Email #1
I don’t know yet what you want to ask me, but here are some things I would ideally want to tell you. Maybe we can discuss them when you call.
- This is your Owen Meany moment. I don’t know the details of your legal power, but I assume that like most state and local public health authorities you have considerable emergency powers. The time may come (or may be here right now) when you make and enforce decisions the city and state political leadership oppose.
Three standards that may be useful for thinking about when to make decisions or recommendations or predictions that you suspect you will need to make soon:
- Once it is obvious that you should do something, it will also be obvious in hindsight – to you and everyone else – that you should have done it sooner. The rule of thumb: Consider doing now what you already suspect you will need to do soon. Or resign yourself for being blamed later for not having done it sooner.
- Vis-à-vis overreacting versus underreacting: You’re not “damned if you do and damned if you don’t.” You’re damned if you underreact and darned if you overreact.
- Anything you can’t do or can’t make yourself do that you anticipate doing soon, tell people now that you anticipate doing it soon. This is what I like best about the excellent COVID-19 risk communication coming from U.K. Health Minister Matt Hancock and Chief Medical Officer Chris Whitty: They are forewarning the public about the pretty extreme social distancing measures they may soon be implementing, so people can prepare for those measures, both emotionally and logistically. (See for example this March 3 news story.) Another way I have said this to clients: “A week or so from now, what will you wish you had told people today?”
- Tell people about doubling. Maybe tell the story – and put out the image – of the pasha and the grains of rice on a chessboard. Yes, it’s true and worth saying that the risk to local residents right now is low – not as low as it looks, but low. But with exponential growth, things look small until very, very shortly before they look huge. The failure of imagination that keeps people thinking that small will remain small is important to counter. You hope you’re wrong, but you expect this to grow from small to huge, here and everywhere. You want people to prepare for it, emotionally and logistically; and you want people help you take action to mitigate it sooner rather than later.
- From everything we know so far, the most important social distancing recommendations are to seniors – especially people my age (75) and older. Now is the time for at least the elderly to start avoiding large gatherings, stop hugging/kissing/handshaking, try to stay away from medical settings unless absolutely necessary, etc.
Less important than the first four, but on my mind:
- Handwashing is only minimally useful against flu, and we don’t know about COVID-19. Don’t oversell it. Don’t let people imagine it’s a panacea. I’ll bet it is just as effective to say “it’s one of the only measures we can recommend that might help a little and has no downside.”
- Masks, like handwashing, might (or might not) help a little. Given that we’re all potentially transmitting COVID-19 to those around us, people who wear masks to protect themselves might very well be protecting others. The case against mask-wearing is the shortage, and the priority you need to put on the supply for caregivers. I would stress that instead of seeming to claim you know masks are useless.
- I wish you could do something about paid sick leave for people who feel ill, or whose employers shut down, or whose kids are home because their school is closed. But I’m guessing that really is beyond your power.
Email #2
As I wrote to you yesterday, health directors have enormous power in public health emergencies.
I’m trying to picture you telling top political leaders of the city, and even the state, that you plan to do what you think best, and you have the authority to do it:
I am going to jointly recommend the following social distancing measures tomorrow. At the same time, I am going to forewarn the public that I expect some of those measures to become mandatory in the days ahead, as this crisis worsens. I would prefer to make these statements with you standing with me, not against me. But if I must stand alone, I will make them nonetheless.
My guess is that most elected officials would prefer to be on the platform than off the stage, with the health department thereafter running the show.
But this is way beyond my remit. By all means send me what your press team wants you to say, and I’ll try to come up with suggestions that might help and still be sufficiently politically palatable.
Meanwhile, consider asking your press team to look at what U.K. Health Minister Matt Hancock and Chief Medical Officer Chris Whitty have been saying to their public. Or Sara Cody, the chief health officer of Santa Clara County, California (even if she did get briefly “famous” for licking her finger to turn a page while explaining COVID-19 hygiene strategies). Maybe it will help them see what messaging looks like when it aims to foster determination rather than false optimism.
Email #3
Here’s an afterthought (after our call) you might want to consider.
There’s a step between “business as usual” and “the new normal” that can’t be skipped. People in my field often call it the adjustment reaction. Everybody else calls it an OMG moment.
See this short 2005 column from my website: Adjustment Reactions: The Teachable Moment in Crisis Communication.
The key takeaway: The adjustment reaction / OMG moment has to happen as people realize that this is a real crisis, not just a bad flu season. The goal is to help as many people as possible have their adjustment reaction before the crisis is full-blown, so that they’re ready to cope resiliently with what’s coming. And of course you want to guide people’s adjustment reaction so they choose wise rather than unwise precautions.
But you can’t skip that step. Officials often try to skip it, motivated by their fear of fear and “panic panic.” (See Fear of Fear: The Role of Fear in Preparedness … and Why It Terrifies Officials – this one’s from 2003!) Since they can’t skip the public’s adjustment reaction, officials may end up inadvertently postponing it instead. And in the process they lose some of their credibility and thus some of their capacity to guide the public through it.
In other words, if you succeed in alerting the public sufficiently, you will get some pushback, ranging from shock to denial.
If you don’t get much pushback, it probably means you didn’t get through. Precisely because officials find it so scary to scare the public, when they finally bite the bullet they may do so sotto voce (with apologies for the mixed metaphor). They may feel like they’re shouting when in fact they’re whispering. You need to shout.
It can help a bit to tell the public about the adjustment reaction:
This is scary information, and a lot of people’s first reaction may be shock, even a kind of short-term paralysis, an inability or disinclination to cope with such an awful situation. That will pass. Many of us remember 9-11 – a horrific OMG moment for all Americans. But after that OMG moment comes resilience, and determination, and planning, and action. So give yourself permission to be too shocked to take this all in for a day or two. But no longer than that. A day or two is a long time in the life of a virus that keeps duplicating. To slow the spread of the coronavirus, we have work to do together that can’t wait.
Or something like that….
Good luck!
Copyright © 2020 by Peter M. Sandman
