The global coronavirus disease (COVID-19) pandemic has already had an enormous impact and will surely have profound consequences for many years to come.
The authors reflect on three risk communication themes related to the pandemic: trust, tradeoffs, and preparedness. Trust is critically important during such a rapidly evolving event characterized by scientific uncertainty. Reflections focus on uncertainty communication, transparency, and long-term implications for trust in government and science. On tradeoffs, the positive and unintended negative effects of three key risk communication messages are considered (1) stay at home, (2) some groups are at higher risk, and (3) daily infections and deaths.
The authors argue that greater attention to message ‘tradeoffs’ over ‘effectiveness’ and ‘evaluation’ over ‘intuition’ would help guide risk communicators under pressure. On preparedness, past infectious disease outbreak recommendations are examined. Although COVID-19 was inevitably ‘unexpected’, important preparedness actions were largely overlooked such as building key risk communication capacities.
COVID-19: Reflections on trust, tradeoffs, and preparedness, April 2020
When our eldest daughter was about six-weeks-old in 1987, my ex and I took her to a Grateful Dead concert at an outdoor amphitheater north of Toronto. We sat at the back. The dead did this Buddy Holly song as part of their encore and it was fabulous.
‘Food safety recalls are always either too early or too late. If you’re right, it’s always too late. If you’re wrong, it’s always too early.’
That’s what Paul Mead was quoted as saying in response to when to go public with outbreak information over a decade ago.
During foodborne illness outbreaks and incidents information is evolving – what people know, and when the share it can impact public health, and buyer decisions. Go public too late and stuff remains on the market. Go public too early risks making a wrong decision
Doug, Sol Erdozian and I wrote a paper a while back that finally got published this week in the Journal of Environmental Health where we look at the going public situation. There’s no magic answer; just have a plan and a set of criteria to look at when making the decision of what to share when. Talk about uncertainty. And don’t make it up on the fly.
Here’s NC State’s press release about our paper:
There’s an ongoing debate among public health officials about how quickly they should notify the public about foodborne illness outbreaks, and how much information should be shared. Is it better to tell people as early as possible, or could that create panic that is counterproductive?
Food safety researchers are now calling on public health agencies to develop clear guidelines on when to inform the public about foodborne illness outbreaks – something which is often handled on an ad hoc basis at the local, state and federal levels.
To learn more about how health agencies are currently addressing these questions, researchers evaluated 11 case studies of large outbreaks, dating back to 1996.
Not only is there no clear consensus on how to respond, they discovered, but there is no system in place to help officials decide when to tell the public about a foodborne illness outbreak.
“We found that pressure from social media, or from companies, has sometimes influenced when health officials release information, which is problematic,” says Ben Chapman, lead author of a paper on the work and an associate professor of agricultural and human sciences at North Carolina State University.
“Officials need to have clearly defined processes for determining when information should be made public, and those processes don’t appear to exist right now,” Chapman says.
Instead, researchers found that public health agencies – from the federal Centers for Disease Control and Prevention to state and local agencies – make decisions about sharing information on a case-by-case basis.
“There are advantages and risks to both sharing and withholding information,” Chapman says.
Sharing information early in an outbreak can allow consumers to make informed decisions about their food choices that limit risk. But there can also be a lot of uncertainty about that information.
“For example, officials may be investigating a particular restaurant or type of food, but the investigation could ultimately find that the culprit was actually a different source altogether,” Chapman says.
By the same token, withholding information until there is less uncertainty may increase public health risks because the source of the illness may remain accessible to unwitting consumers.
“The best case is to share what you know, and what you don’t know, in an open and transparent way,” Chapman says. “Talking about uncertainty may be uncomfortable for officials, but they need to have a plan for how to do so.”
“Going Public: Early Disclosure of Food Risks for the Benefit of Public Health”
Authors: Benjamin Chapman, North Carolina State University; Maria Sol Erdozaim, Kansas State University; Douglas Powell, Powell Food Safety
Published: March 2017, Journal of Environmental Health
Abstract: Often during an outbreak of foodborne illness, there are health officials who have data indicating that there is a risk prior to notifying the public. During the lag period between the first public health signal and some release of public information, there are decision makers who are weighing evidence with the impacts of going public. Multiple agencies and analysts have lamented that there is not a common playbook or decision tree for how public health agencies determine what information to release and when. Regularly, health authorities suggest that how and when public information is released is evaluated on a case-by-case basis without sharing the steps and criteria used to make decisions. Information provision on its own is not enough. Risk communication, to be effective and grounded in behavior theory, should provide control measure options for risk management decisions. There is no indication in the literature that consumers benefit from paternalistic protection decisions to guard against information overload. A review of the risk communication literature related to outbreaks, as well as case studies of actual incidents, are explored and a blueprint for health authorities to follow is provided.
In the summer of 1994, Intel types discovered a flaw with their Pentium computer chip, but thought the matter trivial; it was not publicly disclosed until Oct. 30, 1994, when a mathematician at Lynchburg College in Virginia, Thomas Nicely, posted a warning on the Internet.
As perceived problems and complaints rose through the weekend Andrew S. Grove, Intel’s chairman and CEO, composed an apology to be posted on an Internet bulletin board—actually a web, but because he was at home with no direct Internet access, he asked Intel scientist Richard Wirt to post the message from his home account; But because it bore Mr. Wirt’s electronic address, the note’s authenticity was challenged, which only added to the fury of the Internet attacks on Intel.
At 8 a.m. the following Monday inside the company’s Santa Clara, Calif. headquarters, Intel officials set to work on the crisis the way they attacked a large problems—like an engineering problem. Said Paul Otellini, senior vice-president for worldwide sales, “It was a classic Intellian approach to solving any big problem. We broke it down into smaller parts; that was comforting.”
By the end of week two, the crisis looked to be subsiding; Then on Monday, Nov. 12, 1994, the International Business Machines Corp. abruptly announced that its own researchers had determined that the Pentium flaw would lead to division errors much more frequently than Intel said. IBM said it was suspending shipments of personal computers containing the Pentium chip
Mr. Grove was stunned. The head of IBM’s PC division, Richard Thoman, had given no advance warning. A fax from Thoman arrived at Intel’s HQ on Monday morning after the IBM announcement, saying he had been unable to find Grove’s number during the weekend. Mr. Grove, whose number is listed, called directory assistance twice to ask for his own number to ensure he was listed.
After the IBM announcement, the number of calls to Santa Clara overwhelmed the capacity of AT&T’s West Coast long-distance telephone switching centres, blocking calls. Intel stock fell 6.5 per cent.
As John Markoff of the N.Y. Times wrote on the front-page in Dec. 1994, the reluctance of Intel to act earlier, according to Wall Street analysts, was the result of a corporate culture accustomed to handling technical issues rather than addressing customers’ hopes and fears.
Only then, Mr. Grove said, did he begin to realize that an engineer’s approach was inappropriate for a consumer problem.
According to one op-ed writer, Intel’s initial approach to the problem—prove you are doing sophisticated calculations if you want a replacement chip—was like saying “until you get to be cardinal, any internal doubts about the meaning of life are your own problem, a debate tha has been going on since before Martin Luther.
Intel’s doctrine of infallibility was facing an old-fashioned Protestant revolt.” (John Hockenberry, Pentium and our Crisis of Faith, N.Y. Times, Dec. 28, 1994, A11; this is how things were referenced before hot links)
Why and how did Intel go wrong? The answer is rooted in Intel’s distinctive corporate culture, and suggests that Intel went wrong in much the same way as other big and unresponsive companies before it.
Intel has traditionally valued engineering over product marketing. Inward-looking and wary of competitors (from experience with the Japanese) it developed a bunker mentality, a go-for-the-juglar attitude and reputation for arrogance.
According to one former engineer, Federico Faggin, a co-inventor of Intel’s first microprocessor, “The attitude at Intel is, ‘We’re better than everyone else and what we do is right and we never make mistakes.’”
Finally, on Dec. 20, Grove apparently realized that he and his company were standing at Ground Zero for an incoming consumer relations meteor. Intel announced that it would replace the defective chips—and pay for the labor—no questions asked, for the life of the original PC.
Discussing Intel’s previous position, Grove said, “To some people, this seemed arrogant and uncaring. We apologize for that.”
So what does a consumer with a Pentium do? Teach Intel that this isn’t about white paper. It’s about green paper—the money you paid and the performance you didn’t get. Replace that chip. After all, consumers deserve to be treated with respect, courtesy and a little common sense.
The number of victims was being reported in other media as recently as this week as just 98.
And, the internal document says the real number of victims of Chipotle’s Simi Valley outbreak could be higher still. “In reviewing the food logs provided by Chipotle for both 8/18/15 and 8/19/15, it is estimated at least 1500+ entrees were sold each day.” Sandy Murray, who did the analysis for the division, wrote: “Thus, the actual number of customers and employees ill from this outbreak is likely to be substantially higher than the reported number of 234.”
This week Chipotle ran print advertisements in 60 newspaper markets Wednesday with an apology from Steve Ells, the burrito chain’s founder and co-chief executive. His apology though only went to the victims of the current nine state E. coli 026 outbreak and the Boston College outbreak.
“From the beginning, all of our food safety programs have met or exceeded industry standards, “ Ells says (Pinto defense). “But recent incidents, an E. coli outbreak that sickened 52 people and a Norovirus outbreak that sickened approximately 140 people at a single Chipotle restaurant in Boston, have shown us that we need to do better, much better.”
No mention was made of the other foodborne outbreaks.
The publicly traded Chipotle also had one of its better days since its troubles began. CMG stock was up 2.49 percent or $13.79 per share, closing at $568.65 per share.
Powell has often used the term, making people sick is bad for business; or as Fortune Magazine alliterates, the food industry has a $55.5 billion problem. Peter Elkend and Beth Kowitt of Fortune published sister pieces on the intersection of food safety and business focusing on Blue Bell’s recent listeria outbreak and re-entry to the marketplace.
Food-borne illness is a giant, expensive challenge for companies big and small—and the surprise is, their exposure to the risk (and the liability when linked to an outbreak) is arguably bigger than ever. “Thirty years ago if you had a little problem, you were not going to get discovered,” says David Acheson, former associate commissioner for foods at the U.S. Food and Drug Administration, who today runs a consulting firm. “Now the chances of getting caught are significant, and it can be the end of your company.”
For instance, since 2006 investigators have fingered a bacterial strain called E. coli O157:H7 (at one time widely thought to be found only in meats) in bags of baby spinach, in hazelnuts, and in cookie dough. They’ve identified botulism in pasteurized carrot juice and found salmonella in peanut butter, ground pepper, jalapeño peppers, Turkish pine nuts, and pistachios. They’ve discovered hepatitis A virus in pomegranate seeds; cyclospora in bagged salad mix; and Listeria monocytogenes in ice cream.
“I’m skeptical that these are new connections,” says Ben Chapman, associate professor of food safety at North Carolina State University, who runs a website called the Barfblog (I meant new pathogen/food contamination -ben). “It’s stuff that’s always been there, and now we’re looking for it.” That would help explain why FDA-regulated food recalls have more than doubled over the past decade, to 565 last year, according to insurance company Swiss Re—with nearly half related to microbiological contamination. In interviews with more than 30 experts, nearly all said the rise in recalls was less an indicator of deteriorating food safety than it was of our improving capacity to connect the dots between foods and microbes.
Molecular techniques (PFGE to whole genome sequencing) also get a shout out from friend of barfblog, Linda Harris.
Up until the 1990s, most outbreaks we found were in the same geographic location—the church picnic where everyone eats the same bad potato salad and calls in sick the next day. Then new technology enabled scientists to determine the various DNA fingerprints of food-borne bacteria, which were uploaded into a common database. Investigators were suddenly able to link disparate cases of illness by finding bacterial matches. “It revolutionized outbreak investigation,” says Linda Harris, a microbiologist in the department of food science and technology at the University of California at Davis.
Whole genome sequencing is the biggest advance I’ve seen in my 15 years in food safety.
The episode reveals not only how difficult it is to trace the source of food-borne illness but also what happens when a company is slow to tackle the causes—and doesn’t come clean with its customers. Experts say Blue Bell’s responses this year were an example of “recall creep.” That occurs when executives hope that taking limited action—as the company did five times when informed of findings of listeria—will solve the problem and minimize commercial damage, only to find themselves forced to expand the recall repeatedly. It’s the opposite of Johnson & Johnson’s actions in the 1982 Tylenol-tampering episode, when the brand famously saved its reputation by swiftly recalling every bottle of the medication.
Eklund and I spoke a lot about Blue Bell’s sharing of information specifics, which I’ve criticized as lacking. When a company is linked to illnesses and deaths and they say stuff like ‘food safety is important to us’ or ‘we’re going to step up what we are doing around microbiolgical sampling, cleaning and sanitation’ or ‘we’re hiring the best’ it often lacks substance. Sure, tell folks what you are doing but more important is pulling back the curtain on how many samples, what they are looking for, how they determined where and what to look for and what they are going to do if they find an issue. That’s what we mean by marketing food safety.
But Eklund quotes Gene Grabowski, a PR consultant involved in Blue Bell’s response as playing the we’re sorry and trust us game,
“In my playbook, you apologize sincerely once and then you move on.” (He has been supplanted by a team from PR giant Burson-Marsteller led by Karen Hughes, who served as a top White House communications adviser to George W. Bush.) “Had the company known then what it knows now,” Grabowski says, “it would have done a full recall of all products earlier than it did.”
Two decades into the world of online discussions, immediate news exchange, and Twitter flame wars and some are still sadly following the apologize and move on approach.
Earlier this week I spent some time with NC State’s Food Science Club and told some stories about how I got into the food safety nerd world. One of the career-shaping experiences in my past (that I didn’t share) was making a Jon Stewart correspondent-type video with Christian Battista at Biojustice 2002.
We talked to lots of folks about their perceptions, concerns and understanding of GE foods and it gave me some hands-on experience in risk communication. The video led to some writing, which led to some criticism of putting out evidence-based opinions.
A couple of food science students I know, Nicole Arnold and Lily Yang (and others), are jumping into the communicating food risk world and put together a much slicker introductory video to a project they’re calling Don’t Eat the Pseudoscience.
I’m looking forward to their next steps as they do their own engaging with the passionate eaters of the world.
This document may set some sort of dubious record for the use of collaboration, partnership, and resources in relation to food safety.
Does anybody do anything, and will there be fewer sick people?
The best practices identified in this document are intended to encourage and enhance timely reciprocal communication of recall information among the U.S.Food and Drug Administration, State and local government agencies (herein after partner agencies) during Class I recalls and outbreaks. Information sharing between the agencies will save government resources and promote a safe and secure food supply.
The focus of the Partnership for Food Protection (PFP) Surveillance, Response and Post Response Workgroup was to enhance recall transparency,communication, and sharing of information that would help move us forward with implementing an Integrated Food Safety System (IFSS). The workgroup identified best practices for sharing recall activities that will not unduly impact the hih workload of partner agencies’ recall staff.
To develop the best practices, the following recall activities associated with information sharing were identified:
Differing regulations such as commissioning and sharing agreements that impact the timely sharing of recall information
Format of information to be shared
Information technology issues between partner agencies
Identification of FDA and partner agencies recall staff members with whom information can be shared and methods of contacting
Consideration and possible identification of a universal recall reporting portal to capture and share recall and outbreak information in timely manner which is accessible by all authorized partner agencies
Not all best practices will be applicable in every situation; however, they should be considered where appropriate for the effective coordination of recall activities and the leveraging of mutual resources. This is living document. As additional best practices are identified, they will be captured in this document.
Partnership for Food Protection’s Surveillance, Response and Post Response Workgroup presents
Besides academic use, the words risk, safety, and security are frequent in ordinary language, for example, in media reporting. In this article, we analyze the concepts of risk, safety, and security, and their relation, based on empirical observation of their actual everyday use.
The “behavioral profiles” of the nouns risk, safety, and security and the adjectives risky, safe, and secure are coded and compared regarding lexical and grammatical contexts.
The main findings are: (1) the three nouns risk, safety, and security, and the two adjectives safe and secure, have widespread use in different senses, which will make any attempt to define them in a single unified manner extremely difficult; (2) the relationship between the central risk terms is complex and only partially confirms the distinctions commonly made between the terms in specialized terminology; (3) whereas most attempts to define risk in specialized terminology have taken the term to have a quantitative meaning, nonquantitative meanings dominate in everyday language, and numerical meanings are rare; and (4) the three adjectives safe, secure, and risky are frequently used in comparative form. This speaks against interpretations that would take them as absolute, all-or-nothing concepts.
The Concepts of Risk, Safety, and Security: Applications in Everyday Language
Nicole Arnold, MS student at N.C. State University writes:
I never knew that I sounded like a twelve year old until I recorded myself for a video competition to take part in IFT’s first inaugural Food Communicator’s Workshop. A few snowflakes in North Carolina had shut things down; I couldn’t use a university studio so I was forced to record myself in my bedroom via YouTube.
Maybe it was because I boasted of being part of the behind the scenes of barfblog (and mentioned 40,000 subscribers) or because nobody else could bear the discomfort of recording themselves, but they chose me.
Sponsored by CanolaInfo, the IFT workshop was created to prepare and encourage students and young professionals to communicate food science information and issues through various channels. As a group, we dissected multiple media platforms, specifically the infamous Food Babe’s attack on canola oil. The group leaders asked:
How would we respond?
What would we say if we chose to say anything at all?
What type of social media platforms would we use?
During a mock print interview, I grabbed a slip of paper out of a bowl with the words ‘artificial colors’ on it. I know a little bit more about that topic but am less- familiar with GMOs and preservatives (which others received).
With only a minute to look over the content, the interviewer asked me ‘why artificial colors are added to foods when scientific literature links it to cancer?’
I made a rookie mistake and used the oft-used phrase that the dose that makes the poison. The mock reporter’s eyes lit up.
Poison. I had said it.
An actual reporter could take that statement and run with it, indicating that my statement equated colors to poisons.
I should have talked about how safety reviews are conducted on artificial coloring and that while there are no certainties or guarantees in safety, regulators assess risk by calculating exposure and the amounts needed to cause problems. Many studies are based on mouse models – which may or may not be all that transferable to humans. Based on the current available science, the U.S. FDA and other public health-protecting bodies throughout the world have deemed certain artificial colors as low risk.
It’s tricky, but as food communicators, our messages should be clear, concise and explain the uncertainties of the science. And shouldn’t use clichés.
Nicole Arnold is a MS student in Food, Bioprocessing and Nutrition Sciences, a barfblog news team member, and is a vegetarian studying mechanically tenderized beef safety.
Here’s a video submission from Ohio State’s John Frelka.
“Firstly, this is not a complaint,” the woman began. “[The burger] is the only thing he ate differently from us that day so we assume it was the burger. Just wanted you to be aware. We thought the burgers were fantastic and know it was probably a one-off.”
And it probably wasn’t the burger (that would take 2-4 days, unless it was norovirus).
But the response from the chef is an instructive lesson in what not to do when chatting with customers.
On Wednesday, owner Mike Duffy posted a screengrab of the private message from the Wellington woman, saying “he wanted to get in first.”
When people complained he was breaching her privacy, he posted on Thursday the rant against his customers.
“Almost 20 years in this f—ing industry and never had a person who ate what I cook get sick from it,” he wrote on Ekim Burger’s Facebook page.
No evidence to prove that.
“Plenty of pissed up office jocks pulling the ‘i got food poisoning’ call after going home way to [sic] drunk from a staff Christmas party with someone who they shouldn’t have.
“Loads of middle class no idea house wives completely out of their league complaining that their wine glass should have more in it.
“Dozens of to [sic] drunk to drive but gonna anyway cos they can lawyer’s with no regard for the position they put you in as the license holder by driving home.
“100000s of eggs on Sunday mornings when no one, least of all the other staff wants to hear some little shit kid banging his or her fork on the wooden table only to be released from its chair to f— up the morning of other diners. So it’s dimwitted parents can talk about what shit the service is even though they’d never tip no matter how good it was.”
Unapologetic, Duffy said the rant was inspired by what he calls a creeping culture of rudeness and entitlement among hospitality patrons, who he said have a responsibility to behave well in restaurants, cafes and bars.
“It’s common courtesy and it’s not common anymore,” he explained.