Exploring Medical and Public Health Preparedness for a Nuclear Incident Proceedings of a Workshop (2019) / Chapter Skim
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5 Implications of Communication, Education, and Information Challenges
5 Implications of Communication, Education, and Information Challenges
Pages 61-92
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From page 61... ...
• "Get inside, stay inside, stay tuned" is a critical message for nuclear preparedness, and planners should do more to take advantage of teachable moments to spread consistent messag ing across platforms, including social media. (Wieder)
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From page 62... ...
, discussed the many communication tools for detonation events that have been developed by the interagency Nuclear/ Radiological Communication Working Group. In addition to describing the many publicly available interagency nuclear threat communication tools, Wieder provided some personal perspective on nuclear detonation messag ing based on her 14 years of work in radiation communications and nearly 10 years of work on nuclear detonation messaging in particular.
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From page 63... ...
. Becker emphasized, however, that while effective risk communication has enormous potential to reduce morbidity and mortality in a nuclear detonation scenario, this same scenario also poses enormous communi cation challenges.
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From page 64... ...
According to Becker, PEMDP resulted in the first peer-reviewed scholar ship specifically on communication and nuclear detonation events. He d escribed how this research identified ambiguity in the way people inter preted the term shelter in place and that it was necessary to move beyond using that phrase and come up with alternatives, which have since been adopted by CDC and other agencies; determined clearly that people want to hear from individuals and agencies that have high credibility on health ssues because most people's concerns center around health issues; found i that people are very resistant to the idea of sheltering if they are not con fident that their children are being well cared for in schools; and identified that there was no guidance on what people should do if they are in a vehicle during one of these events, findings that CDC put into practice (i.e., in guidance on what to do "if you are in a car, bus, or other vehicle during a radiation emergency")
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From page 65... ...
These new tools range from CDC's guidance on what to do if in a car, bus, or other vehicle during a radiation emergency to Ventura County's unique communication initiative (which is described in detail later in this chapter) to the recently released A Decision Maker's Guide: Medical Planning and Response for a Nuclear Detonation (HHS/ASPR, 2017)
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From page 66... ...
A third gap is what Becker described as the desperate need for a communication strategy and messaging tools for areas receiving nuclear incident evacuees. Becker pointed to the Fukushima Daiichi experience to illustrate the importance of such a strategy and such tools.
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From page 67... ...
Becker said that survey studies carried out not just in the United States but around the world have found that responders express a lower willingness to be involved in dealing with radiation events compared to most and sometimes all other types of incidents. As just one example of these many studies, Becker mentioned Veenema and colleagues' 2008 study on hospital-based nurses' willingness to respond to a radiation emergency, where a majority of nurses indicated that they were willing to respond at least some of the time, but more than 15 percent said that they were unwilling to work in any of the more serious radiation event scenarios (Veenema et al., 2008)
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From page 68... ...
. Some people living outside the prefecture have declined to work here due to concern about radiation, said Mitsuhiro Hayashi, head of the facility." Even 7 years post-disaster, while the number of medical doctors in Fukushima had finally reached and even exceeded pre-disaster levels, regis tered nurses, public health nurses, care workers, and clinical psychologists had still not returned in significant enough numbers to be able to fill avail able positions (Ohto et al., 2017)
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From page 69... ...
For preparedness to improve, it is essential that these gaps be addressed urgently. WIRELESS EMERGENCY ALERTS "How many of you believe you have received a wireless emergency alert on your mobile device?
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From page 70... ...
(2016) described a study where they tested 90-character and 140-character WEA messages and tweets alerting people to an unfamiliar hazard, specifically a nuclear device detonation scenario.
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. Perhaps the most significant finding, in Bean's opinion, which he con sidered both a benefit and a challenge of WEA messages, is their role in sparking what is known as milling behavior.
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. Second, WEA messages cannot currently guarantee uniform issuance, in terpretation, and response.
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From page 73... ...
report, "the WEA service needs to interface with social media to be relevant" (Griss et al., 2018)
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The National Academies have been producing reports on risk commu nication for many years. Fischhoff mentioned one, Improving Risk Communication (NRC, 1989)
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From page 75... ...
For many of these risks, because there is so much p sychology, the hardest part is analysis, such as figuring out what few things can be said in a 90- or 360-character message that are relevant to the diversity of decisions that different people face. As an example of an analysis of one of these risks, Fischhoff mentioned a study that he did with his colleague Keith Florig on individuals' decisions that affect radiation exposure after a nuclear explosion (e.g., how urgently to seek shelter, when to evacuate)
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From page 76... ...
Risk Communication Advisory Commit tee, which he chaired. The book, Communicating Risks and Benefits: An Evidence-Based User's Guide, contains more than 20 chapters on different topics (FDA, 2011)
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From page 77... ...
Again he referred to FDA (2011) , where each chapter contains a final section on how to evaluate communication with no money, little money, or money commensurate with the personal, organizational, or political stakes riding on effective communication.
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From page 78... ...
He suggested that the model could be adapted for use in this context as well. A UNIQUE, VIDEO-BASED PUBLIC INFORMATION CAMPAIGN: VENTURA COUNTY, CALIFORNIA "What I have learned as health officer over the years," Levin began, "is that in a threatening situation, public health's responsibility is to tell the
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From page 79... ...
He met some classic great taglines: "Stop, drop, and roll," "Only you can prevent forest fires," and "If you drink, don't drive." Levin and colleagues wanted to define a tagline that was similarly memorable. Ventura County Public Health worked with Wieder and the uclear N Radiation Communications Working Group to come up with the tagline "Get inside, stay inside, stay tuned." Its advantage, Levin noted, is that it is alliterative.
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From page 80... ...
Although he was concerned that Los Angeles County would request that it also needed to have a public information campaign to launch at the same time, making the release of the Ventura County program dependent on Los Angeles County developing its own program, this did not happen. The biggest obstacle was locally appointed administrators, who obstructed the effort until a top appointed official in the county requested that they clear the way.
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From page 81... ...
Improving Local Preparedness: Moving Forward Levin described several steps to continue to improve Ventura County preparedness for a nuclear explosion. Promote "Get Inside, Stay Inside, Stay Tuned" First is to advance the level of knowledge of "Get inside, stay inside, stay tuned" by requiring health-related PSAs among the trailers in movie theaters.
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From page 82... ...
Changes Since Ventura County Launched Its Public Information Campaign Ventura County's nuclear explosion public information campaign was based on one, two, or three devices of 10–15 kilotons. The increased power of the nuclear devices that characterize the North Korea threat significantly increase the expected number of deaths and casualties.
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From page 83... ...
So at 1 a.m. on January 14, in what she described as a "very rare social media posting," she posted the following message on her public Facebook page: In the case of a nuclear threat -- Get Inside.
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From page 84... ...
were not written for state actor events, "Get inside, stay inside, stay tuned" is nonetheless consistent. More recently, in Protective Action Questions & Answers for Radiologi cal and Nuclear Emergencies, EPA (2017b)
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During the false alert in Hawaii, people looked to social media for information. But there were no messages for a nuclear detonation scenario ready to go, at least not for social media, Wieder said.
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, which unlike other annexes includes a whole series of public information tools that was added in 2016. Moreover, in 2018, the annex was updated with the social media messages for a nuclear detonation scenario that were devel oped after the Hawaii false alarm.
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From page 87... ...
DISCUSSION WITH THE AUDIENCE Following Wieder's presentation, she, Becker, Bean, Fischhoff, and Levin participated in an open question-and-answer period with the audi ence, summarized here. "Get Inside, Stay Inside, Stay Tuned" -- But What Exactly Does Inside Mean?
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From page 88... ...
He commented on how beautifully crafted and well-researched messages so often get filtered through news media and social media and are often lost in translation or amplified. He imagined a medical correspondent breathlessly
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From page 89... ...
In addition to looking at what happens when false messages are issued, he called for more research into how to ensure authentic messaging and how to rapidly correct a situation when a false message is issued. Developing New Communication Strategies Erik Caull, Applied Research Associates, mentioned a project at Stevens Institute of Technology called Reinventing Civil Defense that focuses on nuclear risk communication, specifically how to reach millennials and other people who are "glued" to their cell phones.
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From page 90... ...
He added that there is also a need to practice when things go wrong on how to recover. Without practice, he said, "we are really not going to be adequately prepared." Prioritizing Nuclear Safety Messaging David Snyder, local elected official and chair of the National Capital Region Emergency Preparedness Council, commented on the competition for time with first responders, with public information officers, and with emergency managers.
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From page 91... ...
But we recognize the need for it." Also, as a way to compete with various groups' attention, Wieder sug gested using "Get inside, stay inside, stay tuned" as an all-hazards message not specific to nuclear detonation. It could save a lot of lives in a number of different types of situations.
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From page 92... ...
He added that another lesson learned from Fukushima Daiichi was that even professionals with some past training wanted just-in-time refresher train ing that was not generic but informed by the specifics of the event. There was a radiation emergency assistance team on the ground in Japan that put together such a training.
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