access_time published 31.10.2022

The quality of public communication during COVID-19: symptoms of a wider malaise

Annegret Hannawa

Public health

The quality of public communication during COVID-19: symptoms of a wider malaise

31.10.2022

We like accurate weather forecasts. We purchase insurance plans that use certainty as a currency. We want to be able to predict the next turn of events. If we can’t have that, then we experience discomforting stress that we want to escape at any cost [1, 2].

Tolerating uncertainty goes against our human nature. At the same time, the past three years have kept us hostage in an uncertainty roller-coaster that seems to have gotten caught up in a loop. Strike words like “climate change,” “COVID” and “energy crisis” sneak up on us at each corner, again and again startling us back into constant states of distress.

How do we react to this?

“Uncertainty reduction” is a well-researched paradigm in communication science that predicts and explains our reactions [1, 2]. Numerous studies have shown that states of uncertainty drive us into information-seeking behaviour, through which we want to reestablish a comforting degree of certainty – be it through passive observation, by active communication with others, or by extracting information from online resources [3]. In other words, our communication is a critically important process in uncertainty-ridden situations, as it operates the switch that will make things either stay on track or derail.

Although this communication phenomenon has been well-studied and understood for many years, all that knowledge suddenly seems to have “vanished” from Earth during COVID-19. Our communication with each other ran astray as if it went on autopilot. People started to aggress against each other [4], mobilising emotional hurricanes with pointed fingers that instantly froze discussions into ice. Marriages broke. Friendships fell apart. The ever-widening chasm between “compliers” and “deniers” ripped anyone in between into a merciless abyss.

No one seemed to understand why this was happening. We had lost control over our communication – over the one thing that is most characteristic of our human nature [5].

Sadly, the driving force that feeds into this destructive social pattern continues until today, and it remains uninterrupted by any scientific interventions. While conspiratorial storytelling continues to seize the power of digital pathways to harvest successes by focusing on certainty-establishing relief, messages by governments and the news media keep pouring salt into the “uncertainty” wound, keeping us trapped there. In the meantime, many more chasms have ripped open. The greatest of all is the one between communication science and our real-life communication with each other. Many studies have now loudly proclaimed the “do-nots” that could guard us against further conspiratorial inflammations and societal fragmentation [6–9], but exactly those kinds of practices continue to dominate our communications about uncertainty-inducing events. We are now even witnessing spill-over effects into newly emerging uncertainty situations, such as the global energy crisis that hovers over our heads like a dark cloud that is ready to burst at any moment.

This chasm needs to close – rapidly.

COVID-19 has hit us like a tsunami, with recurring waves of destruction leaving us with even more chaotic conditions each time. Governments and citizens were equally overwhelmed by the situation. Everyone did their best at the time, trying to keep their heads together and the crisis under control. No one could have known the ripping effect our communication was going to have on the crisis down the road. But now we know. It is for this reason that I decided to write this evidence-based op-ed piece as a communication science recipe for how to engage in safer communication in similar future crises.

Closing the chasm: Five lessons learned from COVID-19

In February 2022, I led a national “COM-COVID” investigation [10] in Switzerland to measure how communication by the Federal Office of Public Health (FOPH)  about COVID-19 affected the Swiss population during the first two years of the pandemic (fig. 1, table 1).

 

Figure 1. Recruitment process for the COM-COVID survey.

 

Table 1. Respondent demographics (n = 373).

 

 

Men %

Women %

Total sample %

Age, years

18–29

17

21

19

30–39

26

21

24

40–49

27

21

24

50–59

16

23

19

60–69

14

14

14

Swiss region

Bassin lemanique

13

15

14

Mittelland

16

14

15

Northwest

12

16

14

Zurich

16

14

15

East

14

14

14

Central

15

13

14

Ticino

14

14

14

Relationship status

Married

39

38

39

Separated

2

2

2

Divorced

8

10

9

Widowed

1

2

1

Cohabiting

21

17

19

Single

29

31

30

Living status

Lived alone

21

18

20

Lived with roommate

23

18

20

Lived with family

53

58

56

Assisted living / other

3

5

4

Employment status

Full-time

74

32

51

Part-time

10

45

29

Unemployed

16

23

20

Work directly related to COVID-19

Yes

30

30

30

No

70

70

70

Migration status

No family member born in Switzerland

21

18

19

Only self born in Switzerland

11

12

11

 

Among numerous communication measures, I used the “SACCIA safe communication” framework [11–15] for analysing the results (table 2).

 

Table 2. SACCIA safe communication: items and reliabilities.

SACCIA Subscales and Items

Reliability

S

Sufficiency:Assesses the extent to which participants exchanged a sufficient amount of information in order to arrive at a shared understanding.

α = 0.69

(1) They did a good job of making sure the information they shared was sufficiently complete.

 

(2) They provided enough information for me to understand them successfully.

 

A

Accuracy: Assesses the extent to which participants convey correct information, interpret them correctly, and utilise their communication to validate message accuracy.

α = 0.82

(3) What they said seemed accurate to me.

 

(4) They did a good job of making sure the messages they shared were accurate in content.

 

(5) Their attention to accuracy helped me understand things correctly.

 

C

Clarity:Assesses the extent to which messages are expressed and interpreted clearly.

α = 0.78

(6) They expressed themselves clearly.

 

(7) They did a good job of making sure the messages they conveyed were clear.

 

C

Contextualisation: Assesses the extent to which communication is framed within the contextual circumstances that constitute barriers to a shared understand- ing.

α = 0.83

Functional

   

(8) Their communication was in line with their announced goals.

 

   

(9) The way they communicated helped me understand their messages in light of their announced goals.

 

Relational

   

(10) They communicated with me “eye-to-eye” (i.e., with no sense of superiority, no status differences between us).

 

   

(11) Their communication focused on bringing people together.

 

Chronological

   

(12) Their messages helped me understand things in the context of what was happening at the time.

 

   

(13) Their communication was timely (i.e., on time, well-timed).

 

IA

Interpersonal adaptation: Assesses the extent to which participants adapt to the emotional, cognitive or linguistic needs of their conversational partner for the purpose of arriving at a shared understanding.

α = 0.65

(14) The way they talked was sufficiently responsive to my emotional states.

 

(15) The way they talked (e.g., speaking pace, level of detail) helped me grasp things better in my mind.

 

Introductory text: The following questions focus on the amount of information, the quality of information, and the extent to which the Swiss Federal Office of Public Health (FOPH) made sure that you really understood their messages. Please indicate to what extent you agree or disagree with the following statements regarding the FOPH’s COVID-19 communication (1 = strongly disagree, 4 = strongly agree).

 

The study showed that the way the FOPH communicated with the public impacted the Swiss population in critical ways. Every third respondent (38%) expressed dissatisfaction with the FOPH’s communication. Many people experienced symptoms of anxiety (34%) and depression (68%) in response to it. Numerous studies have evidenced a significant impact of the COVID-19 pandemic on people’s mental health [16–20], and the findings of this study point at public health communication as an important source of such impact. In other words, it is not merely the fact, but rather the way in which the FOPH communicated about COVID-19 that impacted the Swiss population’s mental health.

The FOPH’s communication also severely affected people’s perceived ability to cope with the pandemic, which is an important resource for improving mental health [21]. Therefore, the COM-COVID study evidenced that safe public health communication during global crises is not a nice-to-have skill, but a serious public health matter, as it can turn people either into or away from mental health, depending on how it is conducted.

The following five lessons wrap up the key results of the COM-COVID investigation into scientifically informed “safe communication” guidelines to prepare us for similar future crises.

 

Lesson 1: contextualised communication serves positive pandemic outcomes

Specific “safe communication” practices stood out as particularly important in the COM-COVID study for a wide range of outcomes (table 3). Contextualised communication, for example, in the sense of communicating in a way that comes across as a relationship-building effort, was critical for population compliance with vaccination and constituted an antidote against conspiratorial thinking. In other words, getting people to vaccinate and disengaging people from conspiracy theorising were found to be primarily a relationship-building effort. Relationally contextualised communication was also associated with a higher sense of safety, and it made people feel that the FOPH successfully maintained societal peace and mitigated worse pandemic outcomes (tables 3 and 4).

 

Table 3. Amounts of statistically significant variance (R2, p <0.05) accounted for by the FOPH’s pandemic “safe communication” (SACCIA)

 

S

A

C

C

IA

Total variance

Sufficiency

Accuracy

Clarity

Contextualization

Interpersonal adaptation

Trust

 

 

 

 

 

 

 

44%

5% (relational) 1% (functional)

50%

Compliance

 

 

 

 

 

 

Hygiene

5%

5%

Face masks

7% (functional)

7%

Social distancing

8% (functional)

7%

Vaccination

13% (relational)

13%

Conspiracy theorizing

 

 

 

 

 

 

 

7% (relational)

8%

Pandemic outcomes

 

 

 

 

 

 

Sense of safety

10%

46% (44% relational, 2% chronological)

1%

57%

Empowerment

3%

37% (31% chronological, 6% relational)

1%

41%

Ability to cope

3%

47% (40% relational, 7% chronological)

2%

52%

Social peace

5%

31% (29% relational, 2% chronological)

1%

37%

Societal cohesion

2%

44% (36% functional, 8% relational)

1%

47%

Damage control

7%

45% (43% relational, 2% functional)

52%

 

 

 

Table 4. Communication-based pandemic outcomes: items and reliabilities.

Pandemic outcome
 

Reliability
 
Perceived safetyα = 0.87
(1) The way they communicated helped me stay safe during the pandemic. 
(2) I was able to make better health decisions, thanks to the way they communicated during the pandemic. 
3) I think we got through the pandemic more safely thanks to the way they communicated. 
Ability to copeα = 0.85
(4) The way they communicated during the pandemic had a positive effect on me overall. 
(5) I was able to deal with the pandemic better, thanks to the way they communicated. 
(6) The way they communicated during the pandemic made me feel less overwhelmed. 
Self-empowermentα = 0.81
(7) The way they communicated inspired me. 
(8) The way they communicated showed me how doing things jointly effectively solves problems. 
(9) The way they communicated during the pandemic positively affected my performance at work and in general. 
Conflict arbitrationα = 0.90
(10) The way they communicated maintained societal peace. 
(11) The way they communicated pacified societal aggressions. 
(12) The way they communicated calmed conflicts. 
Societal cohesionα = 0.69
(13) The way they communicated made me feel like I can contribute to society in meaningful ways. 
(14) The way they communicated promoted societal cohesion. 
(15) The way they communicated divided society. (–) 
Impact mitigationα = 0.85
(16) The way they communicated prevented COVID from harming our economy in worse ways. 
(17) The way they communicated kept disease progression under control. 
(18) The way they communicated kept us safe. 

Introductory text: Please indicate to what extent you agree/disagree with the following statements regarding the FOPH’s pandemic communication during COVID-19 (1 = strongly disagree, 4 = strongly agree).

 

Chronologically contextualised (i.e., timely) communication was associated with an increased sense of self-empowerment in the Swiss population. This finding rhymes with existing research that has shown that timely dissemination of COVID-19-related health information from authorities increased people’s reassurance and reduced mentally disabling effects [17, 22].

Finally, functionally contextualised (i.e., goal-consistent) communication was associated with a higher sense of societal cohesion and greater compliance with wearing face masks and social distancing directives. This result is consistent with previous research that has indicated that consistent messages about required behaviours to prevent the spread of the virus, in contrast to mixed or contradictory messages, enable public understanding and elevate compliance [23].

 

Lesson 2: accuracy builds trust

In previous research, trust has been found to predict people’s uptake of prevention behaviours [24–28]. Conspiracy beliefs also appear to affect compliance only through levels of trust [29, 30]. Thus, trust constitutes both an opportunity and threat to public health [31]. Governmental communication can quickly swing the public from trust into distrust. Consistent with these previous findings, the COM-COVID results also speak of the importance of increasing trust through safe communication. As stated by a previous study, “without trust, there is no partnership and good communication,” and therefore trust is “essential for the path out of the COVID-19 crisis” [33].

The COM-COVID study delivered missing information as to what communication aspects are needed to establish and maintain population trust during global crises (table 3). The FOPH earned the Swiss population’s trust primarily through a form of communication that prioritised accuracy, relationship-building, and consistency with previously stated goals. Therefore, governments are well-advised to activate their communication with each other as a validation check to make sure they are conveying accurate information to the public, and to be transparent about their estimated accuracy of such information, particularly when unexpected changes arise. Failure to do so can quickly come at the expense of numerous negative outcomes, such as lower population compliance, higher conspiratorial theorising and lower public health [24–31].

 

Lesson 3: the truth and nothing but the truth

The COM-COVID data also showed that honest and transparent communication build trust in times of crisis (table 5). Respondents emphaised that earning people’s trust requires telling and standing by the truth, even if it means admitting mistakes. This finding resonates with previous studies that have found that a lack of transparency reduced trust in health authorities and facilitated the spread of conspiracy theories, limiting the government’s capabilities to maintain crisis control [34]. Indeed, prior research has even found that, while transparent communication of negative content might reduce vaccine acceptance, it still increases trust, whereas non-transparent positive communication does not increase vaccine acceptance either, but instead decreases trust and fertilises conspiracy theories [34].

Table 5. Open-ended improvement suggestions by respondents who had expressed dissatisfaction with the FOPH’s pandemic communication.

The FOPH should have …

Frequency
… been clearer16%
… been more honest and transparent, e.g. by admitting mistakes14%
… communicated in a simpler manner13%
… informed/explained more10%
… reached out through more diverse channels8%
… been less contradictory / more consistent with their messages8%
… presented more objective facts5%
… been more empathic / adaptive to their listeners‘ emotional needs5%
… communicated more frequently4%
… been more accommodating to listeners‘ language needs3%
… propagated less fear and panic2%
… been more timely2%
… been more energetic / less "careful“, more consequential2%
… voiced themselves in a less controlling/threatening way2%
… promoted societal coherence rather than polarisation2%
… provided more encompassing information1%
… been less "one-sided“, more critical1%
… made sure to provide more accurate information1%
… been less negative1%
Total100%

 

Lesson 4: simplicity, clarity and understandable rationales – the “holy trinity” of success

The COM-COVID study further showed that, for the health of the Swiss population and more successful pandemic crisis management, public health offices are advised to communicate more clearly to prevent confusion (table 5). Respondents particularly desired more straightforward messages that are consistent with previously stated goals, get straight to the point and make use of visual aids for clarification, for example by showing clearly structured lists of what and what not to do, and by presenting more precise and better-structured communications. This evidence replicates previous research that has also pointed at “clarity” as an important element of effective pandemic communication, with the rationale that failing to do so contributes to the failure of containing the spread of the virus [23].

The COM-COVID study also showed that governments may benefit from simpler communication. In other words, from a form of communication that is less complicated, for example by avoiding jargon and using simpler sentence structures. Simplicity has also been suggested as a pandemic communication competence in previous studies, which have reported that the use of plain or simple language was positively associated with comprehension, recall, and message persuasion. Simpler language was also found to increase trust and public adherence to COVID-19 prevention measures in previous studies, evidencing that people tend to believe more in information that is easy for them to understand [35].

Finally, COM-COVID revealed that governments could benefit from providing more explanations, for example with respect to how the control measures protect people from infection, why changes to previous communications are made and so forth. This finding replicates previous research that has suggested that effective promotion of COVID-19 preventive behaviours requires a form of communication with the public that focuses on “not only what, but also why” [23].

 

Lesson 5: quality, not quantity

Among the measured SACCIA safe communication practices, “sufficiency” explained no variance in any of the measured constructs (table 3). Previous publications have hypothesised that people’s perceptions of governmental actions as “too little” or “too much” will affect their trust in the government [36]. The COM-COVID study, on the contrary, found no evidence that the quantity of communicated messages predicts any outcomes. In other words, the COM-COVID study revealed that it is not the quantity of communication, but rather the quality of communication that is critical for safeguarding public health in global crises.

Reclaiming control

Understanding how official communication can facilitate and hinder public health objectives is critical for successful crisis management. The COM-COVID study illuminated this process and gave evidence that pandemics involve much more than the spreading of a virus. COVID-19 also affected our social body, in similarly impactful ways. Like in no other situation, COVID-19 put our human communication to a test. The way we communicated affected measures of public safety and health. The next test will be: how much can we improve our communication for a safer future performance? It is yet another communication challenge for us, serving a long overdue lesson we must learn, and it may just repeat itself until we finally do. This challenge requires no rocket science or groundbreaking digital innovation. It rather requires a return to what makes us human – to what has helped our species survive, in many ways, up to this point: our highly advanced capability to communicate. The stakes are getting higher by the day. Global matters that affect entire humanity will increasingly challenge our communication skills, at levels of uncertainty that will rival with those of COVID-19. The bottom-line decisive question will be: will we reclaim control over our communication to get through these events together and grow stronger, or will we continue to allow these events to ruin what we have built up over centuries of existence? For the sake of humanity, I hope we will take this question seriously, as in the long run, only species that flock together have shown to survive.

Funding statement

The COM-COVID study was funded by the Swiss Federal Office of Public Health (FOPH), Bern University of Applied Sciences (Health Division), Stefan Dräger, and Roche Diagnostics.

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Annegret Hannawa

Prof. Annegret F. Hannawa, Ph.D.

Centre for the Advancement of Healthcare Quality and Safety (CAHQS)

Faculty of Communication, Culture and Society

Università della Svizzera italiana (USI)

Via G. Buffi 13

CH-6900 Lugano

 

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