Government Responds to COVID-19: Part 3/3: The power of Communication. And, what comes next?
By Evan Lee and Homa Attar Cohen
In Part 1 of this blog we highlighted the important role that governments have in enabling countries to respond to epidemics. We noted how experience with past biological events often seems to have informed the degree of investment in preparedness, and hence created the gaps that became apparent when COVID-19 arrived. In Part 2 we went into more detail, using Switzerland as a case example. In this installment, we want to emphasize the critical role of communications and messaging: ultimate success in defeating COVID-19 requires governments to engage with and to lead the publics they serve to go along — whether it’s mask wearing and social distancing measures, or signing up and getting vaccinated.
Successfully getting through a health crisis requires first and foremost scientific and medical expertise to understand its nature and to develop the needed tools to combat it.
But all sectors and all industries, as well as important groups such as organized religion and the education establishment, along with the wider public, have to cooperate,which raises the stakes around the importance of managing communications effectively.
MANAGING COMMUNICATION IN AN EVOLVING CRISIS
The nature of COVID-19 requires that consistent, coherent messages be created and shared — and constantly updated as knowledge and data continue to flood in. Information needs vary given the highly diverse constituencies that range from health professionals to essential workers to the media to the public at large.
At the same time, misinformation must be dealt with, especially in the era of social media. In our experience, many scientists and academics underestimate the magnitude of the resources and expertise necessary to develop effective guidance, advice, and other types of messages.
Government itself has agencies and departments across which it can be challenging to collect, integrate new information and data from multiple sources, and to process and share it in ways that enable officials at all levels to function within a coordinated response to a challenge such as COVID-19.
For example, Switzerland, although not a large country with a population of 8.6 million, has 26 cantonal governments, and a decentralized health system in which private insurers play a prominent role in managing how patients access the health system. It has a great deal of expertise, but this is dispersed across universities and teaching hospitals in a multilingual country. It also happens to host the WHO and multiple UN agencies who have an international focus but who also have significant indirect influence.
Communications missteps can have dangerous consequences, spanning the mere nuisance of self-proclaimed experts rushing to promote their own point of view, to the more serious risk of misallocation of precious resources: the unwarranted promotion of hydroxychloroquine as a treatment led to an oversized investment in over 1000 clinical trials to pursue this avenue.
Gaps in communications strategy and management can lead to the the risk of erosion in trust in government at a time when it is vital to ensure compliance with social distancing measures, and the vaccination campaigns that have recently begun, so that the needed level of herd immunity can develop. For example, comprehensive contact tracing app (SwissCovid) has had limited uptake, with only 2.5 million downloads for a population of 8 million as of late October, insufficient for it to realize its potential to help manage response to COVID-19.
A world with social media brings additional challenges as well as opportunities. It does mean that traditional approaches such as press conferences and evening news interviews need to be reinforced with a strategy to work with these platforms in ways to help reinforce key messages, provide critical information while combating dangerous misinformation.
CONCLUSION AND WHAT’S NEXT
The creation of the Global Health Security Index in 2019 was intended to capture the state of preparedness of countries around the world for the emergence of new epidemic threats.
Even this laudable initiative showed that High Income Countries only scored an average of 51.9 points out of 100 — pre COVID-19.
Our review of the GHSI also suggests that many of the gaps in Switzerland’s preparedness that we’ve highlighted (workforce preparedness, organizational preparedness, communications capacity) are also missing from the GHSI’s metrics.
But ultimately, the creation of new laws, organizations, and other structures that are needed to get a country through the still evolving COVID-19, requires clear and informed national and global leadership. Only leaders who are able and willing to be informed by the medical, economic, and societal perspectives that are at stake, can drive the efforts needed to respond to a health crisis as far-reaching as COVID-19 and hopefully avoid the need to take measures in haste during the crisis. One example among many we observed was the accelerated legislative process Switzerland was obliged to follow in order to write and enact a new COVID-19 law in September 2020, and to continue to update it as the course of the pandemic continues to require government to improve its capacity to respond.
We close by highlighting just three areas where we believe governments will have to continue to play an active role:
-Vaccine rollout is ongoing, but there have already been multiple missteps even in high-income countries such as the US and those in the EU, who look enviously at how Israel has been able to forge ahead, even as many middle and low-income countries have yet to start their own vaccination campaigns. How will countries successfully and credibly engage to enable the ‘whole of society’ effort that is required to accept, support, and monitor the phased approaches to vaccination that have been put in places. After the recent missteps — will people still be willing to allow high-risk groups to go first? Large-scale rollout of the new vaccines requires unprecedented efforts.
-The arrival of new variants — even with a virus that is known to mutate readily -seems to have taken even the scientific community by surprise. The UK stands out for its systematic efforts to sequence a high proportion of specimens, effectively transforming a tool that is generally used for research purposes into a tool for public health. This would require new infrastructure and human resource capabilities, but will other countries have to mobilize the needed resources to do the same?
-The end-game. The stuttering start to vaccination campaigns suggests that it will take months rather than weeks to vaccinate a high enough proportion of the population to reach herd immunity — regardless of current supply limitations. How will a phased return to normal life occur?
The world, and Switzerland, are far from done with COVID-19. Even in well-resourced high income countries, the GHSI report had identified gaps prior to the pandemic, and we hope the additional learnings we draw out here can help inform and prepare the way for governments to continue addressing gaps in epidemic preparedness and resilience for both the short-term and long-term.