Friday, November 6

Injecting Fear: Who Caused The H1N1 Controversy?

There is a question being asked more and more by government leaders: Is the fear more harmful than the H1N1 flu?


While many school systems are asking for parents to sign the forms and have their children vaccinated, a few school nurses have already given the swine flu vaccine to students who didn't sign up — including a Brooklyn girl with epilepsy. She wound up in the hospital and then a health worker tried to have the mother sign a consent form after the fact.

Even as some U.S. health officials said the new strain isn't nearly as dangerous as they first feared, President Obama declared it a national emergency. Doing so, regardless whether the reason is warranted or not, grants the government additional powers.

According to the Associated Press, 75 percent of the population fears the vaccine, with 33 percent saying they don't want it nor will they give it to their children. The FDA has been busy trying to fight these fears while attempting to quell fears on the other side of the aisle. Some people are afraid there is not enough to go around, which is especially likely since the U.S. is donating 10 percent of its supply.

And then there are all the other theories. Some claim the vaccine was rushed through the FDA; others claim H1N1 is being used as a weapon against health care reform. Some claim it is to fund drug companies for their support of health care; others claim it is a government conspiracy to immobilize people. Some say people are ignorant not to take it; others say people are ignorant if they do take it. And so on and so forth.

When communication fails, fear spreads faster than the reality.

In one telling CBS news program, Dr. Jennifer Ashton compared the the seasonal flu, which accounts for 36,000 deaths (200 per day), to H1N1, which had accounted for 593 deaths (or about 4 per day). The greater difference is in the people, with a higher death rate among people under 65. (For people in southern Nevada, you can fact check here.)

While most of the opinions don't really add up, one fact does. Mismanaged communication is dangerous, and the H1N1 communication has been mismanaged. So how did that happen?

It seems that the U.S. Centers for Disease Control & Prevention planning assumption placed the infection rate at 40 percent, which is higher than some reports previously stated. (The study by Purdue University researchers projects that 63 percent of the U.S. population will be infected by the end of this year.) At 40 percent, H1N1 could cut deeply into the essential workforce. (The CDC has been working to temper some of these estimates.)

Once the federal government saw these estimates, it had a choice. It could believe or dismiss these figures. If it dismissed them and the worst happens (e.g., the Purdue study), then it receives criticism for not doing enough. If it accepts these numbers and does not deliver a vaccine, then it receives criticism over its vaccination plan. If it accepts these numbers and nothing happens, it receives criticism for overreacting (like last spring). And so on and so forth. You get the idea.

With so many losing propositions, the administration chose the path of least likely criticism. The message became: H1N1 is something to worry about enough that you need to be vaccinated, but not enough that you should worry if you don't get vaccinated because the promise of 120 million vaccinations by October came in at 11 million. Huh?

The path of least criticism is a lack of leadership.

The message was so weak that the government seems to have completely lost any semblance of public trust in regard to H1N1, which empowered a groundswell of competing voices to fill the void. When that happens, the media become even more inclined to cover the conflicting messages over and on top of the "threat to public safety" headline. And so, fear spreads.

Whose fault is that? The only one responsible for the fear pandemic is the federal government and its unwillingness to designate a single coherent voice on the subject from the start. Senior adviser David Axelrod has already admitted as much, noting that the White House also over-promised on the country’s flu readiness and vaccine availability.

Ironically, despite that admission, the administration has yet to take responsibility or hold anyone accountable. Instead, the government has gone on the defense, which has become all too commonplace lately.

The solutions in this case are virtually an exercise in common sense. Effective leadership gives up on public relations in the face of crisis communication. It realizes that being a critic doesn't replace leadership. And, above all, it understands that fear is more dangerous than the flu.


Rich on 12/6/09, 6:15 PM said...


For H1N1 data through Nov. 28, visit the CDC here.


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