In the run-up to the 2009 H1N1 pandemic, we wrote that officials should warn their citizens that “containment” was highly likely to fail: Containment as signal: Swine flu risk miscommunication. It is very long, so in summary, here is how it applies to communicating about containment right now, regarding novel coronavirus.
With the inexorable spread of 2019-nCoV, we are again upset about the way officials and reporters are talking about containment. We think it is crucial to try to prepare the public for the very high likelihood that containment WILL FAIL, if what we mean by “containment” is that we might be able to stop a pandemic.
We wish the public could learn now that containment is far more likely to “help a little” than it is to “work.” Most laypeople think all this effort is to prevent, not slow, the spread. They will be shocked later when officials say,
Well, once we realized how much mild transmission there was, our main goal for containment was to SLOW THE SPREAD, so governments and civil society and individual citizens could prepare, technically and organizationally and emotionally.* And we hoped to FLATTEN THE CURVE of the epidemic so that hospitals wouldn’t be quite as overwhelmed all at the same time.
When they try to explain this after the fact, the naysayers are likely to respond, “They created all that additional disruption and it didn’t even help! And now they tell us they knew all along it probably wouldn’t work!”
The time to say “containment may help but probably only a little” is now.
Not warning about the likely failure of containment also sets people up to be more shocked and less prepared for widespread transmission, and it sets governments up to be blamed for the failure of containment policies they implied would succeed.
We have four kinds of containment policies in mind as we write this: patient isolation; contact tracing and monitoring; quarantines; and travel restrictions. The first two are conventional public health measures, while the last two are far more controversial. In our judgment, the difference is that the first two have less serious downsides than the last two – not that they’re likelier to stop the pandemic. All four are unlikely to stop the pandemic but possibly able to slow it. Whether all four are worth trying is a tougher call, way beyond our expertise.
___________________*We WISH governments wanted to prepare their citizens emotionally for what might happen! Instead, they seem to want the public to ignore the situation, or at most to be just a teensy bit concerned. Officials are worried, alarmed, and anxious, but they keep telling the public not to be.
Copyright © 2020 by Jody Lanard and Peter M. Sandman
