3 ways officials can improve COVID-19 public health messaging, according to science communication experts

public health officials Fauci
Dr. Anthony Fauci, center, has been one of the most prominent US public health officials during the pandemic.

  • Public health officials have struggled to find persuasive ways to convince people to get vaccinated.
  • Researchers in science communication say being straightforward is the best way to make an impact.
  • They suggest being honest with uncertainty, ensuring consistency, and tapping into a crowd mentality.
  • See more stories on Insider’s business page.

Persuading people to get a COVID-19 vaccine remains a challenge even as more than a 120 million people in the US have received at least one dose.

Public health officials have struggled to find persuasive and accessible approaches throughout the pandemic, from explaining where COVID-19 originated to how the virus spreads among individuals, along with steps to prevent its transmission, its inequitable impacts on people’s lives, and now relevant risks and benefits information about vaccines.

COVID-19 is not just a medical issue. It is also a social justice, economic, and political issue. That makes it hard to figure out how best to share information about it, especially since messages come from a range of communicators – including elected officials, journalists, scientists, physicians, and community leaders – and are delivered to diverse audiences.

And the science itself has been uncertain and evolving. New information can change what’s known almost daily, making clear, accurate communication a “moving target.”

As researchers focused on the science of science communication, we can suggest several communication strategies, based on a July 2020 report from the National Academies for Science, Engineering and Medicine, that encourage protective behaviors related to COVID-19.

Clear and open, even about uncertainty

Decades of research in risk communication show that people’s perception of their own risk is key to motivating them to take preventive measures. For that to work, public health messages must be clear, consistent, and transparent.

One way to ensure that, especially for issues that have high uncertainty, like the pandemic, is for science and health messages to include context that connects the news to people’s concerns and prior experiences. What does risk or uncertainty about how the virus is transferred mean for the audience? How can they act on that information in their own lives? The “so what” of the message has to feel relevant. One approach, for example, is to emphasize how adoption of preventive behaviors – such as mask-wearing and hand-washing – leads to local businesses reopening and faster economic recovery.

Ensuring consistency in messaging, even for a rapidly changing issue, also means considering context – the bigger-picture processes shaping the issue. In other words, where do both the information and the uncertainty come from? What do scientists, policymakers, and health care workers know or not know at this point? Then, most crucially, what are people doing to address that uncertainty and what can audiences still do to act in the face of it?

Tap into a crowd mentality

At various points during the pandemic, public health officials needed to persuade people to change aspects of their daily lives. To do this effectively, it helps to remember that people change their behavior and beliefs to better match what they perceive other people are doing – especially those they most identify with. It’s human nature to want to go along with social norms.

Health messages should avoid putting a spotlight on “bad” behaviors, since that can actually exacerbate the problem. Disproportionate attention paid to vaccine hesitancy or people refusing to wear masks, for example, gives the impression that these behaviors are more common than they actually are. Rather, attention to “good” behaviors, such as small business successfully implementing social distancing practices, can be more effective.

But even well-intended efforts to promote social norms, such as vaccination selfies, may provoke significant backlash, including jealousy, anger, and feelings of injustice.

One way to avoid unintended backlash is to consider, before sharing, who is likely to see this message beyond the intended audiences. Are those who might see the message able to act on this information? If people can’t sign up for their own vaccination yet, a photo of a happy newly vaccinated person may make them feel angry and trigger negative feelings about systemic unfairness and resentment toward those who do have access.

Balancing the good news with the bad

The fear of a threat can motivate action. But a fear-based message often leads to people feeling helpless unless it’s paired with clear actions they can take to mitigate the threat.

Alternatively, hope is a powerful motivator, much more so and more consistently than fear or anger in many cases. Fortunately, for science communication in particular, surveys find that the majority of Americans remain hopeful about the promise of science to improve people’s lives.

Communicating hope can happen implicitly, through highlighting what does work and the benefits of actions. For example, clients following mask-wearing policies permitted many small businesses like hair salons to remain safely open.

What tends to be more common, especially in news coverage, is an emphasis on the negative – both in the current situation and in hypothetical futures and risks that could come if people don’t change course. You can see this focus in the coverage of gatherings that violate health regulations, like crowded beaches during spring break.

The weight of constant bad news reduces how equipped individuals feel to deal with a problem or avoid a risk. And this negative tendency can paint an unrealistic picture of an issue that has both wins and losses to report.

Without a fuller picture of the good news – what does work and what people are doing right – it becomes very difficult to envision how the world could look any different, or what anyone can do to move forward to a better place.

Todd Newman, assistant professor of life sciences communication, University of Wisconsin-Madison; Dominique Brossard, professor and chair of life sciences communication, University of Wisconsin-Madison, and Emily Howell, postdoctoral fellow in life sciences communication, University of Wisconsin-Madison

The Conversation
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What you should know about coronavirus variants, according to a virologist

covid vaccine development
(Author not pictured) Epidemiologists predict that within a year current vaccines could need to be updated to better handle new variants.

  • Dr. Paulo Verardi is an associate professor of virology and vaccinology at the University of Connecticut.
  • He says people should be aware of the currently identified five COVID-19 variants.
  • Assume these variants will continue to evolve and adapt, stay vigilant, and get vaccinated.
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Spring has sprung, and there is a sense of relief in the air. After one year of lockdowns and social distancing, more than 171 million COVID-19 vaccine doses have been administered in the US and about 19.4% of the population is fully vaccinated. But there is something else in the air: ominous SARS-CoV-2 variants.

I am a virologist and vaccinologist, which means that I spend my days studying viruses and designing and testing vaccine strategies against viral diseases. In the case of SARS-CoV-2, this work has taken on greater urgency. We humans are in a race to become immune against this cagey virus, whose ability to mutate and adapt seems to be a step ahead of our capacity to gain herd immunity. Because of the variants that are emerging, it could be a race to the wire.

Five variants to watch

RNA viruses like SARS-CoV-2 constantly mutate as they make more copies of themselves. Most of these mutations end up being disadvantageous to the virus and therefore disappear through natural selection.

Occasionally, though, they offer a benefit to the mutated or so-called genetic-variant virus. An example would be a mutation that improves the ability of the virus to attach more tightly to human cells, thus enhancing viral replication. Another would be a mutation that allows the virus to spread more easily from person to person, thus increasing transmissibility.

None of this is surprising for a virus that is a fresh arrival in the human population and still adapting to humans as hosts. While viruses don’t think, they are governed by the same evolutionary drive that all organisms are – their first order of business is to perpetuate themselves.

These mutations have resulted in several new SARS-CoV-2 variants, leading to outbreak clusters, and in some cases, global spread. They are broadly classified as variants of interest, concern or high consequence.

Currently there are five variants of concern circulating in the US: the B.1.1.7, which originated in the UK; the B.1.351., of South African origin; the P.1., first seen in Brazil; and the B.1.427 and B.1.429, both originating in California.

Each of these variants has a number of mutations, and some of these are key mutations in critical regions of the viral genome. Because the spike protein is required for the virus to attach to human cells, it carries a number of these key mutations. In addition, antibodies that neutralize the virus typically bind to the spike protein, thus making the spike sequence or protein a key component of COVID-19 vaccines.

India and California have recently detected “double mutant” variants that, although not yet classified, have gained international interest. They have one key mutation in the spike protein similar to one found in the Brazilian and South African variants, and another already found in the B.1.427 and B.1.429 California variants. As of today, no variant has been classified as of high consequence, although the concern is that this could change as new variants emerge and we learn more about the variants already circulating.

More transmission and worse disease

These variants are worrisome for several reasons. First, the SARS-CoV-2 variants of concern generally spread from person to person at least 20% to 50% more easily. This allows them to infect more people and to spread more quickly and widely, eventually becoming the predominant strain.

For example, the B.1.1.7 UK variant that was first detected in the US in December 2020 is now the prevalent circulating strain in the US, accounting for an estimated 27.2% of all cases by mid-March. Likewise, the P.1 variant first detected in travelers from Brazil in January is now wreaking havoc in Brazil, where it is causing a collapse of the health care system and led to at least 60,000 deaths in the month of March.

Second, SARS-CoV-2 variants of concern can also lead to more severe disease and increased hospitalizations and deaths. In other words, they may have enhanced virulence. Indeed, a recent study in England suggests that the B.1.1.7 variant causes more severe illness and mortality.

Another concern is that these new variants can escape the immunity elicited by natural infection or our current vaccination efforts. For example, antibodies from people who recovered after infection or who have received a vaccine may not be able to bind as efficiently to a new variant virus, resulting in reduced neutralization of that variant virus. This could lead to reinfections and lower the effectiveness of current monoclonal antibody treatments and vaccines.

Researchers are intensely investigating whether there will be reduced vaccine efficacy against these variants. While most vaccines seem to remain effective against the UK variant, one recent study showed that the AstraZeneca vaccine lacks efficacy in preventing mild to moderate COVID-19 due to the B.1.351 South African variant.

On the other hand, Pfizer recently announced data from a subset of volunteers in South Africa that supports high efficacy of its mRNA vaccine against the B.1.351 variant. Other encouraging news is that T-cell immune responses elicited by natural SARS-CoV-2 infection or mRNA vaccination recognize all three UK, South Africa, and Brazil variants. This suggests that even with reduced neutralizing antibody activity, T-cell responses stimulated by vaccination or natural infection will provide a degree of protection against such variants.

Stay vigilant, and get vaccinated

What does this all mean? While current vaccines may not prevent mild symptomatic COVID-19 caused by these variants, they will likely prevent moderate and severe disease, and in particular hospitalizations and deaths. That is the good news.

However, it is imperative to assume that current SARS-CoV-2 variants will likely continue to evolve and adapt. In a recent survey of 77 epidemiologists from 28 countries, the majority believed that within a year current vaccines could need to be updated to better handle new variants, and that low vaccine coverage will likely facilitate the emergence of such variants.

What do we need to do? We need to keep doing what we have been doing: using masks, avoiding poorly ventilated areas, and practicing social distancing techniques to slow transmission and avert further waves driven by these new variants. We also need to vaccinate as many people in as many places and as soon as possible to reduce the number of cases and the likelihood for the virus to generate new variants and escape mutants. And for that, it is vital that public health officials, governments, and nongovernmental organizations address vaccine hesitancy and equity both locally and globally.

Paulo Verardi, associate professor of virology and vaccinology, University of Connecticut

The Conversation
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