As a medical writer, I frequently participate in launches of pharmaceutical products. Behind closed doors, I join doctors and pharma executives to craft messages that will support a launch. While the messages must hew to the science, there’s no law against highlighting a product’s best features. As all marketers know, the right words can cast a product in a new light. It’s like dressing up a child in a lacy dress or tuxedo: the child hasn’t changed, but the fancy duds have the grownups clucking in admiration.
Messaging matters. It matters a lot. It can make or break a pharmaceutical product. It can impact people’s willingness to take a medication as prescribed or to push through side effects to get its full benefits. To follow the rules, as it were.
Which brings us to COVID-19. For a full year now, the public has faced a wall of absolutist messaging that has left people either terrified, enraged at their neighbours’ lack of discipline, guilty for falling out of line or resolutely defiant. “It sometimes seems like the messages have been crafted expressly to demonize and demoralize people,” says Vinay Prasad, Associate Professor of Epidemiology and Biostatistics at the University of California San Francisco. “These states of mind are neither healthy nor sustainable.”
Pre-COVID, public health guidelines emphasized the need for flexibility and community buy-in. From a 2019 World Health Organization report on the use of non-pharmaceutical interventions to reduce the risk of pandemic influenza: “It is important to take into account people’s capacity to act on the advice being given. The recommended behaviour must be doable and be adapted to people’s lifestyle; otherwise, it will not be widely adopted.”
Communications about COVID-19 have stood this advice on its head. Both policymakers and Twitter warriors insisted that everyone jump over the same high bar of restrictions, wielding the pointy stick of shaming to keep people in line. One might argue that this was necessary, but after a year the law of diminishing returns has set in.
It’s time to retire those sticks and bring out a few carrots. To the government spokespeople, public health experts and tweeters of the world, I offer these carrot-shaped messages for consideration:
- Drop “stay home, save lives” and similar slogans. A year in, the words have lost much of their power. It doesn’t mean people no longer care about their loved ones. It’s simply the phenomenon of habituation we learn about in Psychology 101: response to a stimulus lessens with repeated exposure. If you want to maintain a robust response, create a new slogan – perhaps something that heralds a brighter future, like “stay alert, save tomorrow.”
- Forget “we’re all in this together” or even “we must all work together.” It’s dismissive of people who have lost livelihoods, businesses, career opportunities and social connections. Acknowledging the real losses incurred by the restrictions makes people feel respected and heard. For example: “COVID is affecting everyone differently. As we ramp up the vaccination program, we encourage you to do what you can to keep the curve manageable.”
- Give shaming and guilting a rest. TV ads that feature an indoor gathering followed by a person gasping in the ICU will not, at this juncture, persuade the rule breakers. As Zeynep Tufekci notes in a February Atlantic article about pandemic missteps, shaming “entrenches polarization and discourages disclosure, making it harder to fight the virus.” Instead, create ads showing people having a picnic in a park or playing beach volleyball, with the message: “Every day will bring more things we can do safely. Let’s stay the course so we can get there faster.”
- Replace absolutism with harm reduction. The harm reduction philosophy, which gained prominence during the AIDS crisis, emphasizes reducing risk rather than eliminating it. It recognizes that humans have competing drives and needs. For people seeking relationships during the pandemic, for example, one might advise: “COVID is a good time to experiment with slow dating: getting to know someone while not rushing physical contact.”
- Stop pouring cold water on the vaccines. Continually emphasizing the need to stay masked and distanced after the jab reduces the incentive to get it. It leaves people frustrated and hopeless. Here’s a fix: “The vaccine is our passport to normal. It may take a few months, but we’ll get there.”
- Put vaccine risks in context. Countless doctors have told me, using more or less these words, that “the public has a terrible understanding of risk, probably because we experts do a terrible job of communicating it.” A weak grasp of the risk/benefit profile of COVID-19 vaccines leaves people vulnerable to scare stories and resultant vaccine refusal. Indeed, rates of vaccine hesitancy have been disappointingly high throughout the world. The solution? Show, don’t tell. Visually impactful tools such as stick-figure diagrams get the message across more effectively than a wall of words. Put two of those diagrams side-by side – one with the risks of serious harm from COVID-19, another with the much lower risks of vaccination – and people will get it.
- When announcing reopening plans, don’t focus exclusively on COVID-19 metrics. Assure us that you’re aware of the need to balance various facets of public health. Perhaps something like this: “We understand that reopening decisions rest on numerous factors. We are reviewing the situation every day, with inputs from experts in various disciplines, with consideration not only of the pandemic curve but of mental health and opportunity to thrive.”
- Point the way to normality. One of the key functions of public health communication is to maintain public morale and the public needs hope right now. Stop with the doom-laden messages about a forever-changed future in which socializing, cultural activity and travel will never return to their pre-COVID innocence. Instead, consider the time-honoured advice, laid out in the United Kingdom’s 2011 Influenza Pandemic Preparedness Strategy, to promote “a return to normality and the restoration of disrupted services at the earliest opportunity.” Rather than the new normal, promote the “true normal” – a normal that includes hugs and dancing at music festivals. Tell people the true normal is on its way.
See? It’s not that hard.