by Madhumitha Rabindranath

Graphic design by Amy Assabgui

Nearly two years into the pandemic, with no immediate end in sight, desperation is present worldwide. The mantras “mask up!” or “get jabbed!” don’t invoke the same tenacity as before. Dissent against public health mandates is increasing, leading to protests. Now more than ever, governments, public health officials, and science representatives need to revamp their messaging to better equip the public for the long-term effects of the pandemic.

At the start of the pandemic, science communication in public health was straightforward despite knowing relatively little information on COVID-19 disease and its associated SARS COV-2 virus. As new evidence rapidly started to roll out, messages became murky and inconsistent.¹ For example, Ontario repealed most restrictions quickly in Summer 2021 despite the disapproval from consulting medical experts. With constant changes in health measures, confusion arose, resulting in growing non-adherence to important public practices such as masking and vaccinations. To improve public health communication, heeding the following suggestions would be a start.

1. Communicate with a strategic purpose

Some of the mandates in place were more reactive to specific situations and were not immediately intuitive to the public. One example is changing the waiting period for the second COVID-19 vaccine dose from one month to almost three months. The logistics and the science behind this change were not well communicated or consistent, leading to mistrust. Hence, it is important that any public messaging is consistent and transparent.^1,2 Every message or document shared with the public must be crafted to have a specific purpose and be easy enough to follow. Discussing 1-2 important topics during press conferences or tweets with sufficient background would be more receptive, preventing an information overload.

Consistency does not necessarily mean using a one-size-fits-all approach. Different tactics should also be considered to promote the same message such as leveraging visual representations, narratives and addressing specific social values: All of which are currently underused.² People respond differently to specific values and sentiments. For example, individuals who value a common good may respond to messages that emphasize everyone’s role in decreasing disease spread compared to some who value individualism. Using different modes of communication may address individual level hesitancy for specific mandates. Relevance to specific geographic areas should also be considered.³ It is not useful to ask individuals to follow stringent rules in areas of low prevalence. Public health communication should conscientiously consider these specific factors to prevent distilling important messages.

Taking a proactive approach to addressing misinformation before it happens is also strategic.² Trying to constantly address misinformed opinions or conspiracy theories is important but can quickly become futile. Before a well-intentioned campaign against a controversial topic begins, it is already consumed by many individuals and their opinions may be difficult to change. Using a concise and transparent approach to all mandates along with answers for any potential doubts or questions could resolve some dissent. For example, when vaccine mixing was introduced, safety was a major concern for most individuals. Providing an FAQ sheet with creative visuals or leveraging clinicians for dissemination can help provide a consistent and transparent narrative.

2. Embrace neutrality

When some individuals do not follow public health guidelines, it seems easier to start solely targeting this group. We saw instances of this approach taken by some of our leaders in an attempt to guilt people into compliance. This not only led to the polarization of certain groups and vilification from the media but also backfired when several officials decided to go against their own guidelines.⁴ Using a more nuanced tactic would prevent emotionally charged debates over following mandates as polarizing discussions can further dissuade the targeted individuals from trying to adhere to guidelines. Ultimately, we want as many people as possible to do their part in following public health directives within their own capacity rather than a small group that is perfectly compliant.

Neutrality is also important when addressing new and emerging evidence. The research regarding the SARS-CoV-2 virus has been changing rapidly as scientists are trying to unravel the unknown aspects of its biology. This requires updating public health measures. These updates need to be executed with caution especially if they are new or speculative.⁵ For example, public health officials predicting that COVID-19 may become an endemic has the potential to further exacerbate “pandemic fatigue”. We cannot say with confidence that endemicity is close in sight or predict its associated consequences which may or may not work in our favor. At this point, public health measures are still required to be followed and we should continue to cautiously monitor the situation. Without proper guidelines or concrete plans for the public to envision an endemic scenario, it would be best not to discuss it at all in a public sphere. Speculations and opinions on unknown possibilities can be dangerous in public health communications especially since we are less likely to foresee how the public will react.

3. Leverage community leaders

Although some efforts were made by officials to have community-specific messages, they were insufficient. Other than providing resources in different languages, there has been no effort to use community leaders to facilitate compliance. Some of the campaigns targeted to specific groups or marginalized communities started due to the pure civic duty of healthcare professionals, science communicators, and other notable individuals. For example, doctors of South Asian descent formed task forces in different parts of the country to address the unprecedented impact on working-class South Asians. As some racialized groups have grown to distrust healthcare instituitions, efforts should be made to contact local leaders, religious heads, and grassroots organizations who have a long-established relationship with the community. This approach can help diversify the means to deliver the same public health-related messages and address the issues faced by hard-hit communities.

With the volatile and fast-paced nature of the current pandemic, it can be difficult to stay on top of the current literature and make conscientious decisions. However, growing unrest and non-adherence to current measures threaten our progress to control this virus. Public health and governmental bodies should consider different strategies to address miscommunication and improve messaging, especially for future health crises.

References

1. Hung L, Lin M. Clear, consistent and credible messages are needed for promoting compliance with COVID-19 public health measures. Evid Based Nurs. 2022;25:22–22. 
2. Nan X, Iles IA, Yang B, et al. Public Health Messaging during the COVID-19 Pandemic and Beyond: Lessons from Communication Science. Health Commun. 2022;37:1–19. 
3. Slavik CE, Darlington JC, Buttle C, et al. Has public health messaging during the COVID-19 pandemic reflected local risks to health?: A content analysis of tweeting practices across Canadian geographies. Health Place. 2021;69:102568. 
4. Capurro G, Jardine CG, Tustin J, et al. Moral panic about “covidiots” in Canadian newspaper coverage of COVID-19. PLoS ONE. 2022;17:e0261942. 
5. Fischhoff B. Evaluating science communication. Proc Natl Acad Sci U S A. 2019;116:7670–5.