We have seen earlier that the public does not always follow public health advice. Here you can see a public health advisory from the US CDC on precautions that people need to take to protect themselves against flu. But we know that lots of people don't do this. And we've also seen that a really important reason why people don't follow public health advice is because of a difference in perception between the public and experts on the risk that is involved. For example, in the case of flu vaccination, several people believe that the risk from vaccination outweighs the benefit. Scientific studies and public health agents, on the other hand, feel that the benefits from vaccination far outweigh any risk that might exist. One of the big infectious disease threats that we face now is the emergence of the MERS coronavirus in the Middle East. Public health agencies throughout the world have been putting out travel advisories to members of the public on precautions they should take before visiting the Middle East. Here is an example of a travel advisory that the US CDC have put out. Once again, we see that people do not always follow this advice. The government of Saudi Arabia in 2013 advised pilgrims to Saudi Arabia, pilgrims who are going to perform the Hajj to postpone their pilgrimage to a later period if they had any underlying health conditions that might make them more vulnerable to the MERS virus but studies have shown that most people ignored this. A recent study in the journal Eurosurveillance showed that at risk individuals decided to go on the Hajj pilgrimage anyway and their perceptions of the risk of contracting MERS was far lower than public health risk assessments. How does risk communication help in times like this? Now, as we've seen earlier, risk communication is essentially a bridge, a bridge between scientists and public health experts on the one hand, and the public on the other hand, and it's a bridge between these differing ways of understanding risk. So how would risk communication help at a time like this? Here I want to show you a definition of risk communication and this was a definition from the US National Research Council which defined risk communication as "an interactive process of exchange of information and opinion among individuals, groups and institutions in order to manage risk". As we can see from this, something should strike you. When you read this, it's quite clear that risk communication is more than a process of communication specialists telling the public what the risk is. It's a much more interactive process. So, how do we go about this? The key of course is to understand public perceptions and to engage with the public. That is the first step in communication and there are a variety of tools that can be used. Public opinion surveys, focus groups with key stakeholders, media monitoring including social media. And through these tools, we get an awareness or we understand the knowledge, the awareness and perceptions of the public. Based on this, communicators can gather information about what communities already know about the disease, their perceptions of risk and what are the beliefs that underlie these perceptions. They can also understand how people are likely to respond to public health advice. Now, it's not enough just to gather this information. This information, once gathered, must also be fed back to those who are managing the risk and this is a key funciton of risk communication during an infectious disease outbreak or any other form of health emergency. Here's a little model to show you how it all works and you can see that the public is at the center of this model, this little triangle, if you will, and risk communication, as you can see, is a process by which information travels between the public and between the people managing the outbreak. So, risk communicators first of all gather information from the public. They pass that information to those who are assessing the risk and those who are managing the risk and finally, based on that, they feed back information to the public and this is a constant dynamic process. I'm going to leave you with an exercise now. What are the steps you would take to devise a risk communication plan for MERS virus for pilgrims traveling to Saudi Arabia? Use the WHO Outbreak Communications Guide which is part of your reading list and also read the paper in Eurosurvillance as background material.