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The coronavirus has taught public health officials a lot of painful lessons. None may be more important than the value of clear and consistent messages – and the price of confusing and contradictory messages.

Americans who wear masks and who hate masks are united in their frustration about when, where and whether they should be worn. And that doesn’t take into account the all-over-the-map messaging on what kind of masks are most effective.

During the two years of the COVID pandemic, there also has been mixed messaging about vaccines, boosters and social gatherings. Some of that is due to real-time learning by medical and public health professionals on how the virus behaves and can be treated. Waves of variants with differing levels of transmissibility and virulence hasn’t helped. However, learning-on-the-go doesn’t fully explain the messaging jumble that has eroded trust, dashed hopes and contributed to COVID fatigue.

Messaging confusion has failed to debunk misinformation, disinformation and political gamesmanship over bogus cures, deceptive claims and rallying cries for personal freedom that defy best public health practices.

The public health messaging challenge isn’t all that different from the challenge of responding to a crisis when the situation is fluid, facts keep emerging and patience runs thin.

People want the pandemic to end. They also want confidence that what they are told will end the pandemic as soon as possible and allow life to return to normal. To their credit, public health professionals realize their advice has zigzagged over the last two years as knowledge deepened on how to combat COVID and its evolving variants.

There has been a lot of communication by knowledgeable and well-spoken public health officials. Scott Gottleib, an internist, former Food and Drug Administration commissioner and member of the Pfizer board of directors, appears almost weekly on news shows and gushes information. However, listening to him can be is like drinking from a firehose. A deluge of messages can be almost as damaging as too little and ill-timed messages.

The public health messaging challenge isn’t all that different from the challenge of responding to a crisis when the situation is fluid, facts keep emerging and patience runs thin.

The partisan attacks aimed at Dr. Anthony Fauci, a respected immunologist and long-time director of the National Institute of Allergy and Infectious Diseases, have tainted his typically level-headed, plainspoken advocacy for vaccination and opposition to questionable curatives, even when proposed by his former boss. Fauci has been turned into a bogeyman by right-wing politicians to blunt his messages and amplify theirs. 

The task moving forward requires identifying and adopting ways to communicate sensitive, rapidly changing public health information in ways that are clear, consistent and convincing. Regrettably, the task also requires steps to address incidental misinformation and even bigger steps to counter malign disinformation that is amplified on social media and podcasts.

Vish Viswanath, a Harvard public health communication expert, describes the messaging challenge this way: “How do professionals provide need-to-know information that will help an audience make smart decisions, while remaining a credible source of information and acknowledging that they don’t know everything? How do they communicate facts and uncertainty simultaneously?”

Viswanath says it helps if public health professionals understand how they can confuse, frustrate and turn off the audiences. For example, openly debating public health strategies may be honest, but highly confusing to the average person. Providing too much information can be overwhelming. Ignoring misinformation and disinformation in circulation can mean failing to reach people most in need of factual information. Relying on fear and guilt to motivate public responses can backfire. Denigrating people, such as anti-vaxxers, deepens alienation and disregard for advice.

 Vish Viswanath, a Harvard public health communication expert, advises public health professionals to focus their communication on answering a single question: “What do I need to do so I can live my life with some degree of certainty and safety?” Everything else, he says, can just be confusing.

Useful information, Viswanath says, answers one basic question: “What do I need to do so I can live my life with some degree of certainty and safety?” He adds, “Anything outside of this information, though it may be important, should take a backseat to need-to-know information.”

“Total and utter transparency” is essential for public health professionals to earn and retain trust, according to Viswanath. “Audience members won’t be happy if you don’t know everything, but they’ll appreciate that you’re being completely open with them,” he says. “It’s not about us. It’s about understanding what the challenges are in their lives. Our message should solve their problems.”

Solution-centered messages have long been viewed as the winners in marketing communications. That’s the reason infomercials generate sales. They show an everyday problem and demonstrate a solution you can buy, often for only $19.95 with a money-back guarantee and free shipping.

Public health messaging may not be as straightforward as a pitch for Ginsu knives, but Viswanath suggests focusing messages on certainty and safety is a good starting point. Humility can be disarming. “What people need to understand is that science is ever-changing and mutable. All knowledge is partial knowledge, and [COVID-19} is an illustration of that.”

Delivering messages is as important as the message. Viswanath advises a two-level analysis. At a system level, he says public health professionals consider how to share information, field questions, consider feedback and roll out a message through America’s highly decentralized public health system. As for messages, start with what to say, how to say it and where to say it. Tailoring messages is essential to reach audiences with low science literacy or that are prone to believe misinformation. This may require retiring certain words from the message board.

The ultimate challenge for public health professionals is not the science; it will be adopting the discipline of effective communication. That includes delivering a key message and deflating a false message. You don’t have to say everything you know, just enough to guide people through the maze of real danger and dangerous lies to a solution that can save their life and the lives of their loved ones.

The bottom line: Focus on messaging that is clear, consistent and convincing. When messaging changes, be clear and definitive. When you don’t know the answer, tell the truth.