Some day, you’ll cover a health crisis

Karen Palmer

I was in Arkansas in April when CNN began stepping up its coverage of reports of swine flu trickling across the Mexico-U.S. border. I was spending a long weekend with two friends I’d met while on a public health fellowship at the Centers for Disease Control & Prevention (CDC), so needless to say we paid pretty close attention to the coverage.

During our four months with the CDC, we’d worked side-by-side with researchers, doctors and epidemiologists, learning how they investigate, contain and control outbreaks. By the end of the weekend, swine flu had been reported in more than four countries, a handful of states and a few Canadian provinces. Despite the near-constant updates on CNN — and warnings that we were headed for a pandemic — we were, for the most part, completely confused about what was really happening.

It reminded me of the three months I spent covering SARS for The Toronto Star. When Severe Acute Respiratory Syndrome appeared, no one had seen it before, no one knew what caused it, how it spread, how it affected the body or how many people might succumb to the disease. It was a confusing time and, looking back, not my finest hour as a reporter.

What I remember most about covering SARS wasn’t the urgent news conferences or the in-depth interviews about coronaviruses, it was the overwhelming sense that we were running in all directions, often chasing rather than leading and frequently scaring readers more than informing them. We worked incredibly long hours, gave interviews to media outlets outside Canada that were curious about the country’s SARS battle and often felt we needed to babysit our stories to ensure editors understood what we were trying to say. What I remember most was the feeling of incredible frustration.

Herewith, a few lessons learned:

First off, learn the lingo and then learn to forget it. Epidemiologists and public health workers speak their own language. Do you know the difference between an outbreak, an epidemic, an endemic disease or a pandemic? What about the difference between and infection and a disease? It’s important to know and to explain.When SARS hit Toronto, news conferences were peppered with talk about “confirmed cases” versus “suspected cases.” Did this language help readers understand the movement of the outbreak? Mortality rates, morbility rates, rates of infection… this is all jargon and doesn’t really help when people are already feeling panicked.

“Texas declares state of emergency” is a scary headline guaranteed to garner attention. But what does it really mean? Often states of emergency have less to do with the virulence of a virus and more to do with access to federal funding. It allows public health offices to hire more staff or pay overtime when labs are overloaded with outbreak cases. It also gives disease investigators access to information that might otherwise be labelled as confidential and confined to the doctor’s or hospital’s files.

What is quarantine? What does it entail? How is it enforced? In order to follow the story, you need to understand the ins and outs. Readers, listeners and viewers need this kind of information often — and they need it to be clear — so they can act appropriately.

Understanding the standard protocol a health department follows in the wake of an outbreak will help you understand when things have gone awry and when mistakes have been made. The SARS stories that were nominated for awards weren’t the bread-and-butter everyday reporting about the outbreak, they were the investigative stories about nurses informing health officials about the re-emergence of the virus and the fact that their observations were ignored.

Consider, also, Ontario’s handling of the West Nile virus It was a difference in the way Ontario’s medical officer of health released numbers about the outbreak that tipped off a CTV reporter that not all was well with the reporting and confirmation of the disease. It led to a great piece questioning whether the province’s handling of the outbreak led a false sense of complacency and, as a consequence, infections that could have been prevented if the public had the right information.

A colleague at the Canadian Press calls the SARS outbreak the story-of-a-lifetime and she has been widely acknowledged as providing some of the best coverage. She lived by the adage that there is no such thing as a stupid question. When she didn’t understand something, she looked for someone who did. By the end of the first month of the outbreak, she knew more about the virus — about the way it mutated and the way it worked — than some of the researchers she was calling for interviews.

Remember: there really is no such thing as a stupid question.

These kinds of stories are unlikely to go away. We live in a smaller world, where international travel is frequent and people and animals are increasingly pressed closer together. Misuse of antibiotics is rampant and our hospitals are loaded with lethal bacteria impervious to drugs. All this means that, chances are, you’ll end up covering a big public health story at some point, whether it’s an epidemic, outbreak or pandemic.

So read. “The Coming Plague: Newly Emerging Diseases in a World out of Balance” by Laurie Garrett is available on Amazon. “Beating Back the Devil: On the Front Lines with the Disease Detectives of the Epidemiological Intelligence Service” by Maryn McKenna is another great source for learning about outbreak investigations. The Poynter Institute has lots of helpful hints and suggestions. There are tons of sources and resources, so use them.

When an outbreak hits, it affects all beats and requires teamwork from editors and reporters. Stories abound. Editors need to trust that their reporters are taking the story seriously; reporters need to understand that, as tedious as some of the stories seem, a little legwork can go a long way to building a reputation for serious, accurate, fair and balanced reporting during a time of crisis.

Covering a crisis obviously requires editors and reporters to walk a very fine line: reporters need to keep their readers and listeners up-to-date, they need to give them the best information they can to help them make sound decisions, but they can’t be cavalier about readers’ health. Scary headlines eventually backfire: when readers/listeners/viewers get fed up with the scaremongering, they will seek their news elsewhere.

Remember, above all, that your responsibility is to inform readers, not to incite panic.

Karen Palmer is a former health reporter for the Toronto Star. She was a freelance journalist in Africa and Asia and is now in London, Ont. working on a book about Ghana’s witch camps, which will be published in 2010 by Free Press, an imprint of Simon & Schuster.