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OPRW 2018: Outbreak Communications · The SHEA Podcast

• 0:12
  SPEAKER_01: The Society for Healthcare Epidemiology of America today is pleased to present the podcast, Outbreak Communications.
• 0:20
  SPEAKER_01: Start of today's podcast series at http at 13c.5.org.
• 0:29
  SPEAKER_01: This podcast is moderated by Dr.
• 0:31
  SPEAKER_01: J.
• 0:31
  SPEAKER_01: Goodman Cotrel.
• 0:33
  SPEAKER_01: Dr.
• 0:33
  SPEAKER_01: Father at Oregon Health and Science First.
• 0:37
  SPEAKER_01: Dr.
• 0:37
  SPEAKER_01: Guzman Cotrel also serves as an infection prevention and healthcare epidemiology consultant for the Oregon Health Authority's HAI program and as its medical director for Ebola and Emerging Catholics.
• 0:51
  SPEAKER_01: She was appointed chair of the KCDC Outbreak Response and Training Program, ORTP, which provides U.S.
• 0:59
  SPEAKER_01: hospital epidemiologists and others with the tools and training needed to effectively handle the skilling level of the pandemic infectious diseases emergencies.
• 1:15
  SPEAKER_00: Today I'm joined by Dr.
• 1:17
  SPEAKER_00: Deku Rubin, an expert in infection prevention and doctor epidemiology.
• 1:29
  SPEAKER_00: Dr.
• 1:29
  SPEAKER_00: Rubin is a professor of infectious process and the medical director of clinical epidemiology and infection professors at the same time.
• 2:08
  SPEAKER_00: So Zach, let's get started.
• 2:10
  SPEAKER_00: One of your major roles at UCLA is serving as a clinical epidemiologist.
• 2:15
  SPEAKER_00: What does that role look like in your day-to-day work?
• 2:20
  SPEAKER_02: Well, thank you for having me, first of all.
• 2:22
  SPEAKER_02: Every day is a little bit different from the other, but I would say if you break down kind of my role over the year, the vast majority of time is spent really dealing with kind of the just endemic problems surrounding infection prevention, like central line associated bloodstream infections, catheter-associated UTIs, surgical site infection prevention, those kind of things, hand hygiene.
• 2:44
  SPEAKER_02: That is by far the biggest chunk of my time and working with my excellent infection prevention team to kind of identify ways to improve those rates.
• 2:54
  SPEAKER_02: Specific issues kind of related to this podcast, as far as outbreaks go, is a much smaller percentage of time for me.
• 3:01
  SPEAKER_02: So I'd say I'd spend probably 90% of my time dealing with kind of day-to-day endemic issues, and then about 10% of the time on outbreak investigations.
• 3:10
  SPEAKER_02: But for sure, over my career, I can say that the outbreak investigations are probably the most memorable part.
• 3:15
  SPEAKER_02: And that's the part that usually people are most interested in hearing about when I show up at dinner parties and things like that.
• 3:22
  SPEAKER_00: So some listeners who are new to the world of infection control, they might be thinking that a hospital epidemiology podcast focused solely on communication might be an odd topic.
• 3:33
  SPEAKER_00: What is the importance of effective communication in our line of work?
• 3:38
  SPEAKER_02: My thinking is evolved in this for sure.
• 3:40
  SPEAKER_02: So when I first came to UCLA about 12 years ago, you know, I think I had a pretty good basis in kind of the scientific epidemiology side of outbreak investigations and infection prevention in general.
• 3:53
  SPEAKER_02: So I felt like I had a pretty good grasp of the literature.
• 3:56
  SPEAKER_02: I kind of knew how to attack problems, but I hadn't really had a lot of education about how to communicate those kind of goals and activities out to other groups.
• 4:06
  SPEAKER_02: And I think I have a much better appreciation for that now, especially surrounding upbreak investigation specifically.
• 4:12
  SPEAKER_02: So it's important on a day-to-day basis to really be a good communicator as a hospital epidemiologist because for the most part you end up being kind of the shield for your infection prevention department to be able to do what they need to do in the hospital.
• 4:25
  SPEAKER_02: So being able to communicate and tell people why you're doing what you're doing is really critically important.
• 4:30
  SPEAKER_02: It's really acute in an outbreak setting.
• 4:34
  SPEAKER_02: So I think of communication being at least 50% of the outbreak investigation because without effective communication, the other scientific and technical parts of the investigation are not as effective.
• 4:47
  SPEAKER_02: Maybe I could give you an example.
• 4:48
  SPEAKER_02: Early on in my career, this is one of the first outbreak investigations I ever dealt with.
• 4:52
  SPEAKER_02: There was a kind of affiliated, but not a UCLA urologist who contacted me and asked me to come and investigate an outbreak of pseudomonas, urinary tract infections, and bloodstream infections after stystoscopy.
• 5:04
  SPEAKER_02: And I came in and I felt like I knew exactly where to look from a scientific standpoint.
• 5:09
  SPEAKER_02: You know, there were kind of a number of different papers out there in the literature with similar outbreaks.
• 5:15
  SPEAKER_02: I felt like I had a pretty good grasp from the beginning about what to look for and where the problems may be from kind of a technical standpoint.
• 5:23
  SPEAKER_02: But it became immediately clear that I was walking into a somewhat kind of dysfunctional clinic and people were kind of blaming each other.
• 5:31
  SPEAKER_02: There was a lot of finger pointing going back and forth.
• 5:34
  SPEAKER_02: And when I walked into that, I think I could have probably done a better job from the beginning at kind of setting expectations, and I think that would have helped me in the end.
• 5:42
  SPEAKER_02: So even though I knew the technical aspects of the outbreak fairly quickly, I understood them fairly quickly, I think actually being able to implement strategies to mitigate those problems were hampered by the fact that people weren't always on the same page as me.
• 5:58
  SPEAKER_02: And I think that really was a very obvious lesson that I took away from that event, which was you know you have to really communicate effectively from the very beginning if you want to really, I mean, not only save yourself some time and pain later on, but also effectively deal with the outbreak.
• 6:15
  SPEAKER_02: From then on, I've kind of concentrated on the communication a lot more.
• 6:19
  SPEAKER_02: I can say that I think I'm a lot better now than I was, but it's still something that I I learn on every single investigation to do a little bit better.
• 6:27
  SPEAKER_02: After twelve years, I think I'm decent at it, but I still have some room to grow there.
• 6:32
  SPEAKER_00: Yes, absolutely.
• 6:34
  SPEAKER_00: I think with all successes and hiccups along the way as leaders of infection prevention, I think we all learn from these experiences over time.
• 6:42
  SPEAKER_00: Leading an outbreak can be an exciting but definitely a daunting task.
• 6:47
  SPEAKER_00: Who is involved in your communication structure?
• 6:49
  SPEAKER_00: And how do you get these partners aligned quickly?
• 6:52
  SPEAKER_00: Because as we all know, usually these phone calls about a potential outbreak come at 5 p.m.
• 6:57
  SPEAKER_00: on a Friday afternoon.
• 7:00
  SPEAKER_02: Yeah, it's definitely true.
• 7:01
  SPEAKER_02: That's the first law of epidemiology, I think, is that there's no investigation except for at 4 p.m.
• 7:05
  SPEAKER_02: on Friday afternoon when you're trying to get out.
• 7:07
  SPEAKER_02: Outbreaks and outbreak investigations never happen at good times for anybody.
• 7:12
  SPEAKER_02: And people end up having to kind of step away from their day-to-day activities in order to deal with them.
• 7:17
  SPEAKER_02: Again, early in my career I was very nervous about pulling people away from what they were doing to get everything kind of set up, but now I've learned the hard way that it's much better to get it set up early on correctly, pull people away for a little bit of time, and then you're going to save yourself a lot of pain later on.
• 7:35
  SPEAKER_02: You know, even if it's 4 p.m.
• 7:37
  SPEAKER_02: Friday afternoon, I will send out an email.
• 7:40
  SPEAKER_02: I mean, I basically contact the administrators, let them know what's going on as early as I'm got a sense that there may be a problem or that we need to do some investigation.
• 7:48
  SPEAKER_02: And I ask them to kind of help me set up a meeting and bring in a whole host of people.
• 7:55
  SPEAKER_02: And those are not only the technical people that may be directly or even indirectly involved in the outbreak, but we always, in the very first meeting, always pull in both the internal and external communication teams to help us.
• 8:07
  SPEAKER_02: So the internal communication is really focus on communication within the health system to our employees and staff, and then the external communication are kind of the media relations people who will prepare statements potentially for any media queries that may come.
• 8:23
  SPEAKER_02: Because we're in Los Angeles and we're a fairly high visibility organization.
• 8:28
  SPEAKER_02: I think it's really critical to have not only an internal communications plan, but a media relations plan set up very early on.
• 8:35
  SPEAKER_02: So if they're involved from the very beginning, they kind of know the technical issues surrounding the outbreak, they hear what you're doing, and they're able to help you prepare some communication beforehand so that if the media starts to contact you, you're able to kind of push it out fairly quickly and efficiently, and you don't have to scramble to get things done.
• 8:55
  SPEAKER_02: So I felt that it's really, really helpful to have communications people involved very early on.
• 9:02
  SPEAKER_02: A lot of times, you know, I'll end up being the one who kind of writes the initial statement and then they'll go through and edit it.
• 9:07
  SPEAKER_02: But having that ready is is so helpful beforehand.
• 9:10
  SPEAKER_00: Yes, I totally agree.
• 9:12
  SPEAKER_00: In my own experience early on, I didn't realize that there was an entire communication structure in the background of my healthcare system ready to support me.
• 9:22
  SPEAKER_00: I quickly realized that we can't do it all ourselves.
• 9:25
  SPEAKER_00: So we need to use that support and that structure in these types of situations.
• 9:30
  SPEAKER_00: Can you think of a specific example when effective communication was really the critical part of your successful outbreak response?
• 9:38
  SPEAKER_02: Again, I I think it's critical for every outbreak of response I've really dealt with.
• 9:42
  SPEAKER_02: I'll give you just kind of a general idea and then kind of give you a specific incident maybe afterwards.
• 9:47
  SPEAKER_02: But the way I think about it is that you have kind of microcommunication and macro communication and internal and external communication.
• 9:53
  SPEAKER_02: So we talked a little bit about the internal and external communication, but as far as the micro and macro communication goes, it really starts from the very beginning.
• 10:01
  SPEAKER_02: So as I said with that urology outbreak that I first dealt with, kind of walking into the situation on the first day where you're just really trying to sort out what's going on, it's really important to communicate really effectively with the people who are on the ground who you may be working with.
• 10:17
  SPEAKER_02: And I think that's very helpful to set certain expectations in the beginning that you're going to be doing an investigation, you're going to look to see what the what the risk factors are, what the issues are that have led to potential outbreak of infections among the patients, and that you're going to be notifying the health department and that patient notification is going to be part of it at some point as well.
• 10:38
  SPEAKER_02: Just letting people know what to expect.
• 10:40
  SPEAKER_02: Because I think for us it's just another day at the office, but for them it could be potentially a life-altering event because there may be legal suits, they may be newspaper articles that impact them a lot.
• 10:50
  SPEAKER_02: So making sure that you're setting expectations about what you're going to do and that you pledge to them to keep them in the loop the entire time is really critically important.
• 10:59
  SPEAKER_02: I think also setting an expectation that it's going to be a non-punitive kind of a discussion and an investigation, that you are all on the same team, you're all helping with the investigation, and you're all part of fixing the problem together at the end is important too.
• 11:15
  SPEAKER_02: So then that hopefully will decrease some of the finger point and it tends to be natural early on, and some of the anxiety that no matter what is going to be part of that.
• 11:23
  SPEAKER_02: From an internal communication part, that starting that way is really important.
• 11:27
  SPEAKER_02: I think also realizing that you're going to need to communicate more broadly with the staff within your institution is important as well.
• 11:34
  SPEAKER_02: I feel strongly that you should be doing that as early as you can, just let people know that there's an investigation going on.
• 11:40
  SPEAKER_02: Because I think rumors get started and you know, with if if there's not enough information that people have.
• 11:46
  SPEAKER_02: I mean, they need some information, but not too much information.
• 11:49
  SPEAKER_02: But the less information you give people, the more rumors there are, more people fill it in on their own, and the more difficult it can be for you to dispel those rumors later and try to get work done.
• 12:00
  SPEAKER_02: Externally too.
• 12:01
  SPEAKER_02: So dealing with those first patients I think is important.
• 12:04
  SPEAKER_02: I think there's a lot of anxiety on the part of healthcare providers to disclosing the investigation to patients is natural, but I think it's ultimately really detrimental to push that off.
• 12:17
  SPEAKER_02: The longer you push it off, the more it can come back to bite you later.
• 12:21
  SPEAKER_02: Mostly because patients really want to know what's going on early on, if possible.
• 12:26
  SPEAKER_02: And also because if it ends up within the news media, and the news media tends to focus a lot on when you should have notified patients and when you actually notify patients.
• 12:36
  SPEAKER_02: In the outbreaks I've read about, at least in the newspapers, I think that hospitals tend to get dragged over the calls more for slow notification for patients than they do for anything else.
• 12:46
  SPEAKER_02: So I think that's really important to notify people that this is happening, and then also to, again, like I said, prepare statements in case there is a media inquiry.
• 12:55
  SPEAKER_02: And I could tell you it wasn't an outbreak per se, but like one example where communication was really almost all of the things that we did was a couple of years ago when the FDA uh identified an outbreak related to the SORIN 3T heater coolers, which we use here at UCLA.
• 13:14
  SPEAKER_02: And so basically this is a device that they use in the operating room, and what was found is that there was a mycobacterial contamination problem from the manufacturer, and that there were some cases, pretty severe cases of a mycobacterial infection after use of this device.
• 13:29
  SPEAKER_02: And so we were notified by the FDA, the CDC, and our local health department that we needed to contact all the patients who had been exposed to this device going back, I can't remember now, but maybe five years before that point in time.
• 13:43
  SPEAKER_02: And you know, because we're a fairly high-volume center for cardiothoracic surgery, that was that ended up being like 4,000 people that we had to go out and notify.
• 13:51
  SPEAKER_02: So that was a daunting challenge, and from the beginning it was almost all communication.
• 13:56
  SPEAKER_02: So in my experience, again, with most outbreaks, it's best to contact people in person or by phone directly first before they get a letter in the mail.
• 14:04
  SPEAKER_02: It just makes things go a lot more smoothly, and there's a lot less anxiety from their perspective if you can just answer the questions right away.
• 14:11
  SPEAKER_02: But it wasn't possible when we had thousands of patients to notify.
• 14:15
  SPEAKER_02: So what we did was took a few pages from uh previous outbreak investigations that we'd had, knowing that we may get a lot of really anxious calls back, we set up a hotline so that people could just call in.
• 14:28
  SPEAKER_02: And then we sent out letters to everybody who may have been exposed to this machine, not only to explain what happened, but also to contact us to let us know if they were having any symptoms, and we gave them kind of what to look for.
• 14:40
  SPEAKER_02: At the same time, we actually sent out letters to the physicians as well because we didn't want to blindside the physicians, the patient's physicians, who many of them were not affiliated with our institution.
• 14:50
  SPEAKER_02: So I think that was really helpful because a lot of times patients will call their own provider first before they contact UCLA or the other institution.
• 14:59
  SPEAKER_02: So having the physicians know what's going on is really important.
• 15:03
  SPEAKER_02: So I I think it went actually smoothly.
• 15:05
  SPEAKER_02: It was in the newspaper a little bit, but I don't think there was a huge fear around it.
• 15:09
  SPEAKER_02: So we ended up getting not as many calls as I thought we were going to have.
• 15:13
  SPEAKER_02: But having that structure in place with the hotline, actually, we hired some additional nurses to come and help staff was really helpful at the end of the day and kept my anxiety level down, even if a lot of other people were very anxious about it.
• 15:27
  SPEAKER_00: Well, that is such an impressive way to make sure that there is effective communication between your facility, the referring physicians, and the potentially affected patients.
• 15:36
  SPEAKER_00: Your description really reminds me of the work or the crisis and emergency risk of communication rather than the other.
• 15:43
  SPEAKER_00: And I think it really makes me principles of work or to be right or to be further and to be credible.
• 15:56
  SPEAKER_00: And if we definitely open the accessories, three principles of work are also equally important to professive enterprise or to promote access or to cover the accessories.
• 16:08
  SPEAKER_00: If we follow these principles with all of our communications, both internally and externally, I think that's definitely a way to manage an outbreak effective for the other.
• 16:18
  SPEAKER_00: You've mentioned the importance of collaborating with external partners, including public health.
• 16:24
  SPEAKER_00: In the heat of the moment, sometimes I worry that we forget about cultural nuances when communicating to the public during an outbreak.
• 16:31
  SPEAKER_00: One example that I can think of is during the 2014-15 Ebola outbreak.
• 16:36
  SPEAKER_00: My local public health partners in Portland, Oregon met personally with West African immigrants in our area to make sure that they felt supported and they were not targeted with all of the media frenzy.
• 16:49
  SPEAKER_00: Have you ever had a similar experience when managing an outbreak when you had to address stigma and concerns similar to that?
• 16:58
  SPEAKER_02: I guess our health department here has done a really good job at reaching out to the community in in general.
• 17:03
  SPEAKER_02: I've done that, I think, a little less, it sounds like than than you have.
• 17:06
  SPEAKER_02: But but I can say within our own institution that has been an issue.
• 17:10
  SPEAKER_02: And specifically around the Ebola outbreak, you know, fairly early on we were identified as an Ebola treatment center within Los Angeles County and some of the surrounding counties.
• 17:20
  SPEAKER_02: So because we're the receiving hospital from LAX, there was a fairly big concern that we actually may see a case here.
• 17:28
  SPEAKER_02: And so I think after seeing some of the experience from elsewhere in Texas and in New York City, I think we had a very good appreciation that the healthcare workers themselves actually were stigmatized in a lot of cases, that people who worked on these institutions, you know, their children weren't allowed in schools and they were not allowed to go out of their house and a lot of those kind of things.
• 17:50
  SPEAKER_02: And I think people were really anxious about that here.
• 17:52
  SPEAKER_02: And that was getting in the way of trying to develop a really effective treatment team.
• 17:58
  SPEAKER_02: Because if people are afraid of that stigma, they're probably not going to want to sign up for that specific treatment team.
• 18:05
  SPEAKER_02: Because, you know, I guess in New York there are people who are just working at the institution, had nothing to do with the Ebola treatment team and were actually stigmatized and people didn't want to serve them in restaurants and things like that.
• 18:15
  SPEAKER_02: So I mean, we were really, really sensitive to the fact that people who are taking care of these patients directly, including myself, you know, maybe stigmatized this.
• 18:24
  SPEAKER_02: So we did a few things.
• 18:25
  SPEAKER_02: So again, one was just letting everybody know what the actual risks were, trying to dispel a lot of the fears that were being circulated in the lay media and just in the community in general, that really weren't realistic and didn't really take into account the true science behind the outbreak.
• 18:40
  SPEAKER_02: So just trying to dispel this information, that information, we actually put together these informational sessions.
• 18:47
  SPEAKER_02: I think they were I think we were doing them two or three times a week for the first month or month and a half in November and December of 2014, just to let people know what the plan was and what we were doing.
• 18:59
  SPEAKER_02: And I can tell you, most of the people who were actually part of the Ebola treatment team were pretty comfortable with what we were saying from the beginning.
• 19:05
  SPEAKER_02: There were people within the institution who were really gonna have nothing to do with an Ebola patient if they came to the hospital who were actually the most anxious.
• 19:12
  SPEAKER_02: And so part of it is just, again, dispelling rumors, letting people know what the actual science was, letting people know what our plan was and being very open about the risks associated with Ebola was important.
• 19:23
  SPEAKER_02: But I think also addressing the stigma directly and just saying, you know, people who are gonna be on this team just need to know that you know there may be a stigma associated with taking care of these patients, that we would first of all, you know, keep your name out of the media, uh, that people wouldn't know who you were.
• 19:39
  SPEAKER_02: And secondly, if people were still concerned about it and felt like they didn't want to go home because they thought their family may be stigmatized, we actually opened up rooms in our in we have a facility where our transplant patients can kind of be housed after their transplant, after being discharged from the hospital, but be you know before their first visit and stuff.
• 19:58
  SPEAKER_02: So we we were able to reserve some rooms in there so that if people if we did have an Ebola case that came in, that that staff could stay there while they were treating the Ebola patient just to kind of alleviate some of that.
• 20:09
  SPEAKER_02: You know, I think it's important to kind of think about that during any kind of outbreak investigation that there's always going to be some stigma attached to whatever department it is that may be involved and hit it head on is really important.
• 20:20
  SPEAKER_02: Making sure you don't ignore that because it does faster and people can feel really alienated as a result of it and may not be as cooperative.
• 20:27
  SPEAKER_02: And so I think we need to to address that.
• 20:29
  SPEAKER_02: That was one of the first things to do.
• 20:32
  SPEAKER_00: Yes, absolutely.
• 20:33
  SPEAKER_00: I think that can, just like you said, take up a majority of our time.
• 20:38
  SPEAKER_00: Sometimes it's just really making sure everyone is working with the same facts and talking that through with everyone who's concerned.
• 20:47
  SPEAKER_00: Does your communication plan change based on the size of the outbreak?
• 20:51
  SPEAKER_00: If it's an exposure versus a cluster or a large-scale pandemic, how do you scale that up or down depending upon the size of the potential outbreak?
• 21:02
  SPEAKER_02: And you really don't know when you're first getting involved with an investigation how big it's ultimately going to get.
• 21:07
  SPEAKER_02: So I would argue that you should have a pretty good consistent internal communication plan from the beginning.
• 21:14
  SPEAKER_02: You may not want to necessarily roll it out if it's something really small to everybody, but you want to at least make sure that people kind of in the unit who are involved know what's going on.
• 21:23
  SPEAKER_02: You want to have draft communication set up for a broader audience within the institution, and then potentially also for external communications as well, just in case things kind of get bigger.
• 21:34
  SPEAKER_02: My lesson and my pearl, I would say, that I've learned over the last few years is you never know where you're going to end up with these investigations.
• 21:40
  SPEAKER_02: And some of them seem like they're going to be a really big deal and end up fizzling out.
• 21:45
  SPEAKER_02: Nobody seems all that interested.
• 21:46
  SPEAKER_02: And then opposite it can be true too.
• 21:48
  SPEAKER_02: Something that you think is fairly small and limited can actually take on a life of its own and become really spectacular and end up causing a lot of disruption.
• 21:56
  SPEAKER_02: Not just thinking that you know what's going to happen is helpful.
• 21:59
  SPEAKER_02: So having Communication plans and draft messages in place early on is really important because you you want to not have to struggle to try to put those things together if things kind of chip the fan later on.
• 22:11
  SPEAKER_02: So my argument is that you need a pretty consistent internal and external communication plan for every investigation that you're doing.
• 22:18
  SPEAKER_02: It just may be that the size of it may not necessarily need to be the same every single time.
• 22:22
  SPEAKER_02: So if it's something that's fairly limited, you may just hold it back and not actually send it out unless it becomes kind of a bigger issue.
• 22:31
  SPEAKER_02: Whereas if you have something like a pandemic or Ebola, for example, that everybody knows about, you just you're just gonna probably push at it as soon as you possibly can and not really wait for it.
• 22:40
  SPEAKER_02: So I think it's more a question of timing than anything else in my experience.
• 22:44
  SPEAKER_02: That you know you want the communication ready, but you may not necessarily need it if it's gonna be a small, limited issue.
• 22:51
  SPEAKER_00: Yes, I think that those are all great points that you made.
• 22:55
  SPEAKER_00: Consistency is key so that everyone knows what the structure is in terms of scaling up and scaling down the communication plan.
• 23:03
  SPEAKER_00: How can clinicians and other individuals who are involved in infection prevention and outbreak management learn more about outbreak communications?
• 23:12
  SPEAKER_00: Are there specific references that you like to go to or that you would like to recommend?
• 23:17
  SPEAKER_02: Yeah, absolutely.
• 23:18
  SPEAKER_02: I mean, I think the talk a little bit about the error TP tools, but I think those are helpful.
• 23:23
  SPEAKER_02: I think also reference books are helpful too, and there's a number of really good infection prevention books that are helpful.
• 23:29
  SPEAKER_02: I tended to concentrate more on the kind of scientific, technical parts, and then kind of skim through some of the communication, the softer topics, but I can tell you I've gone back to a lot of those chapters and reread them over the years.
• 23:41
  SPEAKER_02: They are very helpful.
• 23:42
  SPEAKER_02: One thing that I think that we did here that wasn't that was actually proposed by our media relations people after Ebola was to put together a formal media training program.
• 23:53
  SPEAKER_02: And that was just a one-day meeting.
• 23:55
  SPEAKER_02: I actually did it with our chief medical officer and my associate medical director for inspection prevention and a few other people.
• 24:01
  SPEAKER_02: It was very, very helpful.
• 24:03
  SPEAKER_02: Basically, what they did is someone who's trained as a reporter, and basically we went through almost like a mock kind of situation, and they helped us kind of develop ways to speak with the media better, and they videotape the whole thing and then show it back to you later.
• 24:19
  SPEAKER_02: So it's very humbling to actually see yourself videotaped and have to critique yourself later.
• 24:24
  SPEAKER_02: I think it was incredibly valuable.
• 24:26
  SPEAKER_02: It just gave me a better understanding of what the media is looking for and how you can help shape some of the narrative as opposed to always just kind of being on the receiving end of whatever they're gonna write.
• 24:37
  SPEAKER_02: So we ended up never having an Ebola case, although we had some Rulai cases, but we never actually had an Ebola case.
• 24:42
  SPEAKER_02: So it ended up being very helpful with later outbreaks that we had to deal with that were highly covered in the media.
• 24:47
  SPEAKER_02: So I I would I would suggest that something that maybe is a little bit out of the box, but media training is helpful in addition to all the other resources that are out there.
• 24:56
  SPEAKER_00: Those are all great suggestions.
• 24:58
  SPEAKER_00: I actually also did media training around the time of the H1N1 pandemic in 2009.
• 25:04
  SPEAKER_00: And one of the pearls that I always share with people who are talking to the media or doing a telephone interview is before I say anything, the first question I always ask is, Am I being recorded?
• 25:17
  SPEAKER_00: Because sometimes you are and sometimes you aren't.
• 25:20
  SPEAKER_00: Sometimes in the pre-interview discussion, if it is being recorded, you must be well aware of that before you start chatting with whoever's on the other side of the telephone line.
• 25:30
  SPEAKER_00: I wanted to make sure that the listeners are all aware of the ORTP website that Zach mentioned.
• 25:37
  SPEAKER_00: The ORTP is the Outbreak Response Training Program, which is a partnership between the CDC and J.
• 25:45
  SPEAKER_00: You can find lots of tools on the website at orpt.org.
• 25:52
  SPEAKER_00: There you'll find all sorts of helpful resources, including three webinars that are archived, which focus specifically on topics that are aligned with today's discussion.
• 26:02
  SPEAKER_00: The first webinar covers effective communication during a crisis.
• 26:06
  SPEAKER_00: The second focuses on conflict management.
• 26:09
  SPEAKER_00: And the third webinar focuses on working with the public during an infectious disease outbreak.
• 26:15
  SPEAKER_00: The website also includes an expert guidance toolkit which has available checklists that you can download, some reference links, and other really helpful tools for hospital epidemiologists.
• 26:26
  SPEAKER_00: This includes some really great uh planning worksheets that you can use when preparing for those interviews with the media and other stakeholders.
• 26:34
  SPEAKER_00: And all of those resources are available, open access and free of charge.
• 26:40
  SPEAKER_00: Zach, thank you so much again for an excellent conversation.
• 26:43
  SPEAKER_00: We've learned a lot about the importance of effective and timely communication, and I think you've really highlighted why it's so important in outbreak management.
• 26:51
  SPEAKER_00: Thank you again.
• 26:53
  SPEAKER_02: Well, thank you for having me.
• 27:00
  SPEAKER_01: Shea will be hosting Outbreak Response Week September 17th through 21st.
• 27:06
  SPEAKER_01: To learn more about Shay's work in outbreak preparedness and response, visit www.shay-online.org.