The goal of this column is help figure out how to alert the public to the risk of an influenza pandemic, and how to involve the public in the pandemic preparedness effort. After a brief discussion of this season’s flu vaccine shortfall in the U.S. — which has helped make influenza newsworthy — we will suggest talking points for a pandemic pre-crisis communication campaign. Then we will discuss some of the difficult risk communication challenges that arise, illustrated with “mini-case studies” of flu pandemic media coverage.

In the last few months we have become increasingly preoccupied with bird flu — the H5N1 flu strain that threatens to turn into a devastating human pandemic. Our friends find this a weird obsession. “Bird flu,” they comment. “Isn’t that the thing that’s a problem in Asia?” We were preoccupied in the months after 9/11 too, but we weren’t alone with it. This is a different kind of edginess, worrying about something that most people consider uninteresting and unimportant.

Many infectious disease experts and medical journalists right now have similar feelings — a sense of impending disaster, a need to sound the alarm, alienation and frustration that people don’t get it. The tension takes a toll. The sources of H5N1 information sometimes have to struggle to keep their equanimity when talking to the largely apathetic public about an uncertain but potentially catastrophic pandemic.

The same tension makes it harder for us to analyze their communication efforts with empathy.

We started drafting this column on November 12, when the pandemic flu numbers game began. Pandemic risk communication since then has been on a roller coaster. This column is current as of December 2. We may add an addendum or two later, as the situation evolves.

We apologize to the reader — and to the worried, dedicated people who are trying to sound the alarm — for the length and edginess of what follows. We hope risk communicators will harvest it for whatever’s useful.