The price of poor pandemic communicationBMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c2952 (Published 09 June 2010) Cite this as: BMJ 2010;340:c2952
All rapid responses
Thomas Abraham's description of the problems and distrust that arose
information about H1N1 was presented as directives for action rather than
descriptions of risk is extremely important for all aspects of medicine,
just flu vaccines.
On the one hand, patients are told they are in charge of managing
diseases, particularly chronic ones. Yet routinely, they are not provided
information about what they personally can expect to gain from doing
things, such as taking medications. They are not told, for example, that
among X number of people with a certain blood pressure level, Y will
experience a stroke--and what that means. And that if they take their
pressure medication as directed, Z will live a healthy life without a
They are not told this because this is not how governments, health
organizations, and others think about disease. Their mindset is, we have a
goal of reducing the number of people with high blood pressure to a
percentage. That is our target. And therefore we will tell everyone that
blood pressure is the most significant known risk factor for stroke, and
therefore they must lower theirs.
People who find their medications too costly, or inconvenient, or do
the side effects become the "noncompliant" thorn in their sides. In the
the US, the frustrated "health directors" may resort to telling fellow
about the harm being caused by those who do not change their ways, leading
to pariah status for at those with self-evident issues such as obesity or
The problem is compounded by epidemiologists uncovering associations,
which the popular press conveys as "eat blueberries and lower your risk."
There is no nuance, no conveyance of true risk and benefit, and a
confusion between cause and effect vs associations.
Some people respond by doing anything and everything they can think
others shut their ears to the cacophony. When it looks like someone with a
vested interest, such as a profit motive, is contributing to the
and all information can become suspect.
Presenting the public with reliable, unbiased information is critical
restoring trust in this process.
Among other things, write patient
Competing interests: No competing interests