Molly A. Sauer

“ Public health scientists were suddenly at the forefront of an unprecedented crisis, tasked with taming a quickly spreading novel virus.5 More than 10 months later, a safe and effective vaccine is only just becoming available, over 430,000 people have died in the United States,6 millions have lost jobs, and a majority of Americans now live their lives virtually. These widespread public health measures have been accompanied by a massive flow of COVID-19 information, misinformation, and disinformation. ”

“ Early communication about an emerging crisis and the necessary actions for the public—even if details are limited or likely to change—is vital to setting the stage for public trust. CERC highlights that the first source of information frequently becomes the benchmark for future communication; as a crisis evolves and new information emerges, the early voices are often more trusted. ”

“ In crises where a new threat such as COVID-19 upends the reality of the entire human population, effective communication holds tremendous potential in reducing uncertainty. Ensuring productive and effective communication is rarely easy, however, as the United States has experienced while balancing communication with politics, uncertainty, and a rapidly evolving pandemic. ”

“ Despite the CERC framework’s tested approach to help mitigate risk and effectively communicate to the public in an emergency, its 6 core communication principles have been applied unevenly over the pandemic thus far. This is a crucial time to review experiences at the federal, state, and local levels and gather important lessons on the effective use of CERC principles and the consequences of failing to uphold them. The importance of a unified approach to crisis communication across agencies and levels has never been clearer. ”

“ A novel pathogen presents a complex, dynamic situation for public health officials and health communicators. Information shared one day may be completely reversed the next as more evidence emerges; guidance can quickly become obsolete. The public can often be forgiving of perceived errors from authority figures. Maintaining credibility is driven heavily by not only being at the forefront and being correct, but also being honest and transparent, even when sharing difficult information. ”

“ Seriously people - STOP BUYING MASKS! They are NOT effective in preventing general public from catching #Coronavirus, but if healthcare providers can’t get them to care for sick patients, it puts them and our communities at risk! ”

“ With many unknowns about COVID-19, including its long-term effects and what comorbid conditions pose the greatest risk, the public has continuously experienced high levels of uncertainty about prevention, treatment, and care, which have been amplified as vaccine candidates and potential rollout strategies have been announced. Respectful communication promotes cooperation and rapport and engages and values community inputs, all of which are essential to promote adherence to public health recommendations. ”

“ A failure of administrative and public health leadership to be consistent and unified in their messaging undermines credibility, with potentially catastrophic consequences for public health and public trust—particularly as we roll out vaccines and states and localities face increasing pressures to reopen. ”

“ Throughout the COVID-19 pandemic, the American people have been shown the full spectrum from apathy to empathy, and in some cases the empathy shown has been called into question by subsequent personal actions. ”

“ Communicating about the safety, efficacy, and importance of vaccination and the rationale for prioritizing these populations is a new, complex challenge for public health authorities.66, 67 The long history of racist and unethical practice by government authorities and medical institutions in these communities has led to high levels of vaccine hesitancy. As we begin the largest vaccination campaign to date in the United States, leaders can and must show respect by recognizing the validity of vaccine hesitancy in these situations and being responsive to community concerns. ”

“ South Dakota Governor Kristi Noem described critical protective actions like wearing masks as optional at a large Fourth of July event and specifically stated social distancing would not be in place.55 This contradicted public health guidance and placed the onus on individuals to determine their own risk.
Trust is a critical antecedent to government legitimacy and credibility, which shapes citizens’ responses to government demands.56 Residents who perceive their public leaders as trustworthy are more likely to comply with government demands ”

“ In addition to the key communication principles outlined in this article, other critical recommendations include tailoring messaging to meet the concerns of different subpopulations, acknowledging uncertainty to express empathy and subsequently improve trust, building public trust generally to increase compliance with public health recommendations, and communicating clearly and consistently about risk so that individuals are well-equipped to take protective action.74
This paper has limitations. We sought to include examples that illustrated each core principle, positively and negatively. ”

“ Several states and localities include small business owners and community leaders on their COVID-19 task forces and initiated targeted initiatives to support marginalized and minority communities.68, 69 In Washington state, these commitments have been accompanied by funds to local community organizations and partners.70 Authorities have also incorporated messaging about where to access basic needs like food, utility and rent support, and non-COVID medical care, helping to build trust in the response and enable people to comply with other restrictions. ”

“ In March, Texas Lieutenant Governor Dan Patrick was criticized for asserting “there are more important things than living” after suggesting that senior citizens might be willing to die to save the economy and that some people need to take some risks to get the country back to normal.58 On school reopening, US Secretary of Education Betsy DeVos forcefully pushed for an accelerated school reopening, despite withholding necessary funding for safe operation as outlined by CDC recommendations. ”

“ Fauci acknowledged the emerging evidence about transmission and the importance of masks and changed their messages, advising individuals to wear face coverings while in public.45, 46
While likely uncomfortable for many leaders, communicating uncertainties and emphasizing the work being done to address them can help strengthen public support and compliance.32, 47 Identifying and investigating gaps in our understanding is core to the scientific process, and this should be communicated clearly. ”

“ Particularly when facing a novel threat with many uncertainties, it is essential that authorities communicate what is currently known, what is unknown, and what steps are being taken to fill those gaps.38 CERC advises leaders to acknowledge areas where they do not yet have information and to articulate the work being done to gather evidence. ”

“ Contradictory messages from political and scientific leadership can greatly undermine the public’s trust and generate misinformation.
Shifting guidelines on mask use demonstrate the challenges of managing unknowns and the importance of upholding the “be right” principle.39 At the outset of the pandemic, WHO and US public health authorities advised the public not to wear masks, despite limited evidence on their potential benefit or detriment to disease control.40 On February 29, 2020, US Surgeon General Dr. ”

“ Early in the pandemic, Republican governors in generally “blue states” (eg, Governor Hogan and Governor Phil Scott of Vermont) demonstrated the importance of a collective crisis response that bridged the political aisle, noting, for example, that wearing masks should not be a political statement.63, 64
Show Respect
With the high level of uncertainty in an emergency context, respectful communication is paramount. ”

“ Dr. Anthony Fauci talks with Dr Jon LaPook about Covid-19. March 8, 2020. Accessed December 12, 2020. https://www.youtube.com/watch?v=PRa6t_e7dgI&feature=youtu.be 43 MacIntyre CR, Chughtai AA. A rapid systematic review of the efficacy of face masks and respirators against coronaviruses and other respiratory transmissible viruses for the community, healthcare workers and sick patients. Int J Nurs Stud. 2020;108:103629. 44 Cheng VC-C, Wong S-C, Chuang VW-M, et al. The role of community-wide wearing of face mask for control of coronavirus disease 2019 (COVID-19) epidemic due to SARS-CoV-2. ”

“ Accessed October 30, 2020. https://www.nytimes.com/2020/09/28/us/politics/white-house-cdc-coronavirus-schools.html 55 Klein B. There “won’t be social distancing” at Mount Rushmore July 4th event attended by Trump, governor says. CNN. June 30, 2020. Accessed October 30, 2020. https://www.cnn.com/world/live-news/coronavirus-pandemic-06-30-20-intl/index.html 56 Brookes S. Crisis, confidence and collectivity: responding to the new public leadership challenge. Leadership. ”

“ August 11, 2020. doi:10.1177/1478929920948684 58 Madani D. Dan Patrick on coronavirus: ‘More important things than living.’ NBC News. April 21, 2020. Accessed October 30, 2020. https://www.nbcnews.com/news/us-news/texas-lt-gov-dan-patrick-reopening-economy-more-important-things-n1188911 59 Oprysko C. Not dangerous: DeVos defends schools reopening according to CDC guidelines. Politico. ”