CERC: Crisis and Emergency

Risk Communication—

Introduction

2018 Update
1 CERC: INTRODUCTION
CS 290397-A
CERC: Introduction
This chapter will introduce:
Crisis and Emergency Risk Communications (CERC)
The Six Principles of CERC
Terms Associated with CERC
The Phases of a Crisis and the Communication Rhythm
The Role of CERC

What is Crisis and Emergency Risk

Communications (CERC)?
The Centers for Disease Control’s (CDC) Crisis and pandemic illness, and earthquakes are just some
Emergency Risk Communication (CERC) manual of the emergencies that we know could threaten
provides an evidence-based framework and best any community at any time. Often, communicating
practices for anyone who communicates on behalf information is the first and only resource available
of an organization responding to a public health for responders to give affected communities at
emergency.1 CERC is built around psychological the onset of an emergency. Through effective
and communication sciences, studies in the field communication, we can impact how our community
of issues management, and lessons learned from responds to and recovers from these potentially
emergency responses. devastating emergencies.
Emergencies can assault communities in an
instant. Hurricanes, chemical releases, bombs,

For the purpose of this manual, the term “emergency” describes any public health event or incident
presenting risk to life, health, and infrastructure including natural, weather-related, and manmade
destruction, infectious disease outbreaks, and exposure to harmful biological, radiological, and chemical
agents. The term “emergency” encompasses “crises” and “disasters.”

Why is CERC important?

ready to act right away and need information on the
“The right message at the right time from the situation and how to stay safe immediately.
right person can save lives.” The CERC framework and its principles can help
—Barbara Reynolds, PhD you provide the public with information to make
CDC Senior Crisis and Risk Communication Advisor the best decisions and to accept the imperfect
nature of choice, under incredibly challenging time
constraints. You can help your organization and your
When a crisis occurs, even if anticipated, initiating community prepare for, respond to, and recover from
a full response can take time. The situation must be an emergency by using CERC’s six main principles:2
assessed and monitored for emerging or secondary be first, be right, be credible, express empathy,
threats, resources must be allocated, and personnel promote action, and show respect. We can have a
and materials must overcome any logistical or safety real and measurable effect on the wellbeing of our
barriers to getting into the affected area. But the communities by what we say, when we say it, and
affected people and those at immediate risk are how we say it.

2 CERC: INTRODUCTION
 The Six Principles
of CERC
Throughout these chapters, six principles of effective emergency
and risk communications are emphasized:

1 Be First:
Crises are time-sensitive. Communicating information quickly is
crucial. For members of the public, the first source of information
often becomes the preferred source.

2 Be Right:
Accuracy establishes credibility. Information can include what is known,
what is not known, and what is being done to fill in the gaps.

3 Be Credible:
Honesty and truthfulness should not be compromised during crises.

4 Express Empathy:
Crises create harm, and the suffering should be acknowledged in
words. Addressing what people are feeling, and the challenges they
face, builds trust and rapport.

5 Promote Action:
Giving people meaningful things to do calms anxiety, helps restore
order, and promotes some sense of control.3

6 Show Respect:
Respectful communication is particularly important when people
feel vulnerable. Respectful communication promotes cooperation
and rapport.

Fully integrating CERC helps ensure that limited resources are managed well and
can do the most good at every phase of an emergency response.

3 CERC: INTRODUCTION
Terms Associated with CERC
Crisis Communication
The term “crisis communication” describes the Risk Communication:
process of providing facts to the public about an Addressing Hazard and Outrage
unexpected emergency, beyond an organization’s In CERC, “hazard” can be explained as the
control, that involves the organization and requires amount of physical, structural, and economic
an immediate response. The crisis may cause harm to damage caused by an event. “Outrage” is the
an organization’s reputation or viability. level of emotion, concern, and even fear, anxiety,
Confronted with the uncertainty of this type of and anger brought on by an event or threat.
situation, crisis communicators must find a way to Good risk communication aims to keep outrage
inform and alert the public about an emergency. The in proportion to hazard so people will have the
content, form, and timing of crisis communication appropriate level of concern to motivate them
can either help reduce and contain harm or make the to act according to the actual danger they face.
situation worse. More information about hazard, outrage, and
Communicator: Member of the organization risk is found in Psychology of a Crisis.
impacted by the crisis
Time pressure: Urgent and unexpected
Crisis and Emergency Risk
Message purpose: Explain and persuade Communication (CERC)
Issues Management Communication CERC encompasses the urgency of crisis
Issues management communication is similar to communication, empowers decision-making,
crisis communication except the organization has and is communicated by an expert that may be a
foreknowledge of the impending crisis and the participant.
opportunity to choose when they will announce the During an emergency, decisions about risks and
issue and reveal the organization’s plan to resolve the behaviors must be made within a narrow timeframe.
issue.4 The decision may be irreversible; the outcome of the
decision may be uncertain. The decision may need to
Communicator: Member of the organization be made with imperfect or incomplete information.
impacted by the crisis Emergency risk communication can be used to
Time pressure: Anticipated; timing is somewhat help an individual make a decision in response to
controlled by the communicator many questions, including the following:
Message purpose: Explain and persuade
1. Should I seek medical treatment?
Risk Communication 2. Do I need to treat my drinking water?
Risk communication provides the community 3. Should I evacuate my home?
with information about the specific type (good
4. Should I keep my child home from school?
or bad) and magnitude (strong or weak) of an
outcome from an exposure or behavior. Typically, CERC combines the need to communicate about
risk communication is a discussion of a negative risks and benefits to your community under
outcome and the probability that the outcomes will urgent time constraints. You can use CERC to
occur. Risk communication can be employed to help provide information to guide individuals or entire
an individual make a choice about a behavior such communities to make the best possible decisions
as smoking, getting vaccinated, or undergoing a about their well-being during an emergency.
medical treatment. Communicator: Expert who is impacted
Communicator: Expert who is not directly by outcomes
impacted by outcomes Time pressure: Urgent and unexpected
Time pressure: Anticipated with little or no time Message purpose: Explain, persuade, and
pressure empower decision-making
Message purpose: Empower decision-making5

4 CERC: INTRODUCTION
 Issues Crisis and
Communication Crisis Management Risk Emergency Risk
Type Communication Communication Communication Communication
Communicator Member of the Member of the Expert who is not Expert who is
organization impacted organization impacted directly impacted by impacted by
by the crisis by the crisis outcomes outcomes
Timing Anticipated; timing is
Urgent and Anticipated with little Urgent and
somewhat controlled
unexpected or no time pressure unexpected
by the communicator
Message Purpose Explain, persuade,
Explain and Explain and Empower
and empower
persuade persuade decision-making
decision-making.

The Phases of a Crisis and the Communication Rhythm

Every emergency, disaster, or crisis evolves in phases. and responding to an emergency. Consider them in
Communication efforts and priorities align with decisions, gather feedback, and respond to their needs.
these phases, and communicators need to adapt Provide two-way communication and engage in active
and respond according to each phase. By dividing listening. (See more on Community Engagement).
the crisis into the these phases—preparation, initial,
Empower decision-making: Public health
maintenance, and recovery—communicators can
leaders and communicators can guide community
anticipate the information needs of the media,
members to make their own decisions by providing
government organizations, private and public
information about the situation, risks, resources
organizations, and the people in an affected area. For
available, and actions they can take. Give options
each of these phases, specific types of information
for communities to decide on their own, what is
need to be created.
in their best interest. (See more on Community
Although some communication tactics change
Engagement).
through the phases of the crisis communication
rhythm, communicators need to maintain three Evaluation: Evaluating a response does not just
objectives throughout all phases: community occur in a formal after-action review; throughout
engagement, encouraging decision-making, a response, gather feedback and test audience
and evaluation. understanding of your messages. An important
Community engagement: Include members of component of the maintenance phase is to tailor
your community and local leaders (i.e., religious messages for specific audiences. Evaluating the reach
leaders, trade union officials, representatives from of your messages and assessing who is taking action
community based-organizations, etc.) in planning for and where there are information gaps can help save
more lives during a response. It’s too late after.

5 CERC: INTRODUCTION
Figure 1-1. Crisis and Emergency Risk Communication (CERC) Rhythm
Accessible information for figures is located in Appendix, page 11.

The CERC Rhythm

Engage Community • Empower Decision-Making • Evaluate
Preparation Initial Maintenance Resolution
■■ Draft and test ■■ Express empathy ■■ Explain ongoing risks ■■ Motivate vigilance
messages ■■ Explain risks ■■ Segment audiences ■■ Discuss lessons
■■ Develop partnerships ■■ Promote action ■■ Provide background learned
■■ Create plans ■■ Describe response information ■■ Revise plan
■■ Determine approval efforts ■■ Address rumors
process 

Preparation
Develop partnerships and build relationships Select and train spokespersons.
with organizations and community stakeholders Refer to Spokesperson for more information on
that you expect to work with in a response. selecting and preparing spokespeople. Potential
Identify organizations that represent different speakers should be respected leaders in your
segments in your community, and connect organization with knowledge or expertise on the
with them before an emergency. Establish situation. Everything the spokesperson says should
shared concerns for your target populations be consistent with all other messaging released by
so you can connect and empathize with their your organization. Spokespersons should be well-
communities. Identify roles and processes versed in the CERC principles and trained prior
for you and your partners to distribute to an event. Repeated practice is the best way to
information during an emergency. prepare for tough questions in an emergency.
Draft and test messages with different Determine the approval process for
populations to make sure that the information releasing information.
is understandable and actionable in a crisis. When a crisis occurs, accurate and concise
Bring draft messages and communication information needs to be released right away and
products like infographics, social media repeated to keep people safe. Determine ahead of
messages, and flyers out to community groups time who needs to approve of information and the
or community representatives for feedback on order in which information will be reviewed, then
content and delivery. Ensure messages are easily when a crisis occurs, remind everyone who needs
understood and will motivate the intended to be aware of your organization’s statements and
actions. Test out the accuracy of any materials that everyone who contributes to ensuring its accuracy
are being translated in other languages. so they can follow this process quickly.
Prepare for the types of disasters you are Engage communities in preparedness planning.
especially likely to face. Get to know and be known by the people
For example, if your organization serves a coastal you will be helping in an emergency. Include
community, prepare specifically for flooding representatives or leaders for established
disasters in addition to all hazards prep. organizations in your preparedness planning
Create crisis communication plans. activities and exercises. Whenever it is relevant,
Using all of the components above and share planning resources with the public and
the additional information described establish ways to exchange feedback. Maintain
in Communication Plans, create a crisis social media activity at all times so that you will
communication plan. have an active following during an emergency.

6 CERC: INTRODUCTION
Initial answer questions like, “Has this happened
Express empathy. before? How can we keep this from happening
Express empathy right away. Put yourself in their again? How long will it take to recover?”Help
shoes. Read social media quickly if you need to your community understand your long-
know what people are thinking. Addressing what term response and recovery plans.
people are feeling, and the challenges they face, Segment audiences - explain the different risks
builds trust and rapport. that exist for different people.
Some emergencies are more likely to affect certain
Example empathy statements: groups of people than others or may have greater
consequences for some people. For instance,
“In addition, we recognize that there will be elderly people and small children may be more
concerns in the U.S. Ebola poses little risk to susceptible to the flu and get sicker when they are
the U.S. general population. It’s important to infected. People living within a disaster zone need
understand how it spreads.” different information and action steps than people
—Dr. Thomas Frieden, outside of or close to the disaster zone.
CDC Director, July 31, 2014
Encourage public support and cooperation with
“I know many of you are concerned about this response and recovery efforts.
flu season and have seen the heart breaking Another way to engage the community and
stories of those who have lost loved ones.” create a lasting recovery is to include community
—Dr. Anne Schuchat, groups to participate in the response efforts. The
CDC Acting Director, February 2, 2018 CERC principle to promote action goes beyond
individual behaviors. During emergencies,
Provide simple explanations of risk. encouraging people to check on their neighbors
Inform affected communities right away about or connect with elderly can save lives. Many
who is at risk and what the risk is. Keeping in mind people want to help when a disaster strikes;
that people can only take in so much information organized and productive community efforts can
at once during an emergency, be simple, concise, help prevent people from unintentionally getting
and direct. in the way of the emergency responders’ efforts or
putting themselves in danger.
Promote action.
Give people things they can do to reduce the risk Address misunderstandings, rumors, and
you are describing and actions to stay safe. unclear facts.
Track social and news media, public comments
Establish your organization’s credibility. or statements at meetings to identify
Explain what your organization is doing to rumors and resolve misunderstandings.
respond to the emergency and how you continue Alter or add clarification messages
to provide updates. to keep information accurate.
Maintenance Resolution
Ensure community understands ongoing Motivate people to take action or
risks and actions they can take to reduce remain vigilant.
risk or harm. Express empathy for those who may still be
It’s important that the community remains vigilant suffering or who have suffered an unrecoverable
on how to care for themselves and others and loss. Although the emergency may no longer be
how to help in recovery efforts. When there are featured in the news, your organization should
gaps in information, people may start to speculate, still be consistently reaching out and reminding
so remind the community that your organization is people of protective actions.
still working for them. Help people understand the
risk and keep the level of outrage in proportion to Promote community preparedness for possible
the level of hazard (see Psychology of a Crisis). Stay future crises.
on top of updates, and reference trusted others. Build off of the current moment while people are
still thinking about emergencies and are engaged
Provide more background information. in response efforts.
During the maintenance phase, work to

7 CERC: INTRODUCTION
Discuss, document, and share lessons learned Evaluate plans.
from the response. Evaluate the performance of the communication
After action reports or debriefs should plan internally and externally by asking the
document gaps, successes, and lessons community and partners, and then use this
from the communication aspects of the information to revise communication plans for the
response. Try to make reports constructive, next emergency.
and based on facts, not feelings.

Five pitfalls to avoid

1. Mixed messages from multiple experts
2. Information released late
3. Paternalistic attitudes
4. Not countering rumors and myths in real-time
5. Public power struggles and confusion

Conclusion: The Role of CERC

The right message from the right person at the right helps to bring a sense of order and understanding to
time can save lives. CERC aims to provide people otherwise chaotic situations.
with the information they need to make lifesaving Good communication enables organizations to
decisions in critical situations. CERC is designed fulfill their mission, maintain public trust, manage limited
around the psychological processes of people resources, and most of all, prevent and reduce illnesses
affected by, responding to, or observing a crisis. and injuries. Throughout every step of an effective
CERC principles are vital to helping people cope response, be first, be right, be credible, express
and begin to rebuild. The right communication empathy, promote action, and show respect.

References
1. Veil S, Reynolds B, Sellnow TL, Seeger MW. CERC as a theoretical framework for research and practice. Health
Promotion Practice (2008) 9, 4, 26S-34S.
2. Reynolds BJ. Principles to enable leaders to navigate the harsh realities of crisis and risk communication. J
Bus Contin Emer Plan (2010) Jul;4(3):262–73.
3. Benight CC, Bandura A. Social cognitive theory of posttraumatic recovery: The role of perceived self-efficacy.
Behaviour research and therapy (2004) 42(10), 1129–1148.
4. Heath RL, Palenchar MJ (Sep 23, 2008) Strategic Issues Management: Organizations and Public Policy
Challenges.
5. Tucker WT, Ferson S. Strategies for Risk Communication. Annals of the New York Academy of Sciences (2008)
1128: ix–xii. doi:10.1196/annals.1399.000

8 CERC: INTRODUCTION
Table 1-1. Specific Hazards Under CDC Emergency Preparedness and Response

Type of Hazard Definition Examples

Bioterrorism Deliberate release of viruses, bacteria, or other germs (agents) ■■ Anthrax

used to cause illness or death in people, animals, or plants. ■■ Botulism
■■ Brucellosis
■■ Plague
■■ Smallpox
■■ Tularemia
Chemical An emergency involving the intentional or unintentional release ■■ Carbon monoxide
Emergencies of a chemical that could harm people’s health. ■■ Chlorine
■■ Mercury
■■ Nerve agents
■■ Oil Spill
■■ Ricin
Infectious An emergency involving unintentional release of viruses, bacteria, ■■ Cholera
Disease or other microorganisms that causes illness or death in people, ■■ E. coli infection
Outbreaks animals, or plants. ■■ Pandemic flu
■■ MRSA infection
■■ Whooping cough
■■ Salmonella infection
■■ Ebola virus
■■ Zika virus
Natural Disasters A disaster in which the proximate cause is a natural hazard. Due ■■ Earthquakes
and Severe Weather to their scope and scale, a natural disaster can be a mass causality ■■ Floods
event. It can be accompanied by severe economic impact. Natural ■■ Hurricanes
disasters are particularly severe in infrastructure poor regions ■■ Landslides/mudslides
and nations, and linked (potentially?) to other disasters (e.g. ■■ Tornadoes
earthquake, tsunami, Fukushima). ■■ Wildfires
■■ Winter weather
Radiation An emergency involving the release of radiation that could harm ■■ Nuclear accident
Emergencies people’s health. ■■ Nuclear blast
■■ Radiation dispersal
device (dirty bomb)
■■ Transportation accident
Explosions Explosion or blast producing numerous casualties with complex, ■■ Industrial explosions
technically challenging injuries—not commonly seen after ■■ Terrorist bombings
natural disasters. ■■ Military strikes

9 CERC: INTRODUCTION
Table 1-2. National Response Framework Incident Categorization

Type of
Incident Definition Examples

Biological Naturally occurring biological diseases (communicable and non- ■■ Anthrax

Incident communicable) in humans—as well as those used in a terrorist event. ■■ Botulism
■■ H1N1 flu
■■ Ricin
■■ Smallpox
Cyber Any incident of national significance with cyber-related issues. ■■ Cyber attacks against
Incident Internet
■■ Cyber attacks against
critical infrastructure
information systems
■■ Technological
emergencies
Food and This is a threat to public health, animal health, food production, ■■ E. coli infection
Agricultural aquaculture, livestock production, wildlife, soils, rangelands, and ■■ Mad Cow Disease
Incident agricultural water supplies. ■■ Melamine contamination
■■ Salmonella infection
Natural A disaster caused by natural events. Due to their scope and scale, a natural ■■ Earthquakes
Disaster disaster can be a mass casualty event. ■■ Floods
Natural events are almost always accompanied by a severe economic ■■ Hurricanes
effect. They are particularly harsh in poor regions and nations, where ■■ Landslides/ mudslides
bridges, buildings, and structures do not remain intact. ■■ Severe weather
■■ Severe winter weather
or ice storms
■■ Tornadoes
■■ Wildfires
Nuclear or Release of radioactive material that poses an actual or perceived hazard to ■■ Nuclear accident
Radiological public health, safety, national security, or the environment. ■■ Nuclear blast
Incident ■■ Radiation Dispersal
Device
■■ Transportation accident
Oil and A threat to public health, welfare, or the environment caused by an event ■■ Chemical spill
Hazardous from oil or other hazardous materials. ■■ Ground water
Materials contamination
Incident ■■ Oil spill
■■ Waste transportation
accident
Terrorism A threatened or actual terrorist incident within the United States. ■■ Biological threats
Incident ■■ Chemical threats
■■ Explosions
■■ Nuclear blast
■■ Radiological dispersion
device

10 CERC: INTRODUCTION
Appendix: Accessible Explanation of Figure
Figure 1-1. Crisis and Emergency Risk During the third phase, maintenance, communicators
Communication (CERC) Rhythm: Crisis need to explain ongoing risks and will have more
communication needs and activities evolve time to segment audiences, providing background
through four phases in every emergency. The information, and addressing rumors. The final phase,
first phase is preparation. During preparation resolution, requires communicators to motivate the
communicators should draft and test messages, public to stay vigilant and communicators should
develop partnerships, create communication plans, discuss lessons learned and revise communication
and determine the approval process for sending out plans for future emergencies. Throughout all phases,
information in an emergency. The second phase is CERC encourages communicators to engage
the initial phase. During the initial phase of a crisis communities, empower community members to
communicators should express empathy, explain make decisions that impact their health, and evaluate
risks, promote action, and describe response efforts. communication efforts.

CS 290397-A

11 CERC: INTRODUCTION