JP Observer: COVID-19 crisis communication must get more creative, inclusive

Box 1 (“One weekend”): A large group in animation is shown at a party. You know, talking and dancing near each other with party food on a table. No masks. Musical notes in the air.

Box 2: (“Two weeks later”) A smaller group of people looking sad at the camera. Less food on the table. Musical notes kind of fractured in the air. Caption: “Not Pictured: One friend who tested positive on Monday. Five friends and family, quarantined. Three friends and family home taking care of a family member who got covid-19. Two friends who have to work more because someone in their family got covid-19 and/or lost their job.”

Box 3: (“Two months later”) Ten people wearing masks are sitting six feet apart from each other in a big group in a park. Each has some snacks. Some have phones. Birds are in the sunny air. One person has a guitar.

Box 4: (“Two years later”). Same as Box 1.

In prominent letters: “Follow the guidelines. It’s much more fun!”

Above is a sketch of a public service ad that could be on TV, Instagram, posters, newspapers, billboards, etc. There should be dozens of other creative messages, long and short, still and video, about dealing with covid-19 that are targeted to different demographic and geographic groups and different perspectives—preferably made by experts (not newspaper columnists).

Too little publicity has been done by political and public health leaders to motivate people to follow scientifically based rules—except to repeat them in imperative, authoritarian directives. Sometimes leaders throw in threats of what could go or is going wrong, like “deaths” and “loss of life.”

An effective covid-19 vaccination could be widely available by this spring, but, meanwhile, the U.S. and Massachusetts are experiencing record-breaking high numbers of cases. The U.S. topped 10 million cases total this month. Massachusetts numbers are skyrocketing. Too many people either don’t know, believe in or just don’t want to follow guidelines and information laid out by officials.

Authorities lecturing the public through speeches and signage as the only public education is appropriate in the first month or so of a crisis, according to experts. But in a long-term pandemic more various and creative devices and styles are required. We haven’t had experienced good crisis communication, and it shows.

State and local political leaders and health officials have done a good job for the most part at the raw basics of information sharing—despite Donald Trump’s model of absence, resistance and incompetence—but it obviously hasn’t been enough or complete. They need to study and follow procedures for dealing with a “landscape” crisis like covid-19.

Now that Trump is on his way out and President-elect Joe Biden and his new task force are planning their attack on the virus, it’s high time officials improve pandemic communications. The record-breaking number of cases around the country compel us to make up for lost time. Leaders have to use many more creative outlets and styles for letting people know about the virus and its prevention.

More than one leader speaking at a press conference—announced shortly beforehand and held in the middle of  a weekday—has bemoaned the fact that he or she repeatedly reminds people from their podiums or in interviews to take specific precautions, but many aren’t cooperating.

Just for starters, how many people see those speeches and interviews… or watch or read local news that report them in detail? To leaders: What about buying ads that reach more people where they are? Government did it with seat belts and cell phone use while driving.

We are already seeing a little improvement in the overuse of one word—“deaths”—by officials. The fact that we are seeing fewer deaths now compared to the huge number of cases in the spring and early summer has, as a classic mixed blessing, helped.

The Centers for Disease Control and Prevention (CDC) website seldom uses the word “deaths” and its synonyms except in statistics reports. When it educates the public about covid-19, the CDC talks about preventing “severe illness” instead.

Why? Not because they’re mimicking Trump’s head-in-sand attitude. And it’s not because they are encouraging denial. They say “severe illness” simply because as a science agency they know this novel coronavirus poses a host of serious dangers to the public in addition to death. Leaving them out is bad for the public.

For individuals, covid causes illness, pain, struggle, hospitalization, loss of work, threats to food and housing supplies, loss of income, hardship for family members, and, sometimes, development of chronic new health problems.

Our society is harmed by the coronavirus because it strains hospitals and medical institutions and their personnel; destabilizes the workforce; drains government resources; and causes loss of businesses and jobs.

Emphasizing death fosters suppression of the related problems. And people decline to take precautions if they think, as many younger people do, they or someone they are close to is unlikely to die of it. Leaders need to talk about the other resulting tragedies more and death much less, even if deaths increase.

It’s shocking that leaders have not talked much about death in one simple way that tends to shake people who otherwise poo-poo risk prevention: Officials and others should say that 215,000 more people died the first six months of 2020 than died in the same time period in 2019. That’s because of covid-19, and it continues.

Describing the universe of problems covid-19 causes also makes it clear that health and the economy are not two different entities except in theory. In pandemic reality, they are firmly entangled at all times, and leaders should say so repeatedly. They should also plan and act—and speak—with that in mind. Thinking and talking about making choices based on concerns about public health OR the economy is dangerous as well as wrong-headed.

The public has received amazingly sketchy information about where it is safe to go and why since the lockdown ended and reopening in stages began. Where are all these mounting cases coming from? How were they transmitted? It’s been nine months and we can guess, but leaders haven’t gathered or given us many scientific facts to go on.

Massachusetts recently issued a report about locations of covid-19 transmissions for a one-month period, October, but it had data for only half the cases. The largest cluster of transmission sites was “households,” but the state didn’t find out where people in the households got it. The second largest cluster of cases came from child care centers—from children, parents and/or staff. Officials did not suggest closing or limiting use of child care centers as a result. Restaurants, which came in third, became the focus of discussions about restrictions. Officials should have said why.

When given little information on a crisis, people’s imaginations tend to fill in the gaps. I have heard people in small towns say that cities are dangerous and people in cities say the opposite.

Many people don’t make situational exceptions. Some do. For example, one person might be willing to eat in a restaurant where their party would be the only people inside; others will not. Attitudes toward K-12 school and covid-19 vary widely, based on information but also based on widely divergent levels and kinds of fears, values, and aspirations by political and health leaders and, to some extent, the people they serve.

Different states have staged their re-openings differently even with similar numbers of cases. Without explanations, that alone is confusing to people.

Our decisions are supposed to be science-based, but we are given too little information to make them. This is why detailed, thorough contact tracing needs to be funded and started soon and results reported widely. More studies about the hazards of specific places and behaviors are needed to determine what practices and set-ups work best.

Good that Biden’s team is emphasizing contract-tracing and testing. The findings from thorough contract tracing, along with their degree of reliability, must be shared as much as testing statistics currently are.

Everyone knows that just telling kids what can go wrong is usually not enough to get them to act right. You have to not only remind them of natural bad consequences, but also threaten to impose some yourself. “Don’t jump on the bed. A slat might break. Also, you won’t be allowed to play a game later if you do.”

Too many authorities have been too hesitant to impose fines or other punishments on people for not following covid-19 prevention recommendations, including those about quarantine. And leaders have not wanted to burden law enforcement. It’s a miracle people have followed the guidance as much as they have. It’s time to crack down on rule-breakers, as well as doing more creative outreach and education to reach and motivate them.

The new 10 pm to 5 am curfew that began on Nov. 6 in Boston as well as the announcement of a statewide mask mandate for anyone outside of their house are all good steps, especially if there is enforcement. We use resources to make, inform about and enforce safety measures concerning speed limits, seat belts and cell phones. Why so little for a viral pandemic? Up until now, too many people haven’t taken direct recommendations from leaders seriously.

Surprisingly few leaders, even given nine months to do so, have created mechanisms to get input from people who have been affected by the covid-19 in various ways, an important element of crisis management.

On its website, McKinsey & Company, a national management consulting firm, stresses that leaders need to involve “stakeholders” (usually referring to employees of the company but in this case it would be the general public) in dealing with a landscape crisis such as covid-19.

WHO, the World Health Organization, talks about the importance of “Risk Communication and Community Engagement  Readiness” (RCCE) and response to coronavirus disease (COVID-19).” WHO stresses the importance of public “dialogue” between officials and private individuals, so they can share useful information and observations.

“Effective RCCE can minimize social disruption. Therefore, in addition to protecting health, it can protect jobs, tourism, and the economy,” WHO’s website, WHO-2019-nCoV-RCCE-2020.2-eng.pdf, says.

Although it sounds impossible at first, it is fairly easy for political leaders, with health experts and others on hand, to hold virtual forums regularly with constituents, encouraging individuals to ask questions and make comments in an open, but well-organized way for a significant portion time. These sessions would supplement the more authoritarian information presentations government executive branch staff make now. The discussion sessions could also be held by local, state and federal legislators. How people can access those discussions remotely, including in different languages and with necessary technology, must to be publicized, too.

Leaders need to create more dialogues and discussions with the public to build trust and safe behaviors. So far we have seen very little back and forth about the virus. It’s pretty much been top down. We can hope that it’s not too late to broaden and strengthen communications.

People are much more likely to understand and cooperate if they think their concerns are heard, considered, and leaders empathize. Attitudes like “We’re all in this together,” thrive when individuals are personally asked to share their thoughts, cooperate with good activities and help one another in a crisis.

A lot of time has passed with this pandemic with minimal creative messaging. As with vaccinations, officials need to speed up the expansion of inclusive communications. The studies have already been done. We know that involving everyday people in discussions about dealing with it will make a big difference in ending the pandemic.

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