Please Refrain…

You never meant to cause us any sorrow.



You never meant to cause us any pain.

You only wanted one time to raise awareness.

But when you think on speculation,

Pause, and please refrain.

Please refrain, please refrain…

Be First.  Be Right.  Be Credible.  It is advice so central to crisis communication that it graces the cover of the CDC Crisis & Emergency Risk Communication (CERC) manual.  These are the tried-and-true basics of emergency and crisis communication.  I have lost track of how many after action reports have lauded those who heeded that advice, and pilloried those who forgot.

And then Prince died.

In the days following Prince’s death, speculation ran wild that he may have died from influenza or some complication thereof—prompted by reports from Prince’s spokespeople that he was recently hospitalized for the flu.  Some of these were written by public health and medical professionals, experts in their respective fields.  These pieces were, in turn, referenced by dozens of news articles and fed into the broader discourse surrounding the artist’s untimely demise.  While Prince having the flu and passing away in short succession may have seemed, superficially, like the perfect opportunity to raise awareness of flu fatalities (and I certainly appreciate this desire), I am left questioning the impact on public opinion of public health now that his death may have been linked to prescription painkillers.

In all fairness, all of the articles that I read readily acknowledged that the cause of Prince’s death was unknown.  But when recognized experts volunteer their opinion, regardless of whether or not they acknowledge the uncertainty, it lends validity to the speculation.  My major concern is that this was an unforced error.  During the response to an actual public health incident, health authorities are responsible for communicating what is known as well as what unknown about a given scenario, and they may be forced to speculate in order to take appropriate actions.  This was not a public health incident.  This was a celebrity death that was leveraged into an opportunity to discuss public health.  None of this speculation was necessary.  I fear that by trying to raise awareness about the severity of influenza, the experts—on whom we rely for clear, accurate knowledge during emergencies—may have damaged their credibility in the eyes of the public.  I fear that this speculation may be viewed by the public as yet another case of public health simply overreacting.

Public health struggles under the best of circumstances to maintain the public’s attention and trust.  Under the worst of circumstances, the burden of too little information and the demand to act and speak quickly can quickly derail a response.

On occasion, a well-meaning but misinformed public demands the impossible of us.

But there’s no study disproving a link between vaccines and autism.

Sometimes we do get it wrong, and recovering from that can be an immense challenge.

Yeah, remember when you guys said any hospital could handle an Ebola case?

Sometimes even when we are technically or factually correct, public perception may still disagree.

Remember in 2009 when you guys said that H1N1 was going to be a pandemic?

And sometimes, the public only reads the headlines, not appreciating the context or nuances of a given issue.

Remember when you guys said there would be a million cases of Ebola?

Now, I am just imagining—and fearing—the next conversation.

Flu isn’t that bad.  Remember when you guys said Prince died from the flu?