Liang

Slide1: 

SARS Community Outreach Arthur P. Liang, MD, MPH National Center for Infectious Diseases Centers for Disease Control & Prevention

Slide2: 

Every medication has 2 effects. . . The one you want The one you don’t want

Slide3: 

Quarantine/Isolation Limit transmission Individual liberties Economic loss Social isolation Social Stigma…

Slide4: 

Quarantine/Isolation …unintended consequences? Limiting transmission Maintaining transmission e.g., HIV, leprosy

Quotations from Callers: 

Quotations from Callers "Has CDC recommended staying away from Chinese markets/restaurants/etc.? That might help.“ “Is it safe to go to Niagara Falls because I know alot of Canadians go there?”

Data: Is there a problem? How big?: 

Data: Is there a problem? How big? Seven discussion groups with: over 60 Key API Opinion Leaders National, State Local Community Based Organizations Governmental Agencies Chambers of Commerce Trade Associations Airline and Health care workers CDC Hotline HSPH Survey

Slide7: 

CDC Hotine Calls by Categories, April 29- May 14 N = 2111 calls

Slide8: 

78% think being on airplane with SARS case is risk. 73% think eating food that has been prepared by someone who was infected with or had been exposed to SARS 45% think SARS is very easily spread 32% (16% are very concerned) may get SARS during the next 12 months. Harvard School of Public Health Telephone Survey Preliminary Results April 11 – April 15, 2003

Results:: 

Results: Fear in general population mild to moderate Fear within API Community, HCW, Travel industry Risk? Transmission? Prevention practice? Look to public health to provide leadership and coordination

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Health problem: SARS Control Tendency to Stigmatize Support the Stigmatized Public health strategies to control disease Early recognition, treatment, and prevention Health education and prevention messages Communication to enhance compassion/reduce blame Dispel myths and correct perceptions of risk Partnerships with affected populations Peer Support Groups Community Support *Adapted from Weiss & Ramakrishna, “Stigma & Global Health,” 2001 What to do?

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The Virus A new, severe respiratory illness has been reported worldwide. Etiology: Coronavirus, SARS-CoV The Behavior “Travel from a SARS affected area & having an exposure to a person infected with SARS” Control Tendency to Stigmatize

Recommendations and Guidelines for People Who May be Affected by the SARS Outbreak.: 

Recommendations and Guidelines for People Who May be Affected by the SARS Outbreak. For individuals considering travel to areas with SARS For individuals who must travel to an area with SARS For individuals who think they might have SARS For family members caring for someone with SARS: For health-care workers For institutions or organizations hosting persons arriving in the US from areas with SARS For schools Control Tendency to Stigmatize

Slide13: 

Develop simple and specific SARS prevention messages *We have developed simple messages, definitions, FAQs, fact sheets, MATT articles, sample letters Develop translated SARS information materials in various Asian languages *In-language FAQs, fact sheets, guidelines, on-line materials, translation of reports and support to other teams Control Tendency to Stigmatize within API Community

Support the stigmatized groups: 

Support the stigmatized groups Disseminate SARS information to API community through multiple and culturally appropriate channels of communication *Community visits, stakeholders, listserv, panels, town hall meetings, Chinese TV program, articles Partner with local API CBOs to educate the community *Discussion groups, community visits, information sharing SARS infection control and occupational teams conferenced with Clinicians and Airline workers

Balancing acts. . .: 

Balancing acts. . . Must be honest that understanding of the epidemic, it’s nature, and cause still evolving “The lady doth protest too much, methinks” Shakespeare’s Hamlet

Conclusion: 

Conclusion Targeting versus stigmatizing Care in all communications Minority with fear out of proportion to current threat. Leading to episodes of over reaction. Public health officials, clinicians & the community must combat fear, stigma and discrimination through health education and communication.