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Letters to the Editor, May 2003

Following OHPE 307.1, our April 25 reprint of Risk Communication: An Overview, we readers wrote about thought-provoking SARS and risk-communication articles they had seen elsewhere. This week, we are pleased to publish the comments from these readers, along with a reprint of one of the noted articles. In addition, we are including a short letter from the Halton Region Health Unit who wrote us after reading last week's feature article on Oral Health. We are delighted to learn from them about their oral-health initiatives.

A. Responses to OHPE 307.1, "Risk Communication: An Overview (reprint)"

1) J. Challis commentary on SARS communications and link to article

Received May 14, 2003

This week's issue of Marketing Magazine contains an interesting, and not always complimentary, critique of Toronto City Hall's response to the WHO travel advisory. It might be worth re-printing; I have attached the article above. While the point of view in the feature is purely that of an advertising consultant, it contains some good points about taking a positive approach to promotionp--and how it took health professionals to finally put the right 'spin' on the WHO situation in Toronto.

Personally, I still find it grating that tens of millions of provincial dollars would be announced to market Toronto tourism; it implies economic impact takes priority over human need. Perhaps, if the Rolling Stones are still going to be showing up courtesy of the taxpayer, the concert could be turned into a benefit and the proceeds donated to the World Health Organization. That might take a little of the parochial edge off Toronto's current image.

John Challis

Communications Officer

Chronic Diseases and Injury Prevention

Muskoka-Parry Sound Health Unit

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2) Marketing Magazine article "Toronto's PR bungle on SARS"

Following is the article Mr. Challis referred to above. It is being reprinted with permission of Marketing Magazine, where it first appeared in the May 12 issue. visit to view the original article and other Marketing Magazine articles.

Toronto's PR bungle on SARS

By Ron Piovesan

The city could have turned a time of crisis into a show of strength. But it blew it. Does this sound familiar: angry criticism levelled at the World Health Organization (WHO) for overblowing the extent of the SARS epidemic? Or how about officials treading around the central issue and insisting vehemently that everything is under control?

It should. This was the tactic China took several weeks ago when confronted with international pressure to come clean on the damage SARS was wreaking across the country. Unfortunately, it was also the same approach Toronto officials took when the WHO announced its travel advisory against the city, which it repealed effective April 30.

The "defensive denial" failed for China and cast serious international doubt about whether Chinese authorities had a firm grasp of what was going on in their own country. China has since changed its tune, admitted that SARS is a huge problem and is now assuring the world that it is finally taking decisive action. When similarly confronted, Canadian officials initially either remained deathly silent or again adopted a strongly defensive approach.

It's a sad state of affairs when Toronto needs to take lessons from a notoriously tight-lipped government on how to communicate effectively in a time of crisis. Instead of learning from the experience of the Chinese, Toronto officials took the odd strategy to repeat every one of their mistakes.

In a time of uncertainty, bordering on near panic, people look to figures of authority for information. The WHO has credibility on global health issues, while Toronto showily squandered its credibility with a "mad as hell" performance by the city's mayor, Mel Lastman. What other mayor would have gotten in front of the world's press to say that he has no idea why an advisory has been placed against his city and rhetorically ponder where those making the charges are based?

Official communications should have been controlled and calm, and should have described what actions were being taken. Rather than appearing in charge of the situation, Toronto officials went out of their way to tell the world how utterly surprised they were that the WHO would issue a travel advisory against the city. "Come here and take back what you said," was in effect the official response, even though major media outlets around the world had reported that Toronto was the worst-hit area outside of Asia.

As a result, global coverage of the WHO advisory didn't focus on the positive steps Toronto was taking to protect citizens and travellers; rather, it was all about Toronto's shocked reply. Such a reactive position holds little credibility with a global audience that has already had more than its fair share of bad news, cover-ups and angry official denials in the last few years.

Defensive messages did not tell the world that Toronto has the situation well in hand; it told the world that Toronto had been caught red-handed. The city's defensive stance at the time even forced the WHO to harden its stance. Far from mitigating the effects of the travel advisory, Toronto's response succeeded in making the world body repeat it.

With each news story covering Toronto's angry reaction, world reporters dutifully reminded their readers how many people in Toronto have died of SARS, how many have been infected and how many cases around the world are thought to have originated in the city. These numbers were in every resulting story, and they added up to discredit Toronto's position.

The city then started talking about a $10-million marketing campaign to address an image crisis that was largely of its own making. With the world's attention focused on Toronto for a few days, the decision to talk marketing budgets was curious. The hard work of doctors and nurses was barely discussed but the proposed $10-million marketing campaign actually got some global coverage. The WHO comes out with a travel advisory, Toronto comes out with an expensive marketing campaign. Tourists, are you now feeling better about the SARS situation in Toronto?

Toronto didn't have to agree with the WHO's position, nor to admit to something that is not accurate. But Toronto officials should have used the global spotlight to carefully and factually explain what the city is doing to protect people. This might have included inviting the global media to Toronto hospitals and putting people of real authority in front of the cameras to highlight the hard work of health-care workers. Offering the opposing view issued by the U.S. Centers for Disease Control would have also been a good tactic.

Some of this was eventually done, but too late. The 24-hour global news cycle does not allow much time for a city to get its crisis messaging together.

RON PIOVESAN is a Toronto-born communications consultant now based in New Delhi, India. He has worked with clients in the U.S., Europe and Asia.

2002 Rogers Media Inc. All rights reserved

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3) P. Sandman and J. Lanard link to their column "'Fear is spreading faster than SARS'-- and so it should!"

Received May 21, 2003

We are submitting to you, for possible inclusion as a link when you next update your risk communication resources, our SARS risk communication column, "'Fear is spreading faster than SARS' -- and so it should!" at

Your list of risk communication resources already includes many of Peter Sandman's earlier works, but nothing as up-to-date as this. Our SARS-column recommendations fairly closely track the U.S. Centers for Disease Control and Prevention's new communication training materials, titled "Emergency Risk Communication CDCynergy," for which Peter was one of the primary advisors and authors (information about the CDC material can be obtained at ).

Our SARS column includes our "three golden rules" for dealing with people's fears, 18 specific risk communication recommendations, and actual good and bad examples of SARS communication from national, international and local experts and officials. We hope it will be useful to practitioners.

All the best,

Peter M. Sandman, Ph.D.

Jody Lanard, M.D.

Princeton NJ USA

The Peter Sandman Risk Communication Web Site

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B. Response to OHPE 310.1, "Access to Oral Health Services"

1) Halton Oral Health Outreach Program

Received May 21, 2003

Just a note to let you know that in Halton Region we have a program called the Halton Oral Health Outreach Program. This is an integrated program serving Long Term Care clients in the community. Our community partners include all long-term care facilities, hospitals, Community Care Access Centre of Halton (CCAC), Supportive Housing and Community Agencies. The Region of Halton Health Department and the Community Care Access Centre of Halton are the principle partners. The CCAC co-ordinates access to dental treatment services and the Health Department provides educational services, consultation and screening.

Recently the health department obtained funding for special needs individuals. This program is called the Dental Care Counts Program and is administered by the health department.

We feel this has been a very successful approach to providing services for a hard to serve population.

If you would like more information please contact

Ellen Duncan Ross

Dental Educator

1151 Bronte Road

Oakville ON L6M 3L1

Tel: (905) 825-6060 x7844

Fax: (905) 825-2247

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Our introduction to the Letters to the Editor column can be found in the OHPE News section of OHPE 268.0,

Our full submission guidelines are on our website at

We look forward to hearing from you.

The Editorial and Management Team of the OHPE