Weeks into the COVID-19 crisis, the U.S. population needs accurate information on the virus, but we are still struggling to get it right. The way that officials, leaders, and experts talk with the public during this crisis matters because it could mean the difference between life and death.
I find there’s a disconnect between communications based on good intentions and those based on good science. What’s proven elusive at several levels of government is a mechanism to marshal facts, vet differing viewpoints, decide who should answer difficult questions, and — most importantly — ensure that all recommendations and directives are based on sound science.
That hasn’t been easy for officials from the president of the United States to local mayors, who are trying to lead despite the inherent difficulties of a rapidly changing situation fraught with unknowns.
But the natural inclination of politicians to communicate aspirationally is coming into conflict with that of scientists, who communicate in terms of what we know and what we don’t know. As we’ve seen, that’s played out in the form of mixed messages, resulting in confusion and dangerous behavior: young people flocking to California and Florida beaches and groups of residents nationwide congregating in public, ignoring social distancing.
On March 23, the White House indicated that to save the economy, people might go back to work as early as Easter. That was directly in opposition to the science-based outlook communicated by federal public health authorities that social distancing could, and likely will, last for several months to halt the spread of disease and protect human life. Days later, the White House retreated from that position.
The result of communication-based on hopes rather than facts is not only confusion, it’s mistrust. Recent polling shows more Americans trust the measured, fact-based communications of public health institutions for their information than they do the White House, and a CBS News poll from March 24th found respondents trusted health authorities (doctors and nurses, 88 percent; the Center for Disease Control [CDC], 82 percent) more than the President (44 percent) to give them accurate COVID-19 information.
The World Health Organization (WHO) notes good communication helps manage individuals’ expectations and fears, making it more likely they’ll follow instructions during pandemics. Done poorly, it undermines trust; economic and financial impacts can follow and lives can be lost, which we’re seeing worldwide. The level of confusion and mistrust growing from poor communication on COVID-19 is more troubling when you consider that we put useful frameworks into place to fight pandemics like this, based on lessons learned from SARS, Middle-East respiratory syndrome (MERS), influenza A (H1N1) and Ebola epidemics.
In addition to WHO pandemic communications checklists and CDC guidance, the following rules for building trust were developed for the U.S. Department of Health and Human Services (HHS). They should be part of the health emergency readiness and response activities of every community, business and organization. Ask yourself if the source of the messages you are watching, hearing and reading appears to have followed these essential precepts:
Was the public involved as a partner and did the messages inform, dispel misinformation and allay fears and concerns as much as possible?
New York’s Governor Andrew CuomoAndrew CuomoZeldin says he's in remission after treatment for leukemia Letitia James holding private talks on running for New York governor: report Governors brace for 2022 after year in pandemic spotlight MORE has been widely praised for his communications, which provide leadership and engage listeners, helping the public understand they have to be part of the solution and reassuring them that even though we don’t know when the crisis will end.
Did the person delivering the message appreciate the public’s specific concerns?
Beyond facts and figures, communicators need to be sensitive to people’s fears and worries on a human, emotional level. Empathy and steadiness are required along with calm, steady and reassuring facts. This was not the case with Texas Lt. Governor Dan Patrick’s recent remarks that grandparents should be willing to die to save the economy, which played on fears, caused anger and struck exactly the wrong note.
Did the person providing the message appear to be honest and open?
Once lost, trust and credibility are nearly impossible to regain. Despite the difficulties of communicating the details of an uncertain situation, Dr. Anthony FauciAnthony FauciThe Hill's Morning Report - Presented by Alibaba - Government shutdown fears increase as leaders dig in Pfizer results offer hope amid worsening pandemic for children The Hill's Morning Report - Presented by Alibaba - Democrats return to disappointment on immigration MORE always appears to be open and transparent. Because he has always told the truth, the Atlantic reported: “his candor has made him an instant icon.”
Were those providing key, credible messages to the public working together?
Conflicts and disagreements among even respected organizations and credible spokespersons create confusion and breed distrust. These reactions are all the worse when the mixed messages are coming from the same organization, as has repeatedly occurred in governmental pronouncements regarding the COVID 19 pandemic.
We know good communication will help us fight COVID-19. During the 2003 SARS epidemic, compliance with Toronto’s quarantine was attributed in large part to clear communication from public health authorities. Improved communications allowed Taiwan’s CDC to manage public reaction during their SARS outbreak. Communications training for public officials contributes to success: a 2019 study found audiences felt reduced anxiety, increased sense of control and greater trust in public agencies in response to messages delivered by officials who had taken communications training.
While researchers race to find treatments and develop vaccines to combat the virus, practicing good communication is now a critical component of worldwide efforts to enhance global health security. Certainly, we face challenges: nearly 40 percent believe social media companies are doing a "poor" job of preventing the spread of false information about coronavirus. In this pandemic, misinformation can be a killer, and the impacts are likeliest to fall on those who are older, have underlying medical conditions and tend to disbelieve facts shared through mainstream media.
To most effectively reach individuals, U.S. organizations, communities and governments should follow HHS and CDC guidelines based on lessons learned from previous outbreaks. All directives should be science-based and when officials don’t know the answers, they should positively admit to uncertainty, allowing people to take precautions and prepare for possible outcomes. Spokespeople should train for clarity of message, transparency and honesty. Taken together, these approaches build trust, ensuring that individuals are able to understand what they face and act responsibly toward their communities while protecting themselves and their families.
Jonathan Fielding, M.D., is a professor of public health and pediatrics at the University of California, Los Angeles.