The COVID-19 guidelines released by the Centers for Disease Control (CDC) in May, proclaiming that vaccinated people no longer needed to wear masks indoors, spurred widespread joy, seeming to herald the beginning of the end of times unprecedented. That’s why last month’s reversal, in which even vaccinated Americans were advised to resume wearing masks indoors—“to maximize protection from the Delta variant”—was to many unwelcome, or worse, suspect. Much of the public saw a flip-flop and assumed some kind of farce. That was predictable: In healthcare communications, mixed messaging is a cardinal sin. A scenario like that of the COVID-19 variants makes it clear how, in our line of work, every sentence is a choice.
George Washington University’s visiting health policy professor Dr. Leana Wen explained to PRWeek that “The CDC is a great peacetime institution. It’s the premiere public health entity to produce scientific data under normal circumstances. But we’re at war…We need to say, ‘You are good at the science, but there is something missing in your communication strategy.’”
At least one thing that was missing in the revised CDC guidance was a crucial piece of clarification. Notwithstanding a surprising outbreak of breakthrough infections, the risk of such infections remains extremely low, with the risk of hospitalizations from them even lower. Vaccinated people are advised to wear masks in some settings not because vaccines are ineffective but to avoid transmitting the virus to the unvaccinated. So, the CDC’s messaging should have continued to target unvaccinated people—those still at the highest risk and the biggest reason that the virus continues to spread.
In other words, as Dr. Robert Pearl explained in Forbes, you’ve got to hear what the CDC isn’t saying. What the CDC is leaving the public to suss out on its own is that, while masks help reduce spread, masking up is far from enough. What’s going to end the pandemic is getting people vaccinated. “If we were to follow the CDC’s guidance, and do nothing else,” Pearl writes, “Americans would need to wear masks permanently. That’s because masks won’t end this pandemic. Only herd immunity will.” Ostensibly contradictory messages that leave people to figure out what you really mean—or just stop listening you—can kill a healthcare campaign.
“Public health needs to be based on science, but having good science doesn’t mean you have an effective public health response,” said Wen. “The CDC keeps getting the science right but the policy interpretation and communication totally wrong.”
Syneos Health Communications EVP Kathleen Starr, PhD, highlights the role of cognitive biases in barring people from receiving information, like the mask guidance, the way it was intended. Optimism bias can keep people convinced that the pandemic is pretty much over and, no matter how we behave, we’re on the upswing. Status quo bias—our deep-seated preference for the current state of affairs, or what we consider our “normal”—could keep people from accepting that, as close as we were to entering precedented times, we must remain vigilant. Confirmation bias (you’ve probably heard of this one) refers to our tendency to seek out or interpret information in a way that confirms what we already believe. And people are biased against information that challenges their belief that our era of restrictions is done.
“These quick shortcuts, which are natural parts of everybody’s thinking, can set us up for faulty on-the-fly judgments,” says Starr. “This is especially true in unfamiliar circumstances that are filled with emotions.”
People need to be able to trust healthcare leaders. Trust opens the public up to receive your messaging, and to seek it out whenever needed, no matter the biases in our way. This is crucial during a crisis like the pandemic, but it’s a basic truth of all healthcare communications. The importance of getting the science right goes without saying. But in many cases the science is practically forceless on its own. A mindful, vigorous communication strategy can address real people’s real concerns, mental biases, and unmet needs to ensure that the science moves them to act differently.
