Give public health policy makers ‘some slack’

By Dennis Archambault

Americans like absolute certainty. I once had a well-respected public relations professor who was successful in his private practice promote the principle of “it all depends.” So much in the management of public opinion – and delivering public information – is relative. This is not to say it’s not factual, based on evidence. The facts as we understand them to evolve in a crisis.

Crisis communication requires careful dissemination of the right information in the right dose at the right time to elicit the right response. The news media will hold people accountable for what is said, or not said. As is the case with the state and federal response to the coronavirus pandemic.

Ramesh Ponnuru, writing in Bloomberg Opinion, notes the apparent inconsistency and evolution in public health advice regarding the coronavirus pandemic, from the use of face masks to vaccinations and travel advice.

There are scientific and common-sense components of public health practice. With well-known diseases like typhoid and cholera, the diseases and the environmental and social factors contributing to the spread of them are well known. The strategies for containing the disease are as well.  There are vaccines for both.

The coronavirus emerged from mysterious causes and wasn’t well understood when it struck the United States. The lack of personal protection equipment raised the question about masking. But what was clear, people needed to keep their distance from one another, and they needed to return to strict personal hygiene practices. Much of this could be accomplished through education, with support from state directives.

When Dr. Anthony Fauci appeared to initially hedge on whether to use masks, he was concerned about depleting the supply needed for essential health workers at the time. As the supply became abundant and the general public health consensus held that face coverings were a reasonable method of preventing the spread of the disease (and later to protect the wearer, as well), his advice and that of others began to push their use. Eventually, even a second mask was recommended. Critics saw this as inconsistent messaging.

Ponnuru referenced another perceived case of inconsistency with comments made by Dr. Rochelle Wolensky, director of the Centers for Disease Control, regarding travel. Dr. Wolensky said that “while we believe that fully vaccinated people can travel at low risk to themselves, CDC is not recommending travel at this time due to the rising number of cases.” Critics again cited inconsistency. But critically thinking readers would understand the nuance in her statement. Vaccinated people are at low risk to themselves. That doesn’t mean they’re not carrying the disease or can’t transmit – which is why masking is still recommended… common sense mixed with sound public health science.

Ponnuru says that during a mysterious viral pandemic, mutating into variants, and conflicting social and political perspectives on public health practice, “all these experts deserve some slack. The stakes and the scrutiny have been higher than ever. They have had to convey information about a little-understood virus to tens of millions of people with less scientific literacy than themselves. Errors and miscommunication were inevitable…But there is a troubling through-line to many of the most damaging episodes of public-health messaging in the pandemic: a fear of candor. Authorities held back from saying what they believed to be true because they thought it would elicit undesirable behaviors from the public.”

What Ponnuru calls “a fear of candor,” is really more fear of people misunderstanding the nuance of fact, or the evolution of fact, or the impact of forceful critics of public health policy on the perception of the fact. What is said, how it is said, and when it is said is an evolving equation that must be analyzed in the public interest. Communication during times like these is exceedingly difficult – yet necessary.

Dennis Archambault is vice president of Public Affairs for Authority Health.