COVID-19 communication in a pandemic

Most governments are hopeless at communicating risks – except for the imaginary ones they conjure up to attack their opponents.

Yet when a major crisis like COVID-19 arises the natural instinct is to assure their citizens that it is a problem which can be contained and which they are doing everything they can to control.

Yet re-assurance can be counter-productive if it fails to prepare the public emotionally for when the worst happens – for instance the COVID-19 virus moving from a ‘problem’ to a pandemic as it now has in Australia. Then, counter-intuitively you need to move beyond re-assurance to start talking more about what people and communities can do to prepare for the worst.

An Australian virologist, Ian Mackay, concerned about this problem decided to approach two people who may well be the world’s leading experts on risk communication – Jody Lanard and Peter M. Sandman. The pair are currently working long hours advising a wide cross-section of organisations on how best to communicate about COVID-19. Whether they are advising the Australian Government or any agencies is unknown although, if they are not, they ought to be – particularly as the country is now declaring COVID-19 as a pandemic. Nevertheless it seems worth posting two blogs in a day given the relevance and urgency of the issue.

Lanard and Sandman wrote in reply to Mackay “We are starting to hear from experts and officials who now believe a COVID-19 pandemic is more and more likely. They want to use the ‘P word’, and also start talking more about what communities and individuals can and should do to prepare.”

They also agreed to Mackay distributing their reply which he did through the daily Nature newsletter.

Lanard and Sandman said that what COVID-19 risk communication wanted and needed was to “hear advice like this:

• Try to get a few extra months’ worth of prescription meds, if possible;
• Think through now how we will take care of sick family members while trying not to get infected;
• Cross-train key staff at work so one person’s absence won’t derail our organization’s ability to function;
• Practice touching our faces less. So how about a face-counter app like the step-counters so many of us use?
• Replace handshakes with elbow-bumps (the ‘Ebola handshake’;
• Start building harm-reduction habits like pushing elevator buttons with a knuckle instead of a fingertip.”

“There is so much for people to do, and to practice doing in advance…..Suggesting things people can do to prepare for a possible hard time to come doesn’t just get them better prepared logistically. It also helps get them better prepared emotionally. It helps get them through the Oh My God (OMG) moment everyone needs to have, and needs to get through, preferably without being accused of hysteria,” they said.

Lanard and Sandman also referred to their 2007 website column, What to Say When a Pandemic Looks Imminent: Messaging for WHO Phases Four and Five, which was written with H5N1 – the bird flu outbreak – in mind.

WHO defines these as: “Phase 4 indicates a significant increase in risk of a pandemic but does not necessarily mean that a pandemic is a forgone conclusion. Phase 5 is characterized by human-to-human spread of the virus into at least two countries in one WHO region.”

Lanard and Sandman say: “One of the scariest messaging failures in the developed world is not telling people vividly what the end of containment will look like, for instance the end of contact-tracing and most quarantines.

They reference the FAQs on the Singapore Ministry of Health web page as “a model that other developed countries can adapt to start talking to their publics about his now, to reduce the shock and anger when governments stop trying to contain all identified cases.

In a paper on WHO Phases 4 and 5 they also have some recommendations on messaging including: “individual and community preparations will focus on three tasks – reducing each person’s chance of getting sick; helping households with basic survival needs during a pandemic; and, minimising and coping with societal disruption”; hand washing is far from a panacea, wearing a facemask may help A BIT. But is has more downside than washing your hands”; and, “getting ready for a pandemic is largely about preparing for possible shortages.”

The advice is, of course, based on rational best practice. But what if you have a government obsessed with tactical manoeuvring and a Prime Minister desperate to prove he is in charge after his disastrous performance during the bushfires? Or some party indoctrinated staffers who can’t resist seeing everything as means of gaining tactical advantage and attacking opponents. What happens if things go awry and the staffers try to distance the ‘in charge’ PM from any repercussions? And what is the likelihood of any of this happening in Australia?

Meanwhile you can reference all of the Lanard and Sandman writings on COVID-19 communication here and past infectious disease risk communication which they consider particularly relevant here.