A Novel Surprise: Texas Ebola and Handling the Press. (A Look at the State's Public Health Information Response to the Nation's First Ebola Case, Transmission and Death in Texas)

Background:  No state expected to have the first case. But on Sept. 30 a Texas hospital patient tested positive for Ebola by the state's public health lab in Austin, making him the first person diagnosed with Ebola in the United States. The unfortunate diagnosis set in motion a ’round-the-clock operation to prevent the disease from spreading. It also set in motion a fast-paced media response that required the ability to respond to a crush of press inquiries, anticipate unusual key triggers, present clear messages and frequent updates, and educate the public about a disease that had not been seen before in the United States. 

Program background:  The Texas Ebola case triggered a public health emergency that demanded the complete attention of local, state and federal leadership, the health care system, emergency responders and even the general public. The tried and true public health tasks of contact tracing and disease investigation were the core of the operation. Providing clear information was critical to help counter the incorrect, misleading and often scary stories that emerged. Ebola, by its nature, is multijurisdictional – creating a public information challenge with rapidly moving information, various agencies and a mix of messages. The response evolved to include numerous issues that aren’t traditionally public health – waste management, experimental treatments, decontamination of homes and vehicles, the handling of human remains, and the monitoring of a pet. 

Evaluation Methods and Results:  Over the course of the event, state and local public health professionals in Texas monitored more than 300 people who had varying risks of exposure to the virus. No secondary cases resulted from community exposure. Public health worked, but was public health able to deliver the right messages at the right time? What were the biggest challenges? What lessons were learned? What worked, and what didn’t? How did visual images and policy decisions square with the science and key messages being emphasized? A close evaluation of the public information response, coupled with an analysis of the coverage and ebb and flow of press inquiries, offers insight into how clearly the messages were delivered and received. This will be discussed in detail during the oral presentation. 

Conclusions:  The Texas public information response to Ebola was a unique challenge involving an unprecedented structure, a novel disease, untested response plans and a mix of surprises and media triggers. It involved coping with chaos while remaining confident, explaining actions that may indicate conflicting messages, and dealing with highs and lows with complete candor. Taking a close look at the Texas public information response can inform future responses related to Ebola, another novel disease or any crisis.

Implications for research and/or practice:  The Texas Ebola response provides insight into crisis communications and can inform other states about how to deal with unprecedented disease events or any complex crisis in their own areas.