On January 30, 2020, the World Health Organization (WHO) declared the 2019 novel coronavirus acute respiratory disease (2019-nCoV) a Public Health Emergency of International Concern. The following day, U.S. Health and Human Services Secretary Alex Azar declared a public health emergency in the United States. These declarations, widely covered in the news and social media outlets, caused many to ask, "What is the government doing about this? How is this different than the Ebola outbreaks in the African continent? Or SARS? Or Zika?"

The hallmarks of public health have always been the “3 P’s” – prevent, promote and protect, and I like to add a fourth: prepare.  Public health does not have the luxury of waiting out an illness to see how many resources should be allocated in response. The CDC has conducted over 400 tests for 2019-nCoV with 13 confirmed cases. Additionally, during the current influenza season, more than 107,000 cases of influenza have been laboratory confirmed despite being only part way through the season.  This underscores the need for public health to be proactive to ensure the health and safety of the communities it serves, as well as keeping them informed.

As with previous outbreaks, the public health system on the state and local levels works to ensure not only the necessary response services, but the key messaging to the communities it serves.  Much of what we do during a response is based on lessons learned from previous threats.  Public health departments and emergency managers have plans in place, developed in advance, for situations like this. Many departments and agencies do annual exercises on both a large and small scale to ensure that staff are up-to-date and familiar with the plans. These plans should be scalable, flexible, and adaptable to address a variety of concerns. The most successful responses are ones in which elected officials have been briefed on planning and response and what their likely role may be, including issues such as emergency declarations, the need for quarantines, and proper messaging. During any potential response, state and local health agencies, working with federal partners, increase surveillance of hospital admissions and notify laboratories of key markers that should be reported to epidemiologists. State laboratories work with federal partners to ensure proper testing can be performed in a timely manner. Public health nurses ready clinics for the possibility of surge management, while preparedness staff work with federal partners on how medical countermeasures may be ordered and delivered, if needed. 

Much of the response will hinge on external partnerships and communications. In the early stages of an outbreak, health departments need to communicate with hospitals, clinics, and private laboratories to ensure proper reporting. Many communities have formed healthcare coalitions, which allow public health, EMS, emergency management, and hospitals, among others, to discuss, plan, and exercise together.

Many governments have a communications plan that details their approach to sharing information. However, agencies should also put in place a Crisis and Emergency Response Communication (CERC) plan. CERC plans should be designed to communicate with key stakeholders, the public, and the media, all of whom will play a vital, yet different role, in how the community will respond. CERC plans are generally broken into three main sections: preplanning, response, and post-incident.

In preplanning, agencies can take this opportunity to agree on assignments, messaging styles, and responsibilities. This is also the time to draft and test messaging, not only media and public releases but emergency notifications to partners. During a response, agencies should look at how they are messaging to their identified stakeholders, i.e., hospitals, partner agencies, and, of course, the public. Avoid conflicting statements and look to have a single individual as a spokesperson. Conflicting statements or multiple authorities, even unintentionally, can cause confusion and distrust. Post-incident is the time to review what worked well and what lessons can be learned and applied.

When composing your plan, here are some ideas to keep in mind:

1. Develop your goals based on your situational analysis.

Defining the issue as a preamble to your plan will serve as a guide for what your objectives are and outcomes you wish to achieve.

2. Identify your stakeholders.

As part of your preplanning, identify the stakeholders in your community. Then during a response, you can target your messaging based on a few groupings/categories that are specific in what they need to know.

3. Divvy up roles.

As mentioned, one spokesperson should take the lead on communicating the message. As your resources allow, assign one individual to craft the message while another can monitor social media by hashtags, direct messaging or posts. Social media responses, however, need to be coordinated efforts so responses are in line with the plan. Social media posts must also follow your established policies specific to the platform.

4. Be aware of the message.

Gather and check the facts before crafting the message. As we have seen with the 2019-nCoV, there has been much said about the origins of the virus. It is important that the message does not feed into these perceptions while acknowledging their concerns. Dispelling these rumors or perceptions with facts and staying on message will minimize rumors and the audience will be reassured that your agency is working on handling the situation. Instead of feeding into these perceptions, redirect that viruses aren’t specific to a race, gender or nationality and can be treated with medicine not stigmas.

Other Links of Note from ICMA

This complimentary e-book, Building Resilient Communities During Disruptive Change -- Part 1: Crisis Communications, looks at ways to develop sound crisis communication practices to help citizens and local government personnel understand and deal with dangerous situations in a timely and prudent manner.

We've put together an infographic, The 8 Key Local Government Personnel You Need On Your Crisis Communications Team, showing the roles and responsibilities of local government professionals in a crisis. If you are with a small community and don't have this kind of bench strength, consider mapping these roles into existing positions or collaborating with other jurisdictions that may have a role in place that you don't. 

Crisis leadership involves getting your message to your audience quickly and directly. Here are some tips from Taking Control of the Message: Media Management During a Crisis for managing the message during a disaster.

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