With the first case of omicron confirmed in California and more cases expected across the U.S., public health officials who know the difference between good and bad crisis communication say they can't afford to be quiet and wait until scientists know how risky the new variant is before they speak out.
"We don't want to just be silent on the matter, because then that can cause fear and then that can allow for misinformation to creep in," says Elya Franciscus, the epidemiology operations manager for COVID-19 in Harris County, Texas.
There's a mantra in crisis communication: Be first, be right, be credible. "One of those is clearly being first," says Crystal Watson, senior scholar at the Johns Hopkins Center for Health Security. "So even though we don't know a whole lot right now, I think it's important to hear from public health officials." That said, being credible also means not giving information you may have to retract as more is learned. Walking that line can be very tricky, as U.S. health officials learned at the start of the pandemic when they underestimated the usefulness of masks in protecting against infection.
"Sometimes these messages can be very definitive and not convey what the uncertainty is," says Watson. The danger of being too definitive is that you can be accused of flip-flopping later if new information necessitates new guidance.
How to get the message right
This time, a lot of local public health departments around the country are working hard to get the message right, says Adriane Casalotti of the National Association of County and City Health Officials. "We have seen local health departments being out there, trying to explain to folks what we do know, but also what we don't know — and what the timeframe is, and what the process is for learning more."
One official who's getting out there is Dr. Matifadza Hlatshwayo Davis, a specialist in infectious diseases and the director of health for the city of St. Louis.
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"The message is: There's no need to panic," she says. "We still need to learn, we still need to wait for science to do its thing. But in the meantime, we have tools available to keep ourselves and our community safe. We have safe and effective vaccines — so go out and get one — we know that masking works, we know that social distancing works, and we know that hand-washing works."
In addition to the "don't panic, do this instead" message, Vish Viswanath, professor of health communication at Harvard's T.H. Chan School of Public Health says Hlatshwayo Davis is also signaling to the community that she's engaged and plans to keep them updated as scientists learn more about the new variant. He says her approach is "exactly what we need."
"That sense of competence and action — 'we are watching it, we are on top of it, we'll work with you' — it won't eliminate, but it will abate many concerns," he says.
Watson notes that the public health measures officials have already been recommending to protect against delta and any SARS-CoV-2 variant — to get vaccinated and boosted, wear masks indoors in public spaces, socially distance and wash your hands — "are still a good idea and are still going to be effective against this variant. We don't know how that effectiveness will change, but we know that these are still tried and true things that have worked for other variants."
Transparency is key to gaining trust
It's also key to encourage people to stay tuned as more is learned, Viswanath says, with messages like this: " 'Here are the guidelines that have always worked, please take these actions, they will continue to work. If we find out that they don't work and there have to be changes, we will tell you.'
"Communicating that sense of transparency is very important," he says.
For Hlatshwayo Davis, how and when she conveys these messages is also important. She's done COVID-19 town halls in the past, taking audience questions, and she likes that format.
"But I want to be careful about timing. I think it's very frustrating to convene people to tell them. 'We don't know. We don't know. We don't know. We don't know.' Right?" she says. So her focus right now is using social media platforms and connecting with local clergy and community groups — the sort of trusted messengers people turn to in times of uncertainty.
When there's more information about omicron to dig into, then her department will "have a town hall where we can have some really good dialogue," Davis says, adding "I'm hoping that will be able to be accomplished within the next two to three weeks."
Know your audience
Vishwanath notes that public health officials are addressing a mixed audience. Not everyone is feeling panicked by the news of omicron. A lot of people are indifferent — or actively resistant — to the idea that there's a new variant of concern. And that can make communication harder. "It's a difficult thing because people are tired, people are fatigued and you have to understand where they're coming from," he says.
Of course, a lot of health department staffers have their own pandemic fatigue. And getting the right message out is only one part of their mission. They also need to be ready to identify and track future omicron cases, while dealing with the current load of delta cases.
"We haven't really slowed down — we've never stopped testing, we've never stopped vaccinating," says Franciscus in Harris County. "So it's easy for us to kind of switch from, 'Oh, maybe it looked like we were hitting a low point and we could maybe start slowing down' to, 'OK, new variant — let's ramp up again.' "
She says her county health department has a plan ready if and when omicron is identified locally.
Hlatshwayo Davis in St. Louis says the public health toolkit is a lot more robust than it was when the pandemic began.
"Are we really at the same place with this new variant as we were in March to 2020? The answer is no," she says.
"We have rapid tests available, we have done contact tracing for two years — we know what works and doesn't work. We have safe and effective vaccines, the ability to provide them now for children above the age of 5. This puts us leaps and bounds [beyond] where we were," she says.
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