(CIDRAP Source Weekly Briefing) – Most people think about possible future pandemics—when they think about them at all—with a good deal of ambivalence. To communicate with ambivalent people, you need to understand the 'risk communication seesaw.'
Whenever people are ambivalent about something, communication happens as if on a seesaw.
Suppose I am simultaneously drawn to two beliefs, "X" and "Y," even though they are somewhat incompatible. I can't decide which side to come down on. Then you come along and insist on X. Immediately I start focusing on Y. I let you represent the X half of my ambivalence while I stand tall for the Y half—and at least for the moment I stop feeling ambivalent.
Ambivalent people, in other words, tend to have a paradoxical response to other people's opinions. If I have no strong opinion on X versus Y, I'm likely to accept yours. If I have one strong opinion, either X or Y, I'm likely to stick to it regardless of what you say. But if I have two strong opinions fighting it out inside my head, I'll probably lean toward the one you're neglecting.
Think of it as a seesaw. Once they have adopted this seesaw response, ambivalent people do what they have to do to keep the seesaw balanced. If you say X, I'll go for Y. If you say Y, I'll pick X. If your position is halfway between X and the fulcrum, I'll sit halfway between Y and the fulcrum. If you move closer to the fulcrum from your side, I'll move closer from my side. If you move out toward your edge, I'll move out toward mine.
People are very likely to be ambivalent about the risk of a pandemic. So when you're talking to them about a possible pandemic, it helps to know how to manage the seesaw.
The most fundamental pandemic-related seesaw is alarm versus reassurance. When the next pandemic arrives, will it be mild or severe? Before it happens, should I be complacent or should I start seriously preparing?
If your pre-pandemic communications are overly reassuring, ambivalent people will have the predictable paradoxical response: They'll get more frightened (and they'll lose faith in you). If your communications sound too alarmist, on the other hand, your stakeholders may end up contemptuous of the issue (and of you) and unwilling to take precautions.
Two strategies to try
Right now, while you're trying to arouse concern, you have two good communication strategies at your disposal.
The first strategy is to say very scary things a little too calmly. Remember, you're trying to alert people. You want to motivate them to take precautions and to support the precautions you're proposing to take. So you need to tell them scary things. But your audience is ambivalent about the pandemic risk. If you tell them scary things in an overemphatic, overinsistent, haranguing tone, they're all too likely to decide that you're just an alarmist with a pandemic obsession. So you know you have to locate yourself somewhere on the calm side of the seesaw.
In a nutshell: Give people the information they need to get more alarmed than you sound, so they conclude that you're not taking the pandemic risk quite as seriously as you should.
This strategy is fundamental to your seesaw dialogue with senior management. You're much better off if your boss keeps urging you to do more than if you're constantly urging your boss to let you do more. But it's also a crucial strategy for talking to employees, to customers, and to acquaintances at parties.
The second good pre-pandemic seesaw strategy is to balance on the fulcrum, to encourage your stakeholders to share the planning dilemma with you. In a May 2005 speech, for example, Australia's Tony Abbott, Minister for Health and Ageing, said: "If a deadly flu pandemic ever seems imminent, no preparations will be enough. But if the current bird flu outbreaks in Asia gradually subside, the government's investment in a stockpile [that is] likely to be time-expired in 5 years will be the health equivalent of a redundant weapons system."
Adjusting your location
Later, after your stakeholders are more concerned, you may want to relocate on the seesaw.
For example, suppose a pandemic strikes but it looks like it's going to be a mild one. You may need to keep people calm by giving them reassuring information. But your seesaw management expertise tells you that it would be a mistake to come across as too unworried. That would leave people alone with their worries. Instead of reassuring them, it could actually alarm them further.
That's the mistake Christine Todd Whitman made on Sep 18, 2001, one week after the 9/11 attacks. In her role as administrator of the US Environmental Protection Agency, she wanted to help people who lived or worked near ground zero feel that they could safely resume their lives. So she announced: "I am glad to reassure the people of New York and Washington, DC, that their air is safe to breathe…"
Two years later, the EPA inspector general criticized this statement as excessively reassuring, given the information available at the time it was issued. In reality, it wasn't reassuring at all, though clearly it was meant to be. In real time, New Yorkers responded to Whitman's over-reassurance by becoming more alarmed about air quality.
The seesaw-savvy solution when you want to reassure: Give people reassuring information—but do so while sounding not very reassured yourself. Give them the information they need to conclude that you're overreacting a little. Obviously, this is exactly the opposite of my advice when you're trying to raise some alarm. It's the same seesaw, but you're picking a different seat.
Lessons from a nuclear accident
In the days after the 1979 Three Mile Island nuclear power plan accident, for example, the Pennsylvania Department of Health was worried that radioactive iodine-131 (I-131) from the accident might contaminate local milk. In a series of news releases, the department kept saying that it was testing local milk for I-131 and so far the milk was clean, but it was still worried about possible future contamination and urged the public to avoid local milk for a bit longer. By the time the health department finally concluded that the local milk posed no I-131 risk, the public had long since reached the same conclusion. People were calmly waiting for worrywart health officials to catch up.
Alarm versus reassurance isn't the only pandemic-related seesaw. I'll talk about some others in my next column.
An internationally renowned expert in risk communication and crisis communication, Peter Sandman speaks and consults widely on communication aspects of pandemic preparedness. Dr. Sandman, Deputy Editor, contributes an original column to CIDRAP Source Weekly Briefing every other week. Most of his risk communication writing is available without charge at the Peter Sandman Risk Communication Web Site, which includes an index of pandemic-related writing on the site.