ABSTRACT
The Zika Virus, Ebola, H1N1, MERS, polio and SARS outbreaks, as well as the HPV and measles vaccines, are issues that have been at the center of medical disputes in recent years. Time and again, in crisis situations caused by disease outbreaks, the importance of Emerging Infectious Disease (EID) communication resurfaces. Yet, as the New York Times medical journalist Lawrence Altman has argued, “even though health officials have had ample time – years – to polish their language skills” and lots of practice, they still failed to communicate important health information in response to the Ebola epidemic in 2014, just as they did during the HIV crisis in the 1980s. And so, as he put it, “history repeats itself” (Ratzan and Moritsugu, 2014). This failure is surprising, especially in light of the vast developments in the field of risk communication and the growing understanding of its importance during pandemic outbreaks. As Barry (2009, p. 324) noted, following the communication crises surrounding the successive outbreaks of Mad Cow Disease, SARS, and H1N1: “In the next influenza pandemic, be it now or in the future, be the virus mild or virulent, the single most important weapon against the disease will be a vaccine. The second most important will be communication.” So why, despite awareness of the importance of risk communication, are
there glaring gaps between health organizations and the public? To address this important question, we must take an empirical approach that takes into account the enormous changes that have occurred in the public sphere during the 21st century. Although extensive literature exists on EID communication, most of it is still theoretical and has not addressed the role of new media in changing and designing the new public sphere. This book will attempt to address these gaps. To that end, we devote special attention to the technological revolution of the digital age, which has engendered a social revolution and led to what is known as “the wisdom of the crowd” – the collective wisdom that shapes societies and nations, economics, and policies today. In this context, we propose coining the term “scientific skepticism.” In the
risk communication literature, and especially in the work focusing on
vaccines, the term “vaccination refusers” has long been used to describe parents who raise doubts or questions regarding vaccine efficacy and safety. However, accumulating studies and data reveal that while many parents do (rationally) evaluate the benefits and risks of vaccines (Velan, 2011; Velan et al., 2012), and as a result tend to delay vaccination for their children or refuse selected vaccines – direct and absolute opposition to vaccination is rare (CDC, 2013; Velan, 2011). The term “vaccination hesitancy” articulates this dilemma (Diekema, 2012; Healy and Pickering, 2011; Smith and Marshall, 2010; Velan et al., 2012). Unlike “vaccination refusal,” or even “vaccination hesitancy,” the term
“scientific skepticism” expresses the idea that in fact, these are not marginal groups, but rather a growing phenomenon of civil skepticism towards various scientific topics, particularly health issues under dispute and characterized by uncertainty. Such issues tend to surface often during EID outbreaks and epidemics. The public’s scientific skepticism addresses not only vaccines, but is a widespread phenomenon, encompassing a variety of health issues and means of disease prevention, as seen, for example, in the case of the Ebola epidemic. To ignore this fact, while labeling the skeptic public as extremists, would mean burying our heads in the sand. This book seeks to explore controversial issues in the context of EID out-
breaks that expose the roots of the gaps between health authorities and the public, and to examine how the public understands science. It makes suggestions regarding how organizations should cope with the wisdom of the crowd, as expressed in social media. The new media have become an important source of health information
and a platform for discussing personal experiences, opinions, and concerns regarding illnesses and treatments, and have contributed to the shift in the role of the public from being recipients to an active and vocal entity. This fundamental shift has created challenges for health organizations, and led to a paradox that must be addressed. On one hand, both the public and the organizations have influence within the public sphere, and the official health organizations are no longer the main source of information. On the other hand, the experts – doctors and health professionals – still have to manage the crisis. This book will raise a crucial question: In a reality in which the public sphere gives laypeople increasing influence, how can organizations respect the power emanating from them, while still exerting influence based on their professional knowledge and expertise, in order to manage the outbreak? In order to deal with the paradox that the organizations face, the second
factor – the public – must be added into the equation. This book will explore the tension between how the public is perceived by the authorities – as ignorant, acting based on emotions, anxiety, and prejudice – versus how the public perceives itself. We will examine the public’s sources of information; what people want to know, and to what extent. We ask: What are the public’s needs and risk perceptions, and do they really act out of panic during outbreaks? Does the public want to receive information that includes
uncertainty? How do people make decisions? How do they understand science? How do they combine science with experience? These central questions encompasses a number of issues, which will be
addressed in detail in the book. For instance, what challenges and dilemmas do organizations face in this new public sphere? What are the different strategies used by the organizations to communicate information? What are the organizational policies and practices? What is the real purpose underlying the organizations’ risk communication? The book will also address the role of journalists and doctors in the com-
munication circuit: are journalists doing their job as the watchdogs of democracy? How do the new media affect their work? What is the role of physicians in risk communication?
