2019 Resolution: Create Your Crisis Communication Plan - Transcript

Moderator: Haley McCalla
Presenters: Kellee Waters, ABJ, CDC EPIC
Date/Time: December 19, 2018, 2:00 – 3:00 pm ET

>>Good afternoon. I am Haley McCalla. I am appointed to the CDC EPIC. Thank you for joining today’s webinar titled 2019 Resolution: Create Your Crisis Communication Plan. Today, we will hear from CDCs Kellee Waters. If you do not wish to be recorded, please exit at this time. You can earn continuing education by completing this webinar. Instructions can be found on our website. Www. emergency.CDC.gov/epic. The code is EPIC1219 with all letters capitalized. To repeat, the course access code to receive continuing education units is, EPIC1219. Today’s webinar is interactive. To make a comment click the chat button on your screen and enter your thoughts. To ask a question please use the Q and a button. The Q&A session will begin after the presenter has presented. Closed captions are also available for this webinar. Details on how to view closed captions are on the screen and in the chat box. We are fortunate to have our colleague, Kellee Waters, as our speaker. She supports the emergency risk communication branch, which oversees the CERC program. She has over 15 years’ experience in public health communication. She has provided support during emergency responses to H1N1, Ebola, Zika, the 2017 hurricane season and others. Previously, she served as an editor, media liaison, and public information officer to both internal and external partners including congressional correspondence. She currently leads the CERC program and has conducted numerous trainings on the subject matter. Thank you, for joining us. Please begin.

>> Thank you. Good afternoon and thank you for joining. As was said we will talk about crisis communication planning which is part of our crisis and emergency risk communication curriculum. As part of this, we will talk about it in terms of New Year’s resolutions. Making Crisis Communication Planning something that you aim to do in the New Year, to be prepared for anything that may come at you. In 2019, what do we want to do? We promise we will eat healthier, exercise more, we all have resolutions to do things personally and professionally to be better people, better employees and what we want to encourage you to do is be better prepared to communicate in emergencies. Before we do that, we want to look a little bit at communication so you have a foundation for what CERC is or the context of Crisis Communication Planning may include. If you’ve already taken CERC training then this will be repetitive. I appreciate your patience. If you have not taken CERC training, then at the end of the webinar, we will connect you with resources for more information. We offer in-person trainings and online training on our website so you can get more information if this basic overview doesn’t give you enough detail. I want to give you some of the highlights of what CERC entails. To begin, CERC principles, in a nutshell, help you provide information to people to make the best out of a bad situation. A crisis by definition is not going to give you the best options. You won’t have the best choices to make. You will have challenging time constraints and people have to make the best decisions they can within those confines. The perk of CERC –I don’t mean to rhyme—We have the expertise. We know some of the best ways that people can make those decisions to keep themselves safe and get themselves out of harm’s way, to minimize the damage to themselves and their health. CERC gives guidance on communicating that guidance well. The right message at the right time from the right person can save lives. That’s what we are aiming for. If we can get people the right message—what we say at the right time, when we say it—that’s crucial. From the right person, who says it. In our case it may not be CDC it may be another federal agency. For those listening, it may not be your organization; it might be a local community member that will share your message. Someone who has more credibility. The combination of these three things can help save lives. It can help people hear a message, understand a message and accept a message so they will act on that message. CERC has been around since 2002. It’s been revised based on the additional experience and the lessons learned from recent public health emergencies including Ebola, Zika and things you may have heard of in the headlines. What we’ve done since the initial concept was drafted is hopefully make shorter resources. We’ve tried to build a framework you can access with more conveniently during an emergency. CERC boils down to the six principles. The first principle, be first: it doesn’t mean you have to be first to say anything. It means be first with information that is in your lane. If we are the CDC, it’s our responsibility to be first with public health information, guidance that can improve people’s mortality and morbidity. The outcomes of their well-being in an emergency. It doesn’t mean we compete with the reporters and everyone with a camera phone. Don’t feel the pressure to be the first to say anything, but if it’s in your lane and you are the expert in that field and in your area, it is your responsibility to be first when people are looking to you for information. You want to be right but you don’t want to wait to say something. To be first and be right, say what you do know. You can say what the circumstances are. You can explain what you are already aware of but you can also say what you don’t know. You can explain what information you still need to gather and explain the process to people. That’s how you are right: including people because it’s not your response, it’s their response. Part of being right doesn’t mean you know all the answers, it’s telling people what you know, what you don’t know and what you are doing to get answers. That leads to being credible. We want to tell the truth. That should seem intuitive. We say things like “it’s going to be okay” when we don’t know that it’s going to be okay. That’s a vague statement. We may say things based on speculation that we can’t backup by data. It’s not that we are lying intentionally but we want to be careful to be credible in a crisis. We want to say things we know we can confirm. We also want to express empathy. The reason this is included is because while we are a professional organization, the circumstances of a crisis are different than everyday circumstances. You are dealing with people who have been emotionally compromised to accept messages. They’ve experienced loss, they’ve experienced disaster and destruction. They need to understand that you understand what they’re going through before they can listen to your message. Expressing empathy is putting into words what people are feeling. It saying, “We understand this is a scary situation. We understand these are uncertain circumstances.” Putting into words, identifying what people are feeling shows you are paying attention to what they’re feeling and you are really listening and in the moment with them. Which leads us to promoting action and this is what CERC comes down to. The point of communicating in a crisis is to encourage people to act in their well-being. We want to give people meaningful things to do that will protect their lives, that will keep them healthy, that will keep them safe, that will help the community work towards rebuilding. Promoting action is a win for us but it’s also a win for people who have been affected in an emergency. It can help to distract, not remove fear or anxiety, it can help to distract from the upset they’ve gone through. Rather than just sitting and waiting for others to do for them and worrying about what they’ve lost and lingering on how bad the situation is, they can participate in their own recovery. Promoting action is extremely important and really what CERC is all about. The sixth principle—I really wish it wasn’t; it should be intuitive. It’s something we like to put out there as a reminder: show respect. It’s important for everyone in a crisis to show respect because people get distracted by their own tasks. Responders are so focused on what they need to do. They are focused on their next assignment, their next task, their next community, their next—what they are there to help with. While the intentions may be good, there needs to be a respectful manner in which all of this work is done. People who are affected by a crisis also may not show respect to each other. They may be focused on themselves, on their losses and their family, just on their immediate circle. It’s good to encourage people to help their neighbors and check on their neighbors, to work as a community. This does encourage community efficacy and helps rebuilding. All of these principles combined—don’t memorize them, but keep them in mind. It will really help the crisis communication planning come together and will help crisis communication flow throughout a response. A CERC rhythm is something that applies to every crisis, no matter if it’s two days, two weeks, or in some cases, two years. Preparation is what you are doing right now. You are taking a class. It’s learning about how to do things well. It’s what we will talk about developing a crisis communication plan or revisiting one you already have to make it better. You can draft messages and test them. You can develop new partnerships or update the partners you have. Preparation is what we are doing today and what we are discussing today. The initial phase of the rhythm is when a crisis happens. It’s right when the crisis happens. You will see ”express empathy”, “promote action”, that’s where CERC principles come in to play. If you have not done anything to prepare, you will find yourself struggling to get started with your response. The maintenance phase is something that happens with every crisis, no matter how long. The length of a maintenance phase can become interesting. If it’s a shorter response, your maintenance phase will give you some opportunity to find out more information about the crisis, get more background on what happened to provide the information. A longer response, the longer the maintenance phase is the more questions will arise. People ask things like “Whose fault is this?” “Could it have been prevented?” Your response is going to get critiqued. More rumors may surface and you will have to address those. The resolution phase is what it sounds like. The community is settling into a new normal. They are becoming resolved to the new situation, post-crisis. This is a really good time for your communications to focus on lessons learned while things are still fresh in people’s minds and to incorporate those lessons into your crisis communication plan, if it helps you to revise that and make it better. What you see throughout is engaging community. Your community needs to be part of the response always. Responders are experts in the field of emergency response, but we need community members to tell us how they receive messages, how they hear messages best, what we need to be doing to speak to them, what their needs are. We need them to take action and to do that we need to empower them to make those decisions. Evaluation used to be the fifth phase of the CERC rhythm and now it’s at the top because it’s something you should be doing all the time. Evaluation is necessary so that you can change, if something is not working you need to reevaluate, readdress, and make it better. With the basis of CERC in mind, again that was an extremely brief overview, we’re going to talk about incorporating that into a crisis communication plan. A crisis communication plan in the preparation phase is important because you need to understand what your organization would do when a crisis happened. If you have a crisis communication plan—if you know you have one, you know what it says—has anyone read it? Does it have three inches of dust on it? Are all the communication contacts listed in it retired? The point of a crisis communication plan is not to do this once, and put it on the shelf, and save it as something you’ve done. The point is to be something that’s active, a living document that you can just grab when an incident happens, reference quickly for your basic needs and a communication response and be able to use. It’s not meant to be complicated, and it’s not meant to give you more paperwork. It’s meant to be helpful. It’s meant to be a really useful tool to anyone working on an emergency in your organization. You plan for the crisis to understand what the best practices are, for engaging with your stakeholders. You do that by understanding who your stakeholders are. You want to be able to list those people. You want to understand who you are talking to in your community by understanding what types of messages those audience need and what language, what types of messages they are going to hear whether they need to be written or visual. To make sure this is something that is readily available whether it’s having copies that you can pass out or having a website that is easily accessible, making sure your plan is something anyone working on your response can get to quickly. Your plan should be realistic. Realistic means if you live in Florida, for example, you probably want a crisis communication plan for hurricanes. It’s something you are likely to have to deal with if you live in the Midwest, perhaps you have a crisis communication plan for tornadoes. But maybe not the opposite. If we live in an area that’s not affected by severe weather, we don’t necessarily have to deal with developing a crisis communication plan for those particular events. Your plan should be realistic for your area, those things you’re probably going to have to deal with—things you’ve dealt with on a regular basis. However, it should also account for worst-case scenarios. While we may not account for alien invasion, maybe accounting for that worst-case, 12-foot snowstorm where power is out for an entire week, and there is no salt to cover the roads. We are thinking about worst-case scenarios of realistic situations. I hope that makes sense. And then, knowing what to include, knowing your area. You are experts on where you respond. You know your communities—who lives there and what language they speak, the socioeconomic levels—you know your resources. You know who your partners should be, and those are the things that should go in a plan. We’re going to talk a little bit more about that in a second. The plan should be a resource for necessary information. It doesn’t need to be complicated. This is as developed and detailed as you want it to be. You can have a plan that is for all hazards so it covers the gamut from natural disasters to infectious diseases. It can list all of your contacts in all of those situations. Or you can have specific plans for specific incidents. If you know you live in an area that’s affected by particular natural disasters, you could have an all hazards plan and one that is specific to a hurricane, a tornado, or an earthquake. This is meant to be useful for your organization. Again, this is something that’s helpful. It’s a tool —it’s not meant to make your life more difficult. It should be kept current, though. If you write this plan and don’t readdress it, you’re going to have outdated points of contact, outdated messaging. If you are going to use it and do it, it needs to be updated on a regular basis. What to consider when you are writing a plan: these are the things I said you should think about including. What you want to include is a scenario. This is what we mentioned when I said you can consider an all hazards plan or you can consider doing a specific crisis. That would be your scenario. If we were to have a hurricane and it was a category 5 and we were to have record flooding: that could be your scenario. Then we would do the following, that could be your scenario. You can make that as broad, affecting the whole state, affecting your region, again, it’s what is useful to your organization. With your community goals—I’m sorry—with your communication goals—you really should list those out. Your communication goals are to prevent illness and injury, but specifically for that hazard, what are your communication goals? They should be listed out. Your key assumptions are things you want to identify and consider as you are developing a plan. They should also be changed as the plan evolves. For example, your key assumptions are certain things about—maybe you have an infectious disease outbreak, and people are showing symptoms that are flulike. A key assumption would be that maybe people wash their hands and cover their cough. But the scientific knowledge will change. Your knowledge of the situation will evolve, so your key assumptions will change too. Key assumptions are also your resources. Your resources and partners are also key assumptions. Those are things you want to list. Your messages are where you can have precleared, pretested messages available that can be tailored specific to any crisis. If you have a pretty aggressive or just a standard or regular flu season every year, then it’s reasonable to include flu-type messaging in your crisis communication plan that you can pull from and just tailor when a flu-type crisis arises. You can and should make it specific to that event but you already have some language to go on. You’re not working from scratch on everything. Your spokesperson should be listed, and you will see it says “spokespersons”. You will have people who aren’t available, they themselves are affected by the crisis and cannot make it and because of the crisis. Their house is underwater. The car is under a tree, so identify a spokesperson and identify a backup to the backup to the backup. That’s what the crisis communication plan does. It considers all of these contingencies so you are ready in crisis. What you want to consider with your crisis communication plan is the audiences your organization might have to speak to. You’re going to want to consider the languages people speak. How many languages will you have to have your messages translated into? Consider the demographics of your communities: race, religion, education, socioeconomic level are all really important. These considerations inform how you develop your messages, how you communicate, and they will determine whether your messages need to be more visual versus more content written out, heavy. They will determine how you reach people in your area. Is it more valuable for people to get messages from an authority figure, from the public health department or from their local pastor? Is it more valuable to hear from a spokesperson they know and trust? All of this is to help people accept these messages so they will be willing and able to take action. When you are able to identify those audiences, you need to consider how you will get those messages out. For the same reason, you want to make sure you are getting the messages out through the right channels to make sure that everyone who’s been affected by a crisis is hearing the messages they need to hear to keep themselves safe and healthy. As with audiences, how you would disseminate messages depends on your community. Do people prefer messages through traditional channels or through social media channels (more updated, current channels)? There have been responses in the past where we have been really lucky in using social media at CDC to disseminate messages very quickly to large mass audiences. There are also communities—for example we worked in Flint, Michigan—where a lot of the community was extremely personally active in sharing messages through church meetings, face-to-face meetings and flyers and handouts and townhall discussions. It just depends on how people like to receive their meetings, and that’s something you should know ahead of time. That’s why in the crisis communication plan you should be aware of your community and their preferences. The messages, when you do consider these channels, you have to consider your staff. How are you going to do this? If you do a hotline make sure you have the resources to staff the hotline. If you offer something here—you don’t have to offer anything—you don’t have to offer all of these things, you can pick and choose what works for you community, but you need to make sure that you are able to manage the choices that you offer. If you offer a hotline, you need to make sure they get updated messages. You’re going to need to make sure you have staff to run the hotline—is it a 24/7 hotline? Those need to be considerations and part of your communication plan. The same goes for social media. You probably shouldn’t have all of the handles monitored all at once—a crisis is very time-consuming. Choose the ones you can manage. As with everything discussed, you may have the capacity to choose all of these, which is wonderful. You may only have the capacity to choose a few, and that’s fine. Your partners can be extremely helpful in this capacity. Your partners as communication channels—getting them to help you share messages will help things go much further. They can serve as a spokesperson, as well. They can be a trusted resource for spreading your message. The CERC chapter on developing crisis communication plans is posted on our website, and it offers more detail. It gives you more reference points for what you can consider including in a crisis communication plan. There are also tools and templates out there to help you further. There are some examples of crisis communication plans floating around the web. CDC actually has some posted on the Internet too that you can look at. There are local health departments including the California Department of Public Health crisis and emergency risk communication toolkit. It’s a great resource to look at to see what they did at a local level to develop a crisis communication plan. There are a lot of resources. It would take way longer than this webinar for me to list them all for you. I would like to show you some resources that are available. Our CERC website has resources and tools that can help you develop a crisis communication plan, a template, and our manual. They are no longer listed by number: the crisis communication plan chapter includes information on how to develop a crisis communication plan in more detail. If you have questions after this webinar—I’m happy to answer questions in a moment—but if you come up with a question you didn’t have time to ask or forgot to ask, you can always email us, and we can try to help you that way. These are some resources to help you. This is just to make sure that when 2019 comes, your organization is prepared and ready for anything that may come. Haley, I’m ready to take questions if you would like to ask them.

>> I will give people a moment to enter questions in the Q&A section. As of right now, we don’t have any questions.

>> Okay. What I can do then is try to show you a sample of what a crisis communication plan looks like if that’s something that would be helpful. We will wait for questions, if anyone has any, I am happy to answer them now. If not, please do send them to that email address that is in the slide deck. The sides will be posted on the website with the webinar, and they will also be available in the invitation, I think. Let me do this very quickly. Okay. I’m going to share quickly. I’m sorry for a bit of a mess here, what a crisis communication plan might look like. This is a very rough template. Please forgive the roughness of it, but it’s something that we use to do exercises when I teach a live CERC course. We detail the hazard that might affect your area. It’s something that might be local to you. It could be all-hazard. It could be specific. It could be a natural disaster. It could be infectious disease. It could be a bad flu. It could be anything. Communication goals, again, those are what you are after. Those are the actions that you want to promote. Your communication should be promoting action and you can list those there. The key assumptions, again, that’s where you want to list things that you already know and things that you have. The resources and things that are available to you. When you look at the messages, knowing that you are going to have to update them and knowing that you’re going to have to tailor them, you can still guess for every hazard the things that people might be asking. Based on previous hazards that you’ve worked on, the things people have asked before: so, “who is in charge?” “What are they doing to investigate?” “What are the health authorities doing to address the situation?” “How concerned should the public be about the situation?” “What are the risks to the community?” Other things: “What should our family do?” “Are we safe?” “Whose fault is this?” Some of these answers you may not have, but some of them you might. You can anticipate some of these questions based on previous emergencies that you’ve worked on and things that you yourself, as a community member, would want to know. Audiences are the people that live in your area, the people that travel to your area, the people that work in your area. These are the people you will want to talk to. As you can see, we have listed several examples here. You’re going to be able to talk to—we’ve broken them down by categories, but several of these will overlap. That’s good news because if you talk to people who work in the travel industry but they also live in the area or community organizations, people who are in schools and faith-based organizations who also work in the medical field, you’re hoping that every message that gets to these different audiences is the same message. They are hearing it at the same place. They’re hearing the same message at all of these different outlets from all these different places. Clinicians, healthcare providers are getting the same information as public health officials. They are getting the same information as the travel industry, and they are getting the same information as all of your partners. This is not an inclusive list. You can definitely expand on this. This is a template. It’s just an example. Some examples of primary communication channels: traditional channels, media, newspapers, television news, or social media websites, radio PSAs, etc.. I think we have some questions.

>> We do have some questions. Some of these are questions outside the scope of the presentation. If we don’t get to your question here, we ask that you send it to epic@cdc.gov, and we can follow up that way to connect with the experts within CDC who can answer the question. This comes from Julia. “What’s your advice about communicating to a church congregation, many different types of people, educational levels, etc.?”

>> We’ve done this in several different emergencies in the past couple of years. That’s why we changed our CERC manual to include an entire chapter on community engagement. What we ended up realizing was that our highly scientific and highly technical strategies for communication using social media and traditional media channels wasn’t covering the gamut of people who needed information in a lot of our emergencies. We started going out into the community, doing outreach, doing in-person, face-to-face public health awareness campaigns and realizing that some of our content or materials were too content-heavy. Making images more visual—less words, more pictures—speaking with those spokespersons, getting buy-in from the community like getting pastors to help share our message and helping them understand the messages so that they would be willing to share them. It’s challenging if there is not an understanding. Like I said in Flint, Michigan, “orthophosphates” is the term for what was preventing the pipes in the Flint water system from protecting people from being exposed to lead. It’s an extremely scientific word. It was on a lot of flyers. It was very confusing. Sitting down and explaining some of the science, making that more clear but also having a conversation, showing up. We actually came to some of the Sunday services. We actually showed up and said, “We’ll answer some questions if you aren’t understanding.” Getting communities’ spokespersons to share the messages, but when there are questions, also offering to show up and be an SME and say, “If you have questions, we’re here.” Hosting a town hall or meeting in the community where you make yourself available to clarify those issues. We’ve done all of these things in several different types of responses that I’ve participated in the past few years, specifically because that gap was there, and we were getting—we were seeing it impacting people’s actions.

>> Thank you, Kellee. Another one. “What were some of the lessons from the 2017 hurricane season?”

>> The 2017 hurricane season actually might be better answered by Jonathan. He was more of a participant in it than I was. I was involved in some of the communications. I was doing more CERC trainings out-of-state, while the responses were going on. I’ll actually punt that to Jonathan.

>> I will take that back. A very large number of lessons that could be two whole webinars to answer that. I would say the biggest lesson is the need to plan ahead for communication breakdown. When all the electronics—all the electronic methods of communication are down, and you’re going to wind up printing millions of documents and distributing them to people physically just to help inform them on how to stay safe. For me, at least, from my limited perspective on that, it’s the need to plan ahead to have that capability. Okay, we’ll go on to the next question. Kellee, can you discuss again the key assumptions and considerations for a CERC plan?

>> Key assumptions are things that you already know, things that you already know about your organization, things you know about where you live, things you know about your partner organizations, things that you know about your resources. For example, you know you have access to a dozen walkie-talkies if all the power goes out. You know that you have gas-operated vehicles and access to a route to pick up staff as long as everyone’s okay, to get everyone to the emergency operations center via this route within 24 hours. I’m making this up as I go along right now. It’s things like that, it’s things that you know you have access to, people you know you have access to, and the things you already know about a situation that will be useful, in that situation. Where you get into points of contact, etc. there’s a list—we didn’t get all the way down there—but you can list those out and more specifically but key assumptions are things you are already aware of about a situation like this.

>> The next question. “Do you have specific resources for planning a nursing home situation or just in general how can one find resources for making communication plans for different types of scenarios?”

>> I wish I had a better answer for you than this. There are so many out there: Google. Like I said, we have templates but ours aren’t specific to — the template I showed you is our template. It’s not filled out because it’s meant to be an exercise. It’s meant to be something we do with different organizations. It’s meant to be different for every organization, so every organization has to tailor their communication plan to fit their needs. As far as we go, it’s not something that we have on hand. I did read out to you, for example, the California Department of Public Health developed their own crisis emergency risk communication toolkit. It’s extremely helpful. It’s something you might want to look at. There are other resources out there. They are online, and you really would just have to do a little bit of a web search for them. I wish I had a better answer than that.

>> I will field this question from Emma. She asks, “How do you integrate communications for people with access and functional needs?” Emma, this is actually a large part of our planning ahead of time. This webinar, for example, we arranged for closed captioning with a provider who can offer that service. It takes, and you can find some guidance by looking up Section 508 compliance requirements. For example, you can make sure that you do have some form of closed captioning for video. You can make sure that you have on webpages, you have alt-text and things like that. These capabilities will add to the ability for people with limited access or the ability to only perceive one modality of communication. This will enable them to perceive the communication from another modality. I would say that if you’re doing it at the moment of an emergency, it’s too late. Have documents made ahead of time and have variations of those documents. For example, it may be something that’s printable, or it may be a PSA that you’ve already recorded. You have some basic information, some basic products already ready so when you need to share them through different channels that work for people with limited access, you will be able to do so. You can find a lot of those kind of documents on the CDC website.

>> To expand on that, in two ways, what our group does—the Emergency Partners Information Connection does outside of emergencies is build partnerships with organizations that can help us reach out to populations that may not get information through all the traditional channels. That’s a really important point that I want to emphasize for your crisis communication plan. It’s identifying those partners in your community who can help you reach out to those populations. For example, Meals on Wheels, YMCAs, any kind of hearing, visual impairment societies, things that are established specifically to reach out to communities with tailored needs for communications. Plan those partnerships. Build those partnerships now. Plan them into your crisis communication plan. That would be part of your pre-crisis planning, when I talked about rhythm. Also, do educational events in the pre-crisis phase so that you can go to these communities and express what your resources are, who you are, what you have available so people can get themselves prepared.

>> Let’s go to Skip’s question. “What’s the best way to determine the scope of the communication plan? Or how far outside of your agency should it reach?”

>> The communication plan should be what your agency will do. You should know what your roles will be within your specific group. That said, you should be aware where you fall inside of an emergency that gets bigger. If it’s something that happens again—it’s all hypothetical—it happens at the county level, know where your organization falls within the county level. If it becomes bigger or citywide, know your role. Know how you will contribute at that level. It should outline what your role would be and who you would report to. But, it doesn’t have to include the role of everyone else. It doesn’t have to be that specific unless you want it to be, unless that is helpful to you. You don’t have to write out the structure of a response at every level, no matter how big it gets, because that could be confusing and cumbersome. It could be an amendment or an addendum to your crisis communication plan, but the core plan should be the communication efforts of your agency.

>> We’re going to go on to Matthew’s question. Kellee, if you don’t mind, I would like to make one comment before you answer. I think I have a good answer for Matthew. “Can you share your experience on how to make a communication plan prep a positive experience in an organization and something that stays alive? In my experience, it is that thing no one wants to do, and once someone finally volunteers, it stays something nobody really wants to look at.” Matthew, the act of putting together a plan in and of itself is enormously valuable, even if you never go back and look at it. I’m not saying you should do that. Even if you never go back and look at it, the act of writing it down on paper, thinking through every little step—that means you’ve thought through your channels, who your audience is going to be, you’ve made new partnerships so you can reach those people. It compels you to do the prep work that you need. If you’re the one that wrote the plan, you may not have any need to go back to it because you already know what the answers are because you figured them out ahead of time. But, if you’re not the person who wrote the plan, and someone new is coming in, they very definitely should read the plan because they won’t have those answers.

>> Okay, to piggyback on Jonathan’s answer. The reason the plan should be developed and the reason the plan should be updated on a regular basis is because the process of doing so—like Jonathan said—is hugely beneficial. Putting you in contact with those partners, keeping you abreast of the latest messaging and the latest points of contact. It’s the process in and of itself that’s just as beneficial as having the plan. For someone who is not part of the process, depending on how you organize it and how you make that plan accessible, ideally someone who is acting as surge staff or who is supporting your response could just grab that plan, flip to the page they need, and see the media contacts they need to reach out to. There’s the messaging session—these are the messages on how to prevent the spread of flu or the messages on Tamiflu. However accessible you make that plan, they should be able to grab it, flip to the page they need, and use it.

>> We’re going to go on to a question. “Thanks for an excellent presentation. Do you have any specific examples of issues that have arisen due to being insensitive to local concerns and expertise? Dover —

>> What?

>> The Pro from Dover syndrome? I don’t know the reference. I apologize.

>> I don’t know the reference either but from being insensitive to cultural needs, yes. We’ve had that happen a few times, which is why—not specifically CDC, but we’ve come across several responses of not understanding what the community needs were. For example, when we had several staff deploying to Africa to deploy for a response to Ebola between 2014 and 2016, there was a misunderstanding about the importance of funeral rituals. They are very hands-on and personalized. Unfortunately, Ebola is extremely contagious even after someone has passed away. They were also key in the Ebola outbreak spreading because of the nature of the funeral practices. Us not understanding that and just communicating that people needed to stop touching, that people just needed to follow these specific health practices and do what they needed to do wasn’t helpful. We really needed to understand the culture and the history. It’s thousands of years—well, maybe hundreds—of ritual and respect for the loss of a loved one that we are coming in and saying, “No, do this instead.” That’s not something that is typically well received. You lose a lot of credibility. That is one of the reasons, not the only, but one of the reasons why our community engagement chapter was crafted. It’s something that now we consider in all of our messaging and consider in our planning, making sure that our partnerships will be able to reach out. Another part of how we responded to that wasn’t just changing our messaging or our activities but also working with local tribal chiefs, medicine men, and local ministers to have them explain the importance of the messaging because we didn’t have the credibility in the community that they did.

>> Okay, this will be our last question because we are running short on time. If we don’t get to someone’s question, please send the question to epic@cdc.gov. We will try to follow up. This question is from Frank: “What do you do to validate and maintain your plan? Do you conduct exercises specifically for the plan? Do you draft reports from various incidents to update the plan? Both? Other?”

>> Both. We are fortunate in that we have the ability to run a couple of exercises a year. We are also unfortunate in that we are seemingly always activated. We are always doing after action reports. We are always observing what’s going wrong and what could be done better. If you are activated, definitely take notes, go back to your plan, revisit it, and fix what’s wrong. If you aren’t activated very often, find time to practice. Find time to exercise. It’s helpful to do it if it’s just your organization. If it’s just your organization, great. If you’re able to do it with some of your partners or plan and exercise with partners in your community, at the county level or city level, that’s even better so you can see how those partnerships will suss out and how you will coordinate messages and make sure you are seeing the same thing or that whoever is taking point on the right messaging. So, both. It’s also revisiting it as needed. If you know that a key point of contact has retired or has left, going ahead and making that change. If you know that a key bit of science has changed. We are learning a lot about different diseases and outbreaks. If you know a key bit of information is different and recommendations have changed, go ahead and change that in your plan.

>> Kellee, we have time for one last question. I’m selecting this one because it’s very relevant to a lot of work that you have done. “As an outsider, for example, humanitarian providing aid in a foreign country: what are some strategies that may be helpful in gaining the trust of locals? How can that be addressed in a short amount of time given an emergency?”

>> It’s really, really helpful to work with already established groups. Both of my trips to Africa during Ebola, for example, we ingrained ourselves with the Red Cross that was already established there. With nonprofit staff that already had a presence on the ground, outside of the emergency. It was staff that the community members already trusted. People who spoke the language or people who already had connections with local community members. It’s making those connections to increase your credibility. Then, it’s explaining why you are there, why you’re there to help, what your purpose is, and it’s listening. Listening is a huge part of why you are there, not to tell them what you think they need. Those three things were really key in the success of my communications efforts in vastly different cultures. There were huge hindrances when not done appropriately.

>> Thank you so much, everyone, for a wonderful Q&A session. We’ll go ahead and wrap up the webinar right now. Thank you again everyone for joining us. If you have additional questions or questions that we weren’t able to get to, you may email them to epic@cdc.gov. Today’s presentation has been recorded and you can earn continuing education for your participation. Please follow the instructions found on emergency.cdc.gov/epic. The course access code is EPIC1219 with all capital letters. Thank you, again. Goodbye. [ Event Concluded ]