Commission staff working document on communicating with the public and the media on Pandemic (H1N1) 2009 - Accompanying document to the Communication from the Commission to the Council, the European Parliament and the European Economic and Social Committee and the Committee of the Regions - Pandemic (H1N1) 2009 {COM(2009) 481} {SEC(2009) 1188} {SEC(2009) 1189} {SEC(2009) 1191} {SEC(2009) 1192}
Date: 2009-09-15
Institutions: European Commission
Subjects: EU action, disclosure of information, disease prevention, epidemiology, exchange of information, health control, health risk, infectious disease, public health, vaccination

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COMMISSION OF THE EUROPEAN COMMUNITIES 

Brussels, 15.9.2009 
SEC(2009) 1190 final 

COMMISSION STAFF WORKING DOCUMENT 
on communicating with the public and the media on Pandemic (H1N1) 2009 

Accompanying document to the 

COMMUNICATION FROM THE COMMISSION TO THE COUNCIL,  
THE EUROPEAN PARLIAMENT AND THE EUROPEAN ECONOMIC AND 
SOCIAL COMMITTEE AND THE COMMITTEE OF THE REGIONS 

Pandemic (H1N1) 2009 

{COM(2009) 481} 
{SEC(2009) 1188} 
{SEC(2009) 1189} 
{SEC(2009) 1191} 
{SEC(2009) 1192} 

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INTRODUCTION 

There is a broad consensus that, in the event of the EU facing a major health threat, the EU 
and its Member States should seek to be transparent and to share information in their dealings 
with the press, the general public, main stakeholders and health professionals.  

Since  2006,  a  network  dealing  with  international  influenza  pandemic  communication  issues 
has developed good working relationships (which are vital in a crisis, when rapid reaction and 
trust  are  needed)  and  ways  of  exchanging  a  wealth  of  experience.  Practical  exercises1  have 
pinpointed  important  issues,  such  as  giving  the  network  a  clear  mandate  and  establishing 
sound communication procedures and efficient tools. 

With  Pandemic  (H1N1) 2009  expected  to  pick  up  pace  from  the  autumn  onwards,  disease 
mitigation  and  the  development  of  vaccines  play  an  important  role.  Indeed,  developing  and 
using a vaccine effective against the Pandemic (H1N1) 2009 influenza virus can be viewed as 
one of the most effective public health measures. Meanwhile, pending the general availability 
of vaccines, personal protective measures such as hand hygiene and social distancing will be 
important.  To  achieve  an  adequate  uptake  of  vaccines  among  risk  groups  and  to  deal  with 
other  prevention  and  vaccination-related  problems,  public  health  authorities  across  Europe 
will face challenges  communicating with their national  media, with the need for  a carefully 
planned communication strategy. 

The  information  that  public  health  authorities  will  have  to  provide  regularly  will  vary  from 
country  to  country  as  the  pandemic  will  develop  differently  across  the  EU.  One  thing  to 
remember, though, is that anything that is fed to the media in one Member State will impact 
on media interest in the other Member States. This will bring with it the need for continuous 
trust building and sharing of messages to the media and the general public. 

PURPOSE AND OBJECTIVES 

This  Commission  Staff  Working  Document  seeks 
to  outline  a  possible  EU-wide 
communication strategy, coordinated by the Commission and featuring joint elements, actions 
and  tools.  This  paper  sets  out  an  operational  plan  for  delivering  targeted  and  scientifically 
validated  messages  for  the  general  public  and  for  specific  risk  groups.  This  will  generate  a 
number of common approaches (e.g. a joint press release, shared national media material and 
national  communication  plans  and  a  joint  information  week)  to  the  public,  health  care 
workers, other professional groups, and other specific target groups. This document is based 
on  discussions  and  activities  already  initiated  by  the  European  Commission  in  conjunction 
with the Health Security Committee Communicators’ network.  

LEGAL BASIS 

Community action in the field of public health, as set out in Article 152 of the Treaty, must 
complement  national  policies  and  be  directed  towards  improving  public  health,  preventing 
human illness and diseases, and obviating sources of danger to human health. The aim is to 

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Reference: 2005, Common Ground, weblink. 

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tackle  the  major  health  scourges  by  promoting  research  into  their  causes,  their  transmission 
and their prevention, and to provide health information and education.  

PUBLIC HEALTH BASIS 

The distribution of accurate, objective and timely information at all levels is critical in terms 
of  minimising  social  disruption  and  economic  consequences  and  maximising  the  success  of 
the response. 

Communication  is  an  essential  element  of  crisis  management.  As  well  as  empowering  the 
public  to  adopt  protective  behaviour,  good  communication  can  facilitate  case  reporting  and 
awareness, reduce confusion and make best use of resources. Good communication also helps 
maintain people's trust in the health authorities during an event.  

From a communication perspective it is important to recognise that every individual has a role 
to play in this outbreak. Social distancing remains an effective way of reducing transmission, 
along with appropriate hygiene measures. 

The public (health) authorities cannot of course stop a pandemic. The European Commission 
will support the national authorities and facilitate coordination with a view to mitigating the 
consequences of the pandemic, communicating and sharing the messages to the public, e.g. by 
way  of  regular  audio-conferences  and  the  regular  updating  via  its  Pandemic  (H1N1) 2009 
website. 

Conflicting  messages  or  vaccination  recommendations  between  Member  States  must  be 
avoided, and any differing messages must be explained. It is essential to communicate factual 
information as soon as possible, to dispel any rumours, and regular updates must be provided 
as the situation unfolds and evolves.  

There is often a tendency to rush to curb anxiety among the public. Just as important, though, 
is the need to curb complacency, i.e. giving people realistic expectations and a chance to take 
appropriate individual action. 

EU HEALTH SECURITY COMMITTEE’S COMMUNICATORS’ NETWORK — THE CORE 
OF THE EU COMMUNICATORS' STRATEGY ON PANDEMIC (H1N1) 2009 

In  June  2008  the  Health  Security  Committee  (HSC)  endorsed  the  creation  of  the  Health 
Security  Committee  Communicators’  Network.  Composed  of  press  officers  and 
spokespersons  from  national  health  authorities  and  EU  agencies,  this  network  held  its  first 
meeting  in  March  2009.  Its  mandate  focuses  on  crisis  communication  in  response  to  health 
threats,  including  chemical,  biological  and  radio-nuclear  threats,  pandemic  influenza  and 
other major infectious diseases.  

A guidance document (known as the Red Book) is intended to help members of the network 
to communicate better during normal and crisis times. It lists the members of the network, its 
terms  of  reference,  standard  operating  procedures,  and  a  guide  to  best  communication 
practices. 

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The network provides a forum where crisis communication-related issues and practices can be 
exchanged,  discussed  and  used  for  coordination  purposes.  All  parties  retain  their  ability  to 
communicate independently.  

The  Commission  stands  ready  to  coordinate  the  communication  strategies  and  messages  on 
the  response  to  the  Pandemic,  in  order  to  maximise  the  impact  of  Member  States  activities 
and  enhance  coherence  and  clarity  of  the  communication  efforts.  Any  Member  State  can 
request the Commission to start a coordination process about an event. 

Training courses and practical exercises for experts in communication have focused on shared 
communication  goals  and  on  interdependence  between  Member  States  during  an  emerging 
situation. 

Since the beginning of the Pandemic (H1N1) 2009 outbreak at the end of April 2009, the HSC 
Communicators network has been active in sharing information on media reports and giving 
advance warning to its members on press releases. As always happens in a health crisis, and 
has happened here too, the media ‘breaks’ stories ahead of confirmation from the authorities. 
The  network  reacted  quickly  to  keep  members  informed  of  media  reports  and,  more 
importantly,  the  reactions  and  plans  of  the  national  authorities  to  media  stories.  Recent 
months have shown that the network has a useful role to play in providing the EU scientific 
experts  with  information  on  the  media  and  general  public  perception  of  national  and 
international-level responses and decisions.  

TARGET  GROUPS  FOR  THE  EU  COMMUNICATION  STRATEGY  ON  PANDEMIC 
(H1N1) 2009 

It is essential for information to be provided to the general population and to specific groups 
such  as  journalists,  priority  groups  for  vaccination  and  travellers.  They  need  both  daily  and 
long-term information on how the pandemic is evolving and how they can protect themselves 
from the virus. 

1. 

European citizens 

European  citizens,  including  civil  society  organisations,  NGOs,  etc,  will  get  information  at 
national  and  European  level.  EU  action  on  the  Pandemic  (H1N1) 2009  is  essential  to  show 
that information management procedures are transparent. The population at large will receive 
leaflets, produced nationally and based on the EU templates on the SANCO web-page. 

2. 

Journalists  

Journalists  are  constantly  looking  for  information  on  the  way  the  situation  is  evolving.  The 
media are the initial source of information, impacting on the way people think and react, so 
the  media's  message  must  be  as  accurate  as  possible.  Having  an  agreed  message  and 
transparency  on  available  information  are  essential  means  of  pointing  up  the  response  and 
coordination  measures  by  EU  and  national  authorities.  Similarly,  ECDC  is  producing  and 
circulating  to  the  network  ‘lines  to  take’  covering  its  technical/scientific  outputs  and  risk 
assessments. 

Journalists will get information and material for onward communication via the SANCO web 
page and via social networks and video platforms.  

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3. 

Young people 

Young  people  are  an  important  target  group.  Three  new  social  media  tools  will  be  used  to 
share concerns and the appropriate prevention measures: Facebook, YouTube and Twitter. 

A daily short message platform on the pandemic might be interesting if it could be updated 
quickly: the EU Health portal and a new page for DG SANCO on Twitter might be a good 
way of doing this. E-cards will be made available on the EU Health portal for people to send 
informal e-mails with information on the pandemic to their contacts.  

Podcasts and the pandemic clip competition will be announced and run on the SANCO Web 
pages. 

One of the most effective responses would have to have an EU celebrity (widely known and 
respected across Europe) speaking about protective measures. 

4. 

Priority groups 

The Staff Working Document on vaccination strategy pinpoints the priority groups, including 
the essential services. 

Priority groups will be defined and addressed differently depending on the context. Member 
States'  approach  will  be  based  on  specific  national  considerations.  They  will  use  whatever 
solutions they think best for protecting and informing their priority groups, adapting the tools 
and solutions proposed in the Commission Staff Working Document on vaccination strategy. 

An  item  page  on  the  SANCO  web  page  will  be  dedicated  to  these  priority  groups,  with 
information, advice and the latest news on the virus. 

5. 

Travellers 

Travellers  are  exposed  in  a  different  way  to  the  pandemic  and  may  require  specific 
information  on  their  country  of  destination.  Here  too,  it  is  not  specific  travel  that  is  being 
targeted, but rather links to validated websites across the EU. There will be leaflets available 
in airports and distributed by airlines. 

STRATEGIC MESSAGE DEVELOPMENT 

While  it  is  not  feasible  for  Member  States  to  have  identical  messages  on  all  aspects  of  the 
pandemic,  it  may  be  possible  to  agree  some  common  strategic  lines  to  take.  These  could 
include: 

•  A  common  view  about  the  general  level  of  risk  posed  by  the  virus  —  e.g.  most  people 
infected will experience only mild illness, but some will become seriously ill. There is no 
cause for undue alarm, but we should not be complacent. 

•  A common view about the challenges all Member States face — e.g. the pandemic is likely 
to cause some disruption and put significant pressure on health systems this autumn. We 
need to be ready for this. 

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•  A common view on the value of public health input — e.g. we cannot stop the pandemic, 

but the measures we are taking will lessen its impact and help save lives. 

•  A common view about the need for EU cooperation — e.g. EU countries are coordinating 

their efforts and sharing information on a daily basis. 

These messages reflect the state of play on the pandemic and its health, social and economic 
effects;  moreover,  they  mirror  the  existing  cooperation  at  European  and  international  level. 
For the sake of good cooperation among all the actors involved and to avoid highly divergent 
messages vis-à-vis of the general public and the media, it would be helpful to highlight this 
common ground.. 

EXISTING COMMUNICATION AND INFORMATION TOOLS 

There  are  already  a  range  of  communication  tools  for  the  public  health  management  of  the 
pandemic  influenza.  The  national  authorities,  the  European  Commission,  the  ECDC,  the 
EMEA  and  their  spokespersons  have  all  since  26  April  2009  provided  frequent  situation 
reports, daily press briefings and interviews, key points and recommendations, updated case 
counts  on  the  web  and  held  numerous  meetings  and  conference  calls  with  public  health 
authorities  and  national  spokespersons,  webcasts,  etc.  All  partners  in  this  process  kept  a 
regular  check  –  several  times  a  day  –  on  the  media  environment,  the  resulting  information 
being distributed through various channels and websites, both nationally and at EU level. 

SANCO Public Health website 

As  soon  as  the  Pandemic  (H1N1) 2009  started,  SANCO  started  providing  information  and 
updates  of  the  situation  on  its  website,  with  a  dedicated  page  on  the  pandemic 
(http://ec.europa.eu/health/ph_threats/com/Influenza/novelflu_en.htm).  At  the  height  of  the 
crisis,  the  site  was  up-dated  several  times  a  day,  including  weekends,  with  situation  reports 
and news from the Commission, the ECDC, Member States and the WHO. The site currently 
contains  news,  epidemiological  information,  press  material,  a  complete  list  of  influenza 
websites  in  the  Member  States,  videos  and  information  on  the  Commission’s  role  in  a 
pandemic. The page is in principle available in 22 languages, although many documents and 
news items are only issued in English to speed up their publication on-line.  

The EU Public Health Portal 

On  the  homepage  of  the  Portal,  a  logo  and  a  link  have  been  created  to  SANCO's  dedicated 
website on H1N1 influenza. News published on the website is also announced on the Portal.  

Portal Newsletter 

A special edition of the Health Portal electronic newsletter was issued in May, focusing in the 
Pandemic (H1N1) 2009. Subsequent newsletters have provided twice a month information to 
some 5000 subscribers. 

MedISys and HEDIS 

MedISys  (Medical  Intelligence  System)  is  a  24/7,  web-based  early  warning  and 
alerting  system  based  on  European  Media  Monitor  technology.  E-mails  breaking 
news alerts to subscribers. 

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HEDIS (Health Emergency & Diseases Information System) is used for information 
exchange  and  awareness  during  infectious  outbreaks  and  health  emergencies  and 
response phases. It has a logbook of action taken, a repository, a database of models, 
maps and events. 

ECDC communication outputs 

ECDC also produces a number of regular communication outputs: 

•  ECDC  dedicated  web  portal  (updated  regularly,  with  scientific  evidence,  guidance,  news 

items, etc.) 

•  Daily situation reports  
•  Weekly pandemic surveillance report  
•  Weekly Pandemic (H1N1) 2009 executive update 
•  Daily strategic media monitoring 
•  Key points to communicate /Lines to take (updated regularly) 
•  Scientific and technical documents on various topics 
•  Eurosurveillance articles 
•  Health  education  series  documents  and  presentations  (targeting  decision  makers  and  the 

general public) 

•  Webcasts (on various topics) 
•  Occasional press conferences on specific scientific topics 

PROPOSALS FOR THE IMPROVEMENT AND DEVELOPMENT OF COMMUNICATION AND 
INFORMATION TOOLS  

Some of the suggested proposals will require substantial finances and human resources. 

Communication  tools  should  be  geared  to  the  target  audience  and  the  message.  Each  target 
audience  requires  a  separate  communication  plan.  Language  and  style  likewise  need  to  be 
geared to the target audience. 

Promotion activities of the following proposals are a key to success, and potentially resource-
intensive needs will need to be considered when devising the communication plan. 

1. Web-based information 

With such rapid information turnover in the media and the widespread use of the internet and 
the  new  technology  and  communication  tools,  the  EU  has  to  be  more  present  in  the  social 
media and web-based communications if it is to reach all communities. 

The  dedicated  SANCO  web  page  on  Pandemic  (H1N1) 2009  will  be  strengthened  to  link 
directly  to  all  the  material  produced  and  published  on  national  websites  (e.g.  video  clips, 
posters, leaflets, fact sheets, Q&As). It will be regularly updated so that the latest version is 
always  available.  It  would  help  if  the  ‘Europe-direct’  service  could  call  on  the  latest 
information  for  public  callers.  It  is  important  for  our  national  partners  and  agencies  to  send 
information for uploading onto the website as soon as it is published.  

This strengthened website would have to be given a publicity boost within the EU institutions 
and throughout the European Union. A leaflet (distributed at airports, major train stations and 
in airplanes) and a web-based publicity message will be produced. Amassing communication 

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material from all over the EU, the website will be the prime example of the EU’s coordination 
role.  

A day-to-day short message platform on the pandemic response may be interesting if it can be 
rapidly updated; the EU Health portal will be used for this action. 

The  numbers  of  users  in  the  EU  of  social  networks  is  exponentially  growing.  One  of  the 
biggest  user  groups  of  these  new  and  trendy  communication  tools  is  the  young  population, 
which  will  be  a  necessary  target  group  for  vaccination  and  school–related  distancing 
measures. In particular Face book and video platforms such as You Tube, are essential tools 
to target the young population. The EC could register on it various messages, radio and TV 
spots on the pandemic and include the winner of the flu video-clip competition or spots made 
by MS. 

E-cards  are  another  trendy  communication  tool  and  allow  easy  and  friendly  information 
exchange. Citizens need to be made part of the information flow. By sending themselves e-
mail to their mailing list they may reach people who don’t have this kind of information. It’s a 
solution  to  diffuse  quickly  information  on  a  subject  by  reaching  a  larger  population  in  its 
private sphere. Having E-cards available on the EU health portal seems to be a good way of 
diffusing information on the pandemic response to citizens. 

2. Coordination of information to call centres 

Member States have created call centres to deal with Pandemic (H1N1) 2009. Given the range 
and  complexity  of  the  questions,  call  centre  workers  must  share  the  questions  and  answers 
and, where possible, issue the same messages to all citizens.  

Sharing  of  information  between  MS  call  centres  and  giving  same  answers  are  essential  to 
have an EU coordinated communication on the public health response to the pandemic. The 
information  sharing  of  persistent  rumours  and  their  potential  validity  are  of  the  utmost 
importance. 

A common platform must be developed to enable call centres to search and input information 
and to allow accurate information or new concerns to be circulated quickly. The HSC will be 
invited to supervise the process and give appropriate answers and templates to call centres by 
creating a web-based information platform on HEDIS2. 

3. A collective response to Pandemic (H1N1) 2009 

To demonstrate that there is a coordinated response across the EU, the Member States and the 
Commission  might  decide  to  have  a  special  day  dedicated  to  communicating  specific 
messages on the H1N1 2009 situation, and protective measures. 

4. Eurobarometer 

If  time  allows,  the  European  Commission  would  be  prepared  to  launch  a  Eurobarometer 
survey on the way European citizens see Pandemic (H1N1) 2009. 

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Reference, link to webpage. 

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ROLE OF PARTNERS 

Communicators in the Member States already use a common information exchange platform 
(on  HEDIS,  where  they  can  share  and  coordinate  messages  and  action  with  each  other,  the 
ECDC and the Commission). Through MediSys3 and other media monitoring sources they are 
able  to  keep  track  of  the  latest  developments  in  the  press  worldwide.  This  information  is 
updated  every  ten  minutes  and  offers  machine  translation  from  over  42  languages.  SANCO 
web  pages  will  provide  essential  reference  information  and  a  link  to  national  websites. 
Leaflets are the next step in circulating these web- addresses with these reference pages on a 
national level. Thought will be given to using the HSC communicators’ network to agree on 
common  dates/timing  of  when  to  issue  coherent  Pandemic  (H1N1) 2009  messages  to  the 
general public.  

The  ECDC  forms  part  of  and  supports  the  HSC  Communicators  Network.  SANCO  and 
ECDC  will  cross-reference  each  other’s  websites  to  make  it  easier  to  share  epidemiological 
reports and management issues. More detailed vaccination-related questions and answers will 
be  linked  to  the  website  of  the  European  Medicines  Agency  (EMEA).  The  Health  Security 
Committee will be kept informed of any issue requiring further validation.  

CONCLUSIONS 

This  Pandemic  (H1N1) 2009  outbreak  poses  complex  communication  challenges.  Getting 
national communicators across the EU public health authorities to pool their resources is the 
best way to guarantee a transparent, shared and coordinated approach to the communication 
needs for the EU on the threat posed by the Pandemic (H1N1) 2009 outbreak. 

The best response to a threat is a grass-roots, bottom-up, localised one, but there will always 
be some need for top-down, centralised efforts. Financial and human resources will be needed 
to ensure that the general public and the journalists, along with other important groups, can 
count on getting reliable, up-to-date information of good quality on the outbreak.  

Finally, this Commission Staff Working Document takes a first look at how, at EU level, and 
in  close  conjunction  with  all  national  communicators,  we  can  provide  Europeans  with 
information  that  is  transparent,  coherent  and  consistent.  The  European  Commission  will 
continue to work closely with the Member States to ensure that this happens.  

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