Real contagions require communication

By Felice J. Freyer, Paul E. Jarris, and Robert M. Pestronk

In the recently released movie Contagion, a deadly flu virus originating in bats and pigs spreads to humans worldwide, killing millions and causing chaos. Moving as fast as the virus is misinformation; one character observes that the falsehoods of a self-serving blogger are as dangerous as the virus itself. Public-health officials strive to release the right information at the right time, but they struggle to counter the irresponsible blogger.

Luckily, 2009's largely forgotten swine flu, or H1N1, wasn't as deadly as the virus in Contagion, but there are parallels between that outbreak and the movie. They include vaccine manufacturing delays and tough decisions about who should be vaccinated first. Also, as in the movie, public-health officials found that their best efforts to inform the public about H1N1 could lead to false impressions.

One difficult question concerned how much should be revealed about those who died of the virus. Health officials understood their responsibility to keep the public informed, but they didn't want to violate privacy laws or trouble the families of the stricken. Some decided to provide the age, sex, and residence of victims; others reported only that someone had died somewhere in the state.

The press and public noticed these differences, which led some to doubt the reliability of health officials. News coverage of the outbreak varied widely, too, as some journalists were more accurate and responsible than others.

These disparities concerned health officials and journalists alike. That's why our three groups - the Association of Health Care Journalists, the Association of State and Territorial Health Officials, and the National Association of County and City Health Officials - teamed up last year to find common ground. We sought to balance the need to protect privacy with the imperative to provide timely information.

It was an unusual collaboration between officials and journalists. We learned a lot about each other's concerns and obligations, and the result was a set of voluntary guidelines for both groups.

The officials agreed that they should withhold information only when there is a clear justification for doing so. The guidelines provide a flexible framework for deciding how much to disclose about deaths and illnesses - recognizing, for example, that a person's age and sex won't identify him or her in New York City, but could very well do so in a small town.

The journalists, for their part, agreed that reporters have an obligation to put information in context and respect people's desire for privacy. The guidelines include standards for ethical and accurate reporting.

The health officials and journalists involved both agreed to provide information to the public as it becomes available, to be as professional and clear as possible in doing so, and to provide consistent advice on how the public should respond.

Contagion is fictional, but the threat of emerging infections is real. There will be other emergencies involving illness and death, health officials will be called on to tell the public what they need to know and do, and journalists will be called on to report accurately and completely. These guidelines will help both groups do their jobs well and quarantine the virus of misinformation.