Communications and jurisdiction

Posted by ealboim under All

In all the discussion about communications confusion surrounding HINI, there has been at least as much media coverage about assigning blame as about underlying issues. 

 On the face of it, the barriers to consistent communication would seem to include the multiplicity of voices and the challenge of responding in real time to a changing circumstance where there is no premium put on gathering and centralizing information. By its very nature H1N1 is more locally variable than national reporting can do justice to. And the need for local information about impact and access to vaccines is more immediately relevant. There is no lack of interest or demand for information but the news media is focused, by definition, on what is news and that tends to emphasize dramatic outcomes rather than incremental information. What suffers from the rush to report the news is reasonable context and perspective. And no matter how reassuring those might be, the fear of the unknown and the random overwhelm. When you layer in exaggerated impulses to establish accountability (or blame in political arenas), you get systemic distortion. There may not be much way to resolve any of that.  

Public health authorities are trying to deal with uncertainty by providing regular briefings. However that is a two edge sword. By appearing regularly, they create a sense of urgency and moment no matter what their actual words try to portray. And, in the alternative, choosing not to appear would create an information vacuum to be filled with the less knowledgeable and a sense that the authorities are not in control. Further, as has become obvious, in their laudable efforts to educate and convince people to vaccinate, they created a sense of urgency and a level of demand that cannot be satisfied by relatively slow and systematic distribution of the vaccine. This, too, may be a dilemma without a solution.  

 AS to jurisdictional complications, we now have a situation where local authorities create rules, standards and procedures that vary dramatically because decision making is so decentralized. On one level, that makes perfect sense. Local circumstances and resources vary and are often best dealt with by people closest to them. On another level, they lead to confusing variability in a world where information instantly crosses boundaries and allows continual comparison. Standards that appear to be contradictory shake confidence in the underlying science and cause citizens to wonder whether their rights are somehow conditioned by where they live. Parents who see children portrayed as high risk categories in one area and not in another are understandably upset when they can’t get immediate access.  

In most national emergencies — economic (like prices and wage controls) or security (the war measures act) — Canadian law permits the imposition of national rules and standards. We have not had sufficient experience with health emergencies to apply principles like Peace Order and Good Government to justify national rules. Even if we cannot contemplate that sort of response, it is not clear why federal and provincial authorities could not have agreed to common definitions and standards for priorities and triage. There can be no doubt that the regional differences and the sorry spectacle of political leaders blaming each other for scarcity or the lack of appropriate distribution mechanisms is undermining confidence in the system as a whole. In that kind of circumstance, it is hard to blame people for queue jumping to ensure they and their families are protected.

 We probably need a federal-provincial agreement after this is over to determine thresholds for declaring health emergencies that can lead to quick national standard setting and the allocation of surge capacity to where it is most needed. Barring that, we need a way for the national government to seize leadership and through an expression of political will, impose consistent standards and procedures in order to shore up confidence. It might do that through asserting emergency powers or by imposing conditions on the funding and distribution of vaccine.  

Hopefully, this episode will not be dramatic and the death toll will be relatively light. But it seems that we would have escaped more through luck than careful and considered preparation. Should it become very severe, we will experience a level of anger and frustration that will shake the foundations of the system. 

 

Elly Alboim is an associate professor at the Carleton School of Journalism and Mass Communications