Tuesday, March 31, 2020

How to Talk to Covid-19 Skeptics

Use really small words
By Teresa Carr

Federal Oversight Issues, News and Analysis - Government ExecutiveMy cousin Tina White is an adjunct professor at a community college and teaches high school math in Moscow, Kansas. Recently she asked me for information to help persuade her friends and colleagues that the threat of Covid-19 was real.

The virus is particularly dangerous for people with underlying health issues, and given that White has a history of severe illness due to compromised immunity, this is a pressing personal matter. “I worry about going back to see any kids face to face,” she said.

The virus has not (yet) hit Kansas as hard as other states. As of this writing, the state health department is reporting 82 confirmed cases of Covid-19, although many people have likely gone undiagnosed due to a lack of testing kits.

Many in her small community still think that the media has overblown the risks, and she was concerned that administrators and school board members would opt to bring students back after spring break.


Meanwhile, here in Texas, the governor issued an executive order temporarily closing schools, bars, gyms, and restaurant dining rooms across the state. Nonetheless, friends have posted articles on social media downplaying the severity of the virus and arguing against the need for social distancing.

The gist: Covid-19 is no worse than the flu (and even if it is, it’s not that bad). People die of heart attacks and in car accidents all the time, the thinking goes, and staying home will only make you sad and help crash the economy. Better to go out and live your life.

To be clear, no one knows exactly how this pandemic will unfold, nor the specific sequence of actions most likely to spare lives as well as livelihoods.

Still, based on the data Covid-19 has left in its wake, scientists can say unequivocally that the virus is deadlier than the flu and, unless we slow transmission of the disease, the surge of patients requiring critical care and ventilation will overwhelm our hospitals.

Science journalists are doing yeoman’s work to provide accurate, accessible information on the virus and the latest advice from public health authorities on how to minimize risk. And yet, that message still isn’t reaching many thoughtful, well-educated folks — or it is reaching them, and they simply don’t believe it.

Why do some people remain cavalier in the face of a pandemic? Is there something people who communicate about it — journalists like me, government authorities, public health officials, or just everyday people talking to an employer or friend — can do better or differently to convey the gravity of the worst pandemic in our lifetimes?

Experts in risk communication have varying thoughts on the best approach -- but one thing I can promise: It does not involve hammering your audience with statistics.

Of course, it also doesn't involve trafficking in mixed or misleading messages. At a White House news conference, Donald J. Trump, as he has frequently done over the course of the rising crisis, once again inaccurately compared the threat of Covid-19 to that of the flu — and even to car accidents — and signaled that he was growing impatient with the strategy of social distancing.

“America will again and soon be open for business — very soon,” Trump said. “We cannot let the cure be worse than the problem itself.”

As the virus infiltrates more communities across America, polls show that people are increasingly likely to view it as a threat, according to the weekly Pollapalooza column in the online outlet FiveThirtyEight. Still, there are partisan differences in how Americans perceive risk.

A recent Kaiser Family Foundation poll found that nearly three quarters of Democrats, but only half of Republicans, are concerned that they or a family member will get sick. Democrats were also far more likely to change their travel plans or skip large gatherings. In a Pew Research Center poll, half of Republicans, but only one in five Democrats thought that the media “greatly exaggerates” risks.

“The virus doesn’t discriminate between liberals and conservatives,” said Jon Allsop, who pens a column on the media for the Columbia Journalism Review. And yet, “there is a clear difference between how those groups have come to see it.”

That’s partly because people on either side of the political divide are getting their information from media outlets that have told a vastly different narrative about the evolution of the global pandemic, Allsop said. Following President Trump’s lead, until recently, much of the conservative media has downplayed the threat of the virus.

Geography is also fueling partisan differences, said Monica Schoch-Spana, a medical anthropologist and senior scholar at the Johns Hopkins Center for Health Security.

To date, large coastal cities that lean Democratic are dealing with the largest numbers of confirmed cases, while Republican-leaning small towns and rural areas have seen far fewer cases — if any.

“If you're in Seattle or New York City right now, you have environmental cues that something extraordinary is going on and you should pay attention,” she said. But if you're in rural Kansas, you don’t.

People process information collectively through what social scientists call “social milling,” explains Schoch-Spana. “People will get a warning, and then consult with everybody.” They might call their mom or their neighbor who’s a nurse and a trusted source to ask what they think.

“If you’re only checking with your little network about whether to feel at risk,” she said, “you may reinforce a bias that’s out of keeping with what public health experts say.” That’s true regardless of your political affiliation.

Peter Sandman, a well-known risk communication researcher and consultant, warns against lumping all skeptics into the same pot. It’s crucial to distinguish people who are truly unconcerned about Covid-19 from those who are so frightened or depressed that they have tripped an emotional circuit-breaker and are now in denial, he said. “In times of crisis, genuine apathy becomes less common and denial becomes more common. This is one of those times.”

It’s true that people in denial will avoid or mistrust content they perceive as threatening, according to Sandman. But, he said, “just as we may mistake denial for apathy, those of us who are busy sounding the alarm about Covid-19 are likely to mistake skepticism for apathy — or worse, mistake it for right-wing ideology.”

He points out that there are legitimate, pressing questions about how much of the economy should be shut down for how long to “flatten the curve” and reduce the burden on the health care system.

Over his long career, Sandman told me, he’s helped forewarn about the dangers of other pandemics — including bird flu and swine flu — that turned out to be less serious than feared. This time he doesn’t think that most public health officials and journalists are being overly alarmist.

Still, he said, we’re all vulnerable to “groupthink.” I was asking why skeptics tune out messages about risk. I should be equally interested, he admonished, “in why alarmists selectively attend to messaging that supports their alarmism.”

My response to skeptical friends on social media has been a firehose of statistics with a few exclamation points thrown in for good measure. This was not helpful. In fact, judging from other comments on the posts, most people found the pundits downplaying the risk of the virus to be far more reasonable.

The research on public education surrounding disasters shows that scary stories and statistics don’t always motivate people to take action, said Schoch-Spana. Most people think of extreme hazards in binary terms — either it will affect me, or it won’t, she said. “If the risk hasn't been communicated in a way that it feels urgent and personal to the person, they aren't going to consider themselves at risk.”

In addition, frightening people who have already blown their emotional fuses pushes them further into denial, said Sandman. He advises being “gently candid” and acknowledging fear. “Talk about the gnawing knot in your own belly, and how you try to cope with it.” And focus on victims to be helped and potential victims to be protected, he said. “Love, too, is an antidote to denial.”

Both Sandman and Schoch-Spana advise telling people about constructive things they can do.

“Numbers do not motivate people,” said Schoch-Spana, “Knowing that you can do something, knowing what to do, and seeing other people just like you doing it. That's when you see behavior change.” We’ve been told a lot of things about infection control — we’ve all got handwashing down, she said.

“What we really need at the same time is a list of to-dos that are about building solidarity.” She suggests tasks like checking on an elderly neighbor, making a meal for a harried health care worker, or taking an online course in mental health first-aid to be better able equipped to deal with psychological effects of a pandemic.

“I’ve been gobsmacked by this event,” said Schoch-Spana noting that navigating a torrent of socially-mediated messages about a rapidly changing crisis can feel overwhelming — even for someone who’s an expert in community resilience to disaster.

To maintain the public’s trust, you must be honest and upfront that we’re learning along the way and advice may change as the situation evolves.

What’s damaging is when messages from the White House change abruptly and differ from those of public health authorities and state and local governments. “It’s improper to, out of the blue, say the cure is worse than the disease,” she said. “That just will fracture the message and leave people scratching their heads.” And they’ll be less likely to listen to you to the next time.

As I was wrapping this up, I got word from my cousin. She’s relieved. The administrators of Moscow Unified School District 209 decided to move instruction online. In the end, she decided that she didn’t need to forward the information on Covid-19 I gave her. “My superintendent knows my condition and told me that he thought about me when early decisions were being made.”

In her small farming community — as with communities nationwide — people tend to look out for one another. And so it seems that what made the threat of the virus real, in the end, was not a barrage of statistics, but the knowledge that it just might pose a risk to people they hold dear.

This article was originally published on Undark. Read the original article.