At a particularly important point in the pandemic, the Centers for Disease Control and Prevention has a messaging problem.
The CDC and its director, dr. Rochelle Walensky, has received increasing criticism for statements and guidance that have been revised or reversed.
The US is facing a mystery. Millions of Americans are vaccinated every day, and state and local governments relax restrictions. As numbers increase in parts of the country, health experts are under the impression of the possibility of a fourth upsurge.
There are no easy answers.
“One of the most important things we say in public health is that you need to have a very simple message,” said Dr. Wafaa El-Sadr, a professor of epidemiology and medicine at Columbia University, said. “But we are in a situation where the message is very complicated.”
The problems started last week with what are considered mixed messages about the state of the pandemic and what is safe for people who have been fully vaccinated.
Walensky warned of a “looming downfall” on March 29 due to the recent increase in the number of cases in the country. In an interview with MSNBC the same day, she raised eyebrows by suggesting that “people who have been vaccinated do not carry the virus.” Many researchers have criticized the comments, saying it is too early to say what effect the vaccines may have on the transmission. The CDC returned her statement a few days later.
The agency then relaxed its travel guidance for people who have been fully vaccinated, but given the gradual increase in the number of cases and the fact that the majority of the U.S. population is still not vaccinated, Walensky said, “I will plead against general travel. ‘
The recent back-and-forth cause has caused confusion and frustration, and it has sent repressed public health messages to some experts saying it is a difficult moment. The CDC has been criticized at a shaky time for trying to rebuild confidence that has eroded over the past year, largely due to political interference by the Trump administration.
“Whether you’re an public health agency or a communications campaign of any kind, an erosion of trust is incredibly damaging,” said Alison Buttenheim, an associate professor of nursing and health policy at the University of Pennsylvania.
She said Walensky’s remarks about vaccinations and transmissions “were not very well thought out”, but she added that erroneous mistakes in public health messages can be saved if handled transparently.
Others were less sympathetic.
“CDC – messages about restrictions on wax was a mess, “tweeted Dr. Vinay Prasad, associate professor of epidemiology and biostatistics at the University of California, San Francisco.
The erroneous mistakes highlight the enormous challenges of public health messages during the pandemic, when science unfolds in real time and developments often happen at an incredible pace. Establishing guidance on public health under such circumstances makes it difficult to address the nuances, especially as the pandemic develops and the situation changes.
“People want a black or white answer: is it risky or not risky?” says Sandra Albrecht, an assistant professor of epidemiology at Columbia University. “But risk is a spectrum – it depends on the context, the circumstances, the individual, geography. There are so many factors contributing to the risk that it’s really difficult to deliver one set of public messages to everyone.”
And conversations about risk become more challenging as the “pandemic fatigue” begins. A recently released Gallup poll found that concerns about contracting the coronavirus have dropped to a low point, with only 35 percent of Americans saying they are very worried or somewhat concerned about the virus.
Albrecht and Buttenheim saw the problems of transferring risk and guidance early in the pandemic. Last year, they teamed up to create Dear Pandemic, an online project to answer questions from the public in an easily digestible way and help people navigate the onslaught of information about Covid-19.
One of the main objectives of the project is to fill the gaps between official guidance with facts and context.
“Many of the things we have done are to discuss the reasons and motives behind the CDC’s public health messages, because the public remains confused,” Albrecht said. “Part of what we do is explain the rationale and evidence to support a certain recommendation.”
Early in the pandemic, for example, Albrecht and Buttenheim tried to address why the CDC and the World Health Organization reversed the recommendations for people to wear masks in public.
“As scientists and health professionals, we understood why the change took place and why it was necessary, but the reasons for the change were not adequately provided to the public,” Albrecht said. “It caused a lot of confusion and gave feed to conspiracy theorists.”
Loren Lipworth, an epidemiologist at Vanderbilt University Medical Center, said the events of the past year have highlighted the importance for the CDC and health professionals to be open about where science stands and to meet people’s expectations. management on how things can change. .
“The CDC must be honest and transparent and share everything in their power to evaluate the evidence, but they must also be careful when we are at a point where we can not say anything yet,” she said.
The balance is especially important now, when the infections in some countries threaten to wipe out the profits to halt the spread of the virus.
And as the number of cases increases and variants of the virus spread across the country, the way people and communities react in the coming weeks could change the course of the pandemic in the US, Lipworth said.
“We are so lucky to have these vaccines, and it’s definitely our way out, so there’s real reason for optimism ahead of us,” she said, “but this is definitely not the time to wake us up.”