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Newsletter TELL ME 2014-05-22

on Thu, 05/22/2014 - 11:05
The TELL ME project was created in response to European Commission Call (DG Research and Innovation ‐ HEALTH), for developing an evidence‐based behavioural and communication package to respond to major epidemic outbreaks.

Go to the TELL ME Brochure


TELL ME experts have developed a new framework model of communication, that consider new media and is not based on a hierarchic, linear structure. It is not an attempt to shape or funnel reality into clear, linear spreadsheets, as some guidelines do. For this reason, the diagram of the proposed model does not use arrows. It draws inspiration from the rhizome theory proposed by the philosophers Deleuze and Guattari, which suggests an alternative to linear models based on binaries, and emphasizes multiple connections and heterogeneity. Also like the rhizome, this model is not based on hierarchic relations, but on relations that proliferate in many directions, and emphasize many possible connections.
Formal stakeholders are not at the center of this model; but rather they encompass the public. Our model contains seven key components, starting with the public sphere in the centre of the diagram, arguably its most important feature. 
TELL ME experts from the University of Haifa, in Israel, published a case study of the 2009 A(H1N1) influenza pandemic. The paper on Disaster Medicine and Public Health Preparedness compared the guidelines for risk communication in case of epidemics or pandemic from 2005 to 2008, released by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC), with CDC reports from 2009 to 2011. Aim of this analysis was to assess the implementation of these guidelines during the swine flu outbreak in 2009, giving also some recommendations for future outbreaks. 
TELL ME experts concluded their work with two recommendations: the first is to define the goal of a vaccination program, by taking into account the segmentation of the population and applying a two-way communication. The second is to plan communication strategies in accordance with the most current theoretical framework, thus including elements like transparency and uncertainty. They also pointed out that organizations should be more involved in the implementation of guidelines.
The issue is still a topical subject, as shown by other papers, as a recent review on the New England Journal of Medicine, ( that analyzes the global response to the same pandemic.
A systematic review ( on main international scientific bibliographic database on communication and preparedness in 2009 A-H1N1 pandemic by TELL ME experts gave some interesting clues that hindered communication. 


Donato Greco, an internationally renowned epidemiologist and expert of public health, focuses on an important point neglected in two recent papers about antivirals published on BMJ. These articles attracted headlines on media all over the world, sometimes confusing avian, pandemic A(H1N1) and seasonal flu, the condition on which the two reviews questioned the efficacy of treatment. But they didn’t take into account timing of treatment. 


Surveillance, vaccination but also good communication are our arms against pandemics: «I'm sure that if you have an open crisis communication and if you don't hide the information, people would appreciate it and can take their own decisions» says Marc Sprenger, Director of ECDC (European Centre for Disease Prevention and Control) in a videointerview to TELL ME project website.


While media report the first case of MERS in America, ECDC asked for timely and transparent risk communication practices in Middle East, where the new coronavirus emerged. The issue has been raised due to the initial choice of the Saudi Ministry of Health to maintain the silence. A lack of transparent information from the kingdom led to skepticism and confusion; rumors of incompetence, coverups and lost records fed on silence and spread quickly, thus leading to a loss of credibility by the Saudi institutions. The high number of cases amongst healthcare workers also caused some people to be worried about going to hospitals for their appointments and raised concerns, fueled by rumors swirling on social media, about inadequate hygiene procedures in some hospitals.
Being the keeper of the two holiest places in Islam – the Grand Mosque in Mecca and the Prophet's Mosque in Medina – Saudi Arabia has a great challenge to face. Many pilgrims are expected in July during Ramadan and millions more will gather in the country in early October for the Hajj, the annual pilgrimage to Mecca, the largest gathering of Muslim people in the world. Clearly, a fast-spreading and potentially lethal disease like MERS-CoV would represent a serious threat for all these pilgrims.
This is the reason why several international voices cried out for more transparency from Saudi authorities. On April 25, the Washington Post editorial board recalled the lesson learned by Chinese government with SARS in 2003, when secrecy and reassurance from the authorities caused a high cost in terms of human health and welfare.