How Do the First Days Count? A Case Study of Qatar Experience in Emergency Risk Communication during the MERS-CoV Outbreak
Identifieur interne : 000839 ( Pmc/Checkpoint ); précédent : 000838; suivant : 000840How Do the First Days Count? A Case Study of Qatar Experience in Emergency Risk Communication during the MERS-CoV Outbreak
Auteurs : Mohamed Nour ; Mohd Alhajri ; Elmoubasher A. B. A. Farag ; Hamad E. Al-Romaihi ; Mohamed Al-Thani ; Salih Al-Marri ; Elena Savoia [États-Unis]Source :
- International Journal of Environmental Research and Public Health [ 1661-7827 ] ; 2017.
Abstract
This case study is the first to be developed in the Middle East region to document what happened during the response to the 2013 MERS outbreak in Qatar. It provides a description of key epidemiologic events and news released from a prime daily newspaper and main Emergency Risk Communication (ERC) actions that were undertaken by public health authorities. Using the Crisis and Emergency Risk Communication (CERC) theoretical framework, the study analyzes how the performed ERC strategies during the first days of the outbreak might have contributed to the outbreak management. Methods: MERS-CoV related events were chronologically tracked, together with the relevant stories that were published in a major newspaper over the course of three distinct phases of the epidemic. The collected media stories were then assessed against the practiced emergency risk communication (ERC) activities during the same time frame. Results: The Crisis & Emergency Risk Communication (CERC) framework was partially followed during the early days of the MERS-CoV epidemic, which were characterized by overwhelming uncertainty. The SCH’s commitment to a proactive and open risk communication strategy since day one, contributed to creating the SCH’s image as a credible source of information and allowed for the quick initiation of the overall response efforts. Yet, conflicting messages and over reassurance were among the observed pitfalls of the implemented ERC strategy. Conclusion: The adoption of CERC principles can help restore and maintain the credibility of responding agencies. Further work is needed to develop more rigorous and comprehensive research strategies that address sharing of information by mainstream as well as social media for a more accurate assessment of the impact of the ERC strategy.
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DOI: 10.3390/ijerph14121597
PubMed: 29257053
PubMed Central: 5751014
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">How Do the First Days Count? A Case Study of Qatar Experience in Emergency Risk Communication during the MERS-CoV Outbreak</title><author><name sortKey="Nour, Mohamed" sort="Nour, Mohamed" uniqKey="Nour M" first="Mohamed" last="Nour">Mohamed Nour</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Alhajri, Mohd" sort="Alhajri, Mohd" uniqKey="Alhajri M" first="Mohd" last="Alhajri">Mohd Alhajri</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Farag, Elmoubasher A B A" sort="Farag, Elmoubasher A B A" uniqKey="Farag E" first="Elmoubasher A. B. A." last="Farag">Elmoubasher A. B. A. Farag</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Al Romaihi, Hamad E" sort="Al Romaihi, Hamad E" uniqKey="Al Romaihi H" first="Hamad E." last="Al-Romaihi">Hamad E. Al-Romaihi</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Al Thani, Mohamed" sort="Al Thani, Mohamed" uniqKey="Al Thani M" first="Mohamed" last="Al-Thani">Mohamed Al-Thani</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Al Marri, Salih" sort="Al Marri, Salih" uniqKey="Al Marri S" first="Salih" last="Al-Marri">Salih Al-Marri</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Savoia, Elena" sort="Savoia, Elena" uniqKey="Savoia E" first="Elena" last="Savoia">Elena Savoia</name><affiliation wicri:level="2"><nlm:aff id="af2-ijerph-14-01597">Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">29257053</idno><idno type="pmc">5751014</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751014</idno><idno type="RBID">PMC:5751014</idno><idno type="doi">10.3390/ijerph14121597</idno><date when="2017">2017</date><idno type="wicri:Area/Pmc/Corpus">000764</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000764</idno><idno type="wicri:Area/Pmc/Curation">000764</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000764</idno><idno type="wicri:Area/Pmc/Checkpoint">000839</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">000839</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">How Do the First Days Count? A Case Study of Qatar Experience in Emergency Risk Communication during the MERS-CoV Outbreak</title><author><name sortKey="Nour, Mohamed" sort="Nour, Mohamed" uniqKey="Nour M" first="Mohamed" last="Nour">Mohamed Nour</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Alhajri, Mohd" sort="Alhajri, Mohd" uniqKey="Alhajri M" first="Mohd" last="Alhajri">Mohd Alhajri</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Farag, Elmoubasher A B A" sort="Farag, Elmoubasher A B A" uniqKey="Farag E" first="Elmoubasher A. B. A." last="Farag">Elmoubasher A. B. A. Farag</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Al Romaihi, Hamad E" sort="Al Romaihi, Hamad E" uniqKey="Al Romaihi H" first="Hamad E." last="Al-Romaihi">Hamad E. Al-Romaihi</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Al Thani, Mohamed" sort="Al Thani, Mohamed" uniqKey="Al Thani M" first="Mohamed" last="Al-Thani">Mohamed Al-Thani</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Al Marri, Salih" sort="Al Marri, Salih" uniqKey="Al Marri S" first="Salih" last="Al-Marri">Salih Al-Marri</name><affiliation><nlm:aff id="af1-ijerph-14-01597">Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</nlm:aff></affiliation></author><author><name sortKey="Savoia, Elena" sort="Savoia, Elena" uniqKey="Savoia E" first="Elena" last="Savoia">Elena Savoia</name><affiliation wicri:level="2"><nlm:aff id="af2-ijerph-14-01597">Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA</nlm:aff><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, Boston, MA 02115</wicri:regionArea><placeName><region type="state">Massachusetts</region></placeName></affiliation></author></analytic><series><title level="j">International Journal of Environmental Research and Public Health</title><idno type="ISSN">1661-7827</idno><idno type="eISSN">1660-4601</idno><imprint><date when="2017">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>This case study is the first to be developed in the Middle East region to document what happened during the response to the 2013 MERS outbreak in Qatar. It provides a description of key epidemiologic events and news released from a prime daily newspaper and main Emergency Risk Communication (ERC) actions that were undertaken by public health authorities. Using the Crisis and Emergency Risk Communication (CERC) theoretical framework, the study analyzes how the performed ERC strategies during the first days of the outbreak might have contributed to the outbreak management. Methods: MERS-CoV related events were chronologically tracked, together with the relevant stories that were published in a major newspaper over the course of three distinct phases of the epidemic. The collected media stories were then assessed against the practiced emergency risk communication (ERC) activities during the same time frame. Results: The Crisis & Emergency Risk Communication (CERC) framework was partially followed during the early days of the MERS-CoV epidemic, which were characterized by overwhelming uncertainty. The SCH’s commitment to a proactive and open risk communication strategy since day one, contributed to creating the SCH’s image as a credible source of information and allowed for the quick initiation of the overall response efforts. Yet, conflicting messages and over reassurance were among the observed pitfalls of the implemented ERC strategy. Conclusion: The adoption of CERC principles can help restore and maintain the credibility of responding agencies. Further work is needed to develop more rigorous and comprehensive research strategies that address sharing of information by mainstream as well as social media for a more accurate assessment of the impact of the ERC strategy.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Raj, V S" uniqKey="Raj V">V.S. Raj</name></author><author><name sortKey="Farag, E A" uniqKey="Farag E">E.A. Farag</name></author><author><name sortKey="Reusken, C B" uniqKey="Reusken C">C.B. Reusken</name></author><author><name sortKey="Lamers, M M" uniqKey="Lamers M">M.M. Lamers</name></author><author><name sortKey="Pas, S D" uniqKey="Pas S">S.D. Pas</name></author><author><name sortKey="Voermans, J" uniqKey="Voermans J">J. Voermans</name></author><author><name sortKey="Smits, S L" uniqKey="Smits S">S.L. Smits</name></author><author><name sortKey="Osterhaus, A D" uniqKey="Osterhaus A">A.D. Osterhaus</name></author><author><name sortKey="Al Mawlawi, N" uniqKey="Al Mawlawi N">N. Al-Mawlawi</name></author><author><name sortKey="Al Romaihi, H E" uniqKey="Al Romaihi H">H.E. Al-Romaihi</name></author></analytic></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct></biblStruct><biblStruct><analytic><author><name sortKey="Savoia, E" uniqKey="Savoia E">E. Savoia</name></author><author><name sortKey="Lin, L" uniqKey="Lin L">L. Lin</name></author><author><name sortKey="Bernard, D" uniqKey="Bernard D">D. Bernard</name></author><author><name sortKey="Klein, N" uniqKey="Klein N">N. Klein</name></author><author><name sortKey="James, L P" uniqKey="James L">L.P. James</name></author><author><name sortKey="Guicciardi, S" uniqKey="Guicciardi S">S. Guicciardi</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Savoia, E" uniqKey="Savoia E">E. Savoia</name></author><author><name sortKey="Lin, L" uniqKey="Lin L">L. Lin</name></author><author><name sortKey="Viswanath, K" uniqKey="Viswanath K">K. Viswanath</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Glik, D C" uniqKey="Glik D">D.C. Glik</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Veil, S" uniqKey="Veil S">S. Veil</name></author><author><name sortKey="Reynolds, B" uniqKey="Reynolds B">B. Reynolds</name></author><author><name sortKey="Sellnow, T L" uniqKey="Sellnow T">T.L. Sellnow</name></author><author><name sortKey="Seeger, M W" uniqKey="Seeger M">M.W. Seeger</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, K W" uniqKey="Kim K">K.W. Kim</name></author><author><name sortKey="Andrew, S A" uniqKey="Andrew S">S.A. Andrew</name></author><author><name sortKey="Jung, K" uniqKey="Jung K">K. Jung</name></author></analytic></biblStruct></listBibl></div1></back></TEI><pmc article-type="case-report"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Environ Res Public Health</journal-id><journal-id journal-id-type="iso-abbrev">Int J Environ Res Public Health</journal-id><journal-id journal-id-type="publisher-id">ijerph</journal-id><journal-title-group><journal-title>International Journal of Environmental Research and Public Health</journal-title></journal-title-group><issn pub-type="ppub">1661-7827</issn><issn pub-type="epub">1660-4601</issn><publisher><publisher-name>MDPI</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">29257053</article-id><article-id pub-id-type="pmc">5751014</article-id><article-id pub-id-type="doi">10.3390/ijerph14121597</article-id><article-id pub-id-type="publisher-id">ijerph-14-01597</article-id><article-categories><subj-group subj-group-type="heading"><subject>Case Report</subject></subj-group></article-categories><title-group><article-title>How Do the First Days Count? A Case Study of Qatar Experience in Emergency Risk Communication during the MERS-CoV Outbreak</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Nour</surname><given-names>Mohamed</given-names></name><xref ref-type="aff" rid="af1-ijerph-14-01597">1</xref><xref rid="c1-ijerph-14-01597" ref-type="corresp">*</xref></contrib><contrib contrib-type="author"><name><surname>Alhajri</surname><given-names>Mohd</given-names></name><xref ref-type="aff" rid="af1-ijerph-14-01597">1</xref></contrib><contrib contrib-type="author"><name><surname>Farag</surname><given-names>Elmoubasher A. B. A.</given-names></name><xref ref-type="aff" rid="af1-ijerph-14-01597">1</xref></contrib><contrib contrib-type="author"><name><surname>Al-Romaihi</surname><given-names>Hamad E.</given-names></name><xref ref-type="aff" rid="af1-ijerph-14-01597">1</xref></contrib><contrib contrib-type="author"><name><surname>Al-Thani</surname><given-names>Mohamed</given-names></name><xref ref-type="aff" rid="af1-ijerph-14-01597">1</xref></contrib><contrib contrib-type="author"><name><surname>Al-Marri</surname><given-names>Salih</given-names></name><xref ref-type="aff" rid="af1-ijerph-14-01597">1</xref></contrib><contrib contrib-type="author"><name><surname>Savoia</surname><given-names>Elena</given-names></name><xref ref-type="aff" rid="af2-ijerph-14-01597">2</xref><xref rid="c1-ijerph-14-01597" ref-type="corresp">*</xref></contrib></contrib-group><aff id="af1-ijerph-14-01597"><label>1</label>Ministry of Public Health, Doha 11111, Qatar;<email>malhajri1@moph.gov.qa</email> (M.A.);<email>eabdfarag@moph.gov.qa</email> (E.A.B.A.F.);<email>halromaihi@moph.gov.qa</email> (H.E.A.-R.);<email>malthani@moph.gov.qa</email> (M.A.-T.);<email>dralmarri@moph.gov.qa</email> (S.A.-M.)</aff><aff id="af2-ijerph-14-01597"><label>2</label>Division of Policy Translation & Leadership Development, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA</aff><author-notes><corresp id="c1-ijerph-14-01597"><label>*</label>Correspondence: <email>mnour@moph.gov.qa</email> (M.N.); <email>esavoia@hsph.harvard.edu</email> (E.S.)</corresp></author-notes><pub-date pub-type="epub"><day>19</day><month>12</month><year>2017</year></pub-date><pub-date pub-type="ppub"><month>12</month><year>2017</year></pub-date><volume>14</volume><issue>12</issue><elocation-id>1597</elocation-id><history><date date-type="received"><day>01</day><month>11</month><year>2017</year></date><date date-type="accepted"><day>09</day><month>12</month><year>2017</year></date></history><permissions><copyright-statement>© 2017 by the authors.</copyright-statement><copyright-year>2017</copyright-year><license license-type="open-access"><license-p>Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">http://creativecommons.org/licenses/by/4.0/</ext-link>).</license-p></license></permissions><abstract><p>This case study is the first to be developed in the Middle East region to document what happened during the response to the 2013 MERS outbreak in Qatar. It provides a description of key epidemiologic events and news released from a prime daily newspaper and main Emergency Risk Communication (ERC) actions that were undertaken by public health authorities. Using the Crisis and Emergency Risk Communication (CERC) theoretical framework, the study analyzes how the performed ERC strategies during the first days of the outbreak might have contributed to the outbreak management. Methods: MERS-CoV related events were chronologically tracked, together with the relevant stories that were published in a major newspaper over the course of three distinct phases of the epidemic. The collected media stories were then assessed against the practiced emergency risk communication (ERC) activities during the same time frame. Results: The Crisis & Emergency Risk Communication (CERC) framework was partially followed during the early days of the MERS-CoV epidemic, which were characterized by overwhelming uncertainty. The SCH’s commitment to a proactive and open risk communication strategy since day one, contributed to creating the SCH’s image as a credible source of information and allowed for the quick initiation of the overall response efforts. Yet, conflicting messages and over reassurance were among the observed pitfalls of the implemented ERC strategy. Conclusion: The adoption of CERC principles can help restore and maintain the credibility of responding agencies. Further work is needed to develop more rigorous and comprehensive research strategies that address sharing of information by mainstream as well as social media for a more accurate assessment of the impact of the ERC strategy.</p></abstract><kwd-group><kwd>MERS</kwd><kwd>emergency risk communication</kwd><kwd>coordination</kwd><kwd>Qatar</kwd><kwd>CERC</kwd><kwd>outbreak</kwd></kwd-group></article-meta></front><floats-group><table-wrap id="ijerph-14-01597-t001" orientation="portrait" position="float"><object-id pub-id-type="pii">ijerph-14-01597-t001_Table 1</object-id><label>Table 1</label><caption><p>First phase of the epidemic (23 September–19 November).</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Date</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Epidemic Events and Other Key Public Health Actions</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Executed SCH Communication Activities and Key Messages</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Al-Raya Newspaper Reports and Key Messages</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Assessment Remarks Based on Crisis Emergency Risk Communication (CERC)</th></tr></thead><tbody><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">23 September 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The first laboratory confirmed case is declared in Britain</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">A novel and virus with great deal of uncertainty. A typical situation at the outset of an emerging virus.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">24 September 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Surveillance system was reinforced. Technical Consultations with WHO & HPA in the UK were initiated</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press conference: Supreme Council of Health (SCH) confirmed the first case admitting lack of knowledge on how to best clinically manage the case. No need to “Panic”, as no further cases were detected.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Despite the scarce information and the overwhelming uncertainty, the SCH managed to timely announce the case and explain the undertaken measures, in line with the CERC which calls for admitting the limitations while telling what actions are being done to bring answers (consultations with the WHO). This constitutes the ‘initial phase’ as described by the CERC. However, empathy was hardly expressed to the patient and his family - it was a little early to generate behavioral messages that conveyed a paternalistic approach (without reality check). These were largely not in accordance with the CERC.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">25 September 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">National Outbreak Control Taskforce (NOCT) was activated</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports on the information shared during the press conference, adding facts about Middle East Respiratory Syndrome Coronavirus (MERS) as sourced from the WHO website. The SCH was blamed for not providing sufficient follow up to the patient.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The Qatari early preparedness based on the previous experience with the SARS and H1N1 helped activate the national response in relatively short time (stakeholder communication and coordination). While CERC stated that people and media would eagerly seek for other sources of information during emergency situations, the SCH seemed not to have considered this behavior as it did not provide a sustained flow of information, allowing for the local media to blame the sluggish response.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">26–27 September 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SCH Maintains close communication with the UK hospital where the patient was transferred to be abreast of the clinical developments of the patient</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports on patient status and transfer to the UK: Family members were interviewed. <break></break>SCH response was described as “late” and that the authorities only come to know about the case from the international media and the WHO. <break></break>Reports on the potential risk of greater spread during the approaching Hajj, and Reports on similarities between MERS and Severe Acute Respiratory Syndrome (SARS).</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Despite initiating reasonable public health measures, the SCH still seemed not to cope with the urgency of the situation. SCH should have publicized the ongoing efforts at the different levels including the persistent follow up of the patient.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">29 September 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Development of the risk assessment plan and roadmap to response with (with support from WHO and FAO)</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press Release: The patient is improving and the SCH was engaged with the UK authorities to closely monitor the patient. This is in response to the rumor that the Qatari authorities are not providing the care to the case.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports on patient status and transfer to the UK: Family members are interviewed. They suggested that a medical specialist should have been sent to UK to accompany the patient.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Although it has come a little late, the SCH reacted to the rumor with a press release but it should have further displayed the progression on the technical efforts with the WHO and FAO to guide the public health response.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">1 October 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Health preparations for Hajj season were initiated: Seasonal flu vaccine is available</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The approaching Hajj season heightened the fears of the public that MERS might spread widely during the big gathering event. This constituted another test to the readiness and the nature of coordination of the authorities at the local and the regional levels. The displayed aspects included: provision of the Flu vaccine (the preventive role of which is yet to be confirmed), besides the pre-travel medical screening and education.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2 October 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Coordination with stakeholders was maintained</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press Release: As a new virus, it was hard even for an advanced country like the UK to discover the nature of the novel virus until late.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Again the messages were not developed according to CERC recommendations. It could have better explain the progression on the preparedness efforts and help shift the public focus to things to do.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3 October 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Healthcare Workers training implemented</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SCH spoke-person is interviewed. Hajj preparations considered Flu and the risk of MERS.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The media reported on the interview which emphasized that: Seasonal flu immunization is mandatory, as per KSA health regulations for pilgrims, and that the health situation was being monitored through information sharing with the KSA and WHO.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The spokesperson seemed to have answered some of the key current questions. While the media focused on Hajj preparations, SCH should have bring the attention to the reinforcement of the preparations (training of the healthcare workers).</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">4 October 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press conference of the Medical Committee of the Qatar Hajj Commission. Various epidemic scenarios were considered.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The media reported on the press conference which addressed the clinical and preventive measures including the risk of MERS. Reports on first MERS case being cured.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The fact that other authorities counted for the new virus in their preparation package to the Hajj season indicated the level of coordination among stakeholders.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">5 October–19 November 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Coordination between the KSA and Qatar authorities during Hajj. Close monitoring of the situation with support from WHO</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Focus on Hajj preventive measures.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports focused on Hajj seasons: public concern of the potential spread of the disease during the season.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Here the authorities indicated their international level of coordination for Hajj with the relevant authorities.</td></tr><tr><td colspan="4" align="left" valign="middle" style="border-bottom:solid thin" rowspan="1">Pilgrimage Season—in 2012 the end of the Hajj season was on 24–29 October. However, pilgrims start to travel to Saudi Arabia 8–10 weeks prior to that. Therefore since the inception of the first case, Qatar was experiencing pilgrimage season.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td></tr></tbody></table><table-wrap-foot><fn><p>CERC: Crisis Emergency Risk Communication; SCH: Supreme Council of Health; MERS: Middle East Respiratory Syndrome Coronavirus.</p></fn></table-wrap-foot></table-wrap><table-wrap id="ijerph-14-01597-t002" orientation="portrait" position="float"><object-id pub-id-type="pii">ijerph-14-01597-t002_Table 2</object-id><label>Table 2</label><caption><p>Second phase of the epidemic (20 November 2012–August 2013).</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Date</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Epidemic Events and Other Key Public Health Actions</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Executed SCH Communication Activities and Key Messages</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Al-Raya Newspaper Reports and Key Messages</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Assessment Remarks Based on CERC</th></tr></thead><tbody><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">20 November 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Second case confirmed in Qatar (6th case worldwide)</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The possibility to have fresh cases was always there, providing a chance to test the recently activated public health preparedness and response including the communication strategies as recommended by CERC.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">21 November 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">WHO notified</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">24 November 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Intensive technical consultations with the WHO</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release focused on confirmation of the second MERS case besides reporting on the SCH actions: <break></break>- Patient transferred to the UK <break></break>- Contact tracing <break></break>- Collaboration with WHO in place</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports focused on second case and similarities between MERS and SARS as reported by WHO</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The second case was not immediately declared despite it was reported to the WHO on time. Yet, the SCH press release served the purposes of informing the public with the key details besides the executed measures in response to it. Highlighting the communication with the WHO seemed to help restore the public trust: reliance on the consultations with the WHO to make the appropriate decisions.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">25 November 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Exposure to camels as a potential source of the infection being hypothesized <break></break>NOTC decides to visit camel barns as part of the field investigation despite concerns of risk of infection</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The media reported the second Qatari case and reflected the public fears and demands to bring about an enhanced response in addition to the capacity to diagnose cases domestically <break></break>Senators and healthcare providers being interviewed <break></break>MERS portrayed as fatal as SARS Camel owners concerned with potential social stigma</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Persistent media attention. The media invested in the novelty of the threat to raise the public concern and thereby, poking the SCH (via telling public demands) to step up its response efforts. This might either indicate that the public was not made fully aware of the ongoing response efforts or the overall response was not yet up to the expected level (the local capacity to laboratory confirm cases then treat them was not there yet). <break></break>Nonetheless, the media attention seemed to help initiate a perception of the virus potential risk.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">27 November 2012</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Consultation with WHO ongoing MERS Cases and deaths continued to be reported from KSA</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SCH press release confirming that most of the measures requested by the public were already in place</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports on personal story of the second Qatari case</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">While this created an opportunity to display competencies, it allowed the media (and the public) to score a triumph of being one step ahead of the SCH by raising public demands to bring about more resources and enhance the overall response. The fact that cases and deaths are also being reported from the other neighboring countries in the region might seem to help accept the risk which is yet an exotic one but now looks natural and fairly distributed.</td></tr></tbody></table><table-wrap-foot><fn><p>Cases and deaths continued to be reported from KSA (Kingdom of Saudi Arabia) through August 2013.</p></fn></table-wrap-foot></table-wrap><table-wrap id="ijerph-14-01597-t003" orientation="portrait" position="float"><object-id pub-id-type="pii">ijerph-14-01597-t003_Table 3</object-id><label>Table 3</label><caption><p>Third phase of the epidemic (20 August 2013–17 March 2014).</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Date</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Epidemic Events and Other Key Public Health Actions</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Executed SCH Communication Activities and Key Messages</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Al-Raya Newspaper Reports and Key Messages</th><th align="center" valign="middle" style="border-top:solid thin;border-bottom:solid thin" rowspan="1" colspan="1">Assessment Remarks Based on CERC</th></tr></thead><tbody><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">20 August 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Third case confirmed Hajj season pilgrimage begins Communication with major stakeholders is maintained including neighboring countries</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release focused on: <break></break>(1) Third case confirmed <break></break>(2) Surveillance in place <break></break>(3) Webpage and helpline being available Public awareness campaign launched</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports on concerns related to forthcoming Hajj season. <break></break>Local media reports a British study tells that camels might have a role in MERS transmission Media reported on the press release, stating that diagnostic capacity was made available.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">This phase largely corresponds to the ‘maintenance phase of CERC’. After a 9 months pause, a new MERS case was reported in Qatar. Despite no cases, in contrary to the initial expectations pertaining the virus behavior, the media fairly occupied the vacuum by reporting on the disease cases and deaths reported by the other neighboring countries in the region. <break></break>Having no cases might indicate either there were no cases for real or the surveillance system was poor (unable to detect cases). The SCH refuted the latter emphasizing the alertness of the surveillance system. <break></break>The public need for access to further information seemed to be appreciated as a specific webpage was introduced. This action came as a response to the public demands. Yet, it is unclear whether the awareness campaign has just coincided with the new case or it was launched as an upbringing of the national response.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">22 August 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SCH launches an awareness campaign including helpline services</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The media reported on the awareness campaign and helpline service.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The campaign seemed to have helped the public get better understanding of the virus threat as more information now was made accessible. The campaign also created a good chance to provide facts, refute rumors and correct misperceptions. But it is unclear whether the campaign was designed based on CERC principles and whether it was followed by assessment.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">27 August 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Fourth case confirmed as contact of previous case</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release announcing the fourth case (patient with comorbidities)</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The prime event is the death of a MERS confirmed case. The SCH decided to declare this death coupled with the cure of another recently confirmed case.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">7 September 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Fourth case dies and third case is cured</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release announcing the death of the fourth case and recovery of the third case</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">This press release seemed to have conveyed two messages; while it acknowledged the death of an infected person, it declared the other was free of the infection and discharged home, indirectly reassuring the public that not all of those who contract the infection will eventually end up dead. The local healthcare system could be still be trusted.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">29 September 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Interview with SCH spoke-person focused on: <break></break>Preventive measures for Hajj season <break></break>Recommendations for Qatari pilgrims <break></break>Updated information on MERS</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The second Hajj season since the start of the epidemic. Despite the previous season passed uneventful in terms of virus spread, concerns remained high that it can still affect Pilgrims. This seemed to have necessitated the SCH sharing of the preparedness measures and coordination between Health and other sectors besides coordination between Qatar and KSA authorities.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">18 October 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Fifth case confirmed End of Hajj season</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release announcing the fifth case</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports on absence of causes related to the Hajj season based on a statement from KSA authorities.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">While declaring Hajj season is over, the fifth case was proclaimed, in line with the SCH policy of transparency. <break></break>As part of the heightened media and public attention, MERS news continued to be newsworthy. Nevertheless, epidemiologists were unable to explain why the virus did not spread in the Hajj big gathering.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">27 October 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Sixth case confirmed <break></break>The Sultanate of Omar announces the first case <break></break>KSA continues to report cases</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release announcing the sixth case (contact of previous case), fifth case cured.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Some of the recently reported cases and deaths were from the eastern part of KSA (sharing borders with Qatar). KSA was the biggest affected country so far.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">More facts were being shared to help establish a realistic understanding of the virus. The press release explained that human-to-human transmission was possible but it also consolidated that it could be treated (locally).</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">3 November 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Seventh case confirmed</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release announcing the seventh case.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">There were concerns now as to why after 9 months of zero cases people begin to hear about new 5 cases being reported in less than 2 months. This created more pressure on the SCH professionals to bring about reasonable explanations.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">13 November 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The Sultanate of Omar announces that the first case died <break></break>Kuwait reports two cases <break></break>KSA reports the virus was detected in camels</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Media kept reporting the spread of MERS in the Gulf Countries.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reporting of new MERS cases from countries across the region seemed to have helped the public accept the virus risk as a fairly distributed one. But the virus detection in camels was a key turning point of the epidemic course. Camels are involved in peoples' lives (socioeconomically) across the Arab Peninsula, making it seriously challenging to investigation efforts.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">19–21 November 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Death of 2 cases (two days apart) <break></break>KSA—55 deaths and 130 reported cases</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release announcing the death of two cases on 19 and 21 November respectively (total 3 deaths in the country).</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Those who died were either suffering a chronic illness already or had an immunosuppressing condition.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reporting more deaths related to MERS and acknowledging the fatality nature of the virus. However, a simple comparison with KSA was reassuring to the local community in Qatar.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">25 November 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Special debriefing from the Qatari national senate focused on prevention and control measures</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The senate recommendation acknowledged the ongoing investigation and control efforts but demanded these to be reinforced in terms of: disease monitoring domestically and abroad; expansion of isolation capacity in the healthcare facilities; screening of humans and animals.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports focused on senators’ demand for reinforced preventive measures. <break></break>The senate demands were somehow portrayed as a response to the media outcry to step up the national response. </td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Since the break out of the first MERS case, this is considered the second remarkable call on SCH and its partners to boost the national preparedness and response to the virus threat. Despite the situation in the country was not as bad as it was in other neighboring countries, but having the subject discussed in the senate could indicate to serious public concerns about the quality of the SCH response. Further, it might indicate the need to make the ongoing investigation and control efforts (besides the available competencies) more visible. Nonetheless, the senate session seemed to have helped secure more resources and support to the ongoing control efforts.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">28 November 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">MERS virus was isolated from camels in Qatar</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Press release: SCH announced the virus was isolated from two camels.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Reports on interviews with camel owners criticizing the Ministry of Environment (MOE) for the lack of proactive measures and for withholding information.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">This epidemiological breakthrough helped proof that SCH was not waiting passively for the big technical institutions to reveal the virus characteristic but rather was really engaged with them in the efforts to understand the disease characteristic and risk. Yet, this discovery also implied that the investigation efforts would not be easy. It would not be easy to convince the camel owners (with the majority involved in the camel race business) to accept the notion that their camels might play a role in the disease transmission.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">2–6 December 2013</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SCH and MOE joint press conference to address the concern of the public and camel owners focused on: <break></break>(1) The status of the outbreak <break></break>(2) Efforts to contain the epidemic <break></break>(3) The recent discovery (the virus isolation from the camels) as a possible progression towards the control of the epidemic <break></break>(4) Screening of camels will be initiated soon <break></break>(5) No plans to impose restrictions on trade as of now</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">The print media neutrally reported the messages which were communicated during the press conference. </td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">SCH and its main partner (Animal Health Department) decided to hold a press conference as a form of communicating the new updates related to MERS, instead of issuing press release. <break></break>For the second time, one of the spokespersons reassured that "the situation is stable" while yet more is to be known about the virus risk and behavior. This was not in accordance with the CERC recommendations. <break></break>It seems that the press conference was a mean to prepare the public to collaborate with the intended national screening surveys. <break></break>The grounds on which the selection of the communication method was unclear.</td></tr><tr><td align="center" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">6 December 2013–17 March 2014</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Animal Health Department announced control of the epidemic in camels as no new human case reported.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1"></td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">Qatar Animal resources are secured from the “leak” of coronavirus. Camels will be subjected to laboratory screening.</td><td align="left" valign="middle" style="border-bottom:solid thin" rowspan="1" colspan="1">While the first key message seemed to have looked over-reassuring as the future of the virus was impossible to predict, the second one, however, was consistent with the official message indicating that the involved authorities were in agreement.</td></tr></tbody></table></table-wrap></floats-group></pmc><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><noCountry><name sortKey="Al Marri, Salih" sort="Al Marri, Salih" uniqKey="Al Marri S" first="Salih" last="Al-Marri">Salih Al-Marri</name><name sortKey="Al Romaihi, Hamad E" sort="Al Romaihi, Hamad E" uniqKey="Al Romaihi H" first="Hamad E." last="Al-Romaihi">Hamad E. Al-Romaihi</name><name sortKey="Al Thani, Mohamed" sort="Al Thani, Mohamed" uniqKey="Al Thani M" first="Mohamed" last="Al-Thani">Mohamed Al-Thani</name><name sortKey="Alhajri, Mohd" sort="Alhajri, Mohd" uniqKey="Alhajri M" first="Mohd" last="Alhajri">Mohd Alhajri</name><name sortKey="Farag, Elmoubasher A B A" sort="Farag, Elmoubasher A B A" uniqKey="Farag E" first="Elmoubasher A. B. A." last="Farag">Elmoubasher A. B. A. Farag</name><name sortKey="Nour, Mohamed" sort="Nour, Mohamed" uniqKey="Nour M" first="Mohamed" last="Nour">Mohamed Nour</name></noCountry><country name="États-Unis"><region name="Massachusetts"><name sortKey="Savoia, Elena" sort="Savoia, Elena" uniqKey="Savoia E" first="Elena" last="Savoia">Elena Savoia</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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