Government considered it an invaluable single access point for information published by official and quasi-official organisations in Hong Kong.

Apart from information supplied to the media, information and advice to doctors on H5N1 was also made available through the Internet and direct mail. In addition, a publicity and health education programme for the community was launched to give health advice and precautionary measures for the prevention of influenza. A list of preventive measures was formulated based on a review of the initial assessments of the first six confirmed cases and three suspected cases of bird flu. General out-patient clinics and private medical practices were used for surveillance of the virus. The Agriculture and Fisheries Department, Urban Services Department and Regional Services Department were involved with surveillance and monitored poultry movements between China and Hong Kong. The Education Department and Social Welfare Department provided schools and childcare centres with up-to- date information on preventive measures, and the Hospital Authority informed the Department of Health immediately of any suspected cases to allow for early investigation.

What should have been done What the government should have done was to think out the messages that would need to be delivered in the early weeks and months of the pandemic itself not a couple of months later. Proper message design requires audience assessment research which admittedly was not possible but the 3 keys in choosing messages on any topic are:
(1) What your audience already knows, thinks, feels, and does. This includes people’s questions and concerns, what they want to learn more about. Importantly, it also includes their accurate impressions about things the experts are misperceiving.

(2) What you want your audience to know, think, feel, and do. This list of the goals of your communication effort should always include telling people what preparations you want them to make and why. It usually includes telling them what preparations you are making — which is fine, as long as you don’t overstate how prepared you are. And it ought to include asking for their input, their own suggestions and their feedback about your evolving preparedness plan.

(3) The relationship between the first two factors. The focus here is on how your audience is likely to respond to the messages you’d like to be giving them, and what additional messages are needed to help produce an appropriate response. This can get complicated. It includes, for example, a list of truths you need to tell people even though you don’t really want to, because otherwise your credibility will self-destruct when they learn those truths elsewhere.
[Peter Sandman]

Q.2: What actions did the Government take to alleviate the situation?
Despite criticism that they should have moved more quickly, the fact remains that the Hong Kong Government was dealing with an enigmatic virus, so there was a limit to the defenses that could be raised against it. Unless you know the enemy, it is difficult to defeat.

They were unsuccessful in the development of a vaccine due to limitations of time posed by WHO and the fact that to develop a vaccine you first need enough material to test. The WHO scientists gave a time frame of 6 months and until then the cases were to be treated with amantadine although amantadine had known side-effects.
In other measures the Government proved a bit better although some criticized some of the measures as being too extreme and some as the decisions being a little late. If the slaughter of poultry would not have halted the H5N1 influenza virus in its tracks, at least the drastic step taken would have exonerated the Hong Kong Government from blame if bird flu were to go on spreading.

The measures undertaken by the government were as follows:

It banned imports of chickens and restricted entry to infected areas.
The mainland stepped up controls over its imports and exports of poultry and the Government banned the importation of chickens from China soon after it was confirmed that H5N1 had infected imported chickens at two market stalls. There will be moratorium before any poultry is imported from the mainland or local farms are restocked. Everything is being done to try to make doubly sure that there are no traces of H5N1 in the next batch of birds arriving here. Intensive screening and thorough testing is being done before the birds are allowed into Hong Kong.
A farm and biggest chicken market declared no-go zones
A farm and part of Hong Kong's biggest chicken market were declared no-go zones after signs of the deadly bird flu virus were detected. Officials closed off a Yuen Long farm and half of the Cheung Sha Wan Temporary Wholesale Poultry Market, declaring them both 'infected areas' or ‘no-go’ zones and police officers, wearing masks, were posted at entrances of these areas to monitor the movements of people and animals to and from the areas.
Mass Slaughter of Chickens and Poultry Ordered
All Hong Kong's estimated 1.2 million chickens were to be slaughtered in a radical attempt to rid of the deadly bird flu virus. Poultry in retail markets - including geese and ducks kept near chickens – were ordered to be destroyed in the massive 24-hour operation beginning today. Teams of five Agriculture and Fisheries Department staff were to visit each of Hong Kong's 160 chicken and 39 mixed poultry farms. They would place groups of birds into plastic containers and then gas them to death with carbon dioxide. After the slaughter, the carcasses were to be disinfected, put into plastic bags and taken to one of Hong Kong's eight landfills for disposal.

Although The Secretary for Economic Services, announced that the mass slaughter of all chicken and poultry would take 24 horns to complete, beginning the following day the Department had failed to meet this target. The execution was conducted in a messy way and exposed a lack of co-ordination between departments. While Agriculture and Fisheries Department staff worked round the clock to carry out their order, half-dead chickens were left on the roadside because cleaning staff of the Regional Services and Urban Services departments had failed to clear them and the Environmental Protection Department had stuck to its rule of closing the landfills at midnight.

The administration was to be blamed for the lack of preparation for the mass slaughter. Chickens were still wandering around after it was claimed the slaughter had been completed. The Government initially said chickens would be killed with carbon dioxide, but the slaughter left rivers of blood and many dead chickens were left uncollected. The Government also failed to keep its promise to accomplish the slaughter within 24 hours.

These reasons were given for the failure:
• Staff was not familiar with catching chickens.
• A lack of carbon dioxide in Hong Kong to gas the chickens and poultry required manual slaughter by cuffing the throats of chickens.
• Staff was not familiar with the exact location of chicken and mixed poultry farms.
• The logistics of providing minimum training and protective clothing to the staff involved in the slaughter were prohibitive.
• The logistics of organising and coordinating the 200 Urban Services Department and Regional Services Department staff involved with the disposal of the carcasses were prohibitive.

Compensation packages announced for farmers
Compensation for farmers to top $40 million was announced and attention was to be directed to the plight of the poultry industry. As both farmers and retailers would be facing a deeply uncertain future, they were be given generous help so that they can weather the present storm and survive with sufficient resources to start up again when it is safe to do so.

Measures to Ensure Virus-free Chickens from Mainland China
After the mass slaughter, it was announced that chickens originating from mainland China would only be allowed to be imported once a mechanism to check the hygiene of such poultry had been developed and implemented. Mainland China health authorities also pledged to step up monitoring of chicken farms. Blood samples from poultry in every truck would be taken and examined by staff of Agriculture and Fisheries Department upon arrival at Man Kam To border entry point. After blood samples were taken, the doors of the rear compartments of trucks, which contained caged chickens, would be sealed with official stamps in an attempt to prevent unauthorised chickens making it to Hong Kong markets. To ensure imported poultry was free from H5N 1 before being sold at markets, Agriculture and Fisheries Department laboratories worked shifts to obtain prompt test results.

A scheme that required the registration of all farms supplying poultry to Hong Kong was announced. Only registered farms were able to export chickens to Hong Kong, and all birds had to carry health certificates. Random spot-checks would be conducted and at least 400 blood samples would be taken and tested each day. Copies of test records and certificates would be sent to the Agriculture and Fisheries Department.

Summary of Actions published by The South China Morning
The SCMP newspaper published a summary of actions taken by the government in response to the crisis, and also provided hotline contacts.

Guidelines were developed for Health-care workers
After accusations were labeled at not giving enough care to the health workers the Department of Health spokesman advised the media that guidelines had been given to the ambulance services. Furthermore, existing guidelines for handling infectious diseases were adequate, as not only ambulance-men were at risk of contracting H5N1. Health-care workers, including doctors and nurses, were at risk too. A briefing session aimed at disseminating information about the virus and establishing additional preventive measures in order to alleviate front-line workers’ concerns

Information for Tourists
On 20th January 1998, the dept of health released info for tourists coming to Hong Kong. In a damage-control move, Secretary for Health and Welfare Katherine Fok Lo Shiu-ching told a meeting of consuls-general that Hong Kong was safe for visitors. “The chance for a tourist catching bird flu therefore is minimal.” -Katherine Fok, Secretary, Health Welfare Bureau She said that as the virus was predominantly transmitted from bird to man, the chances of a tourist catching or transmitting the flu were minimal.
What the government should have done was to think out the messages that would need to be delivered in the early weeks and months of the pandemic itself not a couple of months later. Proper message design requires audience assessment research which admittedly was not possible but the 3 keys in choosing messages on any topic are:

Q3• How did the Government communicate these undertakings to an increasingly hysterical public both locally and internationally?
The government was repeatedly criticised for not being transparent with the public and was accused of keeping them out of the loop. It was said that either they did not have a comprehensive plan or if they did, they did not effectively communicate openly with the people of Hong Kong, the international community and stakeholders who represented diverse interests.

Many watched with apprehension as the bird flu crisis unfolded, the Government reacted to harsh criticism over its handling of the bird flu crisis and unease among Asian neighbours and assembled a taskforce comprised of senior Government officials from the ICC and the SIU. The task force was issued a brief to formulate a “Crisis Communication Strategy” for the Government to implement across all Government departments and quasi-Government agencies.

It was indeed ironic that, when there were hopes that the bird flu saga may have run its course, was the time that the Government took its strongest administrative action with the decision to put the Chief Secretary in charge of a task force to cope with the outbreak and its effects. When the mass slaughter of chickens was ordered, officials must have hoped that the shock effect would be sufficient to end the crisis. That not only proved an unfounded hope, but the way in which the slaughter was conducted raised fresh concern. It was only then that top-level attention was given which should have been applied publicly long ago.

There is no doubt that a crisis like this is best handled with a cool head. But that is no excuse for not taking responsibility at the highest levels. The outbreak, itself, was bad enough, but the ramifications of the episode spread much more widely. The effect on the battered tourist industry was undeniable. The government’s establishment of a high-level taskforce on bird flu signifies that it was prompted by the poor performance of departments and its head.

More and more departments got involved and the co-ordination got wider. The task force embarked on visits internationally to improve image of Hong Kong. The priorities of the taskforce were to examine ways to ensure sanitation in transporting chickens. The Government took action to alleviate the situation and they were;

INTERNATIONNAL - Overseas Visitors
“The bird flu cases had become an international incident and would hit the tourism industry if it was not handled properly.” -Dr. Huang Chen-ya, Health spokesman of the Democratic Party

Briefing Consuls General on H5N1
It was supposed to be the year Hong Kong's tourism industry was meant to break all records as international interest in the handover brought with it a flood of visitors. But the outbreak of the virus and public’s perception that something was being kept from them saw all confident predictions of tourism crashing down.

The government did try to alleviate the situation. There were briefings given to representatives of Consuls General in Hong Kong regarding bird flu which were conducted by Katherine Fok, the Secretary for the Health and Welfare Bureau. Consuls General of Australia, Britain, Canada, Indonesia, Japan, Korea, Malaysia, New Zealand, Norway, the Philippines, Singapore, Thailand and the USA attended the briefing. Government representatives included Dr. Margaret Chan Fu-chun, Director of the Department of Health, Gregory Leung, Deputy Secretary for the Health and Welfare Bureau, and Dr. Leslie Sims, Senior Veterinary Officer, Agriculture and Fisheries Department.

The prime objective for the briefing was to reassure foreign representatives that it was safe for overseas visitors to come to Hong Kong. The briefing also covered the measures that had been taken by the Government to prevent the further spread of the virus.

The WHO findings were presented and Fok stressed that no countries had imposed travel restrictions or quarantine measures on Hong Kong. She reassured representatives that efforts were being made to devise a surveillance system to ensure future chicken and poultry imports to Hong Kong were H5N 1 virus-free.

On 8 December, 1997, Dr. Huang Chen-ya, Health spokesman of the Democratic Party, noted the potential adverse effects of the bird flu crisis on Hong Kong’s vibrant tourism industry. He said that overseas reporters had questioned him about the bird flu, as foreign countries had expressed concern of the possibility that their citizens might contract the bird flu virus while visiting Hong Kong. Health officials in Taiwan and Japan warned their people that Hong Kong was temporarily unsafe to visit. The Research Centre of Bird Flu in Australia warned Australians that it was not safe to visit markets that sold birds in Hong Kong. An article that appeared in the Australian newspaper, The Australian, mentioned that the bird flu might mutate and subsequently give rise to a pandemic, similar to the one of 1968.

The Hong Kong Tourist Association (HKTA) said that its overseas offices in South East Asia had received many enquires concerning the bird flu situation. The Department of Health insisted, however, that WHO had not categorized Hong Kong as a city of high risk. Hence, nothing was done to educate the international audience on bird flu. Under increasing pressure from overseas countries, the Department of Health later prepared a fact sheet that explained the avian flu to tourists and/or tourist groups planning to visit Hong Kong.Some local newspapers commented that the fact sheet did not present all of the facts, however, as H5N1 had already claimed two lives, and no mention was made of this.

The Asian bird flu crisis focused international attention on Hong Kong. Around the world, Governments warned their citizens not to visit Hong Kong, or if visits were inevitable, then visitors should avoid all contact with birds. Japan was the first to announce the development of a vaccine as a result of fears that bird flu H5N1 had reached its shores.

LOCAL PUBLIC
It was the public that suffered the most from the Governments poor handling of the crisis. Senior officials hardly made any announcements till it was late. It was left to the Department of Health to issue statement – the leader hardly addressed the people. In the grip of intense panic that was to be expected people rushed to the hospitals to be tested thereby creating further disorder.

Another discouraging fact was the Chief Executive Tung Chee-hwa's silence on the issue all December. Mr Tung's policy advisers, such as members of the Executive Council, kept their mouths shut on the entire issue - an over-cautious attitude that did not calm the public's fears.

Members of the Provisional Legislature did not any critical questions to officials of the Health Department or Agricultural and Fisheries Department. Members of the Urban Council also failed to hold any emergency meeting to discuss the bird flu.

But the government cleaned up their act after announcement of the slaughter of the chickens and won back little of the public’s approval which was lost after the debacle they made of the slaughter itself. Because the institutional mechanisms, media excepted, were ineffective, public fear led to congestion of the public hospital emergency wards. One cannot actually blame these citizens who carried their children to the wards.

It banned imports of chickens and restricted entry to infected areas.
A farm and biggest chicken market declared no-go zones
Mass Slaughter of Chickens and Poultry Ordered

These actions won them back some of the public approval and helped in allaying the fears a little bit

Compensation packages announced for farmers
There was compensation announced for the farmers whose livelihood were in tatters and these were announced to the affected parties. The poultry industry came under enormous financial pressure at the time when Hong Kong people were advised not to eat chicken during the height of the Asian bird flu crisis. Wholesalers tried to rebuild consumers’ confidence by sterilising Cheung Sha Wan Market, Hong Kong’s largest poultry wholesale market. Wholesale chicken prices continued to fall from HK 13.90 to HK$9.90 per kilogram, and chicken sales dropped by half.

Measures to Ensure Virus-free Chickens from Mainland China
The Chief Secretary announced to the public that chickens from mainland China would only be imported after a battery of test

Health-care workers
After accusations of not giving enough attention to the plight of the health care workers, a Health spokesman advised the media that guidelines had been given to the ambulance services. A spokesperson from the Hospital Authority claimed that a briefing session aimed at disseminating information about the virus and establishing additional preventive measures in order to alleviate front-line workers’ concerns would be held.

Mass Media
Mass media was blamed for exaggerating the incidence of bird flu, this also was irresponsible behaviour for, without pressure and exposure in the mass media, it is doubtful the Government would have reacted to the crisis much faster and more responsibly than ever before. In fact it was the media that gave adequate coverage to the crisis and were responsible for informing the public

Politicians
Throughout the crisis the political parties remained critical of the government’s lackadaisical attitude toward the flu. In their opinion the crisis was handled very poorly. They expressed concern at the way things were being handled and interrogated the Government at every opportunity through the mass media and during meetings of the Provisional Legislative Council. Many commented that the Government was unable to handle the crisis and failed to provide the public with a high degree of transparency regarding information surrounding the bird flu.

Executive Councilor Tam Yiu-chung claimed that the Government had underestimated the deadly bird flu virus, made decisions in a hurry, was ill- prepared and lacked sufficient evaluation processes, and failed to make a comprehensive plan, or if there was one, failed to make it known and available to the public.

But the political parties seemed ill prepared for the crisis as well, veering from one end to another from criticizing the government to issuing statements in support of the Government's decision to ban the imports of chickens from the mainland.
With the benefit of hindsight, Hong Kong during the transition period from 1984 to June 1997 wasted too much time in political disputes at the expense of paying sufficient attention to public health.

CONCLUSION
There is a long list of good reasons for involving the public as early as possible about the decision-making involved and pointers on how to handle a crisis like an H5N1 pandemic. To mention just the most obvious ones: You get better decisions; you get better public understanding of the decisions; and you get more public buy-in, and therefore more compliance in implementing the decisions. You also get a calmer public. People won’t panic as out of control when they feel that they are inadequately warned or involved and don’t end up feeling unprepared.

You have to warn people about the risk of a flu pandemic as they need to prepare, there are things they need to know, facts and ideas they need to get used to — like the reality that scarce medical help will go first to those who are most needed (for their labor or expertise), not to those who are most vulnerable. Most importantly they need prepare emotionally. People adjust to new threats in stages. Typically, apathy and denial give way only reluctantly. Then comes the “adjustment reaction” phase: vicarious rehearsal, hyper vigilance, a temporary flood of emotion as people begin imagining what it might be like. Only after that can we roll up our sleeves and get serious. [Peter Sandman on how to communicate in crisis]


The Asian Bird Flu virus in 1997 is a clear portrayal of how badly things escalate if a crisis is not handled properly in a timely manner and with the buy-in of the public.

Bibliography:
  • South China Post
  • WHO website
  • Newspaper Archives
  • www3.niu.edu
  • Pandemic Influenza Risk Communication: The Teachable Moment Peter M. Sandman and Jody Lanard.
  • Bird Flu – Communicating the Risk Peter M. Sandman and Jody Lanard. Health

  • NOTE TO ANGRY ANONYMOUS PERSON'S COMMENT
    [ AS POINTED OUT BY SOMEONE I SHOULD HAVE WRITTEN THE ENTIRE SITE ADDRESS IN THE BIBLIOGRAPHY, I HAVE DONE BETTER THE PARTS ON WHAT TO DO IN A CRISIS THAT HAVE BEEN PUT IN THIS ARTICLE AND WOULD NOT EVEN CONSTITUTE AS ONE FIFTH OF IT ARE NOW IN ITALICS]
  • MOST OF THIS ARTICLE IS FROM THE NEWSPAPER ARTICLES AND A CASE STUDY PROVIDED BY THE TEACHER ONLY THE BITS ABOUT CRISIS COMMUNICATION ARE FROM THAT ARTICLE SO NOW I HAVE THEM IN ITALICS - I CANNOT NUMBER THEM ON A POST LIKE IN AN ASSIGNMENT WHERE THE FILE'S PDFed AND A LONG LIST OF BIBLIOGRAPHY PROVIDED TO TEACHERS!
  • THIS WAS A CASE STUDY THAT WE HAD TO ANALYSE. THE CASE STUDY WAS PREPARED BY VANESSA H. CLARK UNDER THE SUPERVISION OF DR. GILBERT WONG AND GIVEN TO US AS AN ASSIGNMENT