Page:A Failure to Communicate? How Public Messaging Has Strained the COVID-19 Response in the United States.pdf/7

SAUER ET AL 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 addition to the 6 core communication principles outlined here and in the CERC manual, other communication lessons have been learned during the COVID-19 pandemic. Healthcare workers on the front lines have been reexamining how they communicate to patients and families. Clinicians have been clear about the need to acknowledge emotions, including fear, sadness, and anxiety, before any additional recommendations or guidance are given. Additionally, much has been learned about how to provide information to patients and their families, including the need to provide information in a concise manner free of medical terminology.

The COVID-19 pandemic has severely tested the leadership and communication abilities of many individuals, including political leaders. Seen as a communication success by many is the case of New Zealand’s Prime Minister Jacinda Ardern. Researchers examined speeches and public statements to identify several principles that contributed to her communication success. First, by explaining the overarching principles guiding the government response to handling COVID-19, Prime Minister Ardern conveyed proactive decisiveness and reassurance to the public that expert advice had been taken. Second, once lockdown measures were in place, she directed attention to messaging about the importance of unity and sought to reassure the public that key decisions were being driven by strong communitarian values. Third, by keeping the public aware of the overall trajectory and progress in relation to managing the COVID-19 pandemic helped ensure public acceptance of lockdown restrictions and confidence in government actions.

In Vietnam, the government executed a series of information and communication campaigns to keep the public updated on the latest developments related to COVID-19. Early on in the pandemic, diverse communication channels were set up to reach the entire population. The campaign used short message service/text messaging, and music videos and short films disseminated through mass media channels and social networks such as Facebook, Zalo, YouTube, and Lotus to raise awareness. Through these different streams of communication, the campaigns quickly reached their target audiences with messages promoting awareness and behavior change actions, such as wearing masks in public areas and washing hands.

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. By examining the CERC core communication principles through examples from government and public health leaders, we can see how the United States has both excelled and failed at all levels of government and public health authority.

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 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. 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.

This paper has limitations. We sought to include examples that illustrated each core principle, positively and negatively. Many more communication examples could be included, but we attempted to choose examples that received national media attention. We must also acknowledge an overlap between the CERC principles, and, therefore, many examples could be used to illustrate more than 1 principle.

Despite these limitations, we believe our examination of the CERC principles within specific events during the first 12 months of the pandemic in the United States can help guide future communication efforts. States are now attempting to roll out vaccines equitably and efficiently while also managing the ongoing pandemic. To effectively tackle these new, complex crisis communication challenges, we must revisit the core principles outlined by the CDC and reframe our approach to present a unified voice, respond quickly and accurately, build credibility and public trust, and provide clear and consistent guidance, all with respect and empathy.


 * Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-733. Volume 19, Number 1, 2021