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Host (0:35)

This is the Opinions, a show that brings you a mix of voices from New York Times opinion. You've heard the news. Here's what to make of it.

Caitlyn Rivers (0:48)

My name is Caitlyn Rivers. I'm an epidemiology professor and author of a recent book, Crisis Averted. I specialize in epidemics and pandemics at the Johns Hopkins center for Health Security, and I spent a lot of time during the COVID 19 pandemic writing reports and offering support to elected leaders and public health officials about how to navigate the pandemic. It's usually peak flu season right here in mid December, but we got a late start this year. COVID 19 has been unusually quiet and influenza was a couple weeks later getting started than it is typically, but it is picking up now as we head into the winter holidays. This has been the worst year for walking pneumonia in probably four or five years. Walking pneumonia is a more mild kind of pneumonia. It's called walking pneumonia because people who are sick with it are still going to work and still going to school often, and it's identified when a cough won't go away. And so a doctor orders a chest X ray and I know people who are particularly vulnerable, like those who are immunocompromised, are wondering what should I be doing as I head to the airport for my winter travels. For example, in my years as an epidemiologist, I've really noticed that there's not enough messaging and information available to the public about what's going around. But I think that ought to change because if people did have access to information about what's going around, they could make a lot of choices in their lives to keep themselves and their families healthy.

Public Health Expert (2:19)

I feel like public health messaging has a long way to go. Too often the impulse from public health officials is to reassure or hold off on communicating with the public about things that they're seeing, things that are going on in the community. I think we need to instead learn more from the weather community, where the meteorologists and the Weather experts really see it as part of their central mission to communicate frequently and clearly with the public. And that doesn't always need to mean raising alarms or expressing grave concern. We also hear from meteorologists when it's sunny and nice outside. And I think really building that kind of routine day to day communication is important for building trust and expertise among the public. One thing I find so interesting is in the first half of the 20th century, it was actually against the rules for meteorologists to warn that weather conditions could produce tornadoes. And the arguments that meteorologists gave for why this was taboo or against the rules was a lot like the kinds of arguments you hear today about why there is reluctance to communicate about. COVID for example, meteorologists thought that it would create panic, it would interrupt businesses, and that things like taking shelter from a tornado in a basement, the damp basement, would cause more harm than the threat of a tornado, which of course seems ridiculous to a modern perspective. But over time, meteorology really adapted their perspective of what it means to communicate and what they want the public to do with that information. The weather service now spends quite a bit of money every year and has dedicated experts whose job it is to figure out how best to communicate with the public, to inspire action. And I think in public health, we're more in that early 20th century perspective where we're reluctant to communicate sometimes, or we try to couch our messages in ways that may soften them or prevent secondary harms, instead of just communicating clearly and frequently about what's going on so that people can really understand the threats in their community and potentially take action. One place that I think would be a great start is to talk more about seasonal viruses. What keeps us out of work, what keeps us out of school. These are things like influenza, RSV, COVID 19. There's information available online about what the current levels are, but that information is not really optimized for people to use it. In the same way that you might choose to check the weather to decide whether or not to bring an umbrella. I think social media is an opportunity. I think press releases or press updates that the media can then take and tailor for their audiences, all of those are options and should be adopted for this purpose. Even the New York Times, when you open the front page right there in the top corner, there's a little tiny sentence about the weather, and you could imagine a little tiny sentence next to it about what's going around. That's not something that we necessarily need people to fear or panic about. It's more just if you are someone who's open to wearing a mask but don't want to wear one every day. Or you're thinking about whether that indoor birthday party is right for your family, but you have a wedding to attend next week. I think information about what's going around and what levels are in your community can help you make those kinds of choices. I like this starting point because it gives public health officials a weekly opportunity. There's something to say every week about one of the common viruses, and then once that vehicle or that channel is established talking about seasonal respiratory viruses, we can start to do things like introduce more speculative threats or threats that may be still developing. I think H5N1 is one example of that. This is a novel avian influenza. It does not spread between humans. Right now, it's mostly in animals. But it could change. And if it were to change, it does have pandemic potential. And so I think raising awareness among the public that this is something that experts are watching, taking certain actions to prevent. That kind of communication would also help people to understand what public health is doing in their lives, to protect them and prepare them, instead of starting from zero. In terms of understanding and awareness, I think the public is a lot more familiar and comfortable with uncertainty than we give them credit for. I think many of the communication missteps during the pandemic actually came when public health officials expressed publicly more confidence than they felt or more confidently than the evidence supported. I think that was actually where a lot of the missteps were. On the other hand, I think when uncertainty was expressed, not only were people understanding of that as a thing that is true, but also really appreciated the transparency. Public health has seen a big decline in trust. The Centers for Disease Control and Prevention used to be among the most trusted public institutions, and that has really declined, particularly among party lines, with Republicans reporting a lot less trust in cdc. And we see similar erosions in trust at the state and local levels, which I think is really unfortunate because public health officials are some of the most passionate, devoted public servants that I know, and I really want people to see and understand what an enormous asset they are to our community.