Healthcare: The story of swine flu

... so far. Gemma O'Reilly looks at UK media coverage and official communications around the swine flu pandemic to date.

MARCH 2009 - FIRST CASE IN MEXICO

The world was gripped by breaking news that an unknown flu strain was claiming lives in Mexico. The media were quick to report the first cases of swine flu as they began to emerge in Mexico.

For the first few weeks, the world's press watched as cases were identified across the US and Mexico border and in other countries around the world.

Mexico was forced to pull its tourism advertising while the country battled the virus and remained under the media spotlight. Headlines detailing hundreds of deaths dominated the news agenda.

The Department of Health (DH) was instrumental in helping to brief journalists in the UK on what facts it had on the virus as it tried to stop sensationalist reporting.

DH director general, communications, Sian Jarvis says of the media coverage: 'Initially, we knew this was clearly a very worrying situation. Nobody knew how this virus was going to behave and what was going to happen.

'We saw it claiming lives around the globe - and then it came to the UK. There was a sense of almost a wartime spirit. Everybody was very concerned and everybody wanted to get it right because we all knew it was important.'

APRIL 2009 - DH LAUNCHES SWINE FLU ADVERTISING

As cases started to emerge in the UK, the DH rolled out an edited version of its flu advertising campaign from last year to advise the public on good hygiene techniques.

TV, print and radio ads aimed at stopping the spread of infection were aired and door-drop leaflets containing information about preventive measures were handed out.

Jarvis says eight press officers on the DH's news desk took a record 450 calls on one day in June as the media clamoured for more information on the flu.

However, the DH was not unprepared for the crisis and Jarvis admitted it had been preparing for this type of situation for years. The key messages it was rolling out were to reassure the public that the Government had sufficient antiviral drugs for half the population should they be needed.

'We were massively prepared and had been planning for this for five years or so, at a very detailed level,' explains Jarvis.

'We even had a marketing campaign ready to go. Within days, we had the campaign ready and we had a leaflet drop rolling off the presses almost immediately.

'I think it was a very, very impressive response - and that was because we had put so much effort into planning for this eventuality.'

The DH also set up weekly press briefings for journalists to advise them on what the Government was doing and update them on the latest news.

JUNE 2009 - FIRST UK DEATH AND PANDEMIC ANNOUNCED

The Department of Health quickly swung into action to urge the public not to panic after a new mother became the UK's first patient to die while suffering from swine flu.

The key message from the DH press office was that the majority of cases in the UK had not been severe.

Health Secretary Andy Burnham also encouraged people not to panic after the World Health Organization announced the world was in the grip of a flu pandemic, the first in more than 40 years.

The first UK death saw the pandemic hit the front pages of the national media once again. However, Jarvis says the press, on the whole, has handled the story well.

'Generally I would say that the media have handled it incredibly responsibly,' she says. 'There have been pockets and sometimes maybe someone has got it wrong. But quite often what happens is the story itself will be very well balanced and very well briefed, but the headline might be rather sensationalist.'

3 JULY 2009 - PANIC LEADS TO MASS BUYING OF SWINE FLU DRUGS ON THE WEB

The Government was forced to warn the public against buying swine flu drug Tamiflu over the internet without a prescription.

Chief medical officer Sir Liam Donaldson urged the public not to panic buy and said drugs bought on the internet might be 'poisonous and dangerous'. He was keen to stress that the Government had stockpiled enough vaccines of the real Tamiflu drug. His interview aired as news broke that the UK could soon be diagnosing up to 100,000 cases of swine flu every day.

The Royal Pharmaceutical Society of Great Britain, which had been running a campaign warning of the dangers of buying drugs online, also stepped into the fray to warn against buying the medication online.

At the same time the World Health Organization announced the worldwide spread of swine flu was unstoppable, and that the UK was moving to a 'treatment' phase.

NHS crisis expert Jonathan Street believes the DH managed to get its messaging right and can be complimented on getting the PR right so far.

'The main messages have been well delivered and have hit home with the public as they are not, currently, in panic mode,' he says. 'There have been incidences of queues of anxious patients outside A&E departments, but they have been rare.'

16 JULY 2009 - UP TO 65,000 DEATHS EXPECTED

Sir Liam Donaldson announced in July that the NHS had been advised to plan for between 19,000 and 65,000 swine flu deaths this winter. He was keen to stress that the figures were not predictions but 'worst case scenarios', which would help authorities to plan for any eventuality.

Jarvis says at the beginning of the swine flu crisis the DH had decided to be as open with the public as possible. However, this did bring some difficulties. 'Suddenly, everything that comes across your desk (forecasts, advice, assumptions, scientific evidence) we want to tell the public because people need to be informed in order to make their own decisions,' she explains.

'So we decided to put out the 65,000 deaths figure, which did lead to some sensational headlines. But we knew that was in line with openness and transparency, in terms of building trust with the public. The alternative would have been that the story would probably have got out anyway and we would have been accused of sitting on a secret document, which would automatically have destroyed public trust in a moment. So that has been the way we have approached swine flu.'

19 JULY 2009 - WOMEN WARNED NOT TO GET PREGNANT

At the peak of the crisis in the UK, healthcare PR experts criticised the Government's swine flu messaging, as the media reported that women were being warned not to get pregnant during the pandemic.

Virgo Health co-founder Angie Wiles said of the Government's reaction: 'The Government has the best of intentions, but the worst of communications. The NHS is receiving so many updates that the advice keeps changing and it is failing to keep up with it. GPs and primary care trusts are trying to get on with it, but it is difficult because there is no precedent.'

July saw a swathe of coverage on the crisis, including advice initial advice telling women to delay getting pregnant until after the pandemic had passed. The former secretary of state for health Alan Johnson spoke out against this advice on The Andrew Marr Show on BBC One and said it was an overreaction to say women should not have babies during the pandemic.

The Daily Mail ran a story on the front page with the headline: 'Swine flu: Who can mothers believe?' It criticised the mixed messaging, which was creating confusion for parents.

OCTOBER 2009 - DH APPOINTS AGENCY TO LAUNCH VACCINATION PROGRAMME

The DH selected Consolidated PR to roll out its public campaign to publicise the swine flu vaccination programme. The vaccine, produced by GlaxoSmithKline, was licensed by the European authorities in September.

The national vaccination programme started in October for the 9.5 million people identified as being in the clinical risk groups.

Consolidated's brief includes helping to raise awareness of the vaccine's availability, and helping to overcome persistent media stories that the vaccine is unsafe because it was fast-tracked.

Tonic Life Communications group managing director Oliver Parsons says: 'As the pandemic emerged, the world's media did latch on to a story that was clearly good for headlines. But now that the hype has subsided somewhat, the media now need to rise to the challenge and act as educators to underscore the important role that vaccination, antiviral drugs and hygiene play in the battle against influenza.'

NOVEMBER 2009

Global drugs firm Roche enlisted fresh PR support for Tamiflu, as the swine flu pandemic looks set to worsen this winter. Healthcare shop Tonic Life Communications was awarded the global account for the anti- influenza drug and replaced incumbent Ketchum, which had held the account for two-and-a-half years. Cohn & Wolfe continues to handle Tamiflu's UK PR activity.

Roche head of global communications for metabolism and virology Clare Evans says of the appointment: 'Tamiflu is an extremely high-profile treatment and is vitally important to our society during this pandemic. Consequently, we felt the need to revisit our communications requirements at this time.'

Global sales of Tamiflu totalled CHF2bn (approximately £1.19bn) in the first nine months of 2009, an increase of 362 per cent over the same period last year. The growth was driven by increased demand in the second and third quarters following the swine flu outbreak.

Sales of Tamiflu in the third quarter totalled CHF994m, compared with CHF101m in the third quarter of 2008.

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