Administrative Issues in
Outbreak Investigations:
Working with the Media
OR
...
How to Optimize
Your 15 Minutes of Fame
M. Joan Mallick, R.N., Ph.D.
Part B
Working with the Media
during an
Outbreak Investigation
Introduction

Current discussions about relationships between
health departments and the media seem to focus
on the issue of strategizing how to communicate
during emergency situations
 The term stratagem is defined as “an artifice or trick
in war for deceiving and outwitting the enemy”
(Merriam-Webster Collegiate Dictionary Online,
http://www.m-w.com/cgi-in/dictionary?va=stratagem,
2002)
 This represents a very negative approach and is more
likely to result in poor interagency relationships and
negative media coverage
Introduction
 The most productive approach to working with
the media during any situation is to consider
them as allies who can perform various
assistive activities during an outbreak
investigation including
 alerting exposed persons who may not know
an investigation is taking place
 advising the population of the measures that
are being taken to determine the causes of an
outbreak and their elimination
 explaining the risk of exposure to the general
population after the initial outbreak
Purpose
 The
purpose of this course is to provide
ideas about how to work with media
during emergency situations so that the
goals of both institutions are met
 The ideas come from
 practical experience
 interviews with a
 local television anchor person
 partner in a public relations firm who has
worked with organizations experiencing
health emergencies
Objectives
 At
the completion of this course the reader
should be able to describe
 current methods used by media to collect
information for stories
 ways to provide media access to information based
on the needs of all organizations, including those
being investigated
 public relations advice for organizations being
investigated
 actions that diminish the credibility of health
department information
 counterproductive methods of restricting access
Scenario 1

One Sunday morning I woke up to banner
headlines that read something like this
Hundreds Sick After Attending
Conference Banquet

No one from the health department had
been advised of the incident by
convention attendees, EMS, or local
emergency room staff
 We learned of the incident from
the press that had issued an
important public health alert
 We
also learned from the press that
 no one had been critically ill
 no one had been hospitalized
 people had been transported by the city’s EMS
 they were taken to three different hospitals
 Since it was the closing banquet of the
convention, most people had left the city to
return to their homes, all around the US,
including Puerto Rico

We knew from these reports that the
investigation would take an extended
period of time because the exposed group
was so scattered. In terms of the media
this meant that we were in a yin and yang
situation:
Extended
media
interest
More time
to
explain
the
situation
We also knew that we had a big
Credibility Problem
Because we had
generally good
relations with the
City Hall
media, the health
department’s basic
credibility was not
in question
 However, the city
owned the banquet
center & city
council served as the
Health
local Board of
Department
Health

Convention
Center
 There
were grave doubts that one
city department would carefully
investigate and/or report on
problems in another department
How to Maximize Our Media
Opportunities

Our choices and possible consequences
 keep the media out
 raises
doubts that investigation will
 be thorough
 encourages media to meet with “experts”
for speculative opinions
 made it difficult to prevent disgruntled
employees from taking advantage of the
situation to undermine the departments
 encourages aggressive searches for secrets
Choices & Consequences
 allow them in but restrict time and
place access
 has many of the same disadvantages
of complete restriction
 makes concerns about what is not
being revealed as important as what
is being revealed
 encourages clandestine media
research
Choices and Consequences
 Allow
access to various investigative
activities
 Builds a trusting relationship between
organizations
 Allows fuller understanding by the media of the
complexity of the process and uncertainty of the
outcome
 The role of outside experts becomes one of
commenting on whether media staff have
interpreted information correctly
Providing Access
 We
chose to allow a newspaper
science reported to follow staff as
they developed interview protocols,
interviewed exposed persons, and
analyzed data
Establishing the Ground Rules
 Ground
rules for access were established as
follows
 All personal information was to remain confidential
 personal information would be restricted to the
extent possible
 names would be masked when the reporter was
reading interview response forms
 if the reporter overhead a name while listening to
an interview (after informed consent of the
interviewee), it was to remain confidential
 the reporter was not allowed to contact
interviewees based on knowledge of their name
or location
Ground Rules
 Staff outside the immediate investigation staff
would be accessible, but the observer should clear
the interview with the administration first
 medical staff who might not be directly
involved should be made available to the
observer to clear up medical details
 The observer and administrator should meet at
the beginning and end of each day
 to review planned events
 to provide an opportunity to discuss and clarify
observations
The Outcome
 Our
experience with the newspaper
was a positive one. The stories were
detailed and provided a more serious
approach to our work. What started
out as a sensational story became
one that informed the public not
only of the details of the
investigation but of the nature of
public health investigations
Scenario 2
At about 3 p.m. on a Wednesday
afternoon I received a phone call from a
pediatrician in a local emergency room.
She said that for the second day in a row,
students from a middle school were in the
ER with complaints of nausea, headaches
and lethargy. She realized the school had
not called the health department the day
before as they had said they would. By
this time the media had also been notified
The Media Issues

This situation raised the issue of who
communicated with the media
 the school system interpreted communicating
with the media as controlling the media
 they wanted to limit access almost completely
 they wanted to control all information that the
media received
 the health department, having had good
outcomes previously was less concerned about
providing the media access to information

Health department staff controlled the
information by virtue of the fact that they
were uncovering the details of the cause ot
the outbreak. Therefore, we could have
mandated that information come from them
and not the school board. Would it have been
wise to do so?
Sounds Like Good Advice
 An
Ohio public relations firm
specializes in working with
companies and organizations that
are experiencing emergencies that
affect the well being of
 its employees
 its customers
 its “neighbors”
Sounds Like Good Advice
 It
gives a three part piece of
advice that should guide all
public relations activities in
communicating bad news
Tell it first –
Tell it all -- Tell the truth
 The
school system had already ignored
most of this common sense advice
 The health department and the media had
not learned of the problem from them first
 the media had learned the second day
because the students were sent to the ER
on a school bus
Our Dilemma? Did we want to be
Jiminy Cricket or Pinocchio?
Our Strategy
The school system was as reluctant to
provide us information after the incidents
were reported as they were to report the
incidents in the first place
 Struggling over access to the media
would provide another source of tension
between the two agencies
 We decided to allow the school system to
determine how the media would be
informed

The Results
As we surveyed the school environment,
discussed investigation methods, and/or
traveled to and from investigation sites,
all media eyes were upon us
 We saw pictures on television and in the
news that were taken through windows of
the school


School employees
and families
became a primary
source of media
information about
what may have
happened and why

Teachers and staff,
some still angry over
previous contract
negotiations with the
school board, took the
opportunity to become
anonymous news
sources

As the media story
of the event
continued the
news was all bad
 School
administrators eventually
recognized the importance of regular
communication with the media
!
Revised Approach

Though not directly intended as such the
final method for working with the media
turned out to be quite clever
The school board hired a
consultant whose job was
described as to conduct an
independent investigation
and report to the board, the
parents, and the media

The consultant realized he would be
duplicating health department
efforts by conducting his own
investigation
 He routinely consulted with health
department administrators for
information updating the investigation

He saw his role primarily as
convincing the media that the whole
truth and nothing but the truth was
hereafter being told
 he realized the importance not only of
describing the findings but describing
the process
The consultant’s
resources (= large
consulting fee)
allowed him to
develop fancy
audio visual
presentations for
press conferences
and parent
meetings
His polished approach
presenting public health
information assured
everyone that progress
was being made
 He was also able to
present remedial actions
in a positive light and
defuse the hostility
associated with the
problems that caused the
outbreak


The health department
staff were relieved of
the stresses of
 quickly solving the
mystery of the outbreak
 convincing the media of
its own veracity
 struggling with the
school board over
“media rights”
 speaking for the school
system
Staff were disappointed that they were
not give credit for solving the outbreak
mystery
 However, administratively, the tradeoff was well worth the sacrifice
 Encouraging use of media consultants
appears to be a good piece of advice
for use by health department
administrators

Epilogue—A Personal Note
I
hope you enjoyed these stories and
gained some insight into techniques to
improve the integration of
investigative efforts and media
relations
 Questions about the technical aspects
of the investigations or the findings
may be directed to me through the
Supercourse evaluation forms online