Do's and Don'ts of Crisis Communications for Public Health
Infectious disease outbreaks, though always unique, are not novel. In fact, the Centers for Disease Control and Prevention (CDC) has published a 350-page Crisis and Emergency Risk Communication (CERC) manual that lays out steps for preparing for, and responding to, a public health crisis. Yet even the best-laid plans often go awry.
Crisis Expedites the Flow of Information
During an emergency, everything is moving at warp speed as the normal flow of information turns into an avalanche. To keep up with this heightened pace, normal routines and standards are upended in the name of exigency. While useful (and often necessary), these changes also have consequences.
For example, consider that non-peer reviewed pre-prints became acceptable publications during the COVID-19 pandemic, as researchers strained to share any available data about the novel virus as quickly as possible. Unfortunately, these findings often were taken as definitive statements of fact, rather than preliminary results to be further analyzed and confirmed (or repudiated).
Who to Trust?
Faced with such a deluge of information from scientists, medical and public health officials, policymakers and the media, it is nearly impossible for any individual to sort through what is accurate, what is new and what should be prioritized. Effective crisis communications are therefore reliant upon trusted, respected spokespeople who have the skills, the capacity, the knowledge and the institutional support to engage with audiences about the rapidly changing nature of an emergency. Yet, too often, the public health community’s messengers lack the credibility, training or capacity to reach broad audiences in ways that resonate.
What Qualifies as an Emergency?
How a person responds to crisis communications is also dependent on circumstance. What seems like an emergency to some is just another setback to others. Individuals from underserved communities who are already contending with existing health, environmental and social challenges are less motivated to respond to crisis messaging, and the result is that these groups often end up bearing a disproportionate share of the burden from emergencies, such as infectious disease outbreaks.
Given these challenges, what steps can be taken to improve health crisis communications before the next infectious disease outbreak rolls around?
Amplifying your voice also means being willing to talk with journalists. Providing outside expertise and advice on scientific research helps media outlets ensure accuracy, while respecting their publishing process. "If we call you, please answer the phone in a timely way, be willing to talk to us in a timely manner," pleaded Karen Kaplan, Science and Medicine Editor at the Los Angeles Times.
Seek Help From Communications Professionals
Fine suggested that scientists always coordinate with communications professionals when interacting with the media. "You don't want to talk and say something that you didn't mean that's either going to hurt the reputation of your institution or your own reputation," she cautioned. On the other hand, a bonus of this kind of collaboration, said Fine, is that it allows communications staff, who may lack a technical background, to "gain a better understanding of your research and help guide you in your messaging."
Scientists also must be willing to engage in 2-way communications with different communities, especially those who have been traditionally underserved, marginalized and ignored. As Ponder explained, "We as scientists need to be in those spaces, making sure that we are countering incorrect information and giving context in a way that is accessible, fun, creative and colorful."
Only by making an honest effort to establish relationships with these groups can the public health community hope to build the trust and credibility that is required to promote an effective crisis response.
ASM Ambassadors reflected on how communities around the world were impacted at the start of the COVID-19 pandemic. Here they share how crisis communication affected their communities’ responses to the outbreak.
Don't: Let it Consume You. Do: Take a Breath
"Be First" is listed as the top principle of effective emergency and risk communications in the CDC’s CERC manual. However, as Fine warned, "once you say it, you can't take it back. And once it's in writing, it's forever." Rather than sacrificing accuracy for speed, a better approach is to pause to think about what is being communicated and who is being reached before disseminating the information on a given platform.
Readers also benefit from a "less is more" approach, according to Rebecca Rozelle-Stone, Ph.D., professor of philosophy and religion at the University of North Dakota. "Online articles and social media can feel like images and headlines are just screaming at you," she said. "You can walk away quickly, but you feel exasperated and distraught."
Instead, Rozelle-Stone encouraged an approach of consuming less information and taking more time to read content. "Thinking about local issues, which gives us a greater sense of efficacy and agency, tends to happen when we’re reading at a slower pace," she pointed out. "Connecting the dots between social contexts and crises are steps that increase empathy into the plight of other people," which helps ameliorate crisis fatigue.
Do: Change the System.
For her part, Kaplan would love to see greater efficiency in the peer-review and article publication process. "If journals were able to turn things around faster, there'd be less need to throw so many things up on a pre-print," she explained.
The Need for Better Communication
Addressing issues that are internal to the public health community would also positively impact how scientific and medical information is communicated to broad audiences. "When crises are there and facts need to be relayed, there’s no way around it," admitted Rozelle-Stone. However, she added, "keeping people’s eyes on just the catastrophe increases the sense of impotence."
Instead, Rozelle-Stone suggested a different approach. "Interspersing crisis stories with stories of hope, agency and dignity can prove useful" in overcoming feelings of hopelessness and helplessness that often lead to despair and inaction.
Ultimately, the public health community needs to start addressing these challenges now in order to see results when the next infectious disease outbreak hits. Admittedly, there is a lot of work to do, and hardly any of it is easy: nobody likes thinking about worst-case scenarios. Yet, a crisis is a crisis because it is an unexpected change from normal. Only by changing what normal looks like can we do a better job communicating when the next infectious disease outbreak occurs.
In This Issue:
- Letter From the Editor
- Hunting for the Next Pandemic Virus
- Vaccines Before Outbreaks? Jumpstarting Infection Prevention
- Outbreak Detection with Wun-Ju Shieh
- The Rise and Fall of Infectious Diseases
- How Pathogens Survive and Thrive in a Changing Climate
- Do's and Don'ts of Crisis Communication for Public Health
- What's Hot in the Microbial Sciences