2.3 Key Issues and Lessons Identified

2.3.1 Public communications

2.3.1.1 Public information campaign

The communications strategy developed during the pandemic was successful in conveying accurate and timely information both to the public and to health professionals. Qualitative research indicated that while there was some complacency given the nature of the pandemic, the public information campaign decreased anxiety and increased understanding and compliance with public health measures. The research will be used to inform future response communication strategies.

It is important to finalise a revised national health pandemic communications strategy that incorporates key lessons identified during the 2009 pandemic and includes identification of responsibilities and objectives, actions and audiences throughout a pandemic. It would be beneficial to plan a robust evaluation process to provide timely feedback on message clarity and impact during delivery of a public information campaign to understand and address issues as they arise, such as confusion regarding eligibility for vaccination when the first messages focused on priority groups but availability was quickly extended to the whole population when only one dose was found to be needed.

While there was a national media network (NHEMRN) in place to coordinate media messaging and engagement, there was not a complementary public communications network, which could have assisted in the development and coordination of messages and timing of the release of advertising. The clearance process for communication material was time-consuming. Improving synergies between national and jurisdictional public advertising campaigns could enhance the impact of public messages.

It was useful to have at the national level a Deed of Standing Offer in place with the various contractors (such as research and advertising agencies), so that communication materials could be developed quickly. However, some of the pre-pandemic work undertaken by these agencies focused on avian (H5N1) influenza and were of limited relevance to this response. A key improvement would be to have simple health emergency templates in place and high-level materials with immediate prevention messages available that can be tailored at the time.

While there were clear messages about which groups were at high risk of severe outcomes, communication with high-risk groups could have been improved. In particular, it has been identified that earlier engagement with Indigenous Australian audiences is needed. There is also a need for consistent approaches to engaging with high-risk communities – such as Indigenous people or people from non-English-speaking backgrounds – where unsupported mass media has not been shown to be effective.

The business sector expressed concerns that there was limited opportunity to engage with, and provide input into, relevant government pandemic planning and decision-making processes. While the nature of the 2009 pandemic led to limited impact on the business sector, separation of the business sector from the general public in future pandemic planning may be considered in order to enhance effective communication with these stakeholders.

2.3.1.2 Websites

The Health Emergency website provided access to up-to-date information and plans during the pandemic. Initially there were delays in this website becoming fully functional, due in part to the need to create a user-friendly site relating to the pandemic. As it was a new site, it was not known by the general public as the source of official information on the pandemic in Australia, unlike in the case of the well-established Centers for Disease Control and Prevention (CDC) website in the United States. Initially there was also duplication and confusion between the respective purposes of the Health Emergency and Pandemic Influenza websites.

The Health Emergency website was supported by state and territory government websites which provided more local information. However, there were some issues with synergies between jurisdictional and other health organisation websites. Given the rapidly evolving situation, websites were sometimes behind media reporting. A more centralised, consistent, current and accessible government information resource, such as a whole-of-government website, designed to provide relevant Commonwealth and state and territory government information to the public would have been beneficial.

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2.2.1.3 Telephone hotlines

It was important to have a national telephone hotline available throughout the pandemic response. This hotline was well used by the public early in the pandemic; however, overall use declined as the pandemic progressed, and operating hours could have been reduced in line with decreasing demand. The use of a number with fewer digits than a standard 1800 number (the hotline number was 180 2007) did cause some confusion.

In the context of rapidly changing information during a pandemic, further consideration should be given to the best use of hotlines as it is important to ensure that information provided via national and jurisdictional hotlines is current and consistent.

2.2.1.4 Social networking

New media was not used at national level in 2009. The use of social networking tools, such as Facebook, Twitter and blogs, should be considered as a means of delivering key messages in a timely manner.

2.3.2 Media

The National Health Emergency Media Response Network (NHEMRN) was invaluable in supporting coordinated national and jurisdictional media responses.
In most instances media reporting was balanced and fair, particularly during the early stages when the media played a critical role in promoting hygiene messages. The Australian Government situation reports and talking points provided effective bases for consistent messaging.

2.3.2.1 Spokespeople

The Commonwealth and jurisdictional communication strategies were predicated on a reliable and trusted spokesperson. The roles of the CMO and jurisdictional CHOs were shown to be vital in providing highly credible spokespeople on health matters. They were credible, apolitical, authoritative figures, which were required in communicating with the general public and complemented the messages being delivered by the Australian Government and state and territory health ministers. Even in this moderate pandemic, the intense media demand was difficult to handle when the spokespeople were also charged with managing the pandemic response at the most senior levels. A deputy spokesperson who could be seen publicly alongside the senior spokesperson to engender public trust through recognition would relieve the workload pressure. A second spokesperson who is recognised and trusted by the public would be particularly important in a severe pandemic when the senior spokesperson may be less available for the media.

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2.3.2.2 Coordination

There were multiple government plans associated with communications during an influenza pandemic and a lack of clarity with respect to how each plan would interact with the others. In some cases plans were not activated as they were intended to be.

Consideration should be given to implementing an appropriate mechanism to enable early sharing of information in confidence to improve national coordination and timeliness of message delivery. While coordination between governments generally worked well and continued to improve as the pandemic progressed, there were some aspects that raised concerns. For example, some jurisdictions reported that they were informed of some major announcements regarding the Pandemic (H1N1) Vaccination Program via press release at the same time as the public and media. This was improved for the rollout of the paediatric vaccination program, which allowed jurisdictions to plan complementary communication activities. It is acknowledged that communications in general improved as the pandemic progressed.

While communications networks are described in plans to provide coordination of national communications, guidelines for individual networks are not clear. For example, the whole-of-government public communications network was not used. The value of a team working exclusively on national information sharing, especially informing premiers and chief ministers and other federal government departments, cannot be underestimated. Although the Department of the Prime Minister and Cabinet activated its national PanComm website, the Commonwealth and jurisdictional health departments were consumed with attending to their own websites and did not have the experience or expertise available to contribute to another website.