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Interim Guidelines for Smallpox Response and Management in Scotland in the Post-Eradication era
X Communication
A smallpox outbreak will necessitate extensive communication activities throughout the UK. Communications in Scotland will be run from the SEHD in close collaboration with DH, by a team according to strategies and procedures that are defined before an event. Thus communication activities should have been occurring before any cases of smallpox are suspected, as well as strategies and procedures being in place should any cases arise.
Clinical, laboratory and epidemiological information
At Alert Level 0, Diagnostic Algorithms (see
Figure 10), will be distributed to all clinicians from RSDRGs via PCTs who will be responsible for adding the contact details of local SDEs.
In the event of an Alert Level 2, the suggested channels of communication for exchange of information between UK-NSOCC, SSOCC, RSOCCs and local clinical, laboratory and public health services are summarised in
Figure 9.
A series of telephone numbers with a large number of lines will be required, which will need to be secure and dependable and able to cope with large call volumes. These are:
Smallpox Reporting Telephone Number for clinicians to report suspected cases to RSOCCs. Number will be required in each Scottish Region.
Smallpox Contacts Telephone Number for category A and B contacts to report the presence of fever or other constitutional symptoms. This would be best set up at local level, with contacts reporting to RSOCC.
Smallpox Contact Tracing Number to allow potential contacts to identify themselves to RSOCC following an announcement about exposures. They may also choose to identify themselves to their own GP or through the NHS Helpline or NHS24, which may be able to grade individual's risk of exposure to infection using telephone triage.
Smallpox Advice Number for providing information to the general public. There are likely to be large numbers of "worried well" who may have symptoms and require reassurance. This information could also be provided through a dedicated website.
Public and media
Pre-event disclosure of relevant information as part of a phased response to a credible threat is essential to establish public trust and co-operation in the event of smallpox cases arising.
Prior to any smallpox case, there needs to be communication between SEHD, in close collaboration with DH, SCIEH in close collaboration with HPA and local providers about these interim guidelines and their interpretation for local planning purposes, including information for the public and media responses.
There also needs to be inter-agency working at all levels with health and emergency services working with UK, Scottish, Regional and Local emergency planning departments so that their roles in communicating to the public and media are known and understood should cases of smallpox occur.
Good communication during an event can reduce public anxiety and enhance the workings of emergency service responders and health care workers. The public should understand that a plan is being followed and given explanations for various actions being undertaken. Therefore, one of the primary communication objectives is to instil and maintain public confidence by providing the public with information that addresses their questions, fears and concerns. General information about smallpox, and updates on the status of any outbreak could be provided on a dedicated website.
The purpose of smallpox communication plans should be to help local, regional and national public health staff effectively educate the public, health care professionals, policy makers, partner organisations and the media about smallpox, smallpox immunisation, and important health strategies related to smallpox (eg. isolation and restrictions of movements) prior to an outbreak or confirmed cases of smallpox.
Alert Level 0 Communication Activities
Increase public, health care provider, public health official, policy maker, media and key partner knowledge and understanding of smallpox disease, smallpox immunisation, and the general approaches/concepts that will be used should there be a confirmed case or outbreak of smallpox; this includes isolation, immunisation strategies, and vaccine administration. Ideally, communications and education will help "de-mystify" smallpox and increase knowledge and understanding of isolating and restricting movements of smallpox patients.
Start to build up relationships with key media personnel who can be used to convey information to the public in a rational way should an event occur.
Increase the range and type of smallpox materials available to the public, health care providers, policy makers, and the media.
Help prepare and establish appropriate public, health care provider, policy maker, and media responses to a smallpox case or outbreak, including an understanding of how the public health system will respond, roles and responsibilities of the different sectors involved, and reasonable expectations regarding the scope and effects of public health actions.
Establish the protocols that would be used to communicate the specific data that would need to be reported daily after a confirmed smallpox case (eg. morbidity and mortality figures; geographic location of cases; number of contacts under surveillance etc.).
Alert Level 1 Communication Activities
Alert Level 2, 3 and 4 Communication Activities
Establish a
Central Communication Command Centre in Scotland at the SEHD:
A staffing assessment will be made and the Centre will be staffed by press officers from the SEHD and SCIEH for extended hours and days.
The Centre will provide information/materials that will enable it to respond to media, public, and health care provider inquiries. Twice-a-day briefings with these partners should be implemented.
The Centre will co-ordinate responses with Regional health press offices to ensure consistency of the information being given to the media.
The Centre should emphasise that the role of all agencies involved in the response to the outbreak is "
to identify the public health threat and take actions to protect the public."
Activate a dedicated smallpox website and make arrangements to update it regularly as events change.
Arrange regular television bulletins by a "news-reader type" (preferably already known to the public) who has had training about smallpox. He or she will provide information regarding the situation, the major actions being taken, information about smallpox, public guidance, and resources etc.
Rumour control will be a major main concern. Thus it will be imperative to immediately issue information updates and to correct, as much as possible, errors and misperceptions.
Lead Directors of Public Health will be asked to designate press officers to co-ordinate communication and media activities and to work with the Central Communication Command Centre in Scotland.
Unified, consistent public health messages will need to be given to the media, public and health care providers in the event of a smallpox outbreak.
Annex: key contacts
Reference Laboratories
CPHL
Dr David Brown
Central Public Health Laboratory
61 Colindale Avenue
London
NW9 5HT
Tel: 020 8200 4400 ext 3018
CAMR
Special Pathogens Reference Unit
Centre for Applied Microbiology & Research (CAMR)
Porton Down
Salisbury
Wiltshire
SP4 0JG
Tel: 01980 612100 (out of hours ask for Diagnosis on call)
Approved courier for Hazard Group 4 organisms
Gosafe International Ltd
Unit 15
Shield Road
Ashford
Middlesex
TW15 1AU
Tel: 0879 600 0129
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