PANDERIA: Pandemics, panics and international borders

Transcription

1 INGSA WORKSHOP MATERIALS PANDERIA: Pandemics, panics and internatinal brders Writing team: Kristiann Allen, Peter Gluckman and James Wilsdn DOCTOR READS A PATIENT S CHART

2 PANDERIA: Pandemics, panics and internatinal brders Nte: materials in this case are fictinal and shuld nt be taken t represent real-life peple, places r events. A new highly infectius disease, labelled African Frest Respiratry Encephalitis (AFRE), is spreading acrss Western and Central Africa. S far it has claimed 6,500 lives f which 4,000 have been in the cuntry f Panderia. AFRE is thught riginally t have been transmitted t peple frm the nwendangered red-backed frest babn, and is nw spreading thrugh human-t-human transmissin. This transmissin is happening mst likely thrugh drplet spread, as the disease starts with a respiratry infectin. Within 24 hurs it becmes encephalitis, which is ften fatal r which can leave individuals with neurlgical damage. On scial media, #KickutAFRE is nw a rallying cry. Peple in Africa and utside have created Facebk grups as tls fr public awareness and advcacy, psting infgraphics n AFRE preventin and sharing infrmatin. The Centers fr Disease Cntrl (CDC) and the Wrld Health Organizatin (WHO) wrk with these grups t disseminate as much accurate infrmatin as pssible. Backgrund and cntext Average fatality rates frm AFRE are arund 50%, but can vary frm 25% t 90%. The mrtality rate is higher in wmen than in men, especially pregnant wmen. Cmmunity engagement is imprtant t cntrlling utbreaks, thrugh a package f interventins: case management, use f face masks, surveillance and cntact tracing, a gd labratry service, safe burial practices and scial mbilisatin. Early supprtive care with rehydratin has been shwn t imprve survival. There is as yet n licensed treatment t neutralise the virus but tw candidate vaccines are under develpment thanks t rapid deplyment f internatinal funds and expediting the ethical review prcesses fr human trials. Effrts t tackle AFRE als have t cntend with the pwer f scial media. Claims f cures and panicinducing cnspiracy theries have ften fllwed sudden utbreaks f diseases generally. The cnversatins abut AFRE are n exceptin. Facebk, Instagram and Twitter are prminent in African cities, but inaccurate infrmatin is wrse than n infrmatin at all. Fr every scial media pst pushing accurate infrmatin, there seems t be anther ne abut all manner f suppsed cures, r rumurs that pisned water, nt AFRE, are causing peple t die. The scial media cnversatin has becme chatic, with pliticians, experts, NGOs and cmmunity leaders all trying t be heard. Cnfusin and rumur have made it harder fr health care wrkers and gvernment fficials t cmbat the utbreak. In Hamudu, a Panderian reginal capital, medical staff were chased away by lcal residents wh feared that their infected relatives wuld be taken away fr treatment, but wuld never return. The dilemma The Chief Medical Officer f Panderia is wrking hard t disseminate accurate infrmatin. She acknwledges that: Lts f peple are really scared and nt getting prper infrmatin abut what happens in the treatment centres. They see peple ging int the hspitals and cming ut in bdy 2

3 bags. Sme are turning t traditinal healers in a bid t cmbat the disease thrugh prayers and exrcisms, rather than medical science. Als, unscrupulus merchants are selling AFRE vaccines at extrtinate rates. These suppsed vaccines are made frm limes and nins. Five days ag, a rumur began t circulate n scial media that drinking ht water with cnsiderable amunts f added salt culd prevent AFRE. Already, excessive salt cnsumptin in the summer heat has led t 38 deaths and 140 hspitalisatins in and arund the mst affected regins f Panderia. In situatins like these yu have tw chices, said the Chief Medical Officer in a widely publicised interview. Yu can refute the rumurs ne at a time r yu can try and affect the verall infrmatin envirnment by prviding infrmatin abut the scientific evidence repeatedly. She has taken t hsting chats n Twitter, but is als fcusing n the mre traditinal media. Her netwrk f experts, supprted by varius internatinal agencies, have appeared n lcal Panderian radi statins, distributed psters and dne utreach n AFRE preventin, transmissin, and signs and symptms. Alngside this team, the mayr f Hamudu has nw appinted a rumr manager t dispel myths abut fake cures that are spreading thrugh the city. The rle f scientific advice Yu are the chief scientific advisr f Prxeria, a small neighburing cuntry. It is believed, that the pandemic has nt yet reached Prxeria wing t the largely muntainus and frested brder between the tw cuntries. Histrical tribal differences between the tw cuntries have largely discuraged inter-migratin. Hwever a grup f mre than 40 migrants frm Panderia have managed t enter Prxeria at an illegal brder crssing. Thirteen f these new arrivals have been fund at the central bus statin, but thers have already secured accmmdatin with persnal cnnectins in the cuntry. Seven f the Panderian migrants at the bus statin nw have respiratry symptms. Mass panic is breaking ut and a new hashtag is trending in Prxeria: #KickutPanderians. Yu and the Prxerian chief medical fficer are called t an emergency meeting f Prxeria s Cabinet. What are the cnsideratins that yu will have t take int accunt in the discussin? 3

4 GROUP EXERCISES Exercise 1: Grup discussin What issues des the Science Advisr need t cnsider in preparing respnse? Cmmunicatin f cmplex science What are the tp messages t Cabinet? Hw shuld cmplexity and uncertainty be cmmunicated? Hw might messages and cmmunicatins techniques evlve ver the curse f the pandemic? What is the rle fr scial sciences in this case? Hw can insights frm scial sciences supprt apprpriate cmmunicatins? Hw can scial media be used t best effect. Rle f the Chief Scientific Advisr in emergencies Hw des the urgency f the situatin affect the impact and receptin f science advice? What are the elements f knwledge brkerage that cme int play and hw are these affected by the urgent cntext? What we knw What we d nt knw Risks f actin r inactin Alternate appraches Trade-ffs Crss brder cnsideratins Hw might the internatinal nature f the issue affect the rle f the Chief Scientific advisr in this case? What ther sectrs and stakehlders shuld be engaged? What is the rle f the Science advisr in such engagement? Other cnsideratins? Exercise 2: Rle-playing Listed in n particular rder, the fllwing perspectives (participants may identify thers) have been utlined fr use in a rle playing exercise. Participants are divided int grups and encuraged t bth cnsider the perspective f varius actrs as listed, but als what the science advisr r advisry bdy might d in each situatin. Perspective 1: Prxeria s Chief Scientific Advisr What perspectives and cnsideratins shuld be reflected in any advice given t? Hw wuld yu structure yur advice? T what extent wuld yu reach acrss the natinal brder and engage with Panderian fficials? 4

5 T what extent wuld yu engage with scial and traditinal media? What are yur key messages? Are there limits t the science advice (e.g. plicy cnsideratins abut the legal status f the Panderian s in yur cuntry)? Perspective 2: Gvernment (Panderia and Prxeria) Panderian fficials, already verwhelmed by the public health emergency in their wn cuntry have been cntacted t repatriate the illegal Panderians wh have crssed the brder. Hw wuld they handle the request frm the neighburing gvernment? What are the cnsideratins fr fficials n bth sides f the brder? What scientific knwledge need might cme int play (e.g.: incubatin perid f the disease, quarantine prcedures, respective health management strategies and lessns t share etc). Perspective 3: Internatinal Health cmmunity Yu are the UN Resident Representative in Panderia and have been in tuch with yur cunterpart in Prxeria. Yu are bth liaising regularly with yur respective gvernment interlcutrs. Hw wuld yu integrate lcal science advice int yur planning f the UN respnse in the tw cuntries? What are yur primary knwledge needs frm the Science Advisr (e.g. scial science insights, demgraphic trends and ppulatin patterns?) Hw wuld the science advisr best engage with UN partners? Other perspectives? PHOTO CREDITS COVER: Dctr reads a patient s chart. Credit: Kendra Helmer, USAID, public dmain. This wrk is licenced fr nn-cmmercial reuse, with attributin t INGSA and named authrs, and link t See fr mre inf. 5

6 ABOUT INGSA INGSA prvides a frum fr plicy makers, practitiners, academies, and academics t share experience, build capacity and develp theretical and practical appraches t the use f scientific evidence in infrming plicy at all levels f gvernment. INGSA s primary fcus is n the place f science in public plicy frmatin, rather than advice n the structure and gvernance f public science and innvatin systems. It perates thrugh: Exchanging lessns, evidence and new cncepts thrugh cnferences, wrkshps and a website; Cllabrating with ther rganisatins where there are cmmn r verlapping interests; Assisting the develpment f advisry systems thrugh capacity-building wrkshps; Prducing articles and discussin papers based n cmparative research int the science and art f scientific advice. Anyne with an interest in sharing prfessinal experience, building capacity and develping theretical and practical appraches t gvernment science advice is welcme t jin INGSA. By signing up t the INGSA Netwrk yu will receive updates abut ur news and events and learn f pprtunities t get invlved in cllabrative prjects. G t fr mre infrmatin. INGSA has been supprted by: The Wellcme Trust New Zealand Ministry f Freign Affairs and Trade Ryal Sciety Lndn INGSA perates under the auspices f ICSU. The INGSA secretariat is currently hsted by The Office f the Prime Minister s Chief Science Advisr, New Zealand PO Bx , Symnds Street, Auckland 1150, New Zealand. Tel: ; Web: 6